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Mental health and motor efficiency of older adults living in the Sardinia’s Blue Zone: a follow-up study

Published online by Cambridge University Press:  01 September 2020

Maria Chiara Fastame*
Affiliation:
Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
Ilaria Mulas
Affiliation:
Department of Mechanical, Chemical and Material Engineering, University of Cagliari, Cagliari, Italy
Massimiliano Pau
Affiliation:
Department of Mechanical, Chemical and Material Engineering, University of Cagliari, Cagliari, Italy
*
Correspondence should be addressed to: Maria Chiara Fastame, Department of Pedagogy, Psychology, Philosophy University of Cagliari, Via Is Mirrionis 1, 09123Cagliari, Italy. Phone: +39 070 6757502; Fax: +39 070 6757291. Email: [email protected].

Abstract

Objectives:

The main aim of this study was to examine the impact of age-related changes on mental health, metacognitive, and motor functioning in late adulthood, while controlling for the effect of gender. Additionally, this investigation intended to study the association between motor efficiency indexes and self-reported psychological well-being, depression and cognitive failures over a period of 24 months.

Design:

Prospective longitudinal study: post hoc analysis.

Participants:

Ninety-one community-dwelling older participants (mean age = 78.7 years, SD = 5.6) were recruited in a rural village of the Sardinian Blue Zone – an area of exceptional longevity located in the central–eastern region of Sardinia, an Italian island in the Mediterranean Sea.

Measurements:

All respondents completed a battery of tests and questionnaires assessing motor and general cognitive efficiency, self-reported psychological well-being, negative affect, and cognitive failures.

Results:

The adoption of a multilevel modeling approach highlighted the significative impact of time on psychological well-being, as well as on mobility parameters like gait speed and cadence, while controlling for the gender effect. Overall, psychological well-being and motor swing significantly increase at follow-up, whereas the further above-mentioned measures decreased after 24 months. Moreover, compared to the national cut-off, at baseline and follow-up, participants reported higher perceived emotional well-being. Finally, significant relationships between motor scores and self-reported mental health and metacognitive measures were found both at baseline and follow-up.

Conclusions:

The maintenance of motor efficiency and preserved mental health seems to contribute to the successful aging of older people living in the Sardinian Blue Zone.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2020

