Control Strategies & Mental Health in Impaired Elders

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The primary aim of the proposed longitudinal study is to examine the strategies used by older persons with visual impairment to balance and rebalance control in daily life, and to understand the course and consequences of such strategies over time. Because late-life vision loss constitutes a major threat to one's sense of competence and control, the proposed study provides a unique opportunity to apply the life-span theory of control to a prototypical age-related loss characterized by gradual onset and progressive deterioration. In addition, differences in assimilative and accommodative coping dispositions that may underlie patterns of control-related coping behavior will be examined. Specific aims are: 1. To identify the control strategies used in adapting to age-related vision loss and to assess the extent of change or stability in strategies over time. 2. To identify the extent of change or stability in dispositional assimilative and accommodative coping styles over time. 3. To examine the relationship between control strategies and dispositional coping styles among visually impaired elders and the stability or change in this relationship over time. 4. To identify the control strategies and dispositional coping styles, and patterns of change in each, that are predictive of more positive outcomes (functional competence, psychological well-being) over time. Participants will be 362 older adults with recent onset age-related vision loss. In-person interviews will be conducted at baseline, and 1- and 2-year follow-ups, with interim telephone interviews at 3-month intervals to capture both short- and long-term stability/change in control strategy use, and how such strategies relate to functional and psychological well-being. Cross-sectional and longitudinal relationships will be examined using regression, individual growth modeling, and structural equation modeling. Findings will help to identify elders at risk for poor adaptation and guide the development and delivery of rehabilitation services that maximize functional and psychological well-being.