Clinical Gerontologist最新文献

Objectives: This study examines not only the effects of functional limitations and chronic pain on depressive symptoms in older South Korean women, but also the moderating effect of living arrangements on these relationships.

Methods: This study employed a Correlated Random Effects model using panel data from Wave 5 to Wave 8 of the Korean Longitudinal Study of Ageing. The final sample included 2,443 individuals and 8,360 observations.

Results: The more severe the degree of functional limitations and chronic pain, the higher the level of depressive symptoms in older Korean women. Furthermore, the results of the Correlated Random Effects model showed that the associations between functional limitations and depressive symptoms were more positive among women living alone.

Conclusions: Given the variation in depressive symptoms by living arrangement among older women with functional limitations, the findings underscore the potential importance of living arrangements in the quality of life of older adults in South Korea.

Clinical implications: With an increase in the older population, the number of older women living alone is also growing. To enhance the quality of life in old age, interventions related to geriatric primary care or home care would be needed for older women living alone.

Objectives: The objectives of this study were to estimate the proportions of older adults with chronic, non-cancer pain (CNCP) who use cannabis or prescription opioids, and their pain, function, and measures of depression over time.

Methods: This was a longitudinal, observational secondary analysis of older adults enrolled in the Oregon Center for Aging and Technology study with pain for ≥12 weeks. Predictors were cannabis and opioid use at weekly intervals. Outcomes were weekly pain intensity, pain interference, feeling blue, physical limitations, and annual Geriatric Depression Scale scores.

Results: About 353 participants met criteria with 5% using cannabis and 11% opioids. After controlling for confounders, cannabis use was associated with more pain interference and depression symptoms over time. Opioid use was associated with more pain intensity and interference.

Conclusions: Cannabis was associated with more pain interference and symptoms of depression. Findings were limited by a small sample. Longitudinal data with reliable measures are needed.

Objectives: Although the association between sleep disorders and frailty has been well established, little is known about the cognitive appraisal mechanisms underlying this association. Building on the transactional theory of stress and coping, this study explores the role of self-efficacy and coping style in the association between sleep quality and frailty among community-dwelling older adults.

Methods: In this cross-sectional study, 585 community-dwelling older adults were investigated using the Pittsburgh Sleep Quality Index, Tilburg Frailty Indicator, General Self-Efficacy Scale, and Simplified Coping Style Questionnaire. Descriptive statistics and hierarchical regression were performed. A moderated mediation model was established using the PROCESS macro.

Results: Poor sleep quality affects frailty directly (B = 0.193, p < .01) and indirectly via self-efficacy (B = 0.063, p < .01). The negative impact of poor sleep on frailty through self-efficacy was moderated by both positive and negative coping style (index =  -0.007). The moderating effect was stronger when participants' negative coping tendencies increased.

Conclusions: Poor sleep quality indirectly influences frailty by modifying self-efficacy. Effective coping strategies can help attenuate this association.

Clinical implications: Timely sleep assessment and tailored strategies such as psychoeducational programs and targeted coping skills training may be beneficial for preventing frailty in older adults.

Objectives: To examine the relationship between hearing loss and subjective well-being (SWB) and to investigate the mediating roles of social activity and cognitive function in the link between hearing loss and SWB.

Methods: An analysis of 11,949 older Chinese adults was conducted from the 2018 wave of the Chinese Longitudinal Health Longevity Survey. Multiple linear regression and mediation analysis were conducted.

Results: Hearing loss had a significant negative association with SWB (B = -0.787; 95% CI: -0.961, -0.613). Hearing loss influenced older adults' SWB in the following three ways: first, via the partial mediating effect of social activity (B = -0.021, 95% CI: -0.036, -0.009); second, via the partial mediating effect of cognitive function (B = -0.275, 95% CI: -0.347, -0.252); and third, via the serial mediating effects of social activity and cognitive function (-0.016, 95% CI: -0.021, -0.011).

Conclusions: Social activity and cognitive function play a serial intermediary role in the relationship between hearing loss and SWB among older Chinese adults.

Clinical implications: Multidimensional health and social interventions aimed at improving mental health and social inclusion among adults with hearing loss should be recommended.

Background: Anxiety can exacerbate fear of falling and balance issues, potentially affecting intervention efficacy. This study examines exergaming's impact on fear of falling and balance in anxious and non-anxious older adults.

Materials and methods: Twenty older adults (10 anxious, 10 non-anxious) participated in six weeks of balance-oriented gaming. Fear of falling was assessed using the Falls Efficacy Scale and the Activities-specific Balance Confidence Scale. Balance was measured with the Berg Balance Scale and the Timed Up and Go Test before, after, and six weeks post-intervention.

Results: Both groups showed significant improvements in balance and mobility, sustained during follow-up. However, only the non-anxious group exhibited significant reductions in fear of falling and increased balance confidence. Anxiety was linked to reduced enjoyment, lower efficacy perception, and heightened tension during the intervention.

Conclusion: Exergaming improves balance and reduces fear of falling in non-anxious older adults. Anxiety may diminish these benefits.

Clinical implications: Assessing anxiety levels is crucial when prescribing exergaming interventions. Tailoring treatments to address anxiety could enhance outcomes.

Objectives: This study examines whether chronic tinnitus mediates the relationship between hearing loss and depression in middle-aged and older adults, providing insights into the pathways linking auditory impairment and mental health challenges.

Methods: Data from 3,241 adults aged 50 and older were obtained from the 2011-2012, 2015-2016, and 2017-2018 NHANES cycles and analyzed. Logistic regression assessed the hearing loss - depression association, and mediation analysis tested the mediating role of chronic tinnitus. Subgroup analyses explored age differences.

