Tag Archives: aging

By Karene Booker
Reprinted from Cornell Chronicle, February 19, 2014

Pillemer

Pillemer

A low-cost, six-week program that teaches people how to manage pain and stay active has proven to reduce arthritis pain and disability, yet few of the nation’s 50 million adult arthritis sufferers have used it. By enhancing the program’s content and delivery with the help of community partners, Cornell researchers report that attendance improved dramatically, and participants were significantly more likely to stay in the modified program compared to the original, while experiencing the same physical and mental health improvements.

“Effective health programs may not reach people who need them due to factors such as culture, language, age or income, but changing programs to meet the needs of new target populations can make a dramatic difference,” said study co-author Karl Pillemer, professor of human development in Cornell’s College of Human Ecology.

The study, which was published in February in the Musculoskeletal Journal of the Hospital for Special Surgery (Vol. 10:1), focuses on the Arthritis Self-Management Program, also known as the Arthritis Self-Help Course.

Reed

Reed

“To our knowledge, this is the first controlled study to directly compare the effects of an adapted chronic disease self-management program with the original,” said co-author Dr. M. Carrington Reid, associate professor in geriatrics at Weill Cornell Medical College. He added that rigorously evaluating modified programs such as this one to ensure they still deliver the expected benefits is rare, but critical.

To modify the underutilized program, Reid, Pillemer and his colleagues collaborated with a team of staff from local agencies and senior centers, older adults and program instructors. The team incorporated nearly 40 enhancements suggested by program participants and instructors, such as adding in-class exercise practice and individual action plans to make use of local health programs, expanding information on healthy eating and weight management, and simplifying reading materials.

The adapted and original versions were tested with 201 older adults, with baseline data collected at the beginning, at program completion and 18 weeks later. While both groups experienced equivalent relief in pain, stiffness and perceived disability, attendance in the adapted program improved by 46 percent, and participants were 26 percent more likely to stay in the modified program than in the original.

That means that the modified program could have significantly more reach and impact, the authors say. Their findings not only underscore the value of involving local stakeholders in tailoring interventions to specific populations, but also the importance of conducting controlled experiments to quantify the results, they say. Furthermore, they add, their findings highlight the potential of relatively simple programs to help build self-efficacy for arthritis management and improve quality of life.

The study, “Measuring the Value of Program Adaptation: A Comparative Effectiveness Study of the Standard and a Culturally Adapted Version of the Arthritis Self-Help Program,” was also co-authored by graduate student Emily Chen and senior research associate Charles Henderson of Cornell, and Samantha Parker of Tulane University School of Medicine. It was supported in part by the National Institute of Nursing Research and the National Institute on Aging.

Karene Booker is an extension support specialist in the Department of Human Development.

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Reprinted from Cornell Chronicle, October 21, 2013

Pillemer

Pillemer

Similarities in personal values and beliefs between an adult child and an older mother keeps that child in favor over the long-term, and that preference can have implications for mothers’ long-term care, reports a new Cornell study.“Not only does her favoritism affect adult sibling relationships, but also the patterns of caregiving for mothers," said co-author Karl Pillemer, professor of human development in the College of Human Ecology at Cornell. “Knowing that favoritism tends to be relatively stable can be helpful to practitioners assisting families with their older relatives.The study, published in the October issue of the Journal of Marriage and Family (75:5), reports that about three-quarters of the 406 mothers in the study, who were 65-75 years of age at the study’s onset, identified the same child as their favorite and preferred caregiver at the start and end of the seven-year study.

The mother’s perception of similarity between herself and her child was one of the biggest predictors of who remained the favorite, Pillemer said. He added that recent research with co-author Jill Suitor of Purdue University has found that mothers tend to prefer their “favorites” as their caregivers, compared with her other children.

The findings of the new study, co-authored with Suitor and Megan Gilligan of Iowa State University, are based on data from the Within-Family Differences Study, in which data were collected seven years apart from the same mothers.

