This investigation examines how norms of filial responsibility influence adult children to provide social support to their aging parents. Relying on intergenerational solidarity and social capital theories, the authors hypothesize that filial responsibility as a latent resource is more strongly converted into support when (a) the parent experiences increased need and (b) the child in question is a daughter. Using data from 488 adult children in the Longitudinal Study of Generations, the authors examine change in support provided between 1997 and 2000. Declining health of either parent increases the strength with which filial norms predisposed children to provide support. The conversion of filial norms into support is stronger among daughters than among sons but only toward mothers. Results are discussed in terms of the contingent linkage between latent and manifest functions and the persistence of gender role differentiation in the modern family.

Delirium can accelerate the trajectory of cognitive decline in patients with Alzheimer disease (AD). The information from this study provides the foundation for future randomized intervention studies to determine whether prevention of delirium might ameliorate or delay cognitive decline in patients with AD.

OBJECTIVES:To determine whether patients who developed delirium after cardiac surgery were at risk of functional decline. DESIGN: Prospective cohort study. SETTING: Two academic hospitals and a Veterans Affairs Medical Center. PARTICIPANTS: One hundred ninety patients aged 60 and older undergoing elective or urgent cardiac surgery. MEASUREMENTS: Delirium was assessed daily and was diagnosed according to the Confusion Assessment Method. Before surgery and 1 and 12 months postoperatively, patients were assessed for function using the instrumental activities of daily living (IADL) scale. Functional decline was defined as a decrease in ability to perform one IADL at follow-up. RESULTS: Delirium occurred in 43.1% (n 5 82) of the patients (mean age 73.7 AE 6.7). Functional decline occurred in 36.3% (n 5 65/179) at 1 month and in 14.6% (n 5 26/ 178) at 12 months. Delirium was associated with greater risk of functional decline at 1 month (relative risk (RR) 5 1.9, 95% confidence interval (CI) 5 1.3-2.8) and tended toward greater risk at 12 months (RR 5 1.9, 95% CI 5 0.9-3.8). After adjustment for age, cognition, comorbidity, and baseline function, delirium remained significantly associated with functional decline at 1 month (adjusted RR 5 1.8, 95% CI 5 1.2-2.6) but not at 12 months (adjusted RR 5 1.5, 95% CI 5 0.6-3.3).CONCLUSION: Delirium was independently associated with functional decline at 1 month and had a trend toward association at 12 months. These findings provide justification for intervention trials to evaluate whether delirium prevention or treatment strategies might improve postoperative functional recovery. J Am Geriatr Soc 58:643-649, 2010.