Clinical Gerontologist最新文献

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: 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.

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.