Kyle J. Bourassa

Social participation predicts cognitive functioning in aging adults over time: comparisons with physical health, depression, and physical activity

Objectives: Several risk and protective factors are associated with changes in cognitive functioning in aging adults – including physical health, depression, physical activity, and social activities – though the findings for participation in social activities are mixed. This study investigated the longitudinal association between social participation and two domains of cognitive functioning, memory and executive function. A primary goal of our analyses was to determine whether social participation predicted cognitive functioning over-and-above physical health, depression, and physical activity in a sample with adequate power to detect unique effects. Method: The sample included aging adults (N = 19,832) who participated in a large, multi-national study and provided data across six years; split into two random subsamples. Unique associations between the predictors of interest and cognitive functioning over time and within occasion were assessed in a latent curve growth model. Results: Social participation predicted both domains of cognitive functioning at each occasion, and the relative magnitude of this effect was comparable to physical health, depression, and physical activity level. In addition, social participation at the first time point predicted change in cognitive functioning over time. The substantive results in the initial sample were replicated in the second independent subsample. Conclusion: Overall, the magnitude of the association of social participation is comparable to other well-established predictors of cognitive functioning, providing evidence that social participation plays an important role in cognitive functioning and successful aging.

Divorce and Health Beyond Individual Differences

In this article, we review what is known about the association between marital dissolution and health outcomes in adults. Two of the major empirical findings in the literature—that most people do well following marital separation and that this life event increases risk for poor outcomes—appear to be in contrast. We provide an individual differences framework for reconciling these competing perspectives and suggest that the bulk of the risk for poor outcomes following marital dissolution is carried by a minority of people. Research focusing on at-risk populations is beginning to shed light on the processes that explain why and how marital separation and divorce are associated with ill health. This article outlines a series of future directions that go beyond individual differences to study these mechanisms.

Absent but Not Gone Interdependence in Couples’ Quality of Life Persists After a Partner’s Death

Spouses influence each other’s psychological functioning and quality of life. To explore whether this interdependence continues after a person becomes widowed, we tested whether deceased spouses’ characteristics were associated with their widowed partners’ later quality of life using couples drawn from a multinational sample of aging adults. Independent subsamples (ns = 221 and 325) were assessed before and after a spouse’s death. Regressions revealed that deceased partners’ quality of life prior to their death positively predicted their spouses’ quality of life after the partners’ death, even when we controlled for spouses’ prior quality of life to account for environmental factors shared within couples. Further, widowed participants’ quality of life was lower than nonwidowed couples’ 2 years before and after their partners’ death, but was equivalent 4 years prior. Finally, the strength of the association between partners’ earlier quality of life and participants’ later quality of life did not differ between widowed and nonwidowed participants. These findings suggest that interdependence in quality of life continues after one’s partner has passed away.

Women in very low quality marriages gain life satisfaction following divorce.

Although marital dissolution is associated with increased risk for poor mental and physical health outcomes, many people report improvements in functioning after divorce. To study the hypothesis that women in lower quality marriages would report the best outcomes upon separation/divorce, we investigated the combined effects of marital quality, gender, and marital status for predicting changes in life satisfaction (LS). Participants (N = 1,639; 50.3% men) were drawn from a nationally representative sample (Midlife in the United States Study), which included assessments of marital quality, marital status, and LS, at 2 time points (T1 and T2), roughly 10 years apart. Hierarchical linear regression analyses revealed an interaction between marital quality, marital status, and gender when predicting residual change in LS. Divorced women evidenced a negative association between marital quality and later LS, whereas continuously married women had a positive association between marital quality and later LS. In addition, women in higher quality marriages that become divorced showed the lowest LS, and women in lowest quality marriages show the highest LS among women with similar levels of marital quality. There was no association between marital quality and later LS for divorced or continuously married men. This work extends prior findings regarding gender differences in marital quality to postdivorce well-being, and suggests women in the lowest quality marriages may gain LS following divorce.

