PERSONALITY, REHABILITATION, &HEALTH IN IMPAIRED ELDERS

Lighthouse International, New York NY

Investigators

Abstract

The long-term objective of the proposed research is to better understand the impact of personality on the mental health of elders adjusting to age- related vision impairment. This study will test a model which predicts when faced with vision impairment, neuroticism will have a direct effect on mental health as well as indirect effects through mediating factors (vision-specific stress, coping efforts, and rehabilitation service utilization). Vision impairment is a common, disabling condition of later life that affects an estimated 21 % of American adults age 65 years and older according to a recent, national survey (The Lighthouse Inc., 1995). The development of vision impairment in later life constitutes a major life event requiring significant psychological adjustment. Antecedent factors such as personality and vision-specific stress have typically not been considered as potential predictors of adjustment to vision impairment in elders. Further, rehabilitation is an overlooked, yet critically important aspect of health care in the older population. Moreover, research suggests that neuroticism may be relevant to mental health outcomes in this population. That is, neuroticism has been linked to the appraisal of stress, use of specific coping efforts, utilization of health care services, and to poor mental health following stressful events. However, past research on the linkage between neuroticism and mental health has rarely focused on elders and the "real-world" challenges they face. The conceptual framework is based on and incorporates the work of Lazarus and Folkman (1984) on stress and coping and Bolger and his colleagues (Bolger & Schilling, 1991; Bolger & Zuckerman, 1995) on the mechanism by which neuroticism impacts health. The specific aims of the proposed study are: (1) to examine the relationship between neuroticism and vision-specific stress; (2) to explore the relationship between neuroticism and utilization of vision rehabilitation services; (3) to examine the relationship between vision rehabilitation service utilization and mental health in impaired elders; and (4) to determine and compare the magnitude of the direct effect and indirect effects through mediating factors (vision-specific stress, coping efforts, vision rehabilitation service utilization) of neuroticism on mental health in vision impaired elders. Participants will be 150 community-dwelling elders experiencing a recent vision impairment. Data will be collected through telephone interviews. Using structural equation modeling (SEM), analyses will address overall model fit to the data as well as the direct effects of neuroticism and the indirect effects of neuroticism through mediating factors on the mental health (depressive symptoms, psychological symptoms) of vision impaired elders.