Research on Aging

The poor psychological health of caregivers of the frail aged is examined using the stress paradigm and the crises of decline model of caregiving burden. Whereas stress paradigms generally focus on environmental stressors and individual resources, the crises of decline model conceptualizes stress within the social dynamics of the caregiving dyad. Data from a cross-sectional study of 144 caregivers supported both models. Burden was more likely when the primary caregiver experienced degeneration, conflict, enmeshment, unpreparedness, and unwillingness. Minor psychiatric symptoms were explained in part by burden but also by more traditional stressors (supervisory workload) and resources (physical health, self- esteem, mastery, coping strategies, social network availability). Individualistic interventions to relieve burden and symptoms are justifiable on the basis of this study, but with limits to their likely success-limits imposed by family institutions of care in which primary carers lack experience and feel discomfort with degenerative conditions.

The purpose of this research is to examine how individuals evaluate bodily and medical concerns and define health situations. Responses to a fixed-response health-rating question and an open-ended question probing personal problems are compared and predicted with a set of health status indicators including measures of functional limitations and morbidity. Activity limitation is the strongest predictor of each measure among this national sample of adults (N = 3,497). Age is associated with poorer rated health and more defined health problems in most of the adult years, but this trend is reversed in older ages. Despite higher morbidity and functional limitations among African American women, they were less likely than other respondents to define their health as problematic. In addition, evaluative components of the self such as self-esteem influence ratings of health but not health problem definitions. The findings confirm the overall utility of the self-assessed health as a reliable estimate of current health status and suggest that spontaneously mentioning health problems reflects current as well as future health concerns.

The STAYWELL Program, an 8-session health promotion/disease prevention pro-gram for older adults, was found to have a significant impact on elder participants' health-related beliefs and behaviors. This quasi-experimental study's 146 participants were recruited from 8 western New York senior citizen centers, and 70% (n = 102) were available for a 9-month follow-up assessment. As compared with elders on a waiting list, study participants who experienced the STAYWELL intervention ex-pressed significantly healthier beliefs and reported behavioral changes indicative of a healthier lifestyle at follow-up. All of the intervention effect sizes observed may be characterized as large to very large: (1) The intervention group expressed healthier beliefs as assessed using the healthy belief index-at follow-up, three quarters of them scored higher on this measure than the average person in the waiting list comparison group (U₃ = 77.3%); (2) the intervention group engaged in healthier behaviors as assessed by using the healthy behavior index (U₃ = 92.4%); and (3) they also took fewer medications (U₃ = 74.2%); all p < .05. Extant cohorts in this field (more than 20,000 elders) may offer collaborative opportunities for needed longer follow-up of health outcome end-points.

Little is known about bereaved persons who refuse to participate in bereavement research, although participants have been assumed to be representative of the bereaved. This assumption is examined in a study of older women in their first, second, or third year of widowhood. To identify sources of sample bias, data from deceased husbands' death certificates (N = 2,331) were used to compare respondents and nonrespondents at stages in the recruitment process: assumed located, returned reply card, agreed to hear more, wished to participate, eligible, and interviewed. The low participation rate (N= 376) did not produce a major bias, although small, statistically significant differences in deceased husband's age, race, education, place and cause of death were revealed. Differences by recruitment stage were observed, as were differences by cohort. Recent widows were more likely to participate. Implications for achieving representative samples are discussed.

This study explores the impact of couples' employment/retirement patterns on indicators of marital quality (conflicts, heated arguments, marital happiness). Logistic regressions based on data from the National Survey of Families and Households (N= 672) reveal that the husband retired/wife employed pattern is associated with perceptions of lower marital quality among traditional gender-role couples. On the other hand, traditional gender-role employed husbands with retired wives report somewhat higher marital quality than husbands in dual-earner couples. In addition, dual-retired spouses with recently retired wives score lower on marital happiness than spouses in current dual-earner couples.