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References

Aboutorabi, A., Arazpour, M., Bahramizadeh, M., Hutchins, S. W. and Fadayevatan, R. (2016). The effect of aging on gait parameters in able-bodied older subjects: a literature review. Aging Clinical and Experimental Research, 28, 393405. doi: 10.1007/s40520-015-0420-6 CrossRefGoogle ScholarPubMed
Allahyari, T., Saraji, G. N., Adi, J., Hosseini, M., Iravani, M., Younesian, M. and Kass, S. J. (2008). Cognitive failures, driving errors and driving accidents. International Journal of Occupational Safety and Ergonomics, 14, 149-158. doi: 10.1080/10803548.2008.11076759 CrossRefGoogle ScholarPubMed
Amboni, M., Barone, P. and Hausdorff, J. M. (2013). Cognitive contributions to gait and falls: evidence and implications. Movement Disorders, 28, 15201533. doi: 10.1002/mds.25674 CrossRefGoogle ScholarPubMed
Baltes, P. B., Lindenberger, U. and Staudinger, U.M. (1998). Life-span theory in developmental psychology. In: Lerner, R. M. (Ed.), Handbook of child psychology: Vol. 1. Theoretical models of human development (5th ed., pp. 1029–1143). Hoboken, NJ: John Wiley & Sons.Google Scholar
Blanke, D. J. and Hageman, P. A. (1989). Comparison of gait of young men and elderly men. Physical Therapy, 69, 144148. doi: 10.1093/ptj/69.2.144 CrossRefGoogle ScholarPubMed
Borden, W. and Berlin, S. (1990). Gender, coping, and psychological well-being in spouses of older adults with chronic dementia. American Journal of Orthopsychiatry, 60, 603-610. doi: 10.1037/h0079209 CrossRefGoogle ScholarPubMed
Boyle, P. A., Buchman, A. S. and Bennett, D. A. (2010). Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons. The American Journal of Geriatric Psychiatry, 18, 1093-1102. doi: 10.1097/JGP.0b013e3181d6c259 CrossRefGoogle ScholarPubMed
Broadbent, D. E., Cooper, P. F., FitzGerald, P. and Parkes, K. R. (1982). The cognitive failures questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology, 21, 1-16. doi: 10.1111/j.2044-8260.1982.tb01421.x CrossRefGoogle ScholarPubMed
Browning, C. J., Enticott, J. C., Thomas, S. A. and Kendig, H. A. L. (2018). Trajectories of ageing well among older Australians: a 16-year longitudinal study. Ageing and Society, 38, 1581-1602. doi: 10.1017/S0144686X17000162 CrossRefGoogle Scholar
Carpiniello, B., Carta, M. G. and Rudas, N. (1989). Depression among elderly. Acta Psychiatrica Scandinavica, 5, 445-450. doi: 10.1111/j.1600-0447.1989.tb03004.x CrossRefGoogle Scholar
Charles, S. T. and Carstensen, L. L. (2008). Unpleasant situations elicit different emotional responses in younger and older adults. Psychology and Aging, 23, 495-504. doi: 10.1037/a0013284 CrossRefGoogle ScholarPubMed
De Beni, R., Borella, E., Carretti, B., Marigo, C. and Nava, L. A. (2007). BAC: Benessere e Abilità Cognitive nell’età Adulta e Avanzata [BAC: Wellness and Cognitive Abilities in the Advanced and Adult Age]. Firenze: Organizzazioni Speciali Google Scholar
Diener, E., Seligman, M. E., Choi, H. and Oishi, S. (2018). Happiest people revisited. Perspectives on Psychological Science, 13, 176-184. doi: 10.1177/1745691617697077 CrossRefGoogle ScholarPubMed
Dupuis, S. L. and Alzheimer, M. (2008). Leisure and ageing well. World Leisure Journal, 50, 91-107. doi: 10.1080/04419057.2008.9674538 CrossRefGoogle Scholar
Espy, D. D., Yang, F., Bhatt, T. and Pai, Y.C. (2010). Independent Influence of Gait Speed and Step Length on Stability and Fall Risk. Gait and Posture 32, 378382. doi: 10.1016/j.gaitpost.2010.06.013 CrossRefGoogle ScholarPubMed
Fastame, M. C., Hitchcott, P. K., Mulas, I., Ruiu, M. and Penna, M. P. (2018). Resilience in elders of the Sardinian blue zone: An explorative study. Behavioral Sciences, 8, 30. doi: 10.3390/bs8030030 CrossRefGoogle Scholar
Fastame, M. C., Hitchcott, P. K. and Penna, M. P. (2015). Do self-referent metacognition and residential context predict depressive symptoms across late-life span? A developmental study in an Italian sample. Aging and Mental Health, 19, 698704. doi: 10.1080/13607863.2014.962003 CrossRefGoogle Scholar
Fastame, M. C., Hitchcott, P. K. and Penna, M. P. (2018). The impact of leisure on mental health of Sardinian elderly from the ‘blue zone’: evidence for ageing well. Aging Clinical and Experimental Research, 30, 169-180. doi: 10.1007/s40520-017-0768-x CrossRefGoogle ScholarPubMed
Fastame, M. C. and Penna, M. P. (2012). Does social desirability confound the assessment of self-reported measures of wellness and metacognitive efficiency in young and older adults? Clinical Gerontologist, 35, 239-256. doi: 10.1080/07317115.2012.660411.CrossRefGoogle Scholar
