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).

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AG032379-01A1
Application #
7637670
Study Section
Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
Program Officer
Spotts, Erica L
Project Start
2009-04-15
Project End
2011-03-31
Budget Start
2009-04-15
Budget End
2010-03-31
Support Year
1
Fiscal Year
2009
Total Cost
$175,540
Indirect Cost
Name
Pennsylvania State University
Department
Other Health Professions
Type
Schools of Allied Health Profes
DUNS #
003403953
City
University Park
State
PA
Country
United States
Zip Code
16802
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Graham, Eileen K; Rutsohn, Joshua P; Turiano, Nicholas A et al. (2017) Personality Predicts Mortality Risk: An Integrative Data Analysis of 15 International Longitudinal Studies. J Res Pers 70:174-186
Hoppmann, Christiane A; Infurna, Frank J; Ram, Nilam et al. (2017) Associations Among Individuals' Perceptions of Future Time, Individual Resources, and Subjective Well-Being in Old Age. J Gerontol B Psychol Sci Soc Sci 72:388-399
Infurna, Frank J; Gerstorf, Denis; Ram, Nilam et al. (2016) Maintaining Perceived Control with Unemployment Facilitates Future Adjustment. J Vocat Behav 93:103-119
Wagner, Jenny; Ram, Nilam; Smith, Jacqui et al. (2016) Personality trait development at the end of life: Antecedents and correlates of mean-level trajectories. J Pers Soc Psychol 111:411-29
Gerstorf, Denis; Hoppmann, Christiane A; Löckenhoff, Corinna E et al. (2016) Terminal decline in well-being: The role of social orientation. Psychol Aging 31:149-65
Wagner, Jenny; Hoppmann, Christiane; Ram, Nilam et al. (2015) Self-esteem is relatively stable late in life: the role of resources in the health, self-regulation, and social domains. Dev Psychol 51:136-49
DuPuis, David; Ram, Nilam; Willner, Cynthia J et al. (2015) Implications of ongoing neural development for the measurement of the error-related negativity in childhood. Dev Sci 18:452-68
Fauth, Elizabeth B; Gerstorf, Denis; Ram, Nilam et al. (2014) Comparing changes in late-life depressive symptoms across aging, disablement, and mortality processes. Dev Psychol 50:1584-93
Hülür, Gizem; Hertzog, Christopher; Pearman, Ann et al. (2014) Longitudinal associations of subjective memory with memory performance and depressive symptoms: between-person and within-person perspectives. Psychol Aging 29:814-27

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