Results: Hearing loss increased the odds of depressive symptoms, with chronic tinnitus mediating 16.83% of this effect. In middle-aged adults, chronic tinnitus served as a full mediator in the hearing loss - depression pathway, acted as a partial mediator in adults aged 60-69, and showed no mediating effect in those aged 70 and older.

Conclusions: Hearing loss, chronic tinnitus, and depression are closely linked in middle-aged and older adults. Age-sensitive screening and integrated care addressing both hearing and mental health are crucial to improve well-being.

Clinical implications: Combining hearing rehabilitation with tinnitus counseling and mental health support may improve psychological outcomes in older adults.

Objectives: This systematic review evaluated exergame interventions' efficacy in older adults, focusing on depressive symptoms, activities of daily living (ADLs), and fear of falling.

Methods: We searched five electronic databases from inception to June 2024. Data were synthesized using the inverse-variance method, reporting standardized mean differences (SMDs) with 95% confidence intervals (CIs).

Results: Twenty-four randomized controlled trials (RCTs) with 1,128 participants were included. Exergames significantly improved depressive symptoms (SMD = -0.76, 95% CI: -1.11 to -0.40, p < .001). Meta-regression showed no influence of sample size, health status, intervention duration, gender, or gaming device. No significant effects were found for ADLs (SMD = 0.01, 95% CI: -0.75 to 0.76, p = .988) or fear of falling (SMD = -0.16, 95% CI: -0.40 to 0.08, p = .189).

Conclusions: Exergames enhance mental health in older adults but lack clear effects on physical function or fear of falling. High-quality, long-term studies are needed.

Clinical implications: Exergames offer an engaging intervention to reduce depressive symptoms, complementing mental health therapies. Clinicians should use modern platforms and combine exergames with physical or behavioral interventions to address ADLs and fear of falling.

Objectives: The fall risk appraisal (FRA) matrix provides multidimensional approaches to detecting falls in late adulthood. This study investigated a modified FRA (mFRA) matrix based on self-assessed fall risk (SFR) and fear of falling (FOF). We also compared the mental health and characteristics of the four mFRA groups: Rational (low SFR and low FOF), Irrational (low SFR and high FOF), Incongruent (high SFR and low FOF), and Congruent (high SFR and high FOF).

Methods: This study used data from 181 older adults (MeanAge = 74.58, SDAge = 7.13) in Central Florida. SFR was measured using the CDC Stopping Elderly Accidents, Deaths, and Injuries fall checklist. FOF was measured using the Short Fall Efficacy Scale-International. Descriptive and group comparison analyses were performed using SPSS.

Results: The participants were categorized: Rational (n = 80, 44.2%), Irrational (n = 12, 6.6%), Incongruent (n = 26, 14.4%), and Congruent (n = 63, 34.8%). Rational showed better mental health, fewer falls, and higher health literacy. In contrast, Congruent reported worse mental health, more falls, and lower health literacy.

Conclusions: Findings provided empirical evidence to design fall prevention and interventions that consider older adults' experiential and psychological fall risks.

Clinical implications: Fall risks of older adults may be measured and comprehended as a multidimensional concept.

Objectives: This study investigated the associations between objective sleep quality parameters and multidimensional mental health, including depression and quality of life (QoL), in community-dwelling older adults.

Methods: The data came from an ongoing cross-sectional study involving older adults aged ≥60, residing in an urban city. Nighttime sleep metrics were derived from wrist-worn actigraphy (ActiGraph-GT9X). Domain-specific QoL and depression were assessed using the standardized WHO-QoL-BREF and CES-D scales, respectively. Correlation and regression analyses examined the associations of interest, and subgroup analyses explored sex-specific patterns.

Results: Among 47 participants [mean age = 70.3 ± 6.1 years; female = 53.2%], most participants had short total sleep time (TST; mean = 6.8 h). Significant associations were observed between sleep quality and mental health (r_s = .4), with TST serving as a significant predictor of the QoL-Physical [β (95% CI) = 0.005 (0.0001-0.011), p = .042] and QoL-Social [β (95% CI) = 0.005 (0.0001, 0.010), p = .039]. Associations between TST and the QoL-Psychological [β (95% CI) = 0.008 (0.0001-0.017), p = .047] and QoL-Social [β (95% CI) = 0.011 (0.001-0.021), p = .036] were significant only in males.

Conclusion: Actigraphy-measured sleep quality, particularly increased TST, was associated with better domain-specific mental health in older adults, with patterns differing by sex.

Clinical implications: These findings underscore the need for targeted strategies to promote adequate sleep and well-being in the older population.

Objectives: This study investigated the impact of active music therapy on mood, sleep, and daily functioning in institutionalized older adults without dementia.

Methods: Eighty-five participants aged 65 and older were randomly assigned to an experimental group (n = 39; mean age = 73.5 ± 5.1) receiving active music therapy involving singing, rhythmic instruments, and movement, or a control group (n = 46; mean age = 72.8 ± 5.7) engaged in passive music listening. Sessions lasted one hour, three times weekly for ten weeks. Assessments before and after the intervention included the Mini-Mental State Examination, Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and Everyday Competence Questionnaire.

Results: Compared to controls, participants in the active therapy group showed significant reductions in depressive symptoms and sleep disturbances, alongside improved everyday competence, with medium-to-large effect sizes. Cognitive performance remained stable in both groups.

Conclusions: Active music therapy thus emerges as a safe, low-cost, and non-pharmacological intervention that enhances emotional well-being, sleep quality, and autonomy among cognitively preserved institutionalized older adults.

Clinical implications: These findings highlight music therapy as an engaging and effective strategy to reduce depressive symptoms, improve subjective sleep perception and daytime functioning, and promote independence and resilience in aging populations.