Daniela S. Jopp

Malnutrition is a major global challenge with both short‐ and long‐term health impacts. Studies of historical famines have provided evidence of an association between famine exposure and risk of non‐communicable diseases (NCDs) in later life. However, whether famine exposure has heterogeneous effects on different later‐life NCDs remains unclear. In this study, we investigated whether the effects of exposure to the Chinese Famine of 1959–1961 on later‐life NCDs were disease‐specific, age‐specific, and sex‐specific. We conducted a secondary analysis of data from a large‐scale, nationally representative panel study, i.e., the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020, N = 11,047 adults aged 45 years and older). We measured famine exposure using self‐reported famine experience, life stage using age at famine exposure, and NCDs using 14 chronic conditions. Three main findings emerged. First, the effects of famine exposure for developing NCDs in later life were disease‐specific, with 20%–29% higher odds of digestive disease, memory‐related disease, arthritis, kidney disease and dyslipidemia, versus 10% higher odds of heart disease and diabetes. Second, the effects of famine exposure were age‐specific, with exposure in utero or at ages 0–2 years having the largest impacts on 8 of the 14 later‐life conditions (diabetes, stroke, lung disease, liver disease, digestive disease, cancer, kidney disease, and arthritis), whereas exposure at ages 3–5 years having the largest impact on psychiatric disease and memory‐related disease in later life. Conversely, famine exposure during adulthood was associated with lower odds of various NCDs. This divergence reflects a balance of competing forces: for individuals exposed prior to adulthood, severe developmental damage overshadows the healthy survivor effect, increasing later‐life NCD risk; for individuals exposed during adulthood, completed physiological development minimized programming damage, allowing the healthy survivor effect to dominate. Third, the famine effects were sex‐specific for later‐life cardiometabolic diseases (dyslipidemia, heart disease and stroke), with famine exposure having larger impacts on women than men, pointing to the survivor advantage among men. Future studies should investigate underlying biological mechanisms, intergenerational pathways of transmission, and long‐term growth and body composition in survivors.

Family and professional care providers are essential to allow individuals to remain at home until very old age. However, limited research is available that distinguishes among the multiple domains in which community-dwelling older adults need support. This paper aims to analyse the interplay of health and age in shaping the probability of receiving specific types of care. Analysis is based on a subsample of people aged 65 and older who participated in the Swiss Vivre/Leben/Vivere survey ( N = 2916). We ran a series of logistic regression models to analyze the association of health status (i.e., independent, frail, dependent) and age with types of help (i.e., help with household tasks, help with daily life activities, other instrumental help, non-instrumental help), controlling for sociodemographic characteristics and social contacts. Then, we focused on how the effect of health on the probability of receiving help varies by age. Findings show that health, particularly frailty, strongly explains home care receipt. However, its effect changes with age, depending on the nature of care and provider (i.e., formal vs. informal). For instance, health status varies among older individuals receiving formal help with daily life activities, compared to what happen among younger ones. Furthermore, when this help comes from family, the impact of health is larger among younger than among older. Looking at the interplay between health and age helps to better understand the dynamics behind the receipt of home care among older adults. Research in this area will gain more clarity by distinguishing between the different areas and providers of care.

Introduction: This study examined leisure activity engagement among (near-)centenarians and its association with two aspects of well-being: life satisfaction and purpose in life. We analyzed specific activity types and their combinations, as well as three activity parameters: the total number of activities, the variety of different higher-order activity types, and the distribution of activities across these types (i.e., activity diversity). Methods: We pooled data from two comparable studies conducted in the USA and Germany, yielding a final sample of N = 134 participants aged 96–107 years. Activity engagement was assessed using open-ended questions, with responses coded into 12 activity types further used to compute the activity parameters. Results: Centenarians' common activities included watching TV, social activities, and experiential activities (e.g., reading). The assessed general activity parameters – number, variety, and diversity of activities – were not related to well-being. Life satisfaction correlated positively with physical and experiential activities and negatively with developmental activities (e.g., visiting a museum). Purpose in life was positively linked to experiential activities. Specific engagement patterns of these activity types, rather than overall activity levels, best predicted well-being outcomes. Conclusion: Our results contrast prior findings from younger-old samples, suggesting that the relevance of activity types for well-being may shift in very late life. This supports theories emphasizing emotionally meaningful and less demanding activities as more beneficial with increasing age. Findings underline the need for interventions that enable personally relevant forms of engagement to support life satisfaction and purpose in the oldest olds.

Although the relationship between personality and quality of life has been extensively studied, openness has received relatively little attention. This is despite its importance in the Big Five model and its ability to change over time. To close this gap, our study explored the link between openness and quality of life. Additionally, we examined whether this relationship is influenced by Dimensions of Openness to Emotion (DOE) and self-efficacy, as research suggests both may play significant roles in the personality–quality of life relationship. A total of 419 participants in a community-based convenience sample of the French-speaking regions of Switzerland and of France aged 20–66 years completed the NEO-FFI-R inventory, the General Self-Efficacy Scale, the Dimensions of Openness to Emotion scale, and the WHOQOL-12 measuring quality of life. GAMs, Network and Mediation analysis were conducted with R software. Our analysis suggested that the different facets of DOE relate to quality of life in two contrasting ways, with openness influencing it both positively and negatively, depending on the specific facet: the somatic dimensions of DOE had a negative association, while the cognitive dimensions of DOE had a positive one. Openness contributes to quality of life, especially for individuals who are moderately open to their bodily sensations and who use thoughtful and context-adjusted emotion regulation strategies.

