Gerontology and Geriatric Medicine最新文献

The impact of chronic pain on neuropsychological functioning of older adults is under-studied. The present study examined the relationship between chronic pain, depression, anxiety, cognition, and functional capacity in community-dwelling older adults (ages 60-89) who completed an outpatient neuropsychological evaluation (N = 452). Psychometrically sound and validated measures were used to assess depression (Geriatric Depression Scale [GDS]), anxiety (Beck Anxiety Inventory [BAI]), cognitive functioning (the Mini Mental Status Exam [MMSE] and the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]), and functional capacity (Texas Functional Living Scale [TFLS] and Instrumental Activities of Daily Living Questionnaire [IADL]). Multivariate analyses of covariance (MANCOVA) were conducted to examine differences between individuals with and without chronic pain, adjusting for age, education, gender, marital status, and other medical conditions. Results indicated that participants endorsing chronic pain displayed significantly higher levels of depression and anxiety, as well as lower levels of cognitive functioning and functional capacity, than those without chronic pain. Additionally, results of hierarchical multiple regressions indicated that chronic pain explained unique variance in all outcome variables, beyond demographic characteristics and health status. Chronic pain management may be an important intervention target for clinicians to help address cognitive and psychological functioning in older adults.

Objectives: To examine the role of purpose in life in a sample of patients with Parkinson's disease and its correlations with well-being, quality of life, psychological distress, and motor function; and to compare patients reporting higher versus lower levels of purpose in life. Method: 59 patients completed the Purpose in Life subscale Scales and other questionnaires concerning quality of life, personal well-being, and psychological distress. Their motor function was assessed with the Short Physical Performance Battery. They were divided into (1) High purpose in life individuals-HPIL-(n = 23); (2) Low purpose in life individuals-LPIL-(n = 36). Bivariate correlations between questionnaires and ANOVA between-group were calculated. Results: Purpose in life was significantly and positively correlated to well-being, quality of life and motor function, and negatively to psychological distress. After controlling for age, gender, marital status, years from diagnosis and dopamine medication, HPIL individuals reported significantly higher levels of well-being, quality of life, better physical functioning and lower distress. Discussion: Purpose in life is strongly associated with mental well-being and motor function in patients with Parkinson's disease. These findings suggested the importance of developing interventions to promote purpose in life also in this population.

Objective: This study examined the prevalence and long-term survival of atrial fibrillation (AF) in the older population. Methods: Data was recruited from the longitudinal SNAC study from baseline (2001-2004) for up to 10 years. Results: The population comprised 6,904 persons (59% women) (mean age 73.9 years). The prevalence of AF was 4.9% and increased with age. The hazard ratio (HR) for death in those with AF at baseline was 1.29 during the 10-year observation period. Cox regression analysis in persons with AF (n = 341) showed that men had a higher HR for death (1.57). CHA2DS2-VASc scores were significantly associated with death within 10 years (HR 1.29/score). Any form of anticoagulant use was reported in 146 (42.8%) and was significantly associated with survival (p = .031). Conclusions: The prevalence of AF in the general population was almost 5%, and it shortened life expectancy by nearly 2.4 years over a 10-year period. Despite the proven efficacy of OAC therapies, our results demonstrate that AF continues to be associated with increased mortality, especially among men, and that many older people are at high risk of developing a stroke because they do not receive appropriate anticoagulant therapy. These results emphasize the need for improved preventive and therapeutic modalities.

Background: Given the complexity of existing assessment methods and the scarcity of specialized geriatric healthcare professionals in China, this study aimed to investigate the risk factors for falls in hospitalized older adults patients. Methods: From July 2018 to July 2020, 112 older adults patients hospitalized in the Department of Geriatrics of our hospital were enrolled and grouped into the low-(n = 12), medium-(n = 58), and high-(n = 42) (fall) risk groups according to the Johns Hopkins Fall Risk Assessment. The patient's clinical characteristics, smoking, alcohol consumption, disease, falling history, osteoporosis medication, mobility, Barthel index, MMSE, and JHFRAT score were compared between groups. Results: The high-risk group had the oldest age, and the lowest weight, BMI, as well as highest rate of stroke history and sarcopenia among the three groups. Multivariate linear regression analysis revealed that stroke history (B = 2.66, 95% CI = [0.43, 4.89]; p = .020) and gait speed (B = -4.78, 95% CI = [-8.74, -0.76]; p = .020) were the significant factors associated with fall risk in hospitalized older adults patients. Conclusions: The results suggested that hospitalized older adults patients with stroke history and low gait speed had higher fall risk. These findings may be helpful for fall prevention in hospitalized older adults patients.

Background: The closure of fitness and rehabilitation centers during the COVID-19 pandemic significantly impacted the rural Parkinson's disease (PD) population, a population already vulnerable due to limited access to healthcare, rehabilitation services, and social support. Objective: This study aimed to assess the psychological, social, and physical impact of COVID-19 restrictions on older adults living with PD in a rural region of the southeastern US to better inform future practices. Methods: Participants (5 female, 6 male, age 78.7 ± 2.3 years) were recruited from PD support groups in rural communities across northwestern North Carolina, USA. Structured interviews focused on the impact of COVID-19 on daily physical activity (PA), quality of life, mental health, and social support. Thematic analysis was used to identify key themes. Results: Seven main themes emerged: mental health, life changes, the importance of group/social support, motivation for PA, COVID-19 adaptations/impact on PA, and functioning. These themes reflected increased social isolation, reduced motivation for PA, and negative impacts on quality of life. Conclusions: The study underscores the challenges faced by rural PD communities during isolation events and emphasizes the need for programs that prioritize social interactions to support physical and mental health, with plans to maintain these connections during future isolations.