Fastame, M. C. and Penna, M. P. (2014). Psychological well-being and metacognition in the fourth age: an explorative study in an Italian oldest old sample. Aging and Mental Health. doi: 10.1080/13607863.2013.866635.CrossRefGoogle Scholar
Fastame, M. C., Penna, M. P., Rossetti, E. S. and Agus, M. (2013). Perceived well-being and metacognitive efficiency in life course: a developmental perspective. Research on Aging, 35, 736749. doi: 10.1177/0164027512462411 CrossRefGoogle Scholar
Fastame, M. C., Penna, M. P, Rossetti, E. S. and Agus, M. (2014a). The effect of age and socio-cultural factors on self-rated well-being and metacognitive and mnestic efficiency among healthy elderly people. Applied Research in Quality of Life, 9, 325-334. doi: 10.1007/s11482-013-9238-6 CrossRefGoogle Scholar
Fastame, M. C., Penna, M. P. and Hitchcott, P. K. (2015). Mental health in late adulthood: what can preserve it? Applied Research in Quality of Life, 24, 241-244. doi: 10.1007/s11482-014-9323-5 CrossRefGoogle Scholar
Fastame, M. C., Penna, M. P. and Hitchcott, P. K. (2020). Psychological markers of longevity in Sardinian centenarians: the impact of developmental factors and social desirability. Aging Clinical and Experimental Research, 32, 107-114. doi: 10.1007/s40520-019-01157-y CrossRefGoogle ScholarPubMed
Fastame, M. C., Penna, M. P. and Rossetti, E. S. (2014b). Perceived cognitive efficiency and subjective well-being in late adulthood: The impact of developmental factors. Journal of Adult Development, 21, 173-180. doi: 10.1007/s10804-014-9189 CrossRefGoogle Scholar
Fava, G. A. (1983). Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. Journal of Clinical Psychology, 39, 249251. doi: 10.1002/1097-4679(198303)39:2\249:AID-JCLP2270390218[3.0.CO;2-Y 3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Ferrucci, L., Cooper, R., Shardell, M., Simonsick, E. M., Schrack, J. A. and Kuh, D. (2016). Age-related change in mobility: perspectives from life course epidemiology and geroscience. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 71, 1184-1194. doi: 10.1093/gerona/glw043 CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198. doi: 10.1016/0022-3956(75)90026-6 CrossRefGoogle Scholar
Frimenko, R., Goodyear, C. and Bruening, D. (2015). Interactions of sex and aging on spatiotemporal metrics in non-pathological gait: a descriptive meta-analysis. Physiotherapy, 101, 266272. doi: 10.1016/j.physio.2015.01.003 CrossRefGoogle ScholarPubMed
Fuller-Iglesias, H. R., Webster, N. J. and Antonucci, T. C. (2015). The complex nature of family support across the life span: implications for psychological well-being. Developmental Psychology, 51, 277288. doi: 10.1037/a0038665 CrossRefGoogle ScholarPubMed
Gale, C. R., Cooper, C., Deary, I. J. and Sayer, A. A. (2014). Psychological well-being and incident frailty in men and women: the English Longitudinal Study of Ageing. Psychological Medicine, 44, 697-706. doi: 10.1017/S0033291713001384 CrossRefGoogle ScholarPubMed
Hardy, S. E., Perera, S., Roumani, Y. F., Chandler, J. M. and Studenski, S. A. (2007). Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society, 55, 1727-1734. doi: 10.1111/j.1532-5415.2007.01413.x CrossRefGoogle ScholarPubMed
Heatherington, T. (1999). Street tactics: Catholic ritual and the senses of the past in Central Sardinia. Ethnology, 38, 315334.CrossRefGoogle Scholar
Heck, R. H., Thomas, S. L. and Tabata, L. N. (2014). Multilevel and longitudinal modeling with IBM SPSS. 2nd ed. London: Routledge.Google Scholar
Henry, J. D., Phillips, L. H., Maylor, E. A., Hosie, J., Milne, A. B. and Meyer, C. (2006). A new conceptualization of alexithymia in the general adult population: implications for research involving older adults. Journal of Psychosomatic Research, 60, 535-543. doi: 10.1016/j.jpsychores.2005.09.008 CrossRefGoogle ScholarPubMed
Hitchcott, P. K., Fastame, M. C., Ferrai, J. and Penna, M. P. (2017). Psychological well-being in Italian families: an exploratory approach to the study of mental health across the adult life span in the blue zone. Europe’s Journal of Psychology, 13, 441-454. doi: 10.5964/ejop.v13i3.1416 CrossRefGoogle Scholar
Hybels, C. F., Pieper, C. F. and Blazer, D. G. (2009). The complex relationship between depressive symptoms and functional limitations in community-dwelling older adults: the impact of subthreshold depression. Psychological Medicine, 39, 1677-1688. doi: 10.1017/S0033291709005650 CrossRefGoogle ScholarPubMed
