Healthy Aging and Daily Life:
Intersections and opportunities
Amy Lorek, PhD
Healthy Aging and Daily Life
Outline
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What do we mean when we say healthy aging?
A bit about the PSU Center for Healthy Aging
Examples of Center research
My role as Research and Outreach Associate
Community engagement projects
PRC and CHA intersections and opportunities
Wrap up
Resilience
Physical
Sense of
Emotional
Social
Cognitive
Healthy
Aging
purpose
Social
Connectedness
Independence
PSU Center for Healthy Aging
Research and activities that promote
physical, emotional, and cognitive health
throughout adulthood
http://healthyaging.psu.edu/
Core
Student training
Research
Community engagement
Urgency for Research and Training in Aging
The number of 65+ adults will double
in the next 30 years.
Interdisciplinary work
Human Development
& Family Studies
Biobehavioral
Health
Communication
Problem
focused
research &
training
Kinesiology
Health Policy
Administration
Landscape
Architecture
Nursing
Psychology
Recreation, Park, &
Tourism Management
Research
The
Importance
of Mid-life
• A critical time in life
• What is the role of family to stay healthy
or manage health problems?
Daily Stress
• How does daily stress impact long term
health and well being?
Community
Engagement
• How can our community help us shape
research questions for prevention and
interventions?
Research
The
Importance
of Mid-life
• A critical time in life
• What is the role of family
to stay healthy or manage
health problems?
An example: ESCAPE
The Department of Human Development and Family Studies
The Center for Healthy Aging
Effects of Stress on Cognition, Aging, Physiology, & Emotions
(ESCAPE) Study
Study Features
• Intensive Measurements
Measurement Burst (70 x 4)
• Ecological Validity
Experience Sampling &
Cognitive testing (smartphone)
Co-op City,
Bronx, NY
• Diverse probability sample
~240 adults (ages 25-65)
63% Black, 26% Hispanic
• Measure multiple domains
NIA R01 AG39409
Behavior, cognition, emotion,
stress, personality, physiology
The Department of Human Development and Family Studies
The Center for Healthy Aging
Unconstructive repetitive thought (URT)
“Repetitive thinking about problematic
situations or events” (worry, rumination)
“When I have an important event
coming up, I can’t stop thinking about it”
“I have thoughts I cannot
stop”
“I tend to replay past events as I
would have liked them to happen”
“My thoughts frequently return to
one idea”
-- Negative affect (NA)
--Cardiac effects
(Moberly et al., 2008)
(Pieper et al., 2007)
-- Endocrine response
--Cognition
(Zoccola et al., 2008)
(Klein & Boals, 2002;
Stawski et al., 2006)
The Department of Human Development and Family Studies
The Center for Healthy Aging
ESCAPE Design
Measurement-Burst Design
Completed surveys on smartphone …
1. Waking
2. 5 random times throughout the day
3. Bedtime
Burst 1
9 mos.
Burst 2
9 mos.
Burst 3
9 mos.
Burst 4
14 days
14 days
14 days
14 days
5 moments
5 moments
5 moments
5 moments
The Department of Human Development and Family Studies
The Center for Healthy Aging
Measurements may also lack ecological validity
In vitro
(in lab)
In vivo
(in context)
Measurements in lab
• Insensitive to psychosocial ‘context’ (by design)
• Not approximate cognitive function in everyday life
• Resource intensive
The Department of Human Development and Family Studies
The Center for Healthy Aging
Processing Speed
(12 trials)
Response time (RT)
on correct trials
Verbal Working Memory Spatial Working Memory
(16 trials)
(2 trials)
Accuracy and RT
Total Errors
(Euclidean distance)
The Department of Human Development and Family Studies
The Center for Healthy Aging
Key Findings
1. Exposure to Daily Stressors
• Associated lower working memory
2. Negative Emotional Responses to Daily Stressors
• Lower fluid cognitive ability (younger/MA/Older)
• 10 year incidence of mental/physical health problems
3. Rumination
• Mediates effects of daily stressors on emotional distress
• Mediates effects of life events on cognitive function.
Research
Daily Stress
• How does daily stress
impact long term health
and well being?
An example: MIDUS
National Study of
Daily Experiences
Basic Definitions of Stress
Engineering - “The force exerted upon a body that tends to
strain or deforms it shape.”
Webster's New World Dictionary (2002)
Human - “Stress refers to the pressure that life exerts on us and
the way this pressure makes us feel.”
