Clinical Gerontologist最新文献

Objectives: Wandering is common in people with memory impairment and increases caregivers' stress and burden. Given that people wear shoes when going out, this study aimed to apply a shoe-attached location-tracking device to individuals with mild cognitive impairment (MCI) and evaluate their effectiveness.

Methods: Participants were 23 dyads, including a person with MCI and a family caregiver. The individuals with MCI wore a location-tracking device on their shoes for eight weeks. The study was a multi-method study and included quantitative and qualitative components. A one-group pretest-posttest design was employed to evaluate the effectiveness of the intervention quantitatively, while posttest interviews enabled qualitative examination of participants' experiences.

Results: After the location-tracking devices were applied, caregivers were more likely to allow their loved ones to go out alone (p = .01). Qualitative analyses revealed four themes: (1) satisfaction with the location-tracking device, (2) specific benefits of the shoe-attached location-tracking device, (3) fear of judgment from others, and (4) suggestions for future enhancements.

Conclusions: The shoe-attached location-tracking device was helpful to both individuals with MCI and their family caregivers, indicating potential for wider adoption.

Clinical implications: Making the device widely available can improve well-being of people with MCI and their caregivers.

Objectives: The main purpose of this study is to analyze the effectiveness of a treatment for community-dwelling older adults on physical frailty, anxiety, and depression.

Methods: The sample consisted of 28 participants, of whom 85.71% were female and 14.29% were male. An initial evaluation (T0) was conducted in early 2023, followed by an intervention program from March to October 2023, which included weekly workshops on physical activity, cognitive functions, arts, digital literacy, and well-being. A reevaluation (T2) was carried out between November and December 2023 to assess the program's impact.

Results: The main results of the study showed significant improvements in anxiety, depression, and physical frailty between the two measurements.

Conclusions: This study highlights the importance of intervention programs for addressing physical and psychological frailty in older individuals. Clinical implications: it includes the importance of implementing comprehensive interventions that combine physical activity, mental well-being, cognitive stimulation, and emotional support to effectively address and reduce anxiety, depression, and physical frailty in older adults, thereby promoting overall health and quality of life.

Objectives: Data on the direct and indirect associations between physical activity (PA) and sleep quality in old age via psychosomatic mechanisms (e.g. mobility, pain, loneliness, depression, and anxiety) remain scarce in low- and middle-income countries (LMICs). We explored the association of PA with poor sleep quality (PSQ) among individuals aged ≥ 50 in Ghana and explored the potential mediating factors in this association.

Methods: We analyzed community-based data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. We assessed PA using the International Physical Activity Questionnaire (IPAQ). Two items on nighttime and daytime sleep problems in the last 30 days were used to measure PSQ. Multivariable ordinary least square (OLS) regressions and bootstrapping models were performed to evaluate the associations.

Results: Overall, 1,201 participants (M_age = 66.15 ± 11.58 years; 63.3% female) were included in the analysis. PA was independently associated with decreased PSQ in the overall sample (B = -0.181, 95%I = -0.271 to -0.092) and in women (B = -0.195, 95%I = -0.305 to -0.084). The association was stronger in the ≥ 65 (B = -0.138) than in the 50-64 age group (B = -0.213). Mobility (37.06%), pain (23.66%), loneliness (6.71%), and comorbid anxiety and depression (8.95%) mediated the PA-PSQ association.

Conclusions: PA was associated with decreased PSQ levels, which was particularly explained by psychosomatic factors.

Clinical implications: Clinicians encourage older adults to engage in regular PA and manage psychosomatic problems may improve their sleep health.

Objectives: To investigate whether baseline depressive symptoms impacted the effectiveness of an exercise intervention among (pre)frail older adults.

Methods: This is a subanalysis of a stepped-wedge cluster randomized trial implementing an exercise intervention, with an application of the integration of the Health Belief Model, Theory of Planned Behavior, and Health Action Process Approach, among 149 community-dwelling (pre)frail older adults. The intervention effectiveness was examined by baseline depressive symptoms (depressive symptoms (n = 40) and non-depressive symptoms (n = 109).

Results: Intervention effects were observed among (pre)frail older adults regardless of baseline depressive symptoms on frailty, social function, as well as physical and mental quality of life (QoL). (Pre)frail people with depressive symptoms, compared to those without depressive symptoms, were likely to benefit more in muscle mass, muscle strength, lower extremity function, activities of daily living (ADLs), cognitive function, depressive symptoms, and physical QoL, but less in dynamic balance, instrumental ADLs (IADLs), and mental QoL.

Conclusions: These findings implicate that cognitive and psychological strategies should be integrated into exercise interventions among (pre)frail people with depressive symptoms to improve their functional independence and well-being.

Clinical implications: Interventions that accommodate depressive symptoms may result in improved outcomes for (pre)frail people with depressive symptoms.

Objectives: Past geriatric studies related to the mediating role of physical activity in depression are scarce. This is perhaps the first study to examine the mediating effects of physical activity on the associations between depression and age, and education among older adults.

