Clinical Gerontologist最新文献

Objectives: The current study examined the relationship between social engagement and cognitive function among older Mexican heritage Latinos in the U.S. Although social engagement has been identified as a factor that is protective against cognitive decline and dementia, its association with cognitive health in Mexican heritage Latinos is understudied.

Methods: Data on cognitive health, social network characteristics, perceived social support, and social engagement were collected in a sample of older Mexican heritage Latinos in South Texas.

Results: Social network characteristics, perceived social support, and social engagement were significantly correlated with cognitive health. A hierarchical multiple regression analysis was used to test the relative strength of these factors in predicting cognitive health, while controlling for relevant covariates. Social engagement was found to be a significant predictor of cognitive function, beyond the effects of perceived social support and social network characteristics.

Conclusions: Findings highlight social engagement as a modifiable behavioral factor that may support cognitive health in aging Mexican heritage Latinos.

Clinical implications: The results suggest that screening for and enhancing social engagement may be a valuable clinical strategy for preserving cognitive function in older Latinos at risk of poor cognitive health outcomes.

Objectives: Sleep and circadian problems are prevalent among midlife and older adults. Unfortunately, treatments for these problems are limited by poor memory for treatment.

Methods: We conducted a pilot trial of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction paired with the Memory Support Intervention (TSC+MSI) for midlife and older adults with sleep and circadian problems (N = 26) (preregistration NCT04373538). After treatment, patients were offered optional booster messages. Aims were to (1) test change in clinical outcomes after TSC+MSI, (2) assess perceptions of TSC+MSI, and (3) evaluate patient engagement, preferences, and preliminary outcomes of booster messages.

Results: Following TSC+MSI, patients significantly improved on sleep disruption, sleep-related impairment, functional impairment, and select sleep diary outcomes. Therapist use of memory support strategies moderated improvements in sleep-related and overall impairment. TSC+MSI was perceived as acceptable by patients and feasible by therapists. Most patients opted in to the boosters. Sleep-related impairment significantly improved from pre-booster to post-booster.

Conclusions: Following TSC+MSI and boosters, improvements were observed in clinical outcomes, and signals supported feasibility and acceptability.

Clinical implications: Although comparisons with control conditions and larger samples are needed, TSC+MSI and booster messages may improve sleep and circadian and related outcomes among midlife and older adults.

Objectives: The relationship between affective disorders and frailty in older adults remains underexplored, despite their impact on quality of life and healthcare costs. This study aimed to investigate the relationship between affective symptoms, cognitive impairment, functional decline and frailty.

Methods: A cross-sectional study was conducted with 153 patients aged ≥60 years from two Psychogeriatric outpatient clinics. Standardized tools were used, including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), Pfeffer Questionnaire and Katz Index (to assess functional decline), Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI), and a clinical-sociodemographic questionnaire. Spearman correlations and Poisson regression were performed.

Results: Frailty prevalence was 62.1, and significant associations were found between frailty and depressive symptoms on GDS-15 (OR = 6.74), cognitive impairment on VFT (OR = 2.80), CDT (OR = 4.33), MMSE (OR = 4.88) and functional disability on Pfeffer (OR = 14.95). Multivariate analysis identified polypharmacy (OR = 1.64), depressive symptoms (OR = 1.97), cognitive impairment in VFT (OR = 1.30), and functional disability in Pfeffer (OR = 1.96) as independent predictors of frailty.

Conclusions: These findings reinforce the association between affective disorders, cognitive impairment, functional decline and frailty in older adults.

Clinical implications: The use of integrated tools can help identify patients at greater risk of frailty, guiding multidisciplinary interventions in geriatric mental health.

Objectives: Valid and reliable measurement of mindfulness is essential to identify mechanisms of change and potential racial or cultural differences in mindfulness-based interventions. We examined the psychometric properties of the Five Facet Mindfulness Questionnaire 15-item version (FFMQ-15) in a sample of Black and White caregivers of persons with dementia (PWDs).