Gender similarity also was a consistent factor to show long-term favoritism, which is not surprising because the mother-daughter connection has been shown in previous research to typically be the strongest, closest and most supportive parent-child relationship, Pillemer said.

In addition to looking at personal values, the researchers also looked at whether a child's financial independence, adult roles as a spouse or parent themselves, consistent employment and lawful behavior influenced which child remained the favorite. What was surprising is that whether a child was married, divorced or independent mattered much less than sharing personal values, said Suitor, who is a member of the Center on Aging and the Life Course.

"These mothers are saying that if I can't make my own decisions involving my life then who can best make these decisions for me? Who thinks like I do?" Suitor said. "Who has the same vision in life that I do, has a pretty good sense of what I would do? This is incredibly important with issues related to caregiving, and that is why understanding these family dynamics is so important."

On the other hand, identifying what drove changes when a child fell out of favor has proven much more difficult, the researchers noted.

"One of the few predictors of changes was when children stopped engaging in deviant behaviors, such as substance abuse, during the seven years, and then their mothers were more likely to choose them as the children to whom they were most emotionally close," Gilligan said.

Suitor said, "This is an interesting change because if a child engaged in deviant behaviors seven years ago but then stopped, they were even more likely to be chosen than were siblings who never engaged in deviant behaviors."

Suitor, Pillemer and Gilligan are planning to extend the Within-Family Differences Study to include interviewing Baby Boomers about their adult children.

The study, “Continuity and Change in Mothers' Favoritism Toward Offspring in Adulthood,” was funded by the National Institute on Aging.

By Karene Booker
Reprinted from Cornell Chronicle, October 15, 2013

Jeanne Tsai, associate professor of psychology at Stanford University, speaks at the 2013 Biennial Urie Bronfenbrenner Conference - Jason Koski/University Photography

Recent scientific advances demonstrate the profound effects of emotion on physical health, even how long we live and what diseases we die from. Likewise, there is growing evidence for the effects of aging on our emotions. Both streams of research shed light on root causes of disease and pathways to lifelong health, which is why researchers gathered on campus Oct. 3-4 to better understand the interplay between emotions and health across the lifespan.

The Fourth Biennial Urie Bronfenbrenner Conference, “New Developments in Aging, Emotion and Health,” drew scholars from as far away as Europe to share research on the nature of age differences in emotions, how emotions influence health, the underlying biological and behavioral mechanisms, and possibilities for leveraging these discoveries to promote healthy aging.

“We convened a temporary think tank of long-standing and rising leaders in the two fields to create some unlikely encounters and novel ideas,” said Corinna Loeckenhoff, assistant professor of human development in the College of Human Ecology and director of the Cornell Healthy Aging Laboratory. “We expect the intellectual exchange and networking will lead to new conceptual developments as well as policy and translation opportunities with real-world implications,” she said. Loeckenhoff co-organized the conference with Anthony Ong, associate professor of human development.

Many of those who participated are pioneers in their fields. Laura Carstensen, a professor of psychology and the founding director of the Stanford Center on Longevity, for example, is best known for her theory about how people’s motivations change as they age. She reviewed her recent research on leveraging older adults’ preference for the positive to improve health behaviors. Positive messages about the benefits of exercise, it turns out, are more effective than negative messages about risks of inactivity in motivating older adults to walk regularly. Such insights could revolutionize efforts to help America’s growing population of older adults remain active, she said.

Cornell neuroscientist Adam Anderson, associate professor of human development, said that his research suggests that positive emotions are associated with increased cognitive flexibility and creative problem solving, and this may be due to neural changes that impair selective attention. The aging brain, he says, exhibits this same “leaky filter” pattern. More information can slow down thinking, but there’s an upside as well, he proposed – the rose colored glasses of positivity broaden our field of view and help us see remote connections.