Heart Rate Variability Moderates the Association Between Separation-Related Psychological Distress and Blood Pressure Reactivity Over Time.

Divorce is a stressor associated with long-term health risk, though the mechanisms of this effect are poorly understood. Cardiovascular reactivity is one biological pathway implicated as a predictor of poor long-term health after divorce. A sample of recently separated and divorced adults (N = 138) was assessed over an average of 7.5 months to explore whether individual differences in heart rate variability—assessed by respiratory sinus arrhythmia—operate in combination with subjective reports of separation-related distress to predict prospective changes in cardiovascular reactivity, as indexed by blood pressure reactivity. Participants with low resting respiratory sinus arrhythmia at baseline showed no association between divorce-related distress and later blood pressure reactivity, whereas participants with high respiratory sinus arrhythmia showed a positive association. In addition, within-person variation in respiratory sinus arrhythmia and between-persons variation in separation-related distress interacted to predict blood pressure reactivity at each laboratory visit. Individual differences in heart rate variability and subjective distress operate together to predict cardiovascular reactivity and may explain some of the long-term health risk associated with divorce.

Body mass and cognitive decline are indirectly associated via inflammation among aging adults.

Inflammatory models of neurodegeneration suggest that higher circulating levels of inflammation can lead to cognitive decline. Despite established independent associations between greater body mass, increased inflammation, and cognitive decline, no prior research has explored whether markers of systemic inflammation might mediate the association between body mass and changes in cognitive functioning. To test such a model, we used two longitudinal subsamples (ns=9066; 12,561) of aging adults from the English Longitudinal Study of Ageing (ELSA) study, which included two cognitive measures components of memory and executive functioning, as well as measurements of body mass and systemic inflammation, assessed via C-reactive protein (CRP). Greater body mass was indirectly associated with declines in memory and executive functioning over 6years via relatively higher levels of CRP. Our results suggest that systemic inflammation is one biologically plausible mechanism through which differences in body mass might influence changes in cognitive functioning among aging adults.

Impact of Narrative Expressive Writing on Heart Rate, Heart Rate Variability, and Blood Pressure after Marital Separation

Objective Divorce is a common stressor that is associated with increased risk for poor long-term physical and mental health. Using an experimental design, the current study examined the impact of expressive writing (EW) on average heart rate (HR), HR variability (HRV), and blood pressure (BP) 7.5 months later. Methods Participants from a community sample of recently separated adults (N = 109) were assigned to one of three conditions: traditional EW, narrative EW, or a control writing condition, and were assessed three times for an average of 7.5 months. Each study visit included 27 minutes of physiological assessment; the primary outcomes at each assessment were mean-level HR, HRV, BP scores averaged across six different tasks. Results Participants in the traditional EW condition did not significantly differ from control participants in their later HR, HRV, or BP. However, relative to control participants, those in the narrative EW condition had significantly lower HR (B = −3.41, 95% confidence interval = −5.76 to −1.06, p = .004) and higher HRV 7.5 months later (B = 0.41, 95% confidence interval = 0.16 to 0.74, p = .001). When comparing narrative EW participants to those in the traditional EW and control writing as a single group, these effects remained and were moderately sized, Cohen d values of −0.61 and 0.60, respectively, and durable across all task conditions when analyzed in independent models. The writing condition groups did not differ in their later BP. Conclusions Narrative EW decreased HR and increased HRV after marital separation but did not affect BP. We discuss the possible disconnect between psychology and physiology in response to EW, as well as possible future clinical applications after marital separation.

Schizophrenia, Narrative, and Neurocognition: The Utility of Life-Stories in Understanding Social Problem-Solving Skills.

