Clinical Gerontologist最新文献

Objectives: Extant research on hoarding has largely taken place in urban settings, preventing generalizations to rural communities. Thus, our objective was to provide a profile of late life rural hoarding.

Methods: We used data from a survey distributed at community presentations (N = 97) and data from baseline assessments administered as part of larger treatment outcome studies for geriatric hoarding (N = 55).

Results: On the community sample, 33% of participants scored above the clinical cutoff on a brief screening measure. Of the older adults diagnosed with hoarding disorder, 65% lived with at least one other person and 49% were married, a strong contrast to urban samples. Participants who lived alone had higher levels of clutter than those who lived with at least one other person, but did not report higher levels of subjective hoarding symptoms.

Conclusions: While rurality might lead to lower clutter levels in primary rooms in the home, it does not affect the overall volume of clutter that has accumulated, nor the subjectively experienced level of distress.

Clinical implications: Our rural sample differed substantially from urban samples on characteristics that should be considered by clinicians when forming their case conceptualization for late life hoarding patients.

Objectives: This systematic review examined the use of immersive virtual reality (IVR) to support multidimensional mental health among older adults.

Methods: Seven databases were searched for peer-reviewed studies published between January 2020 and March 2025, with forward and backward citation tracking completed in April 2025 (PROSPERO ID: CRD42025644394). Eligible studies involved adults aged 60 years and older, used fully immersive IVR via head-mounted displays, and assessed mental health outcomes. Ten studies met inclusion criteria, spanning randomized, quasi-experimental, pre - post, and mixed-methods designs across North America, Europe, and Asia.

Results: Eight of the 10 studies reported improvements in mental health. Virtual nature and guided meditation were most strongly associated with reductions in depression and anxiety, while reminiscence-based IVR improved positive affect and life satisfaction. Controlled studies showed stronger correlation than uncontrolled designs. Barriers such as discomfort, cybersickness, and low digital literacy were commonly addressed through facilitator support and age-friendly design, with feasibility demonstrated across community and long-term care settings.

Conclusions: Immersive virtual reality is a promising non-pharmacological approach to supporting mental health and reducing social isolation in older adults.

Clinical implications: When appropriately adapted, brief, facilitator-supported IVR sessions may improve mental health outcomes among older adults in community and institutional settings.

Objectives: Our study examined the prevalence of childhood and adult ADHD in older adults from clinical and control groups, focusing on impulsivity and psychiatric comorbidities.

Methods: The sample included 261 participants aged 65 years and older. ADHD diagnoses were established through DSM-5-based structured clinical interviews (SCID-5), supported by standardized self-report measures (ASRS, WURS) and corroborative collateral information from relatives when available (89% of the clinical group), reflecting routine diagnostic practice in older adults. Sociodemographic variables were assessed and compared across groups.

Results: Adult ADHD was diagnosed in 9.7% of the clinical group and 1.5% of controls. Probable childhood ADHD (WURS ≥ 36) was identified in 22.5% of clinical participants. Individuals with ADHD had significantly higher attentional impulsivity scores. Within the clinical group, probable childhood ADHD was associated with increased rates of suicide attempts, legal problems, and traffic violations. In multivariable analysis, ADHD diagnosis independently predicted higher impulsivity levels after controlling for age, sex, and education (p = .003).

Conclusions: ADHD is associated with clinically relevant impulsivity and behavioral risks in older psychiatric patients, underscoring the importance of considering ADHD in geriatric psychiatric assessments.

Clinical implications: Routine assessment of attentional impulsivity may improve ADHD recognition in older psychiatric patients.

Objectives: To examine the association between work beyond the traditional retirement age and mental health outcomes among older Canadians (65+ years) and to assess whether these associations vary by sex.

Methods: A subsample of (N = 65,033) older adults was drawn from repeated national Canadian Community Health Surveys between 2013 to 2018. Firth's logistic regression model was applied to identify factors associated with self-reported mood and anxiety disorders. Prevalence estimates and adjusted odds ratios with 95% confidence intervals are reported.

