Aging & Mental Health最新文献

Objectives: The present study of older adult immigrants in the United States examined their life satisfaction's relationships with individual resources (physical health, mental health, financial solvency, education, social support, and marital status) and social resources (social activities, employment, health insurance status, receipt of public assistance, and acculturation).

Method: A sample of 1,176 adult immigrants aged 65 years or older was extracted from the 2021 National Health Interview Survey for secondary data analysis.

Results: Logistic regression results indicated that these older adult immigrants' likelihood of life satisfaction was positively associated with physical health, social support, and being Hispanic; such likelihood also had negative associations with depression, mobility difficulty, U.S. citizenship, and English-language proficiency.

Conclusion: Implications included funding for community centers serving older adult immigrants, forming alliances and coalitions involving multiple racial/ethnic groups, social work education and training emphasizing cultural competence with diverse ethnicities, intervention with bilingual social workers, building a supportive social network, and mental health care incorporating native cultural beliefs.

Objectives: Social relationships are fundamental to well-being in later life, yet few studies differentiate between relationship types and the mechanisms through which they operate. This study models how different types of social relationships are associated with life satisfaction in very old age, considering the psychosocial pathways of perceived emotional and practical support, and loneliness.

Method: Direct and indirect associations between relationships and life satisfaction were tested using structural equation modelling on 1,213 community-dwelling older adults (77+) participating in the Swedish Panel Study of Living Conditions of the Oldest Old. .

Results: Close family relationships emerged as the most important, and while children were inherently positive for life satisfaction (standardised coefficient 0.23, p < 0.01), partners had a positive association only through indirect pathways (0.14, p < 0.01) and a negative direct association (-0.19, p < 0.01). Friends were associated with life satisfaction through emotional functions while other relatives and weak ties showed no significant associations.

Conclusion: In very late life, life satisfaction appears to depend on the emotional quality and perceived support within close relationships. As demographic shifts continue, future cohorts may have fewer children and more diverse social networks. These changes may increase the importance of non-kin relationships and more distant relatives for maintaining well-being in old age.

Objectives: The present study investigated a moderated mediation model in which depressive symptoms mediated the relationship between childhood psychological maltreatment and death obsession, with meaning in life moderating both components of the indirect pathway.

Method: The sample for the present study consisted of 904 older adults (50.2% women), aged between 65 and 91 years (M_age= 71.23, SD = 5.72), residing in an urban region of Türkiye. Self-report measures assessing childhood psychological maltreatment, depressive symptoms, death obsession, and meaning in life were administered. Data were analyzed using moderated mediation analysis.

Results: Results indicated that childhood psychological maltreatment was positively associated with both depressive symptoms and death obsession. Furthermore, depressive symptoms significantly mediated the link between early maltreating experiences and death-related cognitive preoccupations. Critically, meaning in life moderated both the association between childhood maltreatment and depressive symptoms and the pathway from depressive symptoms to death obsession. These associations weakened as perceived meaning in life increased, suggesting a protective buffering effect on the indirect effect.

Conclusion: These findings underscore the enduring psychological consequences of early relational maltreatment and emphasize the importance of fostering existential resources such as life meaning to mitigate depressive and death-related vulnerabilities in older adulthood.

Objectives: Family caregivers of individuals with Alzheimer's disease or related dementias (ADRD) may experience reduced quality of life. While some caregiver interventions focus on specific concerns (behavioral symptoms, care-management), or caregiver symptoms (grief, anxiety, depression), Acceptance and Commitment Therapy (ACT) is a transdiagnostic approach that addresses a broad range of psychological symptoms and can be effectively delivered through digital mental health interventions (DMHI), offering a plausible solution to improving access.

Method: Dementia caregivers completed a 6-session DMHI on Acceptance and Commitment Therapy tailored to caregiving stress ('ACT for Caregivers'). Post-completion and 6-week follow-up interviews were conducted. A team-based approach and thematic analysis were used to analyze longitudinal interviews with 28 participants.

Results: We identified three overarching themes: (1) Improvements in Quality of Life (QoL), (2) Facilitators of QoL, and (3) Mixed Impact on QoL. QoL improvements included two subthemes: vibrant living and reduced stress. Facilitators included enhanced emotional awareness/regulation and increased caregiving capacity.

Conclusion: ACT for Caregivers shows promise as a scalable, accessible, and cost-effective DMHI for dementia caregivers, and this study supports that self-reported improvements in quality of life for those completing the program were sustained 6 wk later.

Background: Globally, the number of people aged 60 and over is increasing. The study examined the interconnectedness of emotional, physical, psychological, and social well-being and their collective impact on the happiness of older adults in Ghana.

Methods: We utilized data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) Survey Wave 2. The study employed structural equation modeling (SEM) to examine these relationships among a nationally representative sample of 1,010 older adults aged 60 years and above.

Results: The findings revealed significant positive direct effects of emotional well-being (β = 0.69, p < 0.001), physical well-being (β = 0.39, p < 0.001), cognitive well-being (β = 0.70, p < 0.001), and social well-being (β = 0.09, p < 0.001) on happiness. Additionally, the study identified significant covariances among these domains, with physical well-being showing a unique negative relationship with social well-being (β=-0.21, p < 0.001).

Conclusion: This study provides critical insights into the holistic factors contributing to the happiness of older adults, emphasizing the importance of integrated well-being strategies in enhancing the quality of life for older adults 60 years and older in Ghana.

Clinical trial number: Not applicable.

Objectives: We examine the association between formal support and caregiver well-being. The extant literature indicates that formal support often correlates with worse caregiver mental health outcomes. We tested whether timing of formal support use, rather than the services themselves explain prior findings.

