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"Knight, Bob G"
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Cross-cultural differences in dementia: the Sociocultural Health Belief Model
Background: Many minority ethnic (ME) older adults face several culturally associated and systemic barriers to timely dementia diagnoses that may result in delays to dementia care-seeking. We aimed to develop and propose a model illustrating variables that influence dementia care-seeking among ME older adults. Methods: We conducted a literature review on the effects of these barriers on diagnostic delays and impairment levels at initial evaluation. We also strived to provide a basis for the Sociocultural Health Belief Model (SHBM) to guide future research and service planning pertaining to culture and dementia care-seeking. Results: There was consistent evidence that ME older adults with dementia tended to have greater diagnostic delays and higher levels of cognitive impairment and behavioral and psychological symptoms of dementia at initial evaluation than their non-Hispanic White counterparts. We also found several barriers to dementia care-seeking among ME groups. These barriers included lower levels of acculturation and accurate knowledge about dementia, more culturally associated beliefs about dementia, such as the perception of memory loss as normal aging and stigma associated with dementia, and health system barriers. Conclusions: The SHBM provides an empirically based conceptual framework for examining cross-cultural differences in dementia care-seeking among diverse groups. We provide recommendations for future research, such as the need for research with more diverse ethnic subgroups and the examination of group-specific cultural values. We conclude with a discussion of the clinical and service implications of our review, including potential interventions aimed at facilitating timely dementia diagnoses among ME older adults.
Journal Article
Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial
BackgroundOlder people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.MethodsA randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60–95 years (mean age 74.9±7.7 years; 53% <$12 000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area.ResultsIntervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US $41 218/UK £24 868 per unit). No intervention effect was found for cognitive functioning outcome measures.ConclusionsA lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people.Trial Registrationclinicaltrials.gov identifier: NCT0078634.
Journal Article
The relationship among openness, wisdom, and humor: a preliminary mediation model
ABSTRACTObjectivesWisdom researchers acknowledge the complex nature of this ancient construct, although they are yet to agree on its core components. A key question in the literature is whether Openness and Humour are aspects of wisdom or whether Openness is an antecedent of wisdom with Humour as a consequence. MethodsUsing structural equation modelling, we evaluated data from 457 online respondents aged 16–87 years ( Mage = 35.19, SD = 17.45). We analyzed a model with Openness as a precursor to Wisdom (conceptualised as a latent mediator variable using parcels of the SAWS Experience, Reminiscence/Reflection, and Emotional Regulation items), with Humor as outcome. We compared this model with a model using Wisdom as a latent mediator variable using parcels of the Three-Dimensional Wisdom Scale-12 (3D-WS-12). ResultsA model using Self-Assessed Wisdom Scale (SAWS)-9 latent mediator variable with Openness as precursor to wisdom and Humour as a consequence was good fit for the data and displayed full mediation. Similarly, a model using the 3D-WS-12 as latent mediator variable to measure wisdom and with Openness as a precursor to wisdom and Humour as a consequence also fits the data with full mediation. DiscussionThese findings provide empirical support for theoretical suggestions in the literature that Openness is a precursor to wisdom and that Humour is a consequence of wisdom using two of the most common self-report measures of wisdom. An improved understanding of the nature of wisdom and especially of its potential precursors can also be of use in future efforts to facilitate the development of wisdom.
