Biomedical subjects

Amy Horowitz

Publications and source records attributed to Amy Horowitz.

8 recordsLinked to original sources

PubMed2006

Perceived overprotection: support gone bad?

OBJECTIVE: This article focuses on the effects of perceived overprotection, a potentially problematic aspect of receiving support, on the ability to adjust to a chronic impairment, specifically, age-related vision loss. Perceived overprotection is an especially critical issue in this population of chronically ill older adults because of the safety issues associated with vision impairment and because perceptions on the part of the older adult that the support providers are overprotective may lead to excess disability. METHODS: Participants were 584 older men and women with age-related vision impairment who applied for services at a vision rehabilitation agency. Path analysis was used to examine the effects of perceived overprotection on two positive indicators of adjustment: vision-specific adaptation and environmental mastery. Moreover, antecedents of perceived overprotection were examined. RESULT: Higher levels of perceived overprotection were associated with less optimal adjustment to age-related vision loss, with lower scores on measures of vision-specific adaptation and environmental mastery. Higher levels of functional disability and instrumental support received were associated with higher levels of perceived overprotection. DISCUSSION: Findings indicate that support providers of older adults with visual impairment as well as vision rehabilitation service providers need to be aware of the detrimental impact of perceived overprotection.

Adaptation, Psychological↗

PubMed2006

The impact of assistive device use on disability and depression among older adults with age-related vision impairments.

OBJECTIVE: One can conceptualize adaptive technology as a resource used by disabled older adults in order to maintain competence in everyday life. This study examined the independent relationships between optical and adaptive device utilization and change in functional disability and depression among older adults with age-related vision impairments. METHODS: We interviewed older adults (n = 438) with a recent vision impairment applying for vision rehabilitation services both pre-service and at the 6-month follow-up. We conducted hierarchical regression analyses with functional disability and depressive symptoms as criteria. In order to identify their independent direct effects, we entered optical and adaptive device use into the final step, preceded by Time 1 criterion scores, demographics, baseline disability or depression (depending on criterion), and total rehabilitation service hours. RESULT: Optical, but not adaptive, device use was significantly associated with declines in functional disability and depressive symptoms over time. DISCUSSION: We propose that these differential effects result from the fact that optical devices optimize residual vision and thus allow for greater continuity in the way tasks are accomplished (i.e., reading still performed visually), whereas use of adaptive aids (e.g., talking books) involves learning new methods in order to compensate for lost functions and thus is not as desirable either functionally or psychologically.

Activities of Daily Living↗

PubMed2006

The effect of rehabilitation service use on coping patterns over time among older adults with age-related vision loss.

OBJECTIVE: To enhance our understanding of coping and rehabilitation in the context of adaptation to disability by examining how coping may change over a two-year time period, and how different vision rehabilitation services may affect coping over time. DESIGN: Longitudinal two-wave study (baseline and two-year follow-up). SETTING: Vision rehabilitation agency. SUBJECTS: Older adults with visual impairment. METHOD: In-person interviews using structured assessments of functional vision loss and functional disability, rehabilitation service use and coping strategies. RESULTS: Ninety-five people participated in both study waves. Findings showed change in patterns of coping over the two-year period of the study, as participants adjusted to living with age-related vision loss. Although instrumental coping was the only coping mode with evidence for average change (a decrease), affective and escape/distraction strategies showed individual variation in change over time. Rehabilitation use explained variance in coping at time 2 over and above impairment status and coping at time 1. Those who used a greater number of assistive aids between time points were likely to report more instrumental coping at time 2, and those who used counselling between time points were likely to report more affective coping at the two-year follow-up. Finally, those who used more optical aids were likely to report more escape/distraction coping at time 2, whereas those who saw a low vision specialist tended to report less of this type of coping over time. CONCLUSIONS: Findings suggest that rehabilitation interventions can affect coping patterns over time, and that direction and magnitude of such an effect may depend on the type of rehabilitation received.

Adaptation, Psychological↗

PubMed2005

Dual sensory loss and its impact on everyday competence.