Alex Zautra of Arizona State University, who studies resilience and interventions that help people bounce back from stressors and adversity, shared his recent research on the crucial role of social ties in “unlocking” resilience and his initiative to develop online social intelligence training to help people build and maintain social ties.

Participants (who included other renowned scholars such as George Bonanno, Columbia University; Michaela Riediger, the Max Plank Institute for Human Development; and Laura Kubzansky, Harvard School of Public Health) also debated core assumptions about emotional regulation and personality, the effects of culture, environment and technology, and their implications for policy and practice.

The American Psychological Association plans to publish a book based on the papers presented at the conference, which was sponsored by Cornell’s Bronfenbrenner Center for Translational Research, Institute for the Social Sciences and Department of Human Development; the Scientific Research Network on Decision Neuroscience and Aging; Constance F. Ferris; and Liese Bronfenbrenner.

Conference videos

Karene Booker is an extension support specialist in the Department of Human Development.

By Karene Booker
Reprinted from the Cornell Chronicle, September 5, 2013

Charles Brainerd

Brainerd

Cornell researchers have developed a reliable method to distinguish memory declines associated with healthy aging from the more-serious memory disorders years before obvious symptoms emerge. The method also allows research to accurately predict who is more likely to develop cognitive impairment without expensive tests or invasive procedures.

Their results hold promise for detecting cognitive impairment early and monitoring treatment, but also have implications for healthy adults, said Charles Brainerd, professor of human development and the study’s lead co-author with Valerie Reyna, director of the Institute for Human Neuroscience and professor of human development, both in the College of Human Ecology.

Valerie Reyna

Reyna

Their research, “Dual-retrieval models and neurocognitive impairment,” appears online in the Journal of Experimental Psychology: Learning, Memory and Cognition, Aug. 26.

The memory abilities affected by cognitive impairment differ from those affected by healthy aging, the authors say, resulting in unique error patterns on neuropsychological tests of memory. Their theory-driven mathematical model detects these patterns by analyzing performance on such tests and measuring the separate memory processes used.

“With 10 or 15 minute recall tests already in common use worldwide, we can distinguish individuals who have or are at risk for developing cognitive impairment from healthy adults, and we can do so with better accuracy than any existing tools,” said Brainerd.

The notion that memory declines continuously throughout adulthood appears to be incorrect, they say. “When we separated out the cognitively impaired individuals, we found no evidence of further memory declines after the age of 69 in samples of nationally representative older adults and highly educated older adults,” said Reyna.

To develop their models, the team used data from two longitudinal studies of older adults – a nationally representative sample of older adults, the Aging, Demographics and Memory Study, and the Alzheimer’s Disease Neuroimaging Initiative – that include brain and behavioral measures as well as diagnoses for cognitive impairment and dementia.

Specifically, the researchers found that declines in reconstructive memory (recalling a word or event by piecing it together from clues about its meaning, for example, recalling that “dog” was presented in a word list by first remembering that household pets were presented in the list) were associated with mild cognitive impairment and Alzheimer’s dementia, but not with healthy aging. Declines in recollective memory – recalling a word or event exactly – were a feature of normal aging.

Over a period of between one and a half to six years, declines in reconstructive memory processes were reliable predictors of future progression from healthy aging to mild cognitive impairment and Alzheimer’s dementia, and better predictors than the best genetic marker of such diseases.

“Reconstructive memory is very stable in healthy individuals, so declines in this type of memory are a hallmark of neurocognitive impairment,” Reyna said.

Younger adults rely heavily on recollection, Brainerd said, but this method becomes increasingly inefficient throughout mid-adulthood. “Training people how to make better use of reconstructive recall as they age should assist healthy adult memory function,” he said. “Our analytical models are readily available for research and clinical use and could easily be incorporated into existing neuropsychological tests.”