McEwen (2002)
Less Extreme Situations: Daily Stressors
Challenges and frustrations of daily life (disagreements,
malfunctions, time pressures)
Intensive assessment: “Daily Diaries”
Advantages
1. Assess naturally occurring tangible events:
“capture life as it is lived”
2. Minimize memory bias
3. Evaluate daily exposures
4. Calculate stressor reactivity (within-person slopes)
Daily Stressor Reactivity
Within-person Slopes between Stressor and Affect
Negative Affect
8
High Reactivity
6
Low Reactivity
4
High Reactivity
2
Low Reactivity
0
Stressor-Free Day
Stressor Day
National Study of Daily
Experiences
• Telephone Diary Study Across Eight Consecutive Evenings
• National sample of participants from the daily diary project of
MIDUS II (Npeople = 2,022, Ndays=15,165)
• Mean Age = 57 (SD = 12, Range = 33 – 84)
• 58% Female, 42% Male
• Education
– 28%: HS Diploma or less
– 52%: Some college - 4-yr Degree
– 20%: More than 4-yr Degree
Daily Saliva Collection
16 samples
– 4 per day X 4
consecutive days
– Wake up
– 30 mins after wake
– Before lunch
– Before bed
Overview of Daily Diary and Salivary
Home Collection Times
Daily Diary Collection days
1
2
3
4
5
6
7
Saliva Collection
2
A
Before
Getting Out
of Bed
B
30 min After
Getting Out
of Bed
3
4
5
C
Before
Lunch
D
Before
Going to
Bed
8
Day as the Unit of Analysis
Domains of Daily Experiences
–
–
–
–
–
–
–
–
Time use (Sleep, Work and Social Support)
Physical Symptoms (Duration and Intensity)
Substance Use (Caffeine, Alcohol, Tobacco)
Medications (Confounds of Cortisol)
Positive and Negative Mood
Productivity (Quantity and Quality)
Stressors (40% of the study days)
Positive Events (75% of study days)
Mortality Status and Affective
Reactivity to Daily Stressors
Mroczek et al., in press
Stressor reactivity predicts 10% to 34% increased risk
of reporting chronic conditions a decade later in the MIDUS Study
% change in risk of chronic
condition 10 years later
40
p<.01
30
p<.05
20
Stressor Exposure
(1-Unit Increase)
p<.01 p<.05
10
NS
NS
0
Stressor Reactivity
(1-Unit Increase)
Age (+10 years)
-10
-20
-30
Entire Sample
Initially Disease-Free
Sample
Piazza, J. R., Charles, S. T., Sliwinski, M. J., Mogle, J., & Almeida, D. M. (2013). Affective reactivity to daily stressors and
long-term risk of reporting a chronic physical health condition. Annals of Behavioral Medicine, 45(1), 110-120.
Research
Community
Engagement
• How can our community help us shape
research questions, for prevention,
interventions, and solutions?
The Role of
Research and Outreach Associate
Service
Community
Engagement
Research
Student
training
Community Engagement
Examples:
• PA Rural Adult Health Study
• Healthy Aging Community Lecture Series
• Experience Club
PA Rural Adult Health Study
• University + community = research partners
– Centre County, Office of Aging
– Centre Region Recreation Authority
• Long-term relationship building
• Senior centers
PSU CTSI: Community Engagement and Research Core 2013
PA Rural Adult Health project
• Technologically based
data collection
• Health and wellness measures, interventions,
and programming.
PA Adult Rural Health Study
Health/wellness interventions and programming
• Sedentary behavior (Kinesiology)
• Nutrition education (Nutrition Sciences)
• Leisure (Recreation Park Tourism Management)
• ++ (More to come)
Leisure
• Leisure engagement contributes to
social, emotional, psychological,
and cognitive well-being
• Aging and life-cycle transitions often prompt
changes in leisure participation
• Perceptions of quality of life are not limited to
medical and physical care
Healthy Aging Lecture Series
– A Community Partnership –
Home
Instead
Senior
Care
PSU
Center for
Healthy
Aging
Foxdale
Village
Healthy
The
Village at
Penn
State
Mount
Nittany
Health
Osher
Life-Long
Learning
Institute
Tailoring Memory Making – August 1
“I used to be able to eat that”
November 4
“Experience Club”
Experience in action
Potential CHA and PRC Intersections
Mindfulness component?
• Ross - Cognitive training to reduce crash risk
• Martire - Couples situated intervention to
manage pain
Other ideas:
• Polenick - Reminiscence therapy
• Experience Corp model adapted to rural
settings (PROSPER network?)
Your ideas…?
– Amy Lorek, ael13@psu.edu