Clinical Gerontologist最新文献

Objectives: Financial exploitation (FE) is associated with negative social and health consequences. This study examined the relationship between objective/subjective vision abilities and FE vulnerability among older adults.

Methods: 97 community-dwelling older adults aged 60 and over completed self-report questionnaires assessing subjective vision difficulties, FE vulnerability, and history of FE experiences. Additionally, participants underwent objective vision assessments (distance, near and contrast sensitivity) conducted by a certified gerontological optometrist.

Results: Multiple linear regression and logistic regression models showed that self-reported vision difficulties were associated with FE vulnerability (β = .355, p < .001) and self-reported FE experiences (OR = 7.866, p = .005), while objective vision measures were not.

Conclusions: Self-perceived vision difficulties are more strongly linked to FE than objective measures. Subjective vision may reflect a cognitive averaging of vision ability not fully captured in well-controlled environments characteristic of objective assessments.

Clinical implications: These findings advance our understanding of FE risk factors by highlighting the importance of subjective vision abilities, and suggest practical approaches for identifying and supporting at-risk older adults through patient-reported visual assessments.

Objectives: To investigate whether living alone, loneliness, and their interaction were associated with psychological distress in older adults, and whether these relationships varied according to place of residence.

Methods: A sample of 15,755 adults aged ≥65 years (M = 72.21) living in urban, regional, and rural Australia was drawn from the Sax Institute's 45 and Up, COVID Insights sub-study. Participants completed the DeJong Gierveld short form for Emotional Loneliness and the Kessler 6 Psychological Distress Scale at three pandemic time points.

Results: Psychological distress increased and loneliness decreased over time. Greater loneliness was experienced as the population decreased. Loneliness, but not living arrangements, was associated with psychological distress irrespective of where people lived. For older adults in urban and regional areas, loneliness and living arrangements interacted; loneliness was more strongly related to psychological distress among those living alone than those living with others.

Conclusions: Loneliness is associated with psychological distress irrespective of place of residence. Living alone exacerbates this association among older adults living in more populated areas.

Clinical implications: Older adults living in regional and rural areas and those who live alone in more densely populated areas require special consideration for how their belongingness needs can be met.

Objectives: This study examined the impact of befriending on depression, anxiety, perceived social support and loneliness in older people living in residential aged care homes.

Methods: A pragmatic randomized controlled trial compared depressive symptoms (Geriatric Depression Scale-15), anxiety symptoms (Geriatric Anxiety Inventory), loneliness (UCLA loneliness scale), and perceived social support (Lubben Social Network Scale) measured at baseline, 8 weeks and 16 weeks post baseline for people randomized to receive either befriending or usual care. Trial registration ANZCTR N12619000676112.

Results: Among N = 345 participants, a significant reduction in depressive symptoms for people receiving befriending compared to the control group: 0.76 points lower on GDS at 8 weeks and 0.95 lower at 16 weeks (Cohen's d = -0.458). Loneliness (UCLA) was 2.39 units lower than the control group at 8 weeks and 2.71 units lower at 16 weeks (Cohen's d -0.481). There was no significant difference for anxiety symptoms or perceived social support.

Conclusions: Befriending led to a small improvement in depressive symptoms and loneliness in older people living in residential aged care.

Clinical implications: The improvement in depressive symptoms and loneliness indicates that befriending may be a useful supplement to psychological services for those living in residential aged care.

Objectives: This study explored family perspectives on a six-week video family visit intervention for persons living with dementia in long-term service and support settings, focusing on its barriers and benefits.

Methods: Semi-structured interviews were conducted with five family members. A conventional content analysis was performed to analyze transcript narratives and identify shared meanings of their experiences during the intervention.

Results: Four themes emerged: (1) Facilitating family connections and emotional well-being; (2) Technology as a barrier and a bridge; (3) The need for structured support; and (4) Adaptability in scheduling. Families noted that video family visits provided opportunities to bridge physical distance and maintain family relationships.

Conclusions: Video family visits can serve as a valuable tool to facilitate family connections in long-term service and support settings. By addressing technological barriers, incorporating structured support, and adapting to the specific needs of families and persons living with dementia, video family visits can enhance the quality of life for both patients and their families.

Clinical implications: Healthcare professionals can adapt video family visits to support psychosocial well-being of persons living with dementia and their families. Appropriate training for facilitators and families is important for meaningful and quality video family visits.

Objectives: This study aims to investigate the impact of trait anxiety on sleep disorders within a community-dwelling older adult population, examining the mediating effects of self-perceived aging and loneliness.

Methods: This study was a cross-sectional study. A total of 374 community-dwelling older adults (mean age 73.30 ± 7.56 years; 179 males, 47.9%; 195 females, 52.1%), residing in Jinzhou City, Liaoning Province, China, were recruited. A battery of assessments, including a demographic questionnaire, the State-Trait Anxiety Inventory, the University of California at Los Angeles Loneliness Scale, the Brief Aging Perceptions Questionnaire, and the Pittsburgh Sleep Quality Index, was administered to the cohort. Data analyses were performed using SPSS version 27.0 and PROCESS version 4.0 macro, enabling the computation of descriptive statistics, correlational analyses, and multiple mediation models.

Results: This study found a statistically significant positive correlation between trait anxiety and sleep disorders in older adults. Moreover, the mediating roles of self-perceived aging and loneliness in the relationship between trait anxiety and sleep disorders were identified.

Conclusions: Older adults with trait anxiety have relatively poor sleep conditions. Negative self-perceived aging and feelings of loneliness are key mediating factors.

Clinical implications: To improve the sleep health of older adults in the community, intervention measures should focus on their psychological state, such as alleviating trait anxiety and reducing self-perceived aging and feelings of loneliness.