PURPOSE: This study examined the relation of dual and single sensory impairments, within the context of cognitive function, by using the framework of everyday competence in terms of the probability of difficulty with specific personal and instrumental activities of daily living (ADLs and IADLs, respectively). DESIGN AND METHODS: The Longitudinal Study on Aging, composed of individuals aged 70 and older in 1984 (N = 5,151), provided data for the present analyses. In each IADL and ADL domain, binary logistic regressions assessed the probability of difficulty associated with sensory impairment and cognitive status after sociodemographic and physical health covariates were controlled for. RESULTS: One fifth of older adults reported dual sensory impairment, which was associated with greater IADL than ADL task difficulty compared with single sensory loss. Further, high levels of dual impairment were shown to increase the risk of difficulty in three of six IADL tasks (preparing meals, shopping, and using the telephone) over vision impairment alone. Overall, cognitive status was a significant predictor of both ADL and IADL difficulties, which was not expected from the everyday competence framework. IMPLICATIONS: Findings highlight the importance of sensory resources for everyday competence and suggest the need for effective vision and hearing rehabilitation to assist older adults in improving or maintaining their functional independence.

Activities of Daily Living↗

PubMed2005

Major and subthreshold depression among older adults seeking vision rehabilitation services.

OBJECTIVE: Authors examined the potential risk factors of major and subthreshold depression among elderly persons seeking rehabilitation for age-related vision impairment. METHODS: Participants (N=584), age 65 and older, with a recent vision loss, were new applicants for rehabilitation services. Subthreshold depression was defined as a depressive syndrome not meeting criteria for a current major depression (i.e., minor depression, major depression in partial remission, dysthymia) or significant depressive symptomatology. RESULTS: Seven percent of respondents had a current major depression, and 26.9% met the criteria for a subthreshold depression. Poorer self-rated health, lower perceived adequacy of social support, decreased feelings of self-efficacy, and a past history of depression increased the odds of both a subthreshold and major depression, versus no depression, but greater functional disability and experiencing a negative life event were significant only for a subthreshold depression. Only a history of past depression was significant in increasing the odds of having a major versus a subthreshold depression. CONCLUSION: Results highlight similarities in characteristics of, and risk factors for, subthreshold and major depression. Future research is needed to better understand both the trajectory and treatment of subthreshold depression, relative to major depressive disorders.

Age Factors↗

PubMed2004

Positive aspects of caregiving and adaptation to bereavement.

This study examined how positive aspects of caregiving affect adaptation to bereavement among older adults who cared for a family member with dementia. The sample consisted of 217 caregivers who were part of the Resources for Enhancing Alzheimer's Caregiver Health Study. Using pre- and postloss data, hierarchical regressions were carried out to examine the effects of positive aspects of caregiving (caregiving benefit) on postloss depression and grief. Findings show that preloss caregiving benefit was associated with higher levels of postloss depression and grief, even after controlling for caregiver demographic characteristics, contextual factors, and caregiving burden. This effect was particularly strong for the relation between benefit and grief. Results demonstrate the importance of studying both positive and negative aspects of caregiving and their relation to bereavement outcomes.

Adaptation, Psychological↗

PubMed2004

Stability and change in social negativity in later life: reducing received while maintaining initiated negativity.

OBJECTIVE: This article examines stability and change in social negativity and the links between social negativity and instrumental support over time among disabled older adults. The analyses focused on family relationships because social negativity tends to be more prevalent in family compared with nonkin relationships. Social negativity received and initiated are each addressed separately to determine whether or not they show similar patterns and links to instrumental support over time. METHODS: Latent growth curve methodology was used to examine change over time in social negativity and instrumental family support in relation to age, gender, and family network size at baseline. Participants, 570 older adults with chronic visual impairment, were interviewed three times over an 18-month period. RESULTS: Social negativity received showed a decrease over time, whereas levels of social negativity initiated remained more stable. Links with instrumental support were positive but stronger for received compared with initiated social negativity. DISCUSSION: The differential pattern of stability and change over time in received versus initiated social negativity and their links to instrumental support suggest different origins for the initiation versus receipt of social negativity.

Affect↗

PubMed2004

Congruence between disabled elders and their primary caregivers.

PURPOSE: This study examines the extent and independent correlates of congruence between disabled elders and their caregivers on several aspects of the caregiving experience. DESIGN AND METHODS: Participants were 117 visually impaired elders and their caregivers. Correlational analyses, kappa statistics, and paired t tests were used to examine the extent of congruence. Hierarchical multiple regression analyses identified significant correlates of congruence on four target issues: elder's functional disability, elder's adaptation to vision impairment, caregiver's overprotectiveness, and caregiver's understanding of the vision problem. RESULTS: Caregivers assessed elders as more disabled and rated themselves as more overprotective than did the elders. Although independent correlates varied by target issue, two domains most consistently influenced congruence across measures: the caregiver's assessment of the elder's status and quality of the relationship. IMPLICATIONS: Findings underscore the importance of addressing congruence by target issue, rather than as a global characteristic of the caregiving relationship.

Aged↗