Psychological Terminal Decline as a Multidimensional Process of Age, Approaching

作为年龄多维过程的心理终末衰退正在逼近

• 批准号: 7802085
• 负责人: Denis Gerstorf
• 金额: $ 14.34万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7802085
• 关键词: Accounting; Adopted; Adult; Affect; Age; Aging; Aging-Related Process; Area; Berlin; Birth; Cessation of life; Characteristics; Climacteric; Cognitive; Data; Data Set; Deterioration; Development; Elderly; Emotional; Exhibits; Face; Gender; Geriatrics; Goals; Health; Health Care Costs; Health Expenditures; Healthcare; Hospice Care; Individual; Knowledge; Life; Light; Longevity; Medical Sociology; Methods; Metric; Modeling; Multivariate Analysis; Participant; Pathology; Pathway interactions; Pattern; Personal Satisfaction; Persons; Policies; Population; Preventive Intervention; Process; Psychiatry; Psychology; Recording of previous events; Relative (related person); Research; Sampling; Sensory; Side; Social Functioning; Social Policies; Social Well-Being; Societies; Socioeconomic Status; Structure; System; Techniques; Terminal Disease; Testing; Time; Travel; age effect; aged; allostatic load; analytical method; clinically relevant; cognitive function; cost; design; end of life; expectation; experience; hazard; innovation; mortality; multidisciplinary; pathological aging; programs; psychologic; public health relevance; social; tool

DESCRIPTION (provided by applicant): Evidence is building that late-life changes in sensory and cognitive function are marked by pronounced, proximate to death terminal decline. Relatively little is known, however, about if and when other aspects of psychological functioning may deteriorate with approaching death or how such declines may be interrelated. The proposed project moves beyond current, single domain, examinations of terminal decline to consider and develop a multidimensional view of the processes underlying late-life change - "terminal cascades." We will examine late-life change across five domains broadly representative of the functional system in old age (sensory, physical, cognitive, well-being and social relations) and explore how these changes are interrelated. Objectives include (1) testing for unique associations between changes in functionality and subsequent mortality, (2) determining whether age-, death-, or pathology-related processes are the primary contributors to late-life change, and (3) describing the prototypical, multivariate change trajectories individuals follow into death. Recent and forthcoming innovations in the analysis of change will be applied to multidisciplinary 15-year longitudinal data from deceased participants of the Berlin Aging Study (N = 430+; 70-103 years). New analytic tools will be developed for modeling multivariate change. These tools and analyses shall allow for more precise descriptions of how individuals progress from one multivariate within-person profile of functioning to another over time (age, distance-to-death, pathology) and will thereby help to clarify which segments of society are likely to experience which types of decline. Empirical results will shed light on how and why some individuals age more successfully than others (e.g., experience less decline prior to death), point to particular pathways by which more and more individuals can maintain a life lived fully and with dignity into advanced ages, and yield practical information for the design and implementation of preventive interventions focused on alleviating the societal and personal costs of late-life decline. PUBLIC HEALTH RELEVANCE: The end of life in old age is often characterized by costly deteriorations in functionality and health - seemingly inevitable declines that contribute substantially to health care costs and societal burden. Little is known, however, about which aspects of late-life psychological function deteriorate, in what order, or how quickly such declines occur. As a first step in identifying the pathways by which more individuals can maintain a life lived fully and with dignity, the major goal of the proposed project is to obtain a better understanding of how late-life changes across domains of sensory, physical, cognitive, well-being, and social functionality are structured and interrelated. This knowledge will contribute to developing effective programs and policies that target the areas most likely to alleviate the social and personal costs of late-life decline (e.g., designing suitable health or hospice care).