Objective: Schizophrenia researchers have focused on phenomenological aspects of the disorder to better understand its underlying nature. In particular, development of personal narratives—that is, the complexity with which people form, organize, and articulate their “life stories”—has recently been investigated in individuals with schizophrenia. However, less is known about how aspects of narrative relate to indicators of neurocognitive and social functioning. The objective of the present study was to investigate the association of linguistic complexity of life-story narratives to measures of cognitive and social problem-solving abilities among people with schizophrenia. Method: Thirty-two individuals with a diagnosis of schizophrenia completed a research battery consisting of clinical interviews, a life-story narrative, neurocognitive testing, and a measure assessing multiple aspects of social problem solving. Narrative interviews were assessed for linguistic complexity using computerized technology. Results: The results indicate differential relationships of linguistic complexity and neurocognition to domains of social problem-solving skills. More specifically, although neurocognition predicted how well one could both describe and enact a solution to a social problem, linguistic complexity alone was associated with accurately recognizing that a social problem had occurred. In addition, linguistic complexity appears to be a cognitive factor that is discernible from other broader measures of neurocognition. Conclusions and Implications for Practice: Linguistic complexity may be more relevant in understanding earlier steps of the social problem-solving process than more traditional, broad measures of cognition, and thus is relevant in conceptualizing treatment targets. These findings also support the relevance of developing narrative-focused psychotherapies.

After the end: Linguistic predictors of psychological distress 4 years after marital separation

Divorce is a stressful life event that is associated with increased risk for poor mental and physical health. A key goal for research in this area is to understand individual differences in who fares well or poorly over time, and whether behavioral markers of risk immediately after a separation predict longer term adjustment. This article investigates psychological distress in a sample of separated adults (N = 134, 84 of whom completed all follow-up assessments) who participated in an initial study and a follow-up assessment approximately 4.5 years later. Using multiple regression we examined whether two linguistic behaviors—the use of words from categories such as first-person pronouns and present tense words (verbal immediacy) and first-person plural pronouns (we-talk; e.g., “we” or “our”)—predicted self-reported psychological distress at follow-up. Increased use of first-person plural pronouns predicted greater psychological distress 4.5 years after marital separation. Additional analyses revealed that this effect was driven largely by differences in self-concept disturbance over time. The extent to which people use first-person plural pronouns following marital separation predicts increased risk for psychological distress years later, and this behavioral indicator may identify people who are at greater risk for poor adjustment over time.

Smoking and Physical Activity Explain the Increased Mortality Risk Following Marital Separation and Divorce: Evidence From the English Longitudinal Study of Ageing

BACKGROUND Marital separation and divorce are associated with an increased risk of early mortality, but the specific biobehavioral pathways that explain this association remain largely unknown. PURPOSE This study sought to identify the putative psychological, behavioral, and biomarker variables that can help explain the association of being separated or divorced and increased risk for early mortality. METHODS Using data from the English Longitudinal Study of Ageing, a representative community sample of aging adults (N = 5,786), we examined the association of marital status and life satisfaction, health behaviors measured 2 years later, biomarkers measured 4 years later, and mortality outcomes from the subsequent 4 years. RESULTS Consistent with prior literature, older adults who were separated/divorced evidenced greater risk of mortality relative to those in intact marriages over the study period, OR = 1.46, 95% CI [1.15, 1.86]. Marital status was associated with lower levels of life satisfaction, β = -0.22 [-0.25, -0.19] and greater likelihood of smoking 2 years later β = 0.17 [0.13, 0.21]. Lower life satisfaction predicted less frequent physical activity 2 years later, β = 0.07 [0.03, 0.10]. Smoking, but not physical activity, predicted poorer lung functioning 2 years later, β = -0.43 [-0.51, -0.35], and poorer lung function predicted increased likelihood of mortality over the following 4 years, β = -0.15 [-0.27, -0.03]. There was a significant total indirect effect of marital status on mortality through these psychological, behavioral, and biomarker variables, β = 0.03 [0.01, 0.05], which fully explained this mortality risk. CONCLUSIONS For separated/divorced adults, differences in life satisfaction predict health behaviors associated with poorer long-term lung function, and these intermediate variables help explain the association between marital dissolution and increased risk of earlier mortality.