The co-authors of the paper are Carlos Gomes, a graduate student in the field of human development; Anna Kenney ’11, Caroline Gross ’12 and Emily Taub ’10 of Cornell – all of whom helped conduct the research as undergraduates in Brainerd’s lab; and Nathan Spreng, assistant professor of human development and Rebecca Q. and James C. Morgan Sesquicentennial Faculty Fellow in the College of Human Ecology.

The research was supported in part by the National Institutes of Health and the CAPES Foundation, a federal agency under Brazil’s Ministry of Education.

Karene Booker is extension support specialist in the Department of Human Development.

By Karene Booker
Reprinted from Cornell Chronicle, September 19, 2013

Network of brain regions, highlighted in red and yellow, show atrophy in both healthy aging and neurodegenerative disease. The regions highlighted are susceptible to normal aging and dementia.

Brain regions associated with memory shrink as adults age, and this size decrease is more pronounced in those who go on to develop neurodegenerative disease, reports a new study published Sept. 18 in the Journal of Neuroscience (Vol. 33:38). The volume reduction is linked with an overall decline in cognitive ability and with increased genetic risk for Alzheimer’s disease, the authors say.

“Our results identify a specific pattern of structural brain changes that may provide a possible brain marker for the onset of Alzheimer’s disease,” said Nathan Spreng, assistant professor of human development and the Rebecca Q. and James C. Morgan Sesquicentennial Faculty Fellow in Cornell’s College of Human Ecology.

The study is one of the first to measure structural changes in a collection of brain regions – not just one single area – over the adult life course and from normal aging to neurodegenerative disease, said Spreng, who co-authored the study with Gary R. Turner of York University in Toronto.

Overall, they studied brain data from 848 individuals spanning the adult lifespan, using data from the Open Access Series of Imaging Studies and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). About half of the ADNI sample was assessed multiple times over several years, allowing the researchers to measure brain changes over time and determine who did and did not progress to dementia.

The researchers found that brain volume in the default network (a set of brain regions associated with internally generated thoughts such as memory) declined in both healthy and pathological aging. The researchers noted the greatest decline in Alzheimer’s patients and in those who progressed from mild cognitive impairment to Alzheimer’s disease. Reduced brain volumes in these regions were associated with declines in cognitive ability, the presence of known biological markers of Alzheimer’s disease and with carrying the APOE4 variant of APOE gene, a known risk factor for Alzheimer’s.

“While elements of the default network have previously been implicated in aging and neurodegenerative disease, few studies have examined broad network changes over the full adult life course with such large participant samples and including both behavioral and genetic data,” said Spreng. “Our findings provide evidence for a network-based model of neurodegenerative disease, in which progressive brain changes spread through networks of connected brain regions.”

The study, “Structural Covariance of the Default Network in Healthy and Pathological Aging,” was supported in part by the Canadian Institutes of Health Research.

Karene Booker is an extension support specialist in the Department of Human Development.

By Susan S. Lang
Reprinted from the Cornell Chronicle, August 7, 2013

Karl Pillemer

Pillemer

“What’s interesting here is that despite recent changes in gender roles and in the ability to stay in touch these days with cellphones and email, being the nearest daughter is still, to a great extent, ‘destiny,’” said Karl Pillemer, professor of human development in the College of Human Ecology and of gerontology at the Weill Cornell Medical College; his co-author is sociologist J. Jill Suitor of Purdue University.

Furthermore, the researchers found “that the child a mother expected would care for her before she needed care was most often the one who actually did it,” Pillemer said. “So mothers’ expectations are typically met. This is especially striking because we asked mothers about who they expected would care for them about five to seven years before they needed help.”

The researchers report that adult children living within a two-hour drive of their mother are six times more likely to provide care later than siblings living farther away, and that daughters are more than twice as likely as sons to become caregivers. Also, children who shared their mother’s values had an increased likelihood of becoming caregivers.

The study is posted online and will be published in a forthcoming issue of the journal The Gerontologist.