描述（由申请人提供）：有证据表明，晚年感觉和认知功能的变化以明显的、接近死亡的终末衰退为标志。然而，关于心理功能的其他方面是否以及何时会随着死亡的临近而恶化，以及这种下降如何相互关联，我们所知甚少。拟议的项目超越了目前的，单一的领域，终端下降的检查，考虑和发展的过程中的晚年变化的多维视图-“终端级联。“我们将研究广泛代表老年功能系统（感官，身体，认知，幸福和社会关系）的五个领域的晚年变化，并探索这些变化是如何相互关联的。目标包括（1）测试功能变化与随后死亡率之间的独特关联，（2）确定年龄，死亡或病理相关过程是否是晚年变化的主要贡献者，以及（3）描述个体死亡的原型，多变量变化轨迹。最近和即将到来的创新变化的分析将被应用到多学科的15年纵向数据从已故的参与者的柏林老龄化研究（N = 430+; 70-103岁）。将开发新的分析工具来模拟多变量变化。这些工具和分析将允许更精确地描述个体如何随着时间的推移从一个多变量的人内功能特征发展到另一个多变量的人内功能特征（年龄，死亡距离，病理学），从而有助于澄清社会的哪些部分可能经历哪些类型的衰退。实证结果将揭示一些人如何以及为什么比其他人更成功地衰老（例如，老年人在死亡前经历的衰退较少），指出了越来越多的人能够在晚年保持充分和有尊严的生活的具体途径，并为设计和实施预防性干预措施提供了实用信息，重点是减轻老年衰退的社会和个人成本。公共卫生相关性：老年人生命的结束往往以功能和健康的代价高昂的恶化为特征-这似乎是不可避免的衰退，大大增加了医疗保健费用和社会负担。然而，关于晚年心理功能的哪些方面恶化，以什么顺序恶化，以及这种下降发生的速度，我们知之甚少。作为确定更多人能够维持充分和有尊严的生活的途径的第一步，拟议项目的主要目标是更好地了解晚年如何跨越感官，身体，认知，幸福和社会功能的结构和相互关联。这些知识将有助于制定有效的计划和政策，针对最有可能减轻晚年衰退的社会和个人成本的领域（例如，设计适当的保健或临终关怀）。

项目成果

Aging, Disablement, and Dying: Using Time-as-Process and Time-as-Resources Metrics to Chart Late-Life Change.

衰老、残疾和死亡：使用时间作为过程和时间作为资源指标来绘制晚年变化。

• DOI: 10.1080/15427600903578151
• 发表时间: 2010
• 期刊: Research in human development
• 影响因子: 2.4
• 作者: Ram,Nilam;Gerstorf,Denis;Fauth,Elizabeth;Zarit,Steven;Malmberg,Bo
• 通讯作者: Malmberg,Bo

Longitudinal associations of subjective memory with memory performance and depressive symptoms: between-person and within-person perspectives.

• DOI: 10.1037/a0037619
• 发表时间: 2014-12
• 期刊: PSYCHOLOGY AND AGING
• 影响因子: 3.7
• 作者: Hueluer, Gizem;Hertzog, Christopher;Pearman, Ann;Ram, Nilam;Gerstorf, Denis
• 通讯作者: Gerstorf, Denis

Methods for the Study of Development - Developing Methods: Introduction to a Special Issue of Research in Human Development.

发展研究方法 - 发展方法：人类发展研究特刊简介。

• DOI: 10.1080/15427600902911114
• 发表时间: 2009
• 期刊: Research in human development
• 影响因子: 2.4
• 作者: Ram,Nilam;Gerstorf,Denis
• 通讯作者: Gerstorf,Denis

Long-term antecedents and outcomes of perceived control.

• DOI: 10.1037/a0022890
• 发表时间: 2011-09
• 期刊: PSYCHOLOGY AND AGING
• 影响因子: 3.7
• 作者: Infurna, Frank J.;Gerstorf, Denis;Ram, Nilam;Schupp, Juergen;Wagner, Gert G.
• 通讯作者: Wagner, Gert G.

Maintaining Perceived Control with Unemployment Facilitates Future Adjustment.

• DOI: 10.1016/j.jvb.2016.01.006
• 发表时间: 2016-04-01
• 期刊: Journal of vocational behavior
• 影响因子: 11.1
• 作者: Infurna FJ;Gerstorf D;Ram N;Schupp J;Wagner GG;Heckhausen J
• 通讯作者: Heckhausen J