Source: OKLAHOMA STATE UNIVERSITY submitted to NRP
UNLOCKING THE SECRET TO OPTIMAL HEALTH STATUS: THE OKLAHOMA CENTENARIAN PROJECT
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0215786
Grant No.
(N/A)
Cumulative Award Amt.
(N/A)
Proposal No.
(N/A)
Multistate No.
(N/A)
Project Start Date
Aug 1, 2008
Project End Date
Sep 30, 2010
Grant Year
(N/A)
Program Code
[(N/A)]- (N/A)
Recipient Organization
OKLAHOMA STATE UNIVERSITY
(N/A)
STILLWATER,OK 74078
Performing Department
Human Sciences
Non Technical Summary
An unprecedented number of extremely old persons will experience nutritional risk, frailty, disease, and death in the coming decades. Many of these individuals have learned to live with two or more chronic health impairments, whereas others will have experienced relatively no change in health status. Another substantial proportion will have managed to delay age-associated health problems well into their nineties. Unlike most persons born after them, centenarians have endured more personal trauma as well as lived through a greater number of adverse socio-historical events (e.g., Influenza epidemic of 1918, Great Depression, World War II, Cold War, 911). Those who have encountered multiple traumatic episodes in childhood, adolescence, or young-adulthood find it especially difficult to manage and control personal and socioeconomic resources used to sustain optimal health functioning. Yet, the association between traumatic life events and health status in extreme old age remains unclear. Purpose of the project is to examine the extent to which psychosocial resources influence the association between past traumatic experiences and current health status among centenarians.
Animal Health Component
45%
Research Effort Categories
Basic
45%
Applied
45%
Developmental
10%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7246010307010%
7246010308010%
7246099307010%
7246099308010%
7246199307010%
7246199308010%
8026010307010%
8026099308010%
8026010308010%
8026199307010%
Goals / Objectives
This investigation will be used to answer three key questions of interest including: 1.) What sex differences exist among centenarians relative to the number of traumatic experiences, degree of psychological, social, and economic resources, and health status outcomes 2.) What are key psychological, social, and economic predictors of health status outcomes in extreme old age 3.) Do psychological, social, and economic provisions exacerbate or diminish the influence of past traumatic life experiences on health status in extreme old age To answer these questions, the following objectives have been proposed: Objective 1: To examine gender differences in psychosocial resources and health status Objective 2: To identify key predictors of health status Objective 3: To assess pathways by which psychosocial resources mediate the influence of traumatic life events on health status
Project Methods
This investigation will include a cross-sectional one-way two-factor (men and women) quantitative design using a convenience sample of 150 participants, age 100 and older. Participation will consist of a two separate one hour face-to-face interview sessions. The first session will include cognitive screening procedures, socio-demographic information, and the assessment of traumatic life events and health status. The second session will involve assessment personality, social support, and economic security. Participants will be required to be cognitively intact and community-dwelling residents who live independently within their own homes, retirement centers, or formal care settings. All participants will be screened using the Short-Portable Mini-Mental Status Exam (SPMSQ, Pfeiffer, 1979). This is a brief 10-item interview that tests short- and long- term recall of information. This instrument will be used to identify persons who have no cognitive impairment, as well as persons challenged by mild, moderate, or severe cognitive problems. Specific answers or comments to questions will be rated as correct or incorrect based on immediate response or non-response. Any item which participants fail to correctly respond after three attempts will be recorded as incorrect. A normative score of 0-2 errors on the SPMSQ is indicative of no cognitive problems. A total of 3-4 errors reflects mild cognitive deficit. In addition, a score of 5-7 errors represents moderate cognitive problems, whereas 8 or more questions answered incorrectly is suggestive of severe cognitive impairment. The SPMSQ is also adjusted by education. Persons with a grade school education or less are generally allowed one additional error, whereas one less error is allowed for persons who possess a high school education or higher. Participants who answer 5 or more SPMSQ questions incorrectly will be considered cognitively frail. These individuals will not be interviewed. Instead, a proxy informant (e.g., family or non-kin caregiver) will complete a 5-10 minute assessment. Informants will first be asked to provide socio-demographic information pertaining to the person of interest (e.g., age, sex, race, education, marital status). The informant will also be asked to provide a global rating of five different domains which reflect the individual's degree of impairment in available social, economic, physical, functional, and mental resources. Informant information will be used to identify and compare demographic and resource characteristics of cognitively frail centenarians. Collaborative efforts will be made with the Centenarian Clubs of Oklahoma, located in Oklahoma City and Tulsa, to identify and recruit sample participants. In addition, Oklahoma State University Cooperative Extension Service agents and educators will be contacted to help identify and recruit centenarians living in non-metropolitan settings. Finally, aging network services including senior nutrition site programs, area agencies on aging, Oklahoma Department of Aging Services-Aging Division, and geriatric health professionals from the Oklahoma State University Health Sciences Center will also be consulted.