Background: The number of centenarians worldwide is expected to increase dramatically, reaching 3.4 million by 2050 and >25 million by 2100. Despite these projections, depression remains a prevalent yet underdiagnosed and undertreated condition among this population that carries significant health risks. Objective: This study aimed to identify and achieve consensus on the most representative signs and symptoms of depression in near-centenarians and centenarians (aged ≥95 years) through an e-Delphi study with an international and interdisciplinary panel of experts. Ultimately, the outcomes of this study might help create a screening instrument that is specifically designed for this unique population. Methods: A modified e-Delphi study was carried out to achieve expert consensus on depressive symptoms in near-centenarians and centenarians. A panel of 28 international experts was recruited. Consensus was defined as 70% agreement on the relevance of each item. Data were collected through a web-based questionnaire over 3 rounds. Experts rated 104 items that were divided into 24 dimensions and 80 criteria to identify the most representative signs and symptoms of depression in this age group. Results: The panel consisted of experts from various countries, including physicians with experience in old age psychiatry or geriatrics as well as nurses and psychologists. The response rate remained consistent over the rounds (20/28, 71% to 21/28, 75%). In total, 4 new dimensions and 8 new criteria were proposed by the experts, and consensus was reached on 86% (24/28) of the dimensions and 80% (70/88) of the criteria. The most consensual potentially relevant dimensions were lack of hope (21/21, 100%), loss of interest (27/28, 96%), lack of reactivity to pleasant events (27/28, 96%), depressed mood (26/28, 93%), and previous episodes of depression or diagnosed depression (19/21, 90%). In addition, the most consensual potentially relevant criteria were despondency, gloom, and despair (25/25, 100%); depressed (27/27, 100%); lack of reactivity to pleasant events or circumstances (28/28, 100%); suicidal ideation (28/28, 100%); suicide attempt(s) (28/28, 100%); ruminations (27/28, 96%); recurrent thoughts of death or suicide (27/28, 96%); feelings of worthlessness (25/26, 96%); critical life events (20/21, 95%); anhedonia (20/21, 95%); loss of interest in activities (26/28, 93%); loss of pleasure in activities (26/28, 93%); and sadness (24/26, 92%). Moreover, when assessing depression in very old age, the duration, number, frequency, and severity of signs and symptoms should also be considered, as evidenced by the high expert agreement. Conclusions: The classification of most elements as relevant highlights the importance of a multidimensional approach for optimal depression screening among individuals of very old age. This study offers a first step toward improving depression assessment in near-centenarians and centenarians. The development of a more adapted screening tool could improve early detection and intervention, enhancing the quality of mental health care for this population.

Background: In recent years, there has been a growing interest in the investigation of very old individuals. However, various challenges arise when collecting data from this age group. Given potential health and cognitive impairments and the difficulty of retrieving accurate self-reported data, involving individuals knowledgeable of the target person as proxy respondents are an invaluable solution. The primary goal of this study is to explore the association between proxy-centenarian relationship and item nonresponse, a pivotal data quality measure. Data and methods: We used data from the phone study conducted within SWISS100, a study on centenarians in Switzerland, focusing on a subsample of 94 centenarians and 75 proxy respondents. We compared characteristics of centenarians who provided self-reports with those interviewed through proxy respondents using descriptive analyses, and Firth’s regression models to investigate the association of different types of proxies (children, other relatives, and non-relatives) with item nonresponse. Results: We noted differences between centenarians participating themselves in interviews and those represented by proxies, observing higher proportions of men and private home residents in the self-report group. There was a low prevalence of item nonresponse among proxy respondents. Proxy type significantly impacted item nonresponse, particularly with non-relatives showing notably higher unanswered question rates. A robust association between non-relatives as proxies and increased item nonresponse persisted even when controlling for potential confounding factors. Discussion and conclusions: This study enhances the understanding of data quality, particularly item nonresponse, and highlights the impact of the proxy-centenarian relationship when studying the oldest-old. The findings stress the importance of carefully choosing proxy respondents, preferably children, to improve data quality and inclusivity for those individuals hard to reach or to interview. Future research should investigate various data quality indicators and rely on larger samples to enhance the representation and methodological rigour in the study of the oldest-old.