Objectives: This study describes the cultural adaptation of Cuidando Juntos (derived from the evidence-based Caregiver Thrive, Learn, Connect) for Latino dementia caregivers, guided by the Cultural Adaptation Behavioral Stage Model, and presents preliminary findings from a Stage Ia trial evaluating preliminary program acceptability.

Methods: A Community Advisory Board comprising Latinas from three U.S. regions collaborated with a bilingual research team to inform adaptations. All modifications were documented using the Framework for Reporting Adaptations and Modifications - Enhanced (FRAME). A Stage Ia trial of the adapted intervention was conducted with five Latino caregivers. Post-intervention, participants completed a focus group; data were analyzed using rapid qualitative analysis.

Results: Nineteen adaptations were made: 13 pre-trial and six after trial completion. Adaptations focused on content alignment with cultural values, dementia-specific modules, and goal-setting exercises to increase social connection. Qualitative feedback from participants and facilitators indicated high satisfaction, practical utility, and cultural relevance. Three themes were identified from the qualitative feedback: extending session time, expanding content, and increasing group activities.

Conclusions: The adaptation process was systematic, community-driven, and culturally responsive. Preliminary findings support the program's acceptability among Latino dementia caregivers.

Clinical implications: Cuidando Juntos shows promise as a culturally attuned intervention to enhance caregiver well-being among Latinos.

Objectives: We examine whether physician-diagnosed and symptom-based asthma are associated with depression, loneliness, and sleep difficulties among older Indians, and whether these associations vary by rural-urban residence.

Methods: We used cross-sectional data from 4,214 adults aged 60 to 101 years (mean age = 68.4, SD = 7.0) from the WHO Study on Global Aging and Adult Health (SAGE, 2015). Asthma is gauged as physician-diagnosed and symptom-based. Multivariable regression and interaction models controlled for sociodemographic and health-related variables.

Results: 5.93% of older adults reported physician-diagnosed while 12.29% endured symptom-based asthma. Physician-diagnosed asthma was associated with higher odds of depression and sleep difficulties but not with loneliness. In contrast, symptom-based asthma was linked with greater odds of depression, loneliness, and sleep difficulties. Rural residence amplified the asthma-sleep association, with similar but non-significant trends for loneliness.

Conclusions: Symptom-based asthma was more strongly associated with adverse mental health outcomes than physician-diagnosed asthma, highlighting the need for better asthma detection, management, and mental health support, particularly in resource-limited contexts.

Clinical implications: The findings underscore the need for comprehensive asthma care with regular mental health screening, especially for those without a formal asthma diagnosis who live in rural India.

Objectives: The aim of this study was to investigate the prevalence of difficulties in personality functioning (PF) in older adults with depression and to explore the mediating role of the attitude toward own aging (ATOA).

Methods: To examine differences in the level of PF between healthy older adults (n = 42) and older inpatients with depression (n = 36), the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQ) was employed. Moreover, in the total sample of older adults (N = 78), we examined whether the relationship between the level of PF and depression is mediated by the ATOA.

Results: Compared with healthy older adults, older inpatients with depression reported significantly greater structural deficits in PF, notably in the subdomains of self-perception, self-regulation, and attachment to internal objects. The mediation analysis demonstrated that the relationship between PF and depression was partially mediated by the ATOA.

Conclusions: Depression is closely associated with impairments in PF even in older individuals. These impairments may be partially mediated by a negative ATOA, which in turn exacerbates depressive symptoms.

Clinical implications: It seems useful to assess PF in older inpatients with depression and to accompany this with an exploration of the patient's ATOA.

Objectives: To explore U.S. geriatricians' practices, beliefs, and attitudes related to opioid pain management and naloxone prescribing in older adults with serious illnesses, particularly in instances of opioid use disorder or misuse.

Methods: A cross-sectional survey was administered anonymously via REDCap to U.S.-based geriatricians.

Results: 211 responses were included in the analysis. Respondents estimated that 19.7% of patients in their panel are prescribed opioids for subacute or chronic pain. Even though 32.7% of respondents had encountered at least one opioid overdose in a patient under their care, the percentage of patients to whom they prescribe naloxone among all their patients prescribed opioids is highly variable (mean 46.8% ± SD 39.0%). Only 18.4% of respondents reported "always" taking a thorough substance use history or using a risk assessment tool when prescribing opioids. Respondents reported low confidence managing opioids in patients with a history of opioid use disorder or misuse. Most respondents (63.0%) endorsed lack of knowledge or comfort as a barrier to prescribing naloxone.

Conclusions: Geriatricians would benefit from enhanced training in safe opioid use management, especially in settings where specialty addiction services are unavailable.

Clinical implications: U.S. geriatricians are not sufficiently prepared to manage opioids in older adults with serious illness.

Objectives: COVID-19 escalated stress within family/neighborhood (local) and national/cultural (global) levels. However, the impact of socioecological levels of stress on pandemic emotion regulation remains largely unexplored.

Methods: Thirty older adults from the Northeast US (63-92 years) reported on pandemic stress and emotion regulation in semi-structured interviews. Responses were coded into socioecological sources of local and global stress, and associated use of cognitive emotion regulation strategies from the Cognitive Emotion Regulation Questionnaire was explored.

Results: Older adults experienced significant distress at global levels, and perception of lacking top-down safety governance may have exacerbated local distress of engaging in daily activities during the COVID-19 pandemic. Participants endorsed coping with local stressors via perspective-taking, acceptance, and other adaptive strategies, while global sources of stress were associated with greater use of maladaptive strategies, including other-blame and rumination.

Conclusion: Quantitative assessments may underestimate significant older adult distress and maladaptive coping toward global stressors. Findings should be replicated with more diverse populations beyond the COVID-19 context.