Unlike previous studies, which have been cross-sectional (analyzed data from one point in time), this study was prospective and took a within-family approach, which allowed the researchers to predict who would become a caregiver over time. The researchers interviewed 537 adults in 139 families prior to any need for care for their mothers; then, seven years later, they followed up with the families to see who had actually had become the caregiver. The researchers assessed whether or not the adult child had provided previous care, his/her gender, employment status, proximity, similarity of opinions to the mom, emotional closeness and whether they had provided advice, comfort or help with household chores.

“The results pose an interesting question regarding the future of informal support for frail or disabled older persons,” Pillemer said. “The cultural and structural factors that lead care to be expected from the nearest daughter may not apply in a society with full employment and high geographic mobility for women.” These factors, he noted, may create added tension for women and their families.

The study, “Who Provides Care? A Prospective Study of Caregiving among Adult Siblings,” was supported by the National Institute of Aging.

Cornell Chronicle writer intern Rebecca Harrison ’14 contributed to this article.

By Karene Booker
Reprinted from Cornell Chronicle April 26, 2013

Anthony Ong

Ong

Want a good night’s sleep? Be positive – consistently. Although happiness is generally good for sleeping, when a person’s happiness varies a lot in reaction to daily ups and downs, sleep suffers, reports a Cornell study published online in the Annals of Behavioral Medicine.

The researchers analyzed data from 100 middle-aged participants in a longitudinal study of midlife in the United States that included telephone interviews about participants’ daily experience as well as subjective and objective measures of sleeping habits. The study looked at the overall levels of positive emotion that the participants experienced in their lives – those associated with more stable personality traits, as well as daily fluctuations in positive emotions in reaction to daily events.

The team found that, as expected, having a more positive general outlook on life was associated with improved sleep quality. However, they found that the more reactive or fragile a participant’s positive emotions were in relation to external events, the more their sleep was impaired, especially for individuals high in positivity to begin with.

“Previous research suggests that the experience of joy and happiness may slow down the effects of aging by fortifying health-enhancing behaviors such as restorative sleep,” said first author Anthony Ong, associate professor of human development in the College of Human Ecology. “Our study extends this research by showing that whereas possessing relatively stable high levels of positive emotion may be conducive to improved sleep, unstable highly positive feelings may be associated with poor sleep because such emotions are subject to the vicissitudes of daily influences.” Ong added, “These findings are novel because they point to the complex dynamics associated with fragile happiness and sleep that until now have been largely attributed to unhappy people.”

Ong co-authored the study, “Linking stable and dynamic features of positive affect to sleep,” with Deinera Exner-Cortens and Catherine Riffin, Cornell graduate students; Andrew Steptoe, University of London; Alex Zautra, Arizona State University; and David Almeida, Penn State University.

The research was funded in part by the National Institutes of Health and the Canadian Institutes of Health Research.

Karene Booker is an extension support specialist in the Department of Human Development.

By Sarah Cutler
Reprinted from Cornell Chronicle, February 29, 2013

Riffin

Loeckenhoff

Tending to older loved ones who have bold personalities may be harmful to their caregivers' physical health, report Cornell researchers.

People who cared for individuals characterized as "easygoing" and "well-intentioned" reported better physical health than those who cared for headstrong and less agreeable people. No effects, however, were found regarding the caregivers' mental health.

The study of 312 pairs of caregivers and care receivers, which is one of the first to look at the influence of care-receiver personality on caregiver health, was published online Dec. 11 in the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences.

Caregiver health was particularly low when those receiving care were both low in agreeableness and highly extraverted -- a combination called a "leader type," said senior author Corinna Loeckenhoff, assistant professor of human development in the College of Human Ecology. "That kind of personality may be very successful in a business setting, but it's not if you're receiving care," Loeckenhoff said.

The findings have implications for the millions of Americans who provide informal eldercare. In 2011, 16 percent of the U.S. population over age 15 -- and nearly 25 percent of those between 45 and 64 years of age -- provided some eldercare, according to the Bureau of Labor Statistics.