Methods: Statistical analyses of cross-sectional data from a nationally representative survey on Malaysian older adult health were conducted. Structural equation modeling was used to assess the extent to which physical activity mediated the relationships between depression and age, and education. Associations between variables were explored using multivariable logistic regressions.

Results: Analyses were based on a sample of 3974 older adults (aged ≥60 years). Only 12.2% of older adults had depression. Age was positively associated with the odds of depression. Better educated older adults were less likely to experience depression than less educated older adults. Physical activity fully mediated the association between depression and age, whereas it partially explained the depression-education relationship.

Conclusions: Older age and low educational levels were risk factors for depression, and physical activity was identified as a mediator.

Clinical implications: Older and less-educated older adults should be encouraged to participate in physical activity, and those at risk of depression should be given special attention.

Objectives: To explore the temporal sequence between cognitive function and activities of daily living (ADLs) in patients with Parkinson's disease (PD) and investigate whether apathy mediates these effects.

Methods: We recruited 486 patients from the Parkinson's Progression Marker Initiative. We constructed a cross-lagged panel model to explore the temporal sequence between cognitive function and ADLs and analyzed the longitudinal mediating effect of apathy on the relationship between cognitive function and ADLs.

Results: The slopes of ADLs and cognitive function were significant (p < .001), and lower levels of cognitive function indicated lower ADLs, suggesting that a decreased cognitive performance preceded ADLs decline. Cognitive function influenced apathy (negatively) (p < .001) and ADLs (p < .001). A significant indirect effect of cognitive function on ADLs through apathy was revealed by bias-corrected bootstrapping (β = 0.181, p < .001).

Conclusions: The rate of change in cognitive function was significantly correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Cognition was indirectly related to ADLs through apathy.

Clinical implications: The rate of change in cognitive function in patients with PD was correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Reducing apathy represents a promising approach to reducing the impact of cognitive decline on ADLs.

Objectives: Age-related macular degeneration (AMD) is a leading cause of vision loss, affecting quality of life. Although AMD is associated with an increased risk of depression, differences between dry and wet forms are not well understood. This study examined depressive symptoms in Greek patients with dry and wet AMD compared to healthy-controls using the Zung Self-Rating Depression Scale (SDS).

Methods: A cross-sectional study included 146 AMD patients (74 dry, 72 wet) and 60 controls. Depressive symptoms were assessed using the Zung SDS. Demographic and clinical data were collected. Statistical analyses compared depression severity and prevalence between groups, adjusting for potential confounders.

Results: Wet AMD patients had significantly higher Zung SDS scores (50.4 ± 7.81) than dry AMD (44.8 ± 6.75) and controls (41.4 ± 7.85, p < .001). Depression prevalence was 56% in wet, 27% in dry AMD, and 20% in controls. After adjusting for visual acuity, age, sex, and other factors, wet AMD remained significantly associated with greater depression severity (p < .001).

Conclusions: Wet AMD is associated with higher depression severity compared to dry AMD, emphasizing the need for integrated ophthalmologic and mental health care.

Clinical implications: Depression is common among AMD patients, particularly those with wet AMD. Screening and psychological support should be incorporated into AMD management.

Objectives: This study aimed to investigate the relationship between hearing loss and depression of older adults and examine how digital device use moderates the relationship between hearing loss and depression.

Methods: Secondary data analyses were conducted using data from the 2020 National Survey of Older Koreans (N = 9,920). Weighted linear regression analyses were conducted to examine the relationship between hearing loss and depression and moderating effect of digital device use.

Results: Approximately 23.2% of the participants reported hearing loss. Hearing loss was significantly associated with increased depression (β = 0.074, p = .005). Digital device use had a marginally significant moderating effect on the relationship between hearing loss and depression (β = 0.050, p = .054).

Conclusions: Hearing loss is associated with greater depression among older adults. Our findings suggest that digital device use does not alleviate depression in older adults with hearing loss. Future studies should consider the specific aspects of digital device use and post-COVID-19 changes to better understand the impact of digital device use on hearing loss and depression.

Clinical implications: Since hearing loss is significantly associated with higher levels of depression in older adults, mental health should be assessed if healthcare professionals work with older adults with hearing loss.

Objectives: This study was conducted to determine the relationships between activities of daily living (ADL), depression, and quality of life. Specifically, the study aimed to evaluate the potential mediating role of depression in the relationship between activities of daily living and quality of life in a sample of Iranian older adults.

Methods: This cross-sectional study recruited 118 older adult adults with multiple chronic conditions in Iran from December 2022 to September 2023. Data were collected using a demographic and health information questionnaire, the Katz Index, the Lawton scale, Old-World Health Organization Quality of Life, and the Geriatric Depression Scale. Path analysis was used to test the hypothesis.

Results: Participants' average age was 70.15 ± 6.91 years. BADL (B = 0.2, p = .02), and depression (B = -0.25, p = .004) were significantly related to the quality of life. The standardized indirect effect of BADL on quality of life was 0.08 (p = .006).

Conclusions: According to the results of this study, functional status can directly and also, indirectly affect the quality of life of older adults with multiple chronic conditions through depression.

Clinical implications: Health care providers are advised to carefully assess older adults' mental health and functional status and consider their relationships to quality of life.