To Örebro University

Objective: Chronic pain is a prevalent condition in older adults, associated with substantial distress. For many older people, chronic pain interferes with their daily life which is reflected in various life domains. This study aimed to investigate whether interactions among self-reported indicators of biological, psychological, social, and existential life domains differ for older adults with no pain, with non-interfering pain, and with interfering pain.

Method: The study was based on the cross-sectional 65+ and Safe Study data (N = 622; age range 64–106 years; 60.6 % women). Network analysis was used to assess the inter-variable associations for older adults reporting no pain, non-interfering pain, and interfering pain separately. Network visualization and centrality tests were performed. Permutation-based analyses were conducted to investigate the connections among variables in three subgroups.

Results: We identified a structural difference between the networks of older adults with no pain and interfering pain, suggesting differences in connectivity among the life domains. The strength centrality metrics showed the central role of presence of meaning in the networks of older adults with no pain and with non-interfering pain, while for older adults with interfering pain, anxiety appeared to be dominant.

Conclusion: The findings illuminated that anxiety regulation and meaning-enhancement are potentially important intervention targets for older adults with recurrent pain. Overall, the study highlighted the value of a holistic biopsychosocial-existential approach for understanding and managing pain in older adults.

Purpose: There is a wide range of individual and work environment factors that influence work ability among workers withpain and stress-related ill-health. The multiple interactions and overlap between these factors are insufficiently understood,and a network approach could mitigate limitations of previous research. This pilot study aimed to explore interactions betweenindividual characteristics and psychosocial work environment and potential links to long-term work ability.

Methods: Prospective data from a prevention project was used. Individuals (N = 147) with pain and/or stress-related ill-health(95% women) at public sector workplaces filled out baseline questionnaires about a collection of individual and work environ-ment factors, which were used for constructing undirected networks. The model was run in three subsamples of workplaces.Finally, a separate model was established with work ability at 6-month follow-up as outcome variable. A shortest pathwayanalysis was calculated to identify mediators of work ability.

Results: Symptom catastrophizing and perceived stress were the most influential factors in all network models. Symptomcatastrophizing and pain-disability risk were found to mediate the relation between perceived stress and long-term workability. Further, demand-control-support factors were interrelated, and patterns of interaction differed between differenttypes of workplaces.

Conclusion: The findings support the importance of individual factors, specifically symptom catastrophizing in an individual’scoping with pain or stress-problems and its influence on long-term work ability. Catastrophizing might play a role in stress-related disorders which should be further investigated. Individual and work environment factors interact and vary acrosscontext, which needs to be taken into consideration to prevent pain and stress-related ill-health at work.

Objectives: Feeling safe in the daily environment is important in late life. However, research on configuration of vulnerability factors for perceived unsafety in older adults is scarce. The current study aimed to identify latent subgroups of older adults based on their vulnerability for perceived unsafety.

Method: We analyzed the data from a cross-sectional survey of residents in senior apartments in a mid-sized Swedish municipality (N = 622).

Results: The results of the latent profile analysis based on frailty, fear of falling, social support, perceived neighborhood problems, and trust in others in the neighborhood indicated the presence of three profiles. These profiles were labelled as compromised body and social networks (7.2%), compromised context (17.9%) and non-vulnerable (74.9%). Profile membership was statistically predicted by age, gender, and family status and profiles differed in perceived unsafety, anxiety and life satisfaction.

Conclusion: Overall, the study findings suggested the existence of latent subgroups of older people based on patterns of vulnerability.

Feeling safe in one’s place of residence is important for the well-being of older adults when ageing in place; in contrast, feeling unsafe is likely to have negative consequences for well-being while ageing. Although substantial knowledge of perceived unsafety has been accumulated within various disciplines, there are certain knowledge gaps related to perceived unsafety in older age. What perceived reasons for feeling unsafe are the most central to older adults? Can emotion regulation strengthen or buffer the negative effects of perceived unsafety on the well-being of older people? What differences exist among older adults regarding why they feel unsafe?

This dissertation aimed to address these questions while investigating perceived unsafety and its associations with well-being in the context of ageing, focusing on senior apartment residents. This dissertation adopted an interdisciplinary approach integrating knowledge of perceived unsafety from psychology, gerontology, and criminology. The findings suggest that perceived unsafety in advanced age is a multifaceted phenomenon. Specifically, perceived unsafety could be explained by different perceived reasons (i.e., fear of crime, unattractive social climate in the neighbourhood, and inconvenient infrastructure at home; Study I). Furthermore, maladaptive cognitive emotion regulation strategies were associated with fear of crime and strengthened its negative association with life satisfaction (Study II). Moreover, distinct profiles of older adults could be identified based on compromises in their key life domains. Older adults belonging to different profiles differed in their perceived unsafety and well-being (Study III).