Progress 08/01/08 to 09/30/10

Outputs
(N/A)

Impacts
The purpose of this investigation was to produce a change of knowledge. Three main objectives were pursued: (a) examination of gender differences in psychosocial resources and health status outcomes; (b) identification of key predictors of health status outcomes; (c) assessment of pathways by which psychosocial resources influence the association between traumatic life events and health status outcomes. Relative to gender differences, three relevant findings emerged. First, centenarian men reported a significant greater average number of traumatic events compared to their female counterparts. In particular, men reported an average of 2.60 traumatic events, whereas women reported experiencing 1.88 traumatic events on average. In addition, centenarian women reported a higher average score indicative of neuroticism (e.g., anxiety, emotional instability) than their male counterparts (M = 25.60 vs. M = 22.02). Finally, centenarian men reported a greater average score relative to functional health capacity than centenarian women (M = 32.60 vs. M = 30.75). As a result, centenarian men report a greater average number of traumatic experiences, yet maintain greater emotional stability and better functional health capacity on average than centenarian women. Identification of psychosocial predictors (e.g., traumatic events, personality traits, perceived economic security, and social support) of health status outcomes (e.g., self-reported number of health conditions, functional health capacity, and nutritional risk) was also considered. Traumatic life events and neuroticism emerged as key predictors of self-reported health conditions. In other words, greater cumulative number of traumatic experiences (Beta = .19, p < .05) and greater neuroticism (Beta = .29, p < .01) were associated with greater number of self-reported health conditions among centenarians. In addition, neuroticism, conscientiousness, and perceived economic security were significant predictors of functional health capacity. In particular, it appears that greater neuroticism decreases functional health capacity (Beta = -.19, p < .05), whereas greater conscientiousness (Beta= .20, p < .05) and positive perceptions of economic security (Beta = .18, p < .05) increase functional health capacity among centenarians. No significant evidence emerged relative to the nutritional risk outcome. Examination of pathways in the association between traumatic life events and health status outcomes was given final consideration. Results from this project indicate that personality traits may lessen the noxious impact of traumatic life events on functional health capacity. In particular, it appears that greater degree of agreeableness (Beta = -.18, p < .05) and conscientiousness (Beta = -.17, p < .05) diminish the negative influence of traumatic life events on functional health capacity. In other words, centenarians who tend to be more agreeable and conscientious may be protected from the deleterious influence of traumatic life experiences.

Publications

  • No publications reported this period


Progress 10/01/08 to 09/30/09

Outputs
OUTPUTS: The following activities have been completed relative to the project: N = 94 interviews completed; N = 25 proxy surveys completed; N = 24 awaiting interview scheduling in Tulsa area; N = 5 awaiting scheduling in Oklahoma City Metro area; and N = 3 awaiting scheduling in Enid, OK/Garfield County. The following events occurred relative to the project: Conducted three-day interview training session with new graduate research assistant hired to work on project for 2009-2010 academic year. Hired summer undergraduate research assistant for data collection and data entry and conducted three-day interview training. Attended the July 2009 Centenarian Celebration hosted by NEATS (Northeast Active Timers) in Tulsa, Oklahoma. Services - No action taken at this time. Products - No action taken at this time. Dissemination: The following actions were taken in disseminating the project: Sent mailing and announcement of project to community retirement centers, assisted-living facilities, and long-term care facilities located in the Oklahoma City and surrounding area. January 30, 2009, Presentation at Annual FCS and 4-H Statewide In-service. June 13, 2009, Workshop Presentation at Calibrating Your Compass: Positive Aging in the Second Half of Life, First Presbyterian Church, Stillwater, Oklahoma. November 10, 2009, Presentation at Calibrating Your Compass (Wisdom and Saging membership group), Stillwater Public Library, Stillwater, OK. PARTICIPANTS: The following persons participated in the project: Alex Bishop, Ph.D., Assistant Professor, Human Development and Family Science, served as principal investigator. Dr. Bishop completed tasks associated with contacting and forming potential collaborators including Oklahoma State University Extension Services, communicating and announcing the study via local and state aging agencies and extension educators, establishing a press release for use by extension services, sample identification and recruitment, and scheduling and conducting on-site oral research interviews. Rebekah Campbell, graduate research assistant contributed to the project by mailing study announcements to Oklahoma City area retirement communities, assisted living homes, and long-term care facilities; phoning and contacting identified centenarians residing in the Oklahoma City metropolitan area; scheduling and completing on-site interviews with study participants, creating DVD interview tapes, revising and editing data codebook, updating participant identifier list; constructing dataset in SPSS 17.0; and coding and entering data. Katie Southard, summer undergraduate research assistant, contributed to the project by engaging in 3 hour training session, assisting with on-site interviews and data collection, organizing data files, and creating DVD interview tapes. Partner Organizations - No action taken at this time. Collaborators and contacts - The following collaborations and contacts have been established relative to consultation and/or sample identification and recruitment for the project: Rev. Richard Ziglar, Director of the NEATS program, Tulsa, Oklahoma. Rev. Ziglar also oversees an Adopt-A-Centenarian program which serves Tulsa and surrounding communities in Northeast Oklahoma. Richard Armend, Director -St. Ann's Retirement Community, Oklahoma City, OK. Pam Cullen, Director of the Centenarian Club of Oklahoma City. Activity and Social Service Directors in assisted living and long-term care facilities. Residential Coordinators within senior retirement communities. Oklahoma Cooperative Extensions Service Educators. Dr. Linda Burks, Ph.D., and Dr. Pat Darlington, Ph.D. - Co-Founders of Calibrating Your Compass, Stillwater, OK. Training and professional development - No action taken at this time. TARGET AUDIENCES: The target audience served through recent recruitment and sampling efforts of the project included: Centenarians (persons 100 years of age and older); Family care providers and guardians of centenarians Old and very old adults residing in urban and rural population centers throughout Oklahoma; Retirement, assisted-living and long-term care centers and facilities within Oklahoma; Centenarians representing racial and ethnic minority groups; Community care providers including psychologists, licensed practicing counselors, nurses, physicians, and other geriatric professionals (e.g., CNA, activity directors, etc.). Efforts - No action taken at this time. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
No noteworthy outcomes/impacts at this time