"The care recipient's personality is just as important a factor for caregiver health as chronic pain and physical impairment," said lead author Catherine Riffin, a graduate student in the field of human development. "Clinical evaluations of caregiving settings should take this into account."

Other co-authors are Karl Pillemer, the Hazel E. Reed Professor in Cornell's Department of Human Development, Bruce Friedman of the University of Rochester and Paul T. Costa Jr., Duke University School of Medicine.

The research was funded in part by the National Institutes of Health and the National Institute on Aging.

Sarah Cutler '16 is a student communications assistant for the College of Human Ecology.

By Susan Kelley
Reprinted from Cornell Chronicle, February 11, 2013

Valerie Reyna

Reyna

Charles Brainerd

Brainerd

Defying the widely held belief that a specific gene is the biggest risk factor for Alzheimer's disease, two Cornell developmental psychologists and their colleagues report that people with that gene are more likely to develop mild cognitive impairment -- but not Alzheimer's.

The study suggests that older adults with healthy brain function can get genetic tests to predict increased risk of future mild cognitive impairment. However, once they are impaired cognitively, the tests won't predict their likelihood of developing Alzheimer's.

"Right now, genetic tests are used in exactly the opposite way. That is, healthy people don't get the tests to predict their risk of mild cognitive impairment, but impaired people get them to predict their risk of Alzheimer's disease," said Charles Brainerd, professor of human development and the study's lead co-author with Valerie Reyna, professor of human development. "So, impaired people think that tests will tell them if they are at increased risk of Alzheimer's, which they won't. And healthy people think that tests won't tell them whether they are at increased risk of cognitive impairment, which they will."

The researchers describe their findings in the January issue of Neuropsychology (27:1).

The work builds on previous research by Brainerd and associates that suggested the ε4 allele of the APOE genotype increases the risk of mild cognitive impairment as well as Alzheimer's.

The researchers analyzed data from the only nationally representative dataset of its kind, the National Institute on Aging's Aging, Demographics and Memory Study. They looked at data from 418 people over age 70 to see if those who carried the allele were more likely to develop mild cognitive impairment compared with those who did not have the allele. They also looked at whether ε4 carriers with mild cognitive impairment were more likely to develop Alzheimer's disease compared with non-carriers with mild cognitive impairment.

They found that healthy ε4 carriers were nearly three times -- 58 percent -- more likely to develop mild cognitive impairment compared with non-carriers. However, ε4 carriers with mild cognitive impairment developed Alzheimer's at the same rate as non-carriers.

While previous studies showed that the ε4 allele was more common in people with Alzheimer's disease, this study shows that it does not increase the risk that healthy or impaired people will become demented. Rather, ε4 increases the risk that healthy people will become cognitively impaired, and impaired people are the primary source of new Alzheimer's diagnoses, Brainerd explained. "The reason ε4 is a risk factor for mild cognitive impairment, but not for progression from mild cognitive impairment to Alzheimer's disease, is that this allele is a marker of initial cognitive declines -- for example, memory and executive function -- that are associated with mild cognitive impairment but not of subsequent declines in cognition or in daily functioning that are associated with forms of Alzheimer's disease."

Brainerd also noted that the effects of ε4 in healthy adults can be detected by the mid-20s. While ε4 is not a risk factor for the severe cognitive declines that signal dementia, it is risk factor for the weaker declines that eventually produce mild cognitive impairment.

The co-authors of the paper are Ronald Petersen and Glenn Smith of the Mayo Clinic; Anna Kenney '11, Caroline Gross '12 and Emily Taub '10 of Cornell -- all of whom helped conduct the research as undergraduates in Brainerd's lab; Brenda Plassman of Duke University Medical Center; and Gwenith Fisher of the University of Michigan.

The research was supported in part by the National Institutes of Health.