Results: The prevalence of self-reported mood and anxiety disorders were 6.9% and 5.3% respectively. We found that paid full-time work was positively associated with self-reported mood disorder (OR = 0.61, 95% CI: 0.50-0.73) and self-reported anxiety disorder (OR = 0.65, 95% CI: 0.52-0.81). Older age (75+) was positively associated with self-reported mood disorder (OR = 0.56, 95% CI: 0.51-0.62) and self-reported anxiety disorder (OR = 0.62, 95% CI: 0.55-0.69). High work-related stress was a significant negative associated factor for both mental disorders [(OR = 1.46, 95% CI: 1.16-1.82), and (OR = 1.38, 95% CI: 1.07-1.77, respectively)]. Being female, single, a current smoker, and multimorbidity were statistically significant negative associated factors for both self-reported mood and anxiety disorders. Although females reported higher prevalence of self-reported mood and anxiety disorders, the significant factors associated with these conditions were largely similar across both sexes.

Conclusions: Our findings emphasize the positive mental health benefits of paid work past age 65+ and its obvious financial benefit.

Clinical implications: This research supports the idea of "active aging" and emphasize the need for further research to explore the motivations behind continued employment and their differential impact on mental health.

Objectives: This study investigated whether the relationship between thwarted belongingness and depressive symptoms was moderated by self-warmth and self-coldness and whether the moderating effects were conditional on place of residence (urban versus rural).

Methods: A sample of 236 Australian adults aged 65 to 97 years (M = 73.63, SD = 6.53) completed the Geriatric Depression Scale, Interpersonal Needs Questionnaire, and Self-Compassion Scale.

Results: The interaction between thwarted belongingness and self-warmth was significant for urban but not rural older adults. For urban older adults, the relationship between thwarted belongingness and depressive symptoms weakened as levels of self-warmth increased. The association between thwarted belongingness and depressive symptoms was significantly stronger for older adults living in rural areas than in urban areas. The relationship between thwarted belongingness and depressive symptoms strengthened as self-coldness levels increased.

Conclusions: Self-warmth is a protective factor for older adults living in urban areas and experiencing thwarted belongingness. Self-coldness is an additional risk factor for older adults experiencing thwarted belongingness.

Clinical implications: Interventions focusing on increasing self-warmth among urban older adults and decreasing self-coldness among older adults might weaken the relationship between thwarted belongingness and depressive symptoms.

Objectives: This study examines the relationship between executive function (EF) in daily life and depressive symptoms in older adults, focusing on how age-related EF deficits contribute to depressive symptoms.

Methods: Data were collected from 404 community-dwelling older adults in Gangwon-do, South Korea. Depressive symptoms were assessed using the Korean version of the Short Form of the Geriatric Depression Scale (KGDS-SF), and EF deficits were measured using the Korean version of the Short Form of the Barkley Deficits in Executive Functioning Scale (KBDEFS-SF), an ecologically validated tool. Regression analysis and a mediation model were employed to investigate how age-related EF deficits contribute to depressive symptoms.

Results: EF deficits, particularly in self-organization/problem-solving and self-regulation of emotion, were significantly associated with increased depressive symptoms. However, only deficits in self-organization/problem-solving mediated the relationship between age and depressive symptoms.

Conclusions: Age-related deficits in self-organization/problem-solving significantly contribute to depressive symptoms in older adults.

Clinical implications: Interventions aimed at improving self-organization and problem-solving skills are critical for managing depressive symptoms in older adults, as these abilities are influenced by age and may mediate the relationship between age and depression.

Objectives: This study examined the relationship between polypharmacy and depressive symptoms among U.S. community-dwelling older adults and whether it varied by gender.

Methods: We conducted a retrospective population-based analysis of 3,354 adults aged 65 and older using data from the 2009 Health and Retirement Study Health and Well-Being Study. Polypharmacy was defined as the use of five or more prescription medications. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CESD-8). Negative binomial regression models assessed associations between polypharmacy and depressive symptoms and whether the relationship varied by gender.

