@article {10557, title = {Lifetime History of Traumatic Brain Injury is Associated with Increased Loneliness in Adults: A U.S. Nationally Representative Study}, journal = {International Journal of Geriatric Psychiatry}, volume = {35}, year = {2020}, pages = {553-563}, abstract = {Background/Objectives: An estimated 55 million individuals worldwide live with chronic disability associated with Traumatic Brain Injury (TBI) which may include cognitive, behavioral and social impairments. Reduced participation in social activities is common after TBI, however few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness, and to identify mediators of this association. Methods/Design: Retrospective cohort study. Nationally representative sample of N=724 adults over age 50 (Health and Retirement Study). Loneliness was evaluated using the 11-item Revised UCLA (R-UCLA) Loneliness Scale (range 11-33). Lifetime history of TBI evaluated retrospectively using the Ohio State University TBI Identification Method. We included the following covariates: age, sex, race, education; and mediators: depressive symptoms, number of comorbidities, chronic pain, difficulty with activities of daily living, and social network index. Results: History of TBI was associated with a 1.28 point (95\% CI: 0.46, 2.11, p<0.05; Cohen{\textquoteright}s D=0.284) increase in R-UCLA loneliness scale scores, after covariate adjustment. Individuals with more recent injuries (within 10 years) and multiple lifetime TBIs reported the highest loneliness scores. In the structural equation model, depressive symptoms and comorbidity burden partially mediated the relationship between TBI and loneliness. All models were adjusted for United States (U.S.) population sampling weights. Conclusions: History of TBI was associated with greater loneliness compared to individuals without TBI in a representative sample of U.S. adults. Managing depressive symptoms and medical consequences of TBI may be a target to ameliorate reporting of loneliness in this population. This article is protected by copyright. All rights reserved.}, keywords = {Loneliness, Older Adults, Traumatic Brain Injury}, doi = {10.1002/gps.5271}, author = {Raj G. Kumar and Katherine A Ornstein and Bollens-Lund, Evan and Watson, Eric M. and Claire K. Ankuda and Amy Kelley and Dams-O{\textquoteright}Connor, Kristen} } @article {9809, title = {Association Between Purpose in Life and Glucose Control Among Older Adults.}, journal = {Annals of Behavioral Medicine}, volume = {52}, year = {2018}, pages = {309-318}, abstract = {

Background: Greater purpose in life is associated with lower rates of certain chronic diseases. Whether purpose in life can protect against development of prediabetes or type 2 diabetes is unknown.

Purpose: To examine the association between purpose in life and blood glucose control among adults >=50 years.

Methods: We conducted a longitudinal cohort study of 3,907 participants of the Health and Retirement Study who at baseline did not have type 2 diabetes or prediabetes. Baseline purpose in life was measured using the Ryff and Keyes{\textquoteright} Scales of Psychological Well-Being and grouped into tertiles (high, medium, and low). We used multivariable linear regression to examine the association between baseline purpose in life and HbA1c over 4 years. Multivariable logistic regression was used to examine the association between baseline purpose and incident prediabetes or type 2 diabetes over the same period.

Results: After adjusting for sociodemographic factors, body mass index, physical activity, and physical and mental health factors, HbA1c was 0.07 percentage points lower among participants with high purpose than those with low purpose (95\% confidence interval [CI] -0.12 to -0.02; p = .011). Participants with high purpose had lower odds of developing prediabetes or type 2 diabetes than those with low purpose (adjusted odds ratio 0.78; 95\% CI 0.62 to 0.98; p = .037).

Conclusions: Among older adults, greater purpose in life is associated with a lower incidence of prediabetes or type 2 diabetes. Strategies to promote greater purpose in life should be tested as a part of type 2 diabetes prevention efforts.

}, keywords = {Biomarkers, Diabetes, Glutamic Acid, Purpose in life}, issn = {1532-4796}, doi = {10.1093/abm/kax012}, author = {Hafez, Dina and Michele M Heisler and Choi, Hwajung and Claire K. Ankuda and Winkelman, Tyler and Jeffrey T Kullgren} }