Methods: Eighty-two caregivers of PWD participated in a treatment study at a VA Medical Center. Internal consistency was calculated using Cronbach's alphas overall and separately by racial group. Average inter-item correlations were used to optimize the scale. Construct validity was examined through bivariate correlations.

Results: Results indicated (a) FFMQ-15 scores demonstrated fair internal consistency overall but poor reliability among Black caregivers, (b) removing two negatively correlated items improved internal consistency for Black caregivers, and (c) mindfulness was negatively correlated with depression, anxiety, and caregiver burden.

Conclusions: Findings indicate some items on the FFMQ-15 may perform differently in Black compared to White caregivers of PWD. Results interpreted with caution; additional research is needed to determine cultural or contextual influence of possible measurement inequivalence.

Clinical implications: The FFMQ-15 may reflect different experiences of mindfulness among Black caregivers of PWD. Culturally responsive assessment is needed; Sociocultural factors and caregiving environment should be considered.

Objectives: Examine different sources of social support/network depending on depressive symptoms among older adults.

Methods: Data were obtained from two waves of the Age, Gene/Environment Susceptibility - Reykjavik Study (AGES-Reykjavik): Wave I (2002-2006, N = 5.764) and Wave II (2007-2011, N = 3.316). Seven questions (meet with friends/children feeling close to family/friends telephone children/friends living alone were used as: single question (social support)/social network score (SNS). The Geriatric Depression Scale (GDS) screened for depressive symptoms, recoded as: low score (GDS score < 6) and high score (GDS score ≥6). Longitudinal linear regression assessed associations between social questions and GDS score at follow-up among low and high depressive symptoms.

Results: Among low depressive symptoms (mean age 77) decrease in depressive symptoms was found for those meeting with children (β: -0.439, p = .007); friends (β: -0.288, p = .002); feeling close to family (β: -0.232, p ≤ .001) and friends (β: -0.217, p = .009). Among high depressive symptoms (mean age 78) decrease in depressive symptoms was when telephoning children (β: -4.679, p = .002); meeting with children (β: -2.725, p = .018).

Conclusions: In older community-dwelling adults regular social support decreases depressive symptoms with most meaningful support arriving from children and friends.

Clinical implications: Incorporating social network assessments into routine geriatric evaluations could help identify individuals at higher risk of developing or sustaining depressive symptoms.

Objectives: Sub-threshold cases of depression and anxiety disorders in older adults are often undetected and undertreated. The 7-item Duke Anxiety-Depression Scale (DUKE-AD) assesses mental distress; this study evaluated the psychometric validity and cross-cultural applicability of its Persian version (DUKE-AD-PERSIAN).

Methods: A cross-sectional study among 500 older adults assessed for content and face validity as measured by 20 experts, and estimated content validity ratio (CVR) and item-level content validity index (I-CVI). Exploratory and Confirmatory Factor Analyses (EFA, CFA) examined the factor structure.

Results: Participants had a mean age of 70.62 ± 7.42 years and mean anxiety-depression score of 25.05 ± 22.39. The implemented EFA and CFA's outputs (CMIN = 29.933, DF = 11, pvalue = 0.002, CMIN/DF = 2.721, RMSEA = 0.05 (95% CI: 0.034, 0.084), PNFI = 0.511, PCFI = 0.515, TLI = 0.969, IFI = 0/984, CFI = 0.984) supported unidimensionality of the scale. The estimated reliability and stability coefficients (Cronbach's α = 0.98, ICC = 0.97) were acceptable.

Conclusions: Findings supported the reliability and validity of the Persian DUKE-AD as a brief self-report measure for assessing anxiety and depression in older adults.

Clinical implications: The Persian DUKE-AD enables efficient screening of anxiety and depression symptoms among older adults, facilitating early intervention in primary care and community health settings.

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: 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.