Results: Over 40% of participants reported polypharmacy. In unadjusted models, polypharmacy was positively related to depressive symptoms (Incidence Rate Ratio [IRR] = 1.44, p < .01). In models adjusting for demographic and health characteristics, there was no statistically significant relationship between polypharmacy and depressive symptoms (Adjusted Incidence Rate Ratio [AIRR] = 0.99, p > .05). There were no significant gender differences in unadjusted or adjusted models in the relationship between polypharmacy and depressive symptoms.

Conclusions: Polypharmacy was not related to depressive symptoms among older women or men.

Clinical implications: Interventions to address physical health may be more salient to depression management than polypharmacy regardless of gender.

Objectives: This study examined the associations between family functioning and depressive symptoms among older adults in Chinese nursing homes, focusing on the mediating roles of perceived stress and psychological resilience.

Methods: A cross-sectional survey was conducted among 229 older adults from five nursing homes in Southwest China. Standardized instruments were used, including the Family APGAR Index, Geriatric Depression Scale (GDS), Chinese Perceived Stress Scale (CPSS), and the 10-item Connor - Davidson Resilience Scale (CD-RISC-10).

Results: Family functioning was negatively associated with depressive symptoms (β = -0.82, p < .01). Perceived stress and psychological resilience were found to be significant mediators. The total indirect effect accounted for 49.56% of the overall association.Specifically, perceived stress (12.47%) and psychological resilience (26.91%) each served as independent mediators. A serial mediation pathway through perceived stress and then psychological resilience explained an additional 10.2% of the total effect.

Conclusions: Family functioning was associated with depressive symptoms among institutionalized older adults both directly and indirectly. The serial mediation model highlights potential pathways linking external and internal psychosocial resources to mental health in nursing homes.

Clinical implications: Interventions focusing on family support, stress reduction, and resilience enhancement may be relevant to the psychological well-being of older adults in nursing homes.

Objectives: We examined the moderating effects of household income, subjective socioeconomic status (SES), social contact, and social engagement on the work-depressive symptoms relationship.

Methods: We analyzed data from 5,216 adults aged 60 and older from six waves (2008-2018) of the Korean Longitudinal Study of Ageing (KLoSA).

Results: Two-level mixed-effects models showed that within-individual variation in work status was negatively associated with depressive symptoms. The relationship between work and depressive symptoms was stronger for older adults with low household income than for those with the average household income and was not significant for those with high household income. Moreover, the work-depressive symptoms relationship was stronger among older adults with low levels of subjective SES and social engagement and fewer social contacts compared with those with average or high levels of subjective SES and social engagement and more social contacts.

Conclusions: The greater impact of work on depressive symptoms in older adults with limited financial and social resources highlights the importance of addressing these deficits to improve mental health.

Clinical implications: Clinicians should consider that the effect of work on depression varies depending on income, subjective SES, and social participation. Addressing financial hardship and promoting social participation are important for preventing depression in older adults.

Objectives: This study explored the impact of childhood hunger experiences on depressive symptoms in Chinese older adults, as well as the mediating roles of physical health and life satisfaction.

Methods: The data was sourced from three waves of surveys conducted by the China Social Tracking Survey in 2016, 2018, and 2020. Use OLS model and KHB method for regression analysis and mediation analysis.

Results: The results showed that childhood hunger experiences significantly increase depressive symptom scores and reduce mental health levels. In addition, physical health and life satisfaction partially mediated the relationship between childhood hunger experiences and depressive symptoms in older adults, and the effect was significant.

Conclusions: The findings of this research emphasize the negative impact of childhood hunger experiences on the mental health outcomes of older adults, with physical health and life satisfaction being important mediating pathways.

Clinical implications: Clinicians may wish to consider the impact of adverse childhood experiences on depressive symptoms in older adults; Healthcare providers or policymakers may want to consider how to reduce the negative impact of adverse childhood experiences, such as cultivating psychological resilience; Clinicians may wish to consider how to preserve the physical health of older adults and improve their life satisfaction.