International psychogeriatrics最新文献

Objectives: A reduction in an aging individual's abilities combined with environmental changes can lead to decline in everyday function. This study examined the association between visual and cognitive abilities with everyday function and assessed whether measures of Social Determinants of Health (SDoH) moderate the associations of these predictors with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Methods: Using a generalized linear mixed model, the longitudinal associations between changes in vision, cognitive function, and everyday functioning were examined.

Results: Decline in reasoning abilities was associated with more ADL limitations, and the association was stronger for older adults with decreased healthcare access and lower economic stability. Furthermore, the associations between memory and speed of processing were associated with more ADL limitations, and the associations were stronger for older adults with lower educational and occupational status. Also, better memory was associated with fewer IADL limitations, and this association was weaker for older adults with higher educational and occupational status, and social and community contexts.

Conclusion: Interventions to enhance cognitive abilities and modify environmental resources are essential to alleviate IADL/ADL limitations in older age.

Objective: This scoping review provides an overview of narrative approaches used to collect experiences of older persons in long-term care and how these approaches support learning and quality improvement.

Introduction: Long-term care organizations increasingly use narrative approaches to collect older persons' experiences and improve care from their perspective, but information about such approaches is scattered.

Inclusion criteria: Studies describing narrative approaches that collected experiences of older persons (or proxies) to support learning and quality improvement in long-term care.

Methods: A systematic search was performed in eight databases (e.g., Embase, CINAHL, PsycINFO). Articles in English or Dutch were eligible, with no publication date restrictions. Searches were completed on 28 April 2022. Several data items were charted using Excel.

Results: Thirty-seven articles were included describing a narrative approach. Most studies originated from Western countries and focused on institutional care. Older persons with and without cognitive decline participated in the approaches. Experiences were mainly collected through interviews, while the process of learning and improving quality of care was often supported by group discussions. Goals and outcomes were formulated at client, professional/relational, and organizational levels.

Conclusion: A variety of approaches are developed to collect narrative information from older persons to improve quality of long-term care. Development opportunities for narrative approaches are including people with (severe) cognitive decline, embedding approaches in organisations for more structural effects to support learning and quality improvement and evaluating the impact and execution of narrative approaches.

Background: As demand for mental healthcare access grows among older adult populations, digital mental health tools have emerged as promising tools. However, bridging the digital divide among older technology users remains critical. This post-hoc analysis evaluated potential factors influencing the adoption of a digital mental health tool in older adults.

Methods: We analyzed data from 37 older adults who used a digital phenotyping app (mindLAMP) for 4 weeks to capture passive sensor data and complete nightly surveys. We examined associations between baseline participant features including demographics, cognition, mood, technology attitudes and use, and usability outcomes including app training metrics, adherence, and self-reported usability.

Results: Participants had a mean age of 72, with most identifying as female (68 %), college educated (76 %), retired (81 %), and White (59 %). The app demonstrated high usability, with baseline training averaging 20.2 (±6.5) minutes and 80 % nightly survey completion. At study completion, 30/37 participants reported finding the app easy to use. While not significant after correction, female sex, Black race, and some college education emerged as potentially promising factors associated with better usability outcomes.

Discussion: These findings suggest that with modest training, older adults can engage with digital health tools and report positive usability experiences. Differences in usability outcomes by sex, race, and education point to potential characteristics that may influence engagement. However, given the small, highly educated sample, these findings should be replicated in larger, more diverse cohorts to better understand which factors support the successful use of digital health tools in older adults.

Background: The aging of the world's population has led to a growing need for innovative strategies to promote active aging and bridge generational divides. Intergenerational Programs (IGPs) that engage young adults (18-30 years) and older adults (65 + years) have demonstrated the potential to improve well-being and reduce ageism. However, the evidence for this pairing of ages is still fragmentary. This review aims to provide a qualitative and systematic synthesis of present IGPs, deepening the main characteristics of their implementations.

