Biomedical subjects

M K Peek

Publications and source records attributed to M K Peek.

11 recordsLinked to original sources

PubMed2006

Acculturation and self-esteem among older Mexican Americans.

Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.

Acculturation↗

PubMed2006

Depression and mental health among older Mexican American spouses.

Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands' and wives' emotional states, but the association was not equal for couples. Husbands' depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being.

Aged↗

PubMed2001

Race differences in cognitive functioning among older adults.

OBJECTIVES: Explaining race differences in cognitive functioning in later life continues to challenge researchers. This study was an attempt to incorporate the clinical literature, emphasizing biological correlates of cognitive functioning, and the social research literature, emphasizing social inequalities and consequent health outcomes, in the examination of sources of race differences in cognitive functioning in older adults. METHODS: With data from Wave 1 of the Assets and Health Dynamics of the Oldest Old survey, the authors used structural equation models (LISREL 8.30) to estimate the direct effects of race on cognitive functioning and indirect effects through social and biological risk factors for the total sample (N = 5,955). RESULTS: Race had a direct association with cognitive functioning. Race also had indirect effects on cognitive functioning through social risk factors-education and health insurance. There did not appear to be indirect effects of race through biological risk factors. DISCUSSION: The direct and indirect effects of race through social risk factors attest to the importance of examining different ways through which race can influence cognitive functioning of older adults. This research also emphasizes the need for researchers to investigate more closely race differences in dimensions of cognitive functioning and cognitive functioning over time.

Black or African American↗

PubMed2001

Networks in later life: an examination of race differences in social support networks.

Although there has been considerable interest in the effects of social support networks on various health outcomes for older adults, there has been little research directed toward the predictors of networks. In this study, we examine race differences in the determinants of social support network characteristics (size, frequency of interaction with network members, proportion of kin, and amount of support received and given to network members) using data from an older community sample drawn from the North Carolina site of the Established Populations for Epidemiologic Studies of the Elderly (EPESE) focusing on adults sixty-five and older (n = 4124). This research focuses on the extent to which race differences in network dimensions are present and whether these variations can be attributed to varying social structural positions held by African Americans and Whites. The results indicate that several race differences persist even when controlling for social structural variables. The structural argument and future implications are discussed.

Black or African American↗

PubMed2000

Race and ethnic variation in the disablement process.

OBJECTIVES: This analysis examines ethnoracial group differences in the transition from health to disability. METHODS: Using data from the AHEAD study, the authors examine the relative influence of each stage in the disablement process in the evolution of ethnoracial group differences in basic and instrumental disability. RESULTS: Predisposing factors account for disability differences between Whites and other Latinos, whereas excess disability among African Americans stems from their higher level of cognitive limitation. The excess disability of Mexican Americans arises from their higher level of physical limitations. The data also reveal a larger impact of medical conditions and physical limitations on acquisition of disability among African Americans and Mexican Americans. This article demonstrates the importance of cognitive status in the disablement process, especially in ethnoracial group differences. DISCUSSION: The authors discuss the practical implications for health care delivery to non-White elders and the theoretical implications for understanding the complexities of disablement.

Activities of Daily Living↗

PubMed1999

Age differences in the effects of network composition on psychological distress.

The main goal of this research is to better understand age differences in the effects of social networks on mental health. Using a social network approach to revise the convoy of social support model (Kahn and Antonucci, 1980), we examine specifically how two aspects of social support networks (kin composition and convoy dimensions) influence psychological distress for older and younger samples (18-59 and 60+). We hypothesize that kin composition will influence distress in general but especially for the younger sample, while two competing hypotheses for the convoy of social support model are tested. Using data from a three-wave panel health study, structural equation models (LISREL 8.20) indicate that a greater proportion of kin in the perceived support network and the presence of family members in the inner circle of the convoy significantly reduce distress, primarily for the younger sample. Implications for the convoy model are discussed.

Adolescent↗

PubMed1999

Gender differences in the risk of developing disability among older adults with arthritis.