Iosa, M., Fusco, A., Morone, G. and Paolucci, S. (2014). development and decline of upright gait stability. Frontiers in Aging Neuroscience, 6. doi: 10.3389/fnagi.2014.00014 Google ScholarPubMed
Jónsdóttir, H. L. and Ruthig, J. C. (2020). A longitudinal study of the negative impact of falls on health, well-being, and survival in later life: the protective role of perceived control. Aging and Mental Health, 1-7. doi: 10.1080/13607863.2020.1725736 Google ScholarPubMed
JudgeRoy, J. O., Davis, B. III and Õunpuu, S. (1996). Step length reductions in advanced age: the role of ankle and hip kinetics. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 51, M303-M312. doi: 10.1093/gerona/51A.6.M303 CrossRefGoogle Scholar
Kahana, E., Kelley-Moore, J. and Kahana, B. (2012). Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life. Aging and Mental Health, 16, 438-451. doi: 10.1080/13607863.2011.644519 CrossRefGoogle ScholarPubMed
Kendig, H., Browning, C. J., Thomas, S. A. and Wells, Y. (2014). Health, lifestyle, and gender influences on aging well: an Australian longitudinal analysis to guide health promotion. Frontiers in Public Health, 2, 70. doi: 10.3389/fpubh.2014.00070 CrossRefGoogle ScholarPubMed
Kiyoshige, E. et al. (2019). Age group differences in association between IADL decline and depressive symptoms in community-dwelling elderly. BMC Geriatrics, 19, 309. doi: 10.1186/s12877-019-1333-6 CrossRefGoogle ScholarPubMed
Ko, S. U., Hausdorff, J. M. and Ferrucci, L. (2010). Age-associated differences in the gait pattern changes of older adults during fast-speed and fatigue conditions: results from the Baltimore longitudinal study of ageing. Age and Ageing, 39, 688694. doi: 10.1093/ageing/afq113 CrossRefGoogle ScholarPubMed
Ko, S. U., Tolea, M. I., Hausdorff, J. M. and Ferrucci, L. (2011). Sex-specific differences in gait patterns of healthy older adults: results from the Baltimore Longitudinal Study of Aging. Journal of Biomechanics, 44, 19741979. doi: 10.1016/j.jbiomech.2011.05.005 CrossRefGoogle ScholarPubMed
Lauretani, F. et al. (2003). Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of Sarcopenia. Journal of Applied Physiology, 95, 18511860. doi: 10.1152/japplphysiol.00246.2003 CrossRefGoogle ScholarPubMed
Levy, B. R., Slade, M. D. and Kasl, S. V. (2002). Longitudinal benefit of positive self-perceptions of aging on functional health. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57, P409-P417. doi: 10.1093/geronb/57.5.P409 CrossRefGoogle ScholarPubMed
Magni, E., Binetti, G., Bianchetti, A., Rozzini, R. and Trabucchi, M. (1996). Mini-Mental State Examination: a normative study in Italian elderly population. European Journal of Neurology, 3, 198-202. doi: 10.1111/j.1468-1331.1996.tb00423.x CrossRefGoogle ScholarPubMed
Mahoney, A. M., Dalby, J. T. and King, M. C. (1998). Cognitive failures and stress. Psychological Reports, 82, 1432-1434. doi: 10.2466/PRO.82.3.1432±1434 CrossRefGoogle ScholarPubMed
Martin, P., Rott, C., Kerns, M. D., Poon, L.W. and Johnson, M. A. (2000). Predictors of depressive symptoms in centenarians. In: Martin, P., Rott, C., Hagberg, B. and Morgan, K. (Eds.), Centenarians: Autonomy versus dependence in the oldest old (pp. 91104). Paris: Serdi.Google Scholar
Mecacci, L. and Righi, S. (2006). Cognitive failures, metacognitive beliefs and aging. Personality and Individual Differences, 40, 1453-1459. doi: 10.1016/j.paid.2005.11.022 CrossRefGoogle Scholar
Michèle, J., Guillaume, M., Alain, T., Nathalie, B., Claude, F. and Kamel, G. (2019). Social and leisure activity profiles and well-being among the older adults: a longitudinal study. Aging and Mental Health, 23, 77-83. doi: 10.1080/13607863.2017.1394442 CrossRefGoogle ScholarPubMed
Montero-Odasso, M., Verghese, J., Beauchet, O. and Hausdorff, J. M. (2012). Gait and cognition: a complementary approach to understanding brain function and the risk of falling. Journal of the American Geriatrics Society, 60, 2127-2136. doi: 10.1111/j.1532-5415.2012.04209.x CrossRefGoogle ScholarPubMed
Nybo, H., Gaist, D., Jeune, B., McGue, M., Vaupel, J. W. and Christensen, K. (2001). Functional status and self-rated health in 2262 nonagenarians: The Danish 1905 Cohort Survey. Journal of the American Geriatrics Society, 49, 601-609. doi: 10.1046/j.1532-5415.2001.49121.x CrossRefGoogle ScholarPubMed
Pau, M. et al. (2018). Texting while walking induces gait pattern alterations in healthy older adults. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 62, 1908-1912. doi: 10.1177/1541931218621433 CrossRefGoogle Scholar