Methods: Four databases (Scopus, Web of Science, PubMed, ERIC) were systematically searched following PRISMA guidelines. After screening 5554 articles, two independent reviewers assessed full texts, and 26 studies were included and systematically coded for narrative synthesis.

Results: The study results indicate that IGPs consistently improve mental health, social inclusion, and community cohesion and reduce ageism for both age groups. Most studies (77 %) reported positive outcomes for both generations, while 19 % showed benefits exclusively for older adults. Interventions are diverse, including educational, community, meaningful activity, physical activity, reminiscence, and technology programs. Relational dynamics (61.5 %) and ageism reduction (54 %) emerged as primary outcome focuses.

Conclusions: Despite these strengths, variability in theoretical frameworks and methods limits comparability. These findings highlight the potential of IGPs to promote intergenerational solidarity and suggest that future research should prioritize standardized approach and balanced evaluations to strengthen the evidence base and guide effective practice in an aging society.

Background: The proportion of older people is growing dramatically, implying that predictors of health-related quality of life (HRQoL) in older adults are of major interest within public health research.

Methods: Analyses were based on the ESTHER study, a German population-based cohort study conducted in the federal state of Saarland, Germany. The study was initiated in 2000-2002 and included 9940 community-dwelling older adults recruited via general practioners. At the 8-year follow-up (2008-2010), 6071 active participants were offered additional home visits, of whom 3124 agreed to participate. These 3124 participants (mean age (SD) 69.6 (6.3) years; 52.6 % female) served as baseline sample for our analysis. Predictions were made at 3-year intervals up to 12 years (20-year follow-up; 2020-2021, n = 1438). Physical and mental HRQoL was assessed using the Short Form Health Survey (SF-12). 47 features were investigated. Random forest regression was used to identify the most important predictors.

Results: Physical HRQoL was predictable up to 6 years, with top 5 predictors being: somatic symptom burden, bio-psycho-social (BPS) health care needs, frailty, age, and BMI class. For mental HRQoL, predictors consistently ranging among the top 5 across all time intervals were: somatic symptom burden, BPS health care needs, symptoms of depression, and symptoms of anxiety. There appeared to be a time-dependent shift in key predictors of mental HRQoL, with symptoms of depression and anxiety being most important in short-term, while somatic symtom burden and BPS health care needs were most important in long-term.

Conclusion: Somatic symptom burden and bio-psycho-social health care needs emerged as key predictors of both, physical and mental HRQoL in older adults. These variables may be important to consider when developing future interventions aimed to improve HRQoL in older adults, and could also be relevant for policies concerned with successful aging.

Objectives: Dementia and sleep disturbance co-occur frequently. Previous research has focused on sleep disturbance and dementia risk, but its impact in established dementia is less clear. The aim of this study was to investigate the frequency of recorded sleep disturbance at the time of dementia diagnosis and its association with adverse outcomes.

Design & setting: Using data from a large South London healthcare provider, a retrospective cohort study was assembled.

Participants: Patients aged 55 years and older with a dementia diagnosis received between 2007 and 2018 (n = 17,235).

Measurements: Recorded sleep disturbance at the time of dementia diagnosis was ascertained using natural language processing algorithms. Multivariate Cox regression models were applied to identify associations with the following adverse outcomes: unplanned hospitalisation, emergency department attendance, mental health crisis care, mortality.

Results: The prevalence of recorded sleep disturbance at the time of dementia diagnosis was 29.0 %. After adjustment for twenty-two different potential confounders sleep disturbance was associated with significantly increased risk of all adverse outcomes (unplanned hospitalisation: adjusted hazard ratio (aHR): 1.06, 95 % confidence interval (CI): 1.01-1.10; emergency department attendance: aHR: 1.09, 95 % CI: 1.05-1.14; mental health crisis care: aHR: 1.58, CI: 1.36-1.84) apart from mortality.

Conclusion: Sleep disturbance at the time of dementia diagnosis is an indicator for a worse prognosis. Preventing and treating sleep disturbance in people with dementia could pose an opportunity to reduce adverse outcomes.