Clinical Gerontologist最新文献

Objectives: We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations.

Methods: Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016.

Results: Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity.

Conclusions: Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not.

Clinical implications: For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.

Objectives: Posttraumatic stress disorder is frequently present in people with dementia, but the symptoms are difficult to recognize and suitable treatments are lacking. The aim of the present study was to investigate which trauma-focused treatments are applicable to these patients.

Methods: The Delphi method is a process which is used to reach consensus from a panel of experts. The study was conducted online and consisted of three rounds with statements about support for treatment, treatment, and implementation.

Results: There are several treatment options available, but it depends on the symptoms, and the severity of PTSD and dementia which treatment is most suitable.

Conclusions: The outcomes offer some practical tips for health care workers, and they provide a fundamental base for future research.

Clinical implications: Clinicians should pay attention to the treatment of PTSD symptoms in people with dementia and it is necessary to examine the type and severity of both PTSD symptoms and dementia. Taking these factors into account, clinicians are able to focus on the best treatment option in order to improve the quality of life of these specific type of patients.

Background: Many older adults in Colombia have lived through violent and stressful life events, particularly in areas of poverty. The aim of this qualitative study was to understand the impact of stressful life events on the mental health and wellbeing of older Colombians living in areas of relative poverty.

Methods: Older adults (aged 60+) living in the Turbo region in Colombia were interviewed face-to-face between August and December 2021. Transcripts were coded in Spanish and English by at least two researchers, using inductive thematic analysis.

Results: Twenty-six older adults participated in the study. Four overarching themes were generated: Living in violent and dangerous communities; Disturbing gender violence and gender roles; Lack of mental health awareness; Coping mechanisms. Older adults experienced a long narrative of stressful life events. Younger generations appeared to disrespect older members of Society. Without any mental health support, older adults coped by accepting the extreme situations or seeking solace in their faith.

Conclusions: The health system and Government need to build up trust and generate an awareness of mental health, as older Colombians will not approach psychological support otherwise. Intergenerational community-based interventions may provide a first avenue of mental health support.

Objectives: This study aimed to explore the relationships between aging attitudes and the outcomes of successful aging, including whether aging attitudinal types moderate psychological adjustment in the context of medical and mental health diagnoses.

Methods: In total, 409 community-dwelling women aged 40-79 years in Australia completed the Reactions to Aging Questionnaire (RAQ), Geriatric Depression Scale, Center of Epidemiological Studies Depression Scale, and Geriatric Anxiety Inventory. Information about medical and mental health diagnoses were collected.

Results: Overall, aging attitudes and all three RAQ subscales were negatively correlated with scores on measures of depression and anxiety, and number of medical diagnoses. Attitudinal types toward aging were found to moderate the relationship between the number of mental health diagnoses and scores on the psychological measures of depression but not anxiety. Unique RAQ domain-specific relationships were found with the number of mental health diagnoses.

Conclusions: The findings support the link between aging attitudes and psychological outcomes, the potential clinical value of RAQ attitudinal typologies classification as well as a multidimensional conceptualization of aging attitudes.

Clinical implications: The findings reinforce the need for efforts to reduce ageism on a societal level, as well as informing clinical decision-making with older clients.

Objectives: Personality traits and affective disorders are both related to functional limitations. It is unknown whether personality traits have an additional effect on functioning in older adults with affective disorders. We studied the association between personality traits and functioning within this group.

Methods: We performed a cross-sectional study of 180 older patients referred to outpatient specialized geriatric mental health care centers with a depressive, anxiety and/or somatic symptom disorder according to DSM-criteria. We studied the association between the Big Five personality traits and functional limitations assessed with the WHO-DAS II, adjusting for potential confounders, including the severity of various affective disorders.

Results: The 180 patients (57.1% female, mean age 69.2 years) had an average WHO-DAS II score of 31.3 (SD 15.1). Lower scores on Conscientiousness were associated with more overall functional limitations (p = .001), particularly limitations in self-care (p = .001) and household activities (p = .001). Lower Extraversion scores were associated with more limitations in getting along with others (p = .001).

Conclusions: Personality traits are related to functional limitations independent of the severity of affective disorders in older adults.

Clinical implications: Personality traits may be used as predictive factors for functioning in older adults with affective disorders.

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: Our understanding of elder abuse (EA) phenomena has largely been shaped from the perspective of researchers and professionals whose conceptualizations often differ from the perceptions of older adults who experience mistreatment. This study sought to understand the most distressing aspects of EA victimization from the perspective of survivors.

Methods: Using a descriptive phenomenological approach, individual interviews were conducted with a diverse sample (n = 32) of EA survivors, recruited from EA support and Adult Protective Services programs in New York City and Los Angeles. Analysis followed a constant comparison process involving two independent coders to understand distressing aspects of EA victimization.

Results: The following themes emerged as the most distressing aspects of EA victimization: fear, disbelief, disrespect, concern for perpetrator and other family members, feelings of loss, and incongruity between survivor wishes and systemic responses. Distressing aspects of EA victimization spanned personal, relational, and systemic levels of ecological influence.

Conclusions: Findings from this study advance basic knowledge on EA phenomena and carry direct implications for programs designed to support and meet the needs of survivors.

Clinical implications: Findings identify particularly distressing psycho-emotional aspects of EA victimization for clinicians interacting with survivors that can serve as targets of intervention.

Objectives: This study assessed the feasibility and efficacy of "Online Resilience," a three-lesson online intervention based on third-wave cognitive behavioral therapy (CBT) principles, inspired by acceptance and commitment therapy (ACT), designed for emotionally healthy adults aged 75 and older.

Methods: A randomized controlled study with 62 participants (mean age = 81) divided into Experimental and Control groups. Outcomes included resilience, well-being, mood, and sleep quality, measured pre-, post-, and at one-month follow-up.

Results: The intervention showed feasibility among emotionally healthy older adults with higher baseline resilience and well-being, with attrition rates comparable to similar programs. Resilience improvements were significant post-intervention but diminished by follow-up. Sleep quality improved significantly at follow-up, though control group data was unavailable for comparison. Mood stability was maintained in the intervention group while declining in controls.

Conclusion: "Online Resilience" shows promise for promoting resilience, mood stability, and sleep quality in older adults, though limited long-term effects and high attrition warrant program refinements.

Clinical implications: Brief, self-guided online interventions like this can enhance access to mental health support for older adults, serving as cost-effective preventive tools. However, future programs should address attrition and target individuals with varying baseline psychological resources.