This study aimed to determine the time elapsed since the last dental care visit and its associated factors among older adults in Peru from 2019 to 2021. This was an analytical cross-sectional study utilizing secondary data analysis. The population comprised 210,862 records of older adults from 2019 to 2021, with a final sample of 11,215 records. The dependent variable was the time elapsed since the last dental care visit, while the independent variable was the year, with population characteristics included as covariates. Both bivariate and multivariate analyses were employed. The mean time elapsed since the last dental care visit was 7.93 years (SD = 8.03) in 2019, 7.93 years (SD = 7.28) in 2020, and 7.76 years (SD = 8.01) in 2021, with non-statistically significant difference between medians (p = .050). Hierarchical multiple linear regression analysis indicated that a model incorporating year, health, geographic, and socio-demographic characteristics demonstrated a greater determination coefficient (R ²% = .90) and validity (p < .001). The mean time elapsed since the last dental care visit among older adults in Peru was 7.93 years in both 2019 and 2020, and 7.76 years in 2021; geographic characteristics, wealth index, and age were identified as associated factors.

Introduction: The gerontological literature suggests that external housing-related control beliefs (HCB) influence activities of daily living (ADL) among older people, but knowledge is scarce for people with Parkinson's disease (PD). This longitudinal study aimed to explore the directions of the relationship between external HCB and ADL among people with PD.

Methods: Baseline (T1) and 3-year follow-up data (T2) were collected from 154 people with PD (mean age = 68 years, T1). Two regression analyses were applied, where dependent (T2 values) and independent (T1 values) variables-external HCB score and PD specific ADL (PADLS)-were switched, adjusting for age, disease severity, cognitive functioning, and accessibility problems.

Results: There was a significant effect of ADL on external HCB (β = 3.07, p < .001, CI [1.28, 4.85]), but no effect in the reverse direction. The proportion with moderate-extreme ADL difficulties increased over time (from 20.8% to 32.5%, p = .006).

Discussion: ADL difficulties seem to lead to higher external HCB, but not the other way around, which contradicts assumptions in environmental gerontology theories. This new knowledge can promote theory development. While additional studies are required to verify whether this is a disease-specific finding, this indicates the importance of targeting ADL if the purpose is to influence external HCB among people with PD.

Behavioral activation therapy is presented as a promising psychological intervention to enhance depression management and related symptoms by increasing engagement in rewarding activities. This study reviews three research endeavors, including randomized controlled trials and a case study. Variability in intervention duration and training approaches is noted, although typically, eight sessions per week were conducted. Therapy components range from participating in pleasurable activities to ongoing support outside sessions. The process of evidence source selection relied on identifying 327 articles across four databases, with three selected for review, utilizing the PRISMA extension for scoping reviews. This ensured rigorous eligibility criteria and a structured methodology for data collection. Overall, these findings support the effectiveness and applicability of behavioral activation therapy in treating depression in older adults. Training non-specialized healthcare personnel would improve the overall quality of medical care and facilitate the dissemination of evidence-based therapies. This, in turn, could be crucial in closing the psychotherapeutic care gap that exists in low and middle-income countries.

Objective: We aimed to assess seasonal and age-related variations in sleep quality using Fitbit data and offer lifestyle recommendations for enhancing winter sleep quality. Methods: Fitbit sleep and activity data of 51 participants randomly recruited from members of the Association for Research in Supporting System of Chronic Disease, a nonprofit organization in the Yamanashi Prefecture of Japan, were collected and retrospectively analyzed from July to December 2022. Sleep stage targets were set at 10% to 25% for deep sleep, 50% to 60% for shallow sleep, and 20% to 25% for REM sleep. Participants were categorized into improved, unchanged, and worsened groups based on sleep stage unit changes between August and December. Results: The median (interquartile range) age was 71 (68-74) years old. There were eight participants in the improved group, 23 in the unchanged group, and nine in the worsened group. The improved group showed significantly more steps (990 ± 1,102 steps/day, p = .039) in December than in August, while the worsened group showed fewer steps (-507 ± 1,638 steps/day, p = .38). Conclusion: Increasing step count in winter may improve sleep quality, as assessed by sleep stage. Further research considering potential confounders and factors affecting winter sleep is needed to support and extend these findings.

The COVID-19 pandemic has significantly impacted the daily lives of older adults. Three case reports illustrate how individuals have coped with loss, maintained routines, and faced emotional challenges. Understanding these experiences can guide efforts to promote the well-being and resilience of older adults during this time. Interview questions included "What was your daily routine and any leisure activities you participated in before COVID-19? During the height of social distancing?" to explore the impact of this pandemic on older adults' daily routines and the effects on their mental and physical health.