Overall, this dissertation findings indicate that feeling unsafe is associated with being less satisfied with life, experiencing more anxiety and depressive feelings, and relying on more maladaptive emotion regulation strategies. Therefore, safety-promotion efforts are considered an important investment in the quality of life of older adults living in senior apartments.

Att känna sig trygg i sin boendemiljö är en förutsättning för välmående hos äldre som åldras i hemmet. Motsatsen, upplevelsen av otrygghet, kan däremot inverka negativt under åldrandet. Trots att olika vetenskapliga discipliner har bidragit med betydelsefull kunskap om äldres otrygghet finns fortfarande ett antal kunskapsluckor inom forskningsfältet. Vilka centrala orsaker till otrygghet uppger äldre? Kan känsloreglering stärka eller buffra negativa effekter av upplevd otrygghet på äldres välmående? Vilka skillnader finns bland äldre när det gäller orsaker till upplevd otrygghet?

Syftet med denna avhandling var att undersöka upplevd otrygghet och dess samband med välmående i relation till åldrande bland äldre i seniorboenden. Avhandlingen har en tvärvetenskaplig utgångspunkt och integrerar kunskap om upplevd otrygghet från psykologi, gerontologi och kriminologi. Resultaten tyder på att äldres upplevda otrygghet är ett mångfacetterat fenomen. Flera olika förklaringar framträdde till varför äldre upplever otrygghet, närmare bestämt rädsla för brott, oattraktivt socialt klimat i bostadsområdet och bristfällig infrastruktur i hemmet (Studie I). Vidare framkom att maladaptiva kognitiva känsloregleringsstrategier var kopplade till rädsla för brott, och förstärkte sambandet med bristande livstillfredsställelse (Studie II). Vidare kunde ett antal distinkta profiler av äldre identifieras, baserade på sårbarhetsfaktorer inom viktiga livsområden. Profilerna skiljde sig åt gällande upplevd otrygghet och välmående (Studie III).

Sammantaget indikerar denna avhandling att upplevd otrygghet är förknippat med lägre livstillfredsställelse, ökad ångest och depressiva symptom och att i högre utsträckning förlita sig på maladaptiva känsloregleringsstrategier. Trygghetsfrämjande insatser kan således anses vara en viktig satsning för att öka livskvaliteten hos äldre i seniorboenden.

Feeling safe is important for quality of life in advanced age. The current study aimed to investigate whether different perceived reasons for unsafety uniquely contribute to the feelings of unsafety in the neighbourhood and at home while ageing. Data from a cross- sectional survey study on older adults living independently in Sweden were analysed (N = 622, age range 64–106 years, 60.6% female). Binary logistic regressions revealed unique associations between fear of crime, unattractive social climate in the neighbour-hood, and inconvenient infrastructure at home with experienced feelings of unsafety, while controlling for socio-demographic fac-tors. When distinguishing between reasons for feeling unsafe in the neighbourhood and at home, different associations with socio- demographic factors emerged. Higher age was positively asso-ciated with health-related unsafety both in the neighbourhood and at home and was not related to fear of crime neither in the neighbourhood nor at home. Female gender was associated with both health-related unsafety and fear of crime in the neighbour-hood and with health-related unsafety at home. Overall, the find-ings highlight the presence of a range of perceived reasons of unsafety relevant for older adults and the importance to consider these subjective unsafety reasons in further research and practice.

Fear of crime is a substantial problem for older adults and is associated with reduced subjective well-being. However, less is known about factors that could moderate the associations between fear of crime and mental health problems and well-being in advanced age. Cognitive emotion regulation could serve as a potentially buffering factor for adverse health outcomes related to fear of crime due to its potential importance in managing feelings when facing threatening situations. The current study investigated the associations between affective fear of crime with depressive feelings and life satisfaction and examined whether adaptive and maladaptive cognitive emotion regulation strategies moderated these associations in a sample of older adults (age 64–106) in Sweden (N = 622). The results showed that affective fear of crime was associated with more depressive feelings, less life satisfaction, and more frequent use of such maladaptive cognitive emotion regulation strategies as rumination, catastrophizing, and blaming others. Moreover, rumination and self-blame moderated the associations between affective fear of crime and life satisfaction. Adaptive emotion regulation strategies were not associated with affective fear of crime and did not decrease the strength of its association with depressive feelings and with life satisfaction. These findings allow us to conclude that maladaptive emotion regulation could be considered a vulnerability factor in the association of fear of crime with life satisfaction.