Peel, N. M., Alapatt, L. J., Jones, L. V. and Hubbard, R. E. (2019). The association between gait speed and cognitive status in community-dwelling older people: a systematic review and meta-analysis. The Journals of Gerontology: Series A, 74, 943-948. doi: 10.1093/gerona/gly140 CrossRefGoogle ScholarPubMed
Pes, G. M. et al. (2013). Lifestyle and nutrition related to male longevity in Sardinia: an ecological study. Nutrition, Metabolism and Cardiovascular Diseases, 23(3), 212-219. doi: 10.1016/j.numecd.2011.05.004 CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2001). Gender differences in self-concept and psychological well-being in old age: a meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56, P195-P213. doi: 10.1093/geronb/56.4.P195 CrossRefGoogle ScholarPubMed
Poulain, M., Herm, A. and Pes, G. M. (2013). The Blue Zones: Areas of exceptional longevity around the world. Vienna Yearbook of Population Research, 11, 87108.10.1553/populationyearbook2013s87CrossRefGoogle Scholar
Poulain, M. et al. (2004). Age-validation and non-random Spatial Distribution of Extreme Longevity in Sardinia: the AKEA Study. Experimental Gerontology, 39, 1423-1429. doi: 10.1016/j.exger.2004.06.016 CrossRefGoogle Scholar
Prince, F., Corriveau, H., Hébert, R. and Winter, D. A. (1997). Gait in the elderly. Gait and Posture, 5, 128135. doi: 10.1016/S0966-6362(97)01118-1 CrossRefGoogle Scholar
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. doi: 10.1177/014662167700100306 CrossRefGoogle Scholar
Rantakokko, M., Mänty, M. and Rantanen, T. (2013). Mobility decline in old age: exercise and sport. Sciences Reviews, 41, 1925. doi: 10.1097/JES.0b013e3182556f1e Google Scholar
Sargent-Cox, K. A., Anstey, K. J. and Luszcz, M. A. (2012). The relationship between change in self-perceptions of aging and physical functioning in older adults. Psychology and Aging, 27, 750-760. doi: 10.1037/a0027578 CrossRefGoogle ScholarPubMed
Silder, A., Heiderscheit, B. and Thelen, D. G. (2008). Active and passive contributions to joint kinetics during walking in older adults. Journal of Biomechanics, 41, 15201527. doi: 10.1016/j.jbiomech.2008.02.016 CrossRefGoogle ScholarPubMed
Smith, J., Fleeson, W., Geiselmann, B., Settersten, R. A. and Kunzmann, U. (1999). Sources of well-being in very old age. In: Baltes, P. B. and Mayer, K. U. (Eds.), The Berlin Aging Study: Aging from 70 to 100 (pp. 450471). New York: Cambridge University Press.Google Scholar
Snowdon, J. and Lane, F. (1995). The Botany survey: a longitudinal study of depression and cognitive impairment in an elderly population. International Journal of Geriatric Psychiatry, 10, 349-358. doi: 10.1002/gps.930100503 CrossRefGoogle Scholar
Strawbridge, W. J., Deleger, S., Roberts, R. E. and Kaplan, G. (2002). Physical activity reduces the risk of subsequent depression for older adults. American Journal of Epidemiology, 156, 328334. doi: 10.1093/aje/kwf047 CrossRefGoogle ScholarPubMed
Syddall, H., Cooper, C., Martin, F., Briggs, R. and Aihie Sayer, A. (2003). Is grip strength a useful single marker of frailty? Age and Ageing, 32, 650656. doi: 10.1093/ageing/afg111 CrossRefGoogle ScholarPubMed
Willcox, B. J., Willcox, D. C. and Ferrucci, L. (2008). Secrets of healthy aging and longevity from exceptional survivors around the globe: lessons from octogenarians to supercentenarians. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63, 1181-1185. doi: 10.1093/gerona/63.11.1181 CrossRefGoogle ScholarPubMed
Zaninotto, P. and Steptoe, A. (2019). Association between subjective well-being and living longer without disability or illness. JAMA Network Open, 2, e196870. doi: 10.1001/jamanetworkopen.2019.6870 CrossRefGoogle ScholarPubMed
Zlatar, Z. Z., Moore, R. C., Palmer, B. W., Thompson, W. K. and Jeste, D. V. (2014). Cognitive complaints correlate with depression rather than concurrent objective cognitive impairment in the successful aging evaluation baseline sample. Journal of Geriatric Psychiatry and Neurology, 27, 181-187. doi: 10.1177/0891988714524628 CrossRefGoogle ScholarPubMed
Ziadni, M. S., Jasinski, M. J., Labouvie-Vief, G. and Lumley, M. A. (2017). Alexithymia, defenses, and ego strength: cross-sectional and longitudinal relationships with psychological well-being and depression. Journal of Happiness Studies, 18, 1799-1813. doi: 10.1007/s10902-016-9800-7 CrossRefGoogle ScholarPubMed
Zijlstra, W. (2004). Assessment of spatio-temporal parameters during unconstrained walking. European Journal of Applied Physiology, 92, 3944. doi: 10.1007/s00421-004-1041-5 CrossRefGoogle ScholarPubMed
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