Method: Using National Study of Caregivers data (NSOC 2015, 2017, & 2021), we analyzed the association between formal support utilization and caregiver mental health. We employed linear regression and Two-Stage Least Squares (N = 3,963) approach to address endogeneity and unobserved caregiver demand.

Results: The results indicated positive or non-significant associations between formal support and mental health outcomes. However, formal support is negatively associated with depressive symptoms (β = -0.40) and generalized anxiety (β = -0.44) when instrumentalizing formal support as a function of caregiver demand for services. When strain on a caregiver is high (i.e. high overload, working, and high frequency caregiving activity), there is a higher propensity for utilizing formal support. Caregivers with high strain showed higher propensity for formal support utilization.

Conclusion: The results highlight that underlying demand functions are important mental health predictors as the negative impacts of caregiver strain may limit the efficacy of formal support services.

Objectives: Concealment, in any form, can have a lasting negative impact on the health of individuals. This study draws on participant concealment experiences from a study on lifetime health experiences of older lesbians and gay men in the UK.

Method: Constructivist grounded theory was used to develop a substantive theory that explains the impact of concealing and revealing on the lives of eighteen participants, nine women and nine men (age range of 50-86) in the UK.

Results: Almost from the time of realising that they were 'different' the need to conceal was significant. This manifested the process of 'masking', as a protective measure and the need to fit in with society. As a result of these experiences scarring occurred that was primarily psychological. 'Coming out' was a major step and involved 'selective revealing', which was interwoven with the experience of living in a supportive community, whilst also coming to terms with oneself, and for some, becoming an activist.

Conclusion: Findings highlight the consequences of concealment while pointing to the transformative potential of affirming environments. This research extends understanding of the lived realities of older lesbian and gay individuals, emphasising both the impact of societal oppression and the resilience required to navigate it.

Objectives: Care refusal behaviours in dementia represent meaningful expressions of autonomy, yet validated assessment tools for Portuguese-speaking populations remain absent. The Refusal of Care Informant Scale (RoCIS) measures care refusal expressions during personal care interactions. This study aimed to conduct cross-cultural validation of the RoCIS for European Portuguese populations, establishing psychometric properties in nursing home settings.

Method: This cross-sectional study employed systematic translation and psychometric evaluation using classical test theory and Rasch analysis. A sample of 183 older adults living with dementia from 12 Portuguese nursing homes was assessed using the Portuguese RoCIS alongside validated measures, including the Cohen-Mansfield Agitation Inventory, Neuro-psychiatric Inventory-Questionnaire, Barthel Index, and Functional Assessment Staging Tool.

Results: The Portuguese RoCIS demonstrated internal consistency (Cronbach's α = 0.834; 95% CI: 0.796-0.867). Rasch analysis confirmed item reliability (0.91) and unidimensionality. Convergent validity was established through significant correlations with agitation (r = 0.523, p < 0.001) and neuropsychiatric symptoms (r = 0.427, p < 0.001). Known-groups validity showed significant discrimination across cognitive dependency levels (F(2,180) = 3.410, p = 0.035).

Conclusion: The Portuguese RoCIS represents the first cross-cultural validation beyond the original country of development, providing strong evidence for the scale's international applicability and supporting relationship-centred dementia care globally.

Objectives: Older adults residing in nursing home (NH) settings are at risk of loneliness, a complex and multi-dimensional concept that adversely affects health. To effectively identify and address loneliness, it is crucial to enhance the understanding of the social, psychological, cultural, and environmental factors associated with loneliness.

Method: A scoping review was conducted to examine the current evidence. Thematic analysis was employed to identify factors influencing (dimensions of) loneliness, which were ranked on proximity to loneliness.

Results: Based on 38 research papers, 27 factors related to loneliness were identified, of which 13 were sufficiently representative. A minority of these factors were directly linked to the social, emotional and existential dimensions of loneliness. The most frequently mentioned factors were categorised into the domains of health and functioning, stress-coping, social contact, and relationship quality.

Conclusion: Loneliness is best addressed within the immediate social environment of NH settings, and staff play a crucial role in fostering a sense of belonging. Moreover, residents' experiences and needs regarding loneliness and its dimensions must be thoroughly assessed and discussed, particularly for those suffering from dementia. Furthermore, our review emphasises the urgent need for comprehensive, inclusive, and consistent research on loneliness in NH settings.

Objectives: Caregivers may experience treatment burden as they care for persons living with dementia and diabetes. This study aims to adapt and validate the Treatment Burden Questionnaire (TBQ) for use among caregivers.

Method: For this cross-sectional study, we pooled data of caregivers enrolled in the Enhanced Quality in Primary Care for Elders with Diabetes and Dementia study (N = 311). The original patient-focused 15-item TBQ scale was adapted to measure caregiver-related burden. We assessed face validity for each item, performed item analysis, and computed the scale's internal consistency (Cronbach alpha). We also performed principal component analysis (PCA) and correlation to assess the construct and convergent validity, respectively.

Results: All 15 items in the caregiver TBQ demonstrated face validity, had high acceptability, with a Cronbach alpha of 0.89. The PCA identified three domains-medication monitoring burden, healthcare access burden, and social care burden. Subscale domain reliability was 0.86, 0.77, and 0.77, respectively. The three subscales exhibited significant small to moderate correlations with the stress thermometer, Medical Outcomes Study, and physical and mental health Patient-Reported Outcomes Measurement Information System scores.

Conclusion: The caregiver TBQ is a reliable and valid tool that captures domains of medication monitoring, healthcare access, and social care burden.