OBJECTIVES: Although older women are disabled from arthritis at higher rates than men, there is an inadequate understanding of the factors that place women at higher risks. The purpose of this research is to improve understanding of gender differences in the process of becoming disabled among older adults with arthritis. METHODS: Gender differences in risk factors associated with developing a disability during a 30-month period are examined among a sample of noninstitutionalized elders with arthritis (N = 749). RESULTS: Results from discrete time-hazard models indicate that sociodemographic factors account for gender differences in disability with activities of daily living (ADLs). However, for difficulties performing instrumental activities of daily living (IADLs), gender differences remain unexplained by variations in demographic and health factors. DISCUSSION: More descriptive and explanatory work needs to focus on gender differences in IADL disability; however, these findings suggest that the gendered nature of the IADL tasks influences gender differences in IADL disability.

Activities of Daily Living↗

PubMed1998

Are expectations for care related to the receipt of care? An analysis of parent care among disabled elders.

This investigation explores the relationship between the degree to which older parents expect assistance from their children and the actual amount of care they receive from their children. Combining the theories of reasoned action and intergenerational solidarity, we hypothesize that global expectations (social norms about receiving care) influence specific expectations (behavioral intentions to seek care), but that it is specific expectations that influence the amount of care received from children. Data were collected at three points over a 12-month period among a sample of impaired older parents (65+) who lived independently in community settings (n = 334). Using structural equation models, the results were consistent with the hypothesis. We conclude that the theory of reasoned action is a useful adjunct to the theory of intergenerational solidarity by proposing that parents adjust their global expectations to reflect the specific realities of the lives of their children.

Adult↗

PubMed1996

Stress in the life course: a life history approach.

This article examines the relationship between stress and distress in the life course, emphasizing the time elapsed between the event and measurement of psychological distress. Stressors are conceptualized as either distal or proximal based on how recently they occurred. Distal stressors are further classified as status changes or undesirable life changes. Using a life history calendar approach, we examine stressors occurring over a 15-year-period. We explore whether distal stressors affect current depressive symptomatology above and beyond the effect of more recent stressors and how these stressors vary in frequency and affect over 3 empirically defined age groups. While some events decrease in frequency over age, others occur consistently across age groups. Most important, distal stressors significantly impact current depressive symptomatology, independent of proximal stressors. Types of distal stressors affecting depression vary over age, indicating that the stage of life at which a stressor occurs is a significant determinant of the stressor's effect on depression.

Adult↗

PubMedDate not supplied

Structural equation modeling and rehabilitation research.

Structural equation modeling (SEM) has been used extensively in the social sciences in the recent past to model human behavior. SEM has been less used by other disciplines, including rehabilitation medicine. This article begins by providing an introduction to structural equation modeling through the discussion of the definition and basic concepts behind SEM using a conceptual model relevant to rehabilitation medicine that describes the pathway from health to disability (the Enabling-Disabling model). The next focus is on several potential pitfalls of which the researcher needs to be aware when using SEM. After this discussion, a hypothetical example is presented using structural equation modeling to evaluate the Enabling-Disabling model. The article concludes with a review of the advantages and disadvantages of using SEM for clinical and social science research. Throughout the article, references are provided for a more detailed examination of SEM.

Humans↗

PubMedDate not supplied

The association between emotional well-being and the incidence of stroke in older adults.

OBJECTIVE: Individuals with high levels of depressive symptoms have an increased risk of many illnesses, including stroke. Measures of depressive symptoms include questions about the presence of negative affect, such as sadness, as well as the absence of positive affect, such as happiness and optimism. We assessed whether positive or negative affect, or both, predicted risk of stroke. METHODS: Data were from a 6-year prospective cohort study of a population-based sample of 2478 older whites and blacks from five counties in North Carolina who reported no history of stroke at the baseline interview. Baseline, in-person interviews were conducted to gather information on sociodemographic, psychosocial, and health-related characteristics of subjects. Thereafter interviews were conducted annually for 6 years. RESULTS: Increasing scores on the modified version of the Center for Epidemiological Studies Depression Scale (CES-D) were significantly associated with stroke incidence for the overall sample (relative risk [RR] = 1.04 for each one-point increase, 95% confidence interval [CI] = 1.01-1.09) over the 6-year follow-up period after adjusting for sociodemographic characteristics, blood pressure, body mass index, smoking status, and selected chronic diseases. Positive affect score demonstrated a strong inverse association with stroke incidence (RR = 0.74, 95% CI = 0.62-0.88). CONCLUSIONS: Increasing scores on the modified CES-D are related to an increased risk of stroke, whereas high levels of positive affect seem to protect against stroke in older adults.

Affect↗