@article {11351, title = {Chronic condition discordance and physical activity among midlife and older couples.}, journal = {Health Psychology}, volume = {40}, year = {2021}, pages = {11-20}, abstract = {

OBJECTIVE: Chronic conditions in middle and later life are associated with lower physical activity. Yet little is known about chronic condition discordance (i.e., the extent to which conditions have nonoverlapping self-management requirements) within older individuals and couples and its implications for physical activity. We determined how the degrees of chronic condition discordance at the individual level and the couple level (i.e., between spouses) were linked to moderate physical activity across an 8-year period.

METHOD: The U.S. sample included 1,621 couples from five waves of the Health and Retirement Study (2006-2014). Dyadic growth curve models estimated how individual-level and couple-level chronic condition discordance were linked to initial levels of and rates of change in moderate activity. Models controlled for age, minority status, education, and own and partner reports of baseline negative marital quality, time-varying depressive symptoms, and time-varying number of chronic conditions.

RESULTS: A considerable proportion of wives (25.4\%) and husbands (18.9\%) reported moderate activity less than once a week. When individuals (wives: β = -0.10; husbands: β = -0.09) or their spouses (wives: β = -0.04; husbands: β = -0.05) had greater individual-level chronic condition discordance, lower initial moderate activity was reported. When husbands had greater individual-level discordance, both wives (β = -0.16) and husbands (β = -0.19) had a faster rate of decline in moderate activity over time. Couple-level chronic condition discordance was not significantly linked to moderate activity.

CONCLUSIONS: These findings suggest the importance of promoting physical activity among individuals and couples managing complex chronic conditions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

}, keywords = {Chronic conditions, Couples, Physical activity}, issn = {1930-7810}, doi = {10.1037/hea0001040}, author = {Courtney A Polenick and Kira S. Birditt and Turkelson, Angela and Helen C Kales} } @article {10476, title = {Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {451-460}, abstract = {Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms.The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006{\textendash}2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner{\textquoteright}s baseline report of negative marital quality and number of chronic conditions in each wave.Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions.Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.}, keywords = {Chronic conditions, Couples, Depressive symptoms, Longitudinal analysis}, issn = {1079-5014}, doi = {10.1093/geronb/gbz137}, author = {Courtney A Polenick and Kira S. Birditt and Turkelson, Angela and Bugajski, Benjamin C and Helen C Kales} } @article {11289, title = {Chronic Condition Discordance and Physical Activity: Longitudinal Associations Among Older Couples}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {605 }, abstract = {Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements) is detrimental for functional health but little is known about mechanisms accounting for these associations. We examined links between chronic condition discordance at both the individual level and the couple level (i.e., between spouses) and physical activity over time. Participants included 1,095 couples from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models showed that greater individual-level discordance was associated with lower baseline physical activity among individuals and their partners. When husbands had greater individual-level discordance, wives and husbands had faster declines in physical activity. The findings highlight the importance of considering both members of a couple when examining the implications of chronic illness for physical activity in middle and later life.}, keywords = {chronic condition discordance, Physical activity}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.2044}, author = {Courtney A Polenick and Kira S. Birditt and Turkelson, Angela and Helen C Kales} } @article {10873, title = {Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability}, journal = {Annals of Behavioral Medicine}, volume = {54}, year = {2020}, pages = {455 - 469}, abstract = {Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability.We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability.The U.S. sample included 3,991 couples drawn from nine waves (1998{\textendash}2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner{\textquoteright}s baseline depressive symptoms, and each partner{\textquoteright}s number of chronic conditions across waves.Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels.Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.}, keywords = {Chronic illness, Disability, multimorbidity, Spouses}, isbn = {0883-6612}, doi = {10.1093/abm/kaz061}, author = {Courtney A Polenick and Kira S. Birditt and Turkelson, Angela and Helen C Kales} }