BACKGROUND The number of centenarians worldwide is expected to increase dramatically, reaching 3.4 million by 2050 and >25 million by 2100. Despite these projections, depression remains a prevalent yet underdiagnosed and undertreated condition among this population that carries significant health risks. OBJECTIVE This study aimed to identify and achieve consensus on the most representative signs and symptoms of depression in near-centenarians and centenarians (aged ≥95 years) through an e-Delphi study with an international and interdisciplinary panel of experts. Ultimately, the outcomes of this study might help create a screening instrument that is specifically designed for this unique population. METHODS A modified e-Delphi study was carried out to achieve expert consensus on depressive symptoms in near-centenarians and centenarians. A panel of 28 international experts was recruited. Consensus was defined as 70% agreement on the relevance of each item. Data were collected through a web-based questionnaire over 3 rounds. Experts rated 104 items that were divided into 24 dimensions and 80 criteria to identify the most representative signs and symptoms of depression in this age group. RESULTS The panel consisted of experts from various countries, including physicians with experience in old age psychiatry or geriatrics as well as nurses and psychologists. The response rate remained consistent over the rounds (20/28, 71% to 21/28, 75%). In total, 4 new dimensions and 8 new criteria were proposed by the experts, and consensus was reached on 86% (24/28) of the dimensions and 80% (70/88) of the criteria. The most consensual potentially relevant dimensions were lack of hope (21/21, 100%), loss of interest (27/28, 96%), lack of reactivity to pleasant events (27/28, 96%), depressed mood (26/28, 93%), and previous episodes of depression or diagnosed depression (19/21, 90%). In addition, the most consensual potentially relevant criteria were despondency, gloom, and despair (25/25, 100%); depressed (27/27, 100%); lack of reactivity to pleasant events or circumstances (28/28, 100%); suicidal ideation (28/28, 100%); suicide attempt(s) (28/28, 100%); ruminations (27/28, 96%); recurrent thoughts of death or suicide (27/28, 96%); feelings of worthlessness (25/26, 96%); critical life events (20/21, 95%); anhedonia (20/21, 95%); loss of interest in activities (26/28, 93%); loss of pleasure in activities (26/28, 93%); and sadness (24/26, 92%). Moreover, when assessing depression in very old age, the duration, number, frequency, and severity of signs and symptoms should also be considered, as evidenced by the high expert agreement. CONCLUSIONS The classification of most elements as relevant highlights the importance of a multidimensional approach for optimal depression screening among individuals of very old age. This study offers a first step toward improving depression assessment in near-centenarians and centenarians. The development of a more adapted screening tool could improve early detection and intervention, enhancing the quality of mental health care for this population.

Background: Internet use has dramatically increased worldwide, with over two-thirds of the world’s population using it, including the older adult population. Technical resources such as internet use have been shown to influence psychological processes such as stress positively. Following the Conservation of Resources theory by Hobfoll, stress experience largely depends on individuals’ personal resources and the changes in these resources. While personal resource loss has been shown to lead to stress, we know little regarding the role that technical resources may play on the relationship between personal resources and stress. Objective: This study aims to investigate the moderating effect of technical resources (internet use) on the relationship between personal resources and stress in younger and older adults. Methods: A total of 275 younger adults (aged 18 to 30 years) and 224 older adults (aged ≥65 years) indicated their levels of stress; change in personal resources (ie, cognitive, social, and self-efficacy resource loss and gain); and internet use. Variance analyses, multiple regression, and moderation analyses were performed to investigate the correlates of stress. Results: Results showed that older adults, despite experiencing higher levels of resource loss (questionnaire scores: 1.82 vs 1.54; P<.001) and less resource gain (questionnaire scores: 1.82 vs 2.31; P<.001), were less stressed than younger adults (questionnaire scores: 1.99 vs 2.47; P<.001). We observed that the relationship among resource loss, resource gain, and stress in older adults was moderated by their level of internet use (β=.09; P=.05). Specifically, older adults who used the internet more frequently were less stressed when they experienced high levels of both loss and gain compared to their counterparts who used internet the less in the same conditions. Furthermore, older adults with low resource gain and high resource loss expressed less stress when they used the internet more often compared to those with low internet use. Conclusions: These findings highlight the importance of internet use in mitigating stress among older adults experiencing resource loss and gain, emphasizing the potential of digital interventions to promote mental health in this population.

Background: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions—depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour—among centenarians in Switzerland. Methods: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID‐19 pandemic, and half were collected after the measures were lifted. Results: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour. Conclusions: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

Background: Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55). Methods: We examined correlations between functional capacity (i.e., PADL, IADL), cognitive capacity (i.e., MMSE), and depressive symptoms (i.e., GDS), and the existence of different profiles using hierarchical clustering. Results: Higher functional capacity was related to higher cognitive capacity and to fewer depressive symptoms. Yet, higher cognitive capacity was associated with more depressive symptoms. Hierarchical clustering analysis elucidated this contradiction by identifying three profiles: low-capacity individuals (i.e., 24 individuals had low functional and cognitive capacities, with low depressive symptoms), high-capacity individuals (i.e., 33 individuals with high functional and cognitive capacities, with low depressive symptoms), and low-functional-high-cognitive-capacity individuals (i.e., 16 individuals showed low functional but high cognitive capacity, with high depressive symptoms). Our post-hoc analyses highlighted arthritis and pain as risk factors for functional dependence and depression. Conclusions: Our findings emphasize the importance of identifying centenarian subgroups with specific resource- and risk profiles to better address their needs, and of treating pain to improve functional capacity and mental health in centenarians.