Journal Article
An evaluation of the factor structure of the Self-Assessed Wisdom Scale (SAWS) and the creation of the SAWS-15 as a short measure for personal wisdom
ABSTRACTObjectivesAlthough wisdom is a desirable life span developmental goal, researchers have often lacked brief and reliable construct measures. We examined whether an abbreviated set of items could be empirically derived from the popular 40-item five-factor Self-Assessed Wisdom Scale (SAWS). DesignSurvey data from 709 respondents were randomly split into two and analyzed using confirmatory factor analysis (CFA). SettingThe survey was conducted online in Australia. ParticipantsThe total sample consisted of 709 participants ( Mage = 35.67 years; age range = 15–92 years) of whom 22% were male, and 78% female. MeasurementThe study analyzed the 40-item SAWS. ResultsSample 1 showed the traditional five-factor structure for the 40-item SAWS did not fit the data. Exploratory factor analysis (EFA) on Sample 2 offered an alternative model based on a 15-item, five-factor solution with the latent variables Reminiscence/Reflection, Humor, Emotional Regulation, Experience, and Openness. This model, which replicates the factor structure of the original 40-item SAWS with a short form of 15 items, was then confirmed on Sample 1 using a CFA that produced acceptable fit and measurement invariance across age groups. ConclusionsWe suggest the abbreviated SAWS-15 can be useful as a measure of individual differences in wisdom, and we highlight areas for future research.
Journal Article
Influences on the perception of elder financial abuse among older adults in Southern California
ABSTRACTBackgroundUnder-reporting of elder financial abuse is partly due to failure of those around the victim to perceive the financial mistreatment as abuse. This study explored the effect of victim and perceiver factors on perception of elder financial abuse in the context of Routine Activity Theory (RAT). Methods488 older adults in Ventura County (CA) were surveyed about financial abuse using vignette method. In the study's Vignette 1, the amount of money taken, the type of frailty, and the relationship of perpetrator and victim were manipulated. In Vignette 2, the victim's age and relationship of perpetrator and victim were manipulated. Respondents’ demographics (age, gender, education, and ethnicity) were collected. ResultsLogistic regression analyses revealed that children of the victim were least likely to be seen as committing abuse in both vignettes. In Vignette 1, there was an interaction of gender of respondent and the amount of money taken. In Vignette 2, non-Whites were less likely to perceive the signing over of the house as financial abuse. Respondents endorsed the concept of a special court with expertize in elder abuse as a way to increase the likelihood that they would report. ConclusionsEven though most financial abuse is perpetrated by family members, older adults are less likely to perceive a financial situation as abuse when it involves a child of the victim, thus making reporting and prevention less likely. The support for a specialty Elder Abuse Court (EAC) suggests that some reluctance to report is based on misgivings about punishing the perpetrator.
Journal Article
Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review
The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings.
The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings.
This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies.
Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018.
In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed.
PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54).
RR1-10.2196/9902.
Journal Article
Handbook of the psychology of aging
Handbook of the Psychology of Aging, Eighth Edition, tackles the biological and environmental influences on behavior as well as the reciprocal interface between changes in the brain and behavior during the course of the adult life span.The psychology of aging is important to many features of daily life, from workplace and the family, to public.
eBook
Adaptation of the three-dimensional wisdom scale (3D-WS) for the Korean cultural context
ABSTRACTBackgroundPrevious research on wisdom has suggested that wisdom is comprised of cognitive, reflective, and affective components and has developed and validated wisdom measures based on samples from Western countries. To apply the measurement to Eastern cultures, the present study revised an existing wisdom scale, the three-dimensional wisdom scale (3D-WS, Ardelt, 2003) for the Korean cultural context. MethodsParticipants included 189 Korean heritage adults (age range 19–96) living in Los Angeles. We added a culturally specific factor of wisdom to the 3D-WS: Modesty and Unobtrusiveness (Yang, 2001), which captures an Eastern aspect of wisdom. The structure and psychometrics of the scale were tested. By latent cluster analysis, we determined acculturation subgroups and examined group differences in the means of factors in the revised wisdom scale (3D-WS-K). ResultsThree factors, Cognitive Flexibility, Viewpoint Relativism, and Empathic Modesty were found using confirmatory factor analysis. Respondents with high biculturalism were higher on Viewpoint Relativism and lower on Empathic Modesty. ConclusionThis study discovered that a revised wisdom scale had a distinct factor structure and item content in a Korean heritage sample. We also found acculturation influences on the meaning of wisdom.
Journal Article