Publications

  • No publications reported this period


Progress 10/01/07 to 09/30/08

Outputs
OUTPUTS: The following activities have been completed relative to the project: N = 48 centenarians identified in Tulsa and surrounding area for sample recruitment, N = 2 interviews completed and N = 7 interviews confirmed and scheduled for December. The following actions were taken in disseminating the project: Made public announcement of study and implications at October meeting of NEATS (Northeast Active Timers) in Tulsa. Made public announcement at Stillwater Project Heart Nutrition Site in Stillwater, Oklahoma. Posted announcement and met with administrative representative from four assisted-living/senior care facilities in Stillwater, Oklahoma, and three facilities in Cushing, Oklahoma. Sent e-mail announcement of study to all directors representing Area Agencies on Aging in Oklahoma. Study announcement and press release placed within Oklahoma State University Extension newsletter. Study announcement and press release placed on Oklahoma State University Division of Agriculture Sciences and Natural Resources website. Study announcement placed and press release placed on Oklahoma State University daily e-communication headlines. PARTICIPANTS: The following persons participated in the project: Alex Bishop, Ph.D., Assistant Professor, Human Development and Family Science, server as principal investigator. Dr. Bishop completed tasks associated with contacting and forming potential collaborators including Oklahoma State University Extension Services, communicating and announcing the study via local and state aging agencies and extension educators, establishing a press release for use by extension services, sample identification and recruitment, and scheduling and conducting on-site oral research interviews. Jessica Brophy, graduate research assistant contributed to the project by publically announcing the study at local Senior Nutrition Sites (e.g., Stillwater, Oklahoma and Cushing, Oklahoma), posting study announcements/flyers within various venues (e.g., senior activity centers, nutrition sites) frequented by older adults, devising a data codebook, and establishing a participant identifier list for purposes of accessing contact information of potential sample participants. Partner Organizations: No action taken at this time. Collaborators and contacts: The following collaborations and contacts have been established relative to consultation and/or sample identification and recruitment for the project: Rev. Richard Ziglar, Director of the NEATS program, Tulsa, Oklahoma. Rev. Ziglar also oversees an Adopt-A-Centenarian program which serves Tulsa and surrounding communities in Northeast Oklahoma. Pam Cullen, Director of the Centenarian Club of Oklahoma City. Lance Robertson, Director of the Oklahoma Division of Aging Services Dr. Glenn Muske, Ph.D., Interim Associate Dean of Oklahoma Cooperative Extension Services, Family and Consumer Sciences Oklahoma Cooperative Extensions Service Educators. Training and professional development: No action taken at this time. TARGET AUDIENCES: The target audience served through recent recruitment and sampling efforts of the project included: Centenarians (persons 100 years of age and older); Family care providers of centenarians; Old and very old adults residing in urban and rural population centers in Oklahoma; and Centenarians representing racial and ethnic minority groups. PROJECT MODIFICATIONS: The following represent problems or potential delays and may demand some changes within the recruitment protocol. The state of Oklahoma does not have a systematic or centralized database or mechanism by which to readily identify persons 100 years and older. The Centenarian Club in Oklahoma City has recently experienced financial difficulty and has relatively disbanded operations. This has delayed identification of centenarians living in and around the Oklahoma City. The HIPPA Privacy Act has presented some difficulty relative to identifying centenarians residing in assisted-living and long-term care facilities. We are awaiting approval from human subjects (IRB) for a recent modification which will involve sending an introductory letter to care facilities across the state and using a follow-up phone call for purposes of recruiting more participants. After a pilot test of the interview protocol, several minor changes were made and human subjects approval (IRB) was needed

Impacts
No noteworthy outcomes/impacts at this time

Publications

  • No publications reported this period