While long-term survivors (5 years+) do not face the stressors of diagnosis and treatment, they continue to face the uncertainties that survivorship brings: recurrence, other cancers, late effects of treatment, and the potential of a shortened life expectancy. This research focuses on the cancer-related health worries of older adult, long-term cancer survivors, the factors that predict these worries, and their link to traditional measures of psychological distress. Specifically, a model is proposed that identifies the personal (including race and gender) and illness/treatment characteristics of survivors that are significantly associated with cancer-related health worries and their effects on anxiety and depression. Descriptive and multivariate analyses of a random sample of 321 long-term survivors in a major cancer center tumor registry are used to address these issues. About one-third of survivors continue to report worries about recurrence, worries about a second cancer, and worries that symptoms they experience may be from cancer. The regression analyses show that cancer-related health worries is a significant predictor of both depression (beta=0.36) and anxiety (beta=0.21). Race is a significant predictor; being African American is related to fewer cancer-related health worries (beta=-0.22). Having more symptoms during treatment is also a predictor of having more cancer-related health worries (beta=0.20). The most consistent predictor of psychosocial distress is dispositional optimism/pessimism, with more optimistic individuals reporting fewer cancer-related health worries (beta=-0.27), lower levels of both anxiety (beta=-0.16) and depression (beta=-0.23). Overall, for many older adult, long-term survivors, the legacy of cancer continues in terms of cancer-related health worries. In spite of these, for most survivors, their quality of life is not dramatically compromised either physically or psychologically.

Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration.

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This article extends previous conceptualizations of person-environment fit from institutional to community settings, focusing on neighborhoods. The authors consider applicability of the congruence construct for understanding the impact of neighborhoods, including dwelling units, on older persons' residential satisfaction.

Recent research in psychosocial oncology has pointed to the traumatic nature of the stress experienced by cancer survivors. Most of this research has focused on children, young adults survivors and their families. This investigation proposes a conceptual model for understanding general psychological distress (anxiety, hostility and depression) and symptoms of posttraumatic stress (hyper-arousal, avoidance and intrusiveness) that may be associated with cancer survivorship among older adults. Findings from a survey of 180 older adult, long-term cancer survivors are used to illustrate the key features of this model. Results of multivariate analysis show that most older adult long-term cancer survivors do not demonstrate clinical levels of posttraumatic stress disorder (PTSD), although over 25% evidence clinical levels of depression. However, many survivors display important symptoms of psychological distress that are related to the continuing effects of cancer and its treatment. Current cancer-related symptoms are the strongest predictors of depression (beta=0.27, p=0.046) and the PTSD sub-dimension of hyper-arousal (beta=0.377, p=0.004). These effects persist even when the effects of other stressors and non-cancer illness symptoms are statistically controlled. Additionally, it appears in this sample that symptoms of PTSD are significantly correlated with traditional measures of psychological distress.