Aging & Mental Health最新文献

Objectives: This study explored the social out-of-home participation experiences of people with dementia and their informal caregivers from a capability-based approach.

Method: Twelve dyadic interviews with people with dementia living in the community and their informal caregivers were conducted. Data were inductively coded using a reflexive thematic analysis approach.

Results: All participants with dementia experienced changes in activities, social interactions or out-of-home mobility, captured in the overarching theme of 'social participation: a changing world'. Four subthemes captured the primary strategies participants used to navigate these changes: (1) creating a sense of comfort and safety in nearby, quiet, and familiar places; (2) pursuing a sense of social identity through meaningful connections; (3) accepting support to maintain independence; and (4) finding a balance, as described by informal caregivers, between their own social needs and those of their spouses. These themes highlight the agency of people with dementia in shaping their social participation amid changes in capabilities and environments.

Conclusion: This study contributes to a more nuanced understanding of social participation in dementia, emphasising the importance of supportive environments that recognise both capabilities and needs can enable continued engagement and foster social health.

Objectives: This study examines the relationship between religious attendance and depressive symptoms among older adults in the United States, focusing on the potential mediating role of church-based social ties.

Method: Longitudinal data from the Health and Retirement Study (2010-2018) were analyzed, including 10,467 respondents over age 50 at baseline. Associations between religious attendance (2010), church-based social ties (2012), and depressive symptoms (2014-2018) were assessed using a series of regression models. Mediation analysis was conducted using generalized structural equation models with bootstrapped confidence intervals.

Results: More frequent religious attendance in 2010 predicted fewer depressive symptoms in 2014, 2016, and 2018. Church-based friendship, but not church-based relatives, significantly mediated these associations.

Conclusion: Religious attendance may protect against later-life depressive symptoms by fostering church-based friendships. Faith-based organizations might consider promoting such connections to support older adults' mental health.

Objectives: The study examined the dynamics among social isolation, loneliness, sleep disturbance, and depressive symptoms in older Korean-American residents of subsidized senior housing. Building upon the well-established link between social isolation and depressive symptoms, we hypothesized three indirect effect models with (1) loneliness as a sole mediator, (2) sleep disturbance as a sole mediator, and (3) loneliness and sleep disturbance as serial mediators.

Methods: Survey data from 318 participants (M age = 79.5 years, SD = 6.66) were used to examine the direct and mediation effect models.

Results: We confirmed that social isolation independently predicted depressive symptoms and found partial support for the mediation models. Among the three mediation pathways proposed, significance was found in the sole mediation by loneliness (B [SE] = 0.86 [0.29], bias-corrected 95% CI = [0.31, 1.47]) and the sequential mediation by loneliness and sleep disturbance (B [SE] = 0.12 [0.06], bias-corrected 95% CI = [0.03, 0.25]). The alternative path, where sleep disturbance precedes loneliness, was not significant, confirming the robustness of the proposed serial path.

Conclusion: Findings underscore the importance of addressing both loneliness and sleep disturbances as interconnected factors in interventions aimed at alleviating the mental health impacts of social isolation.

Objectives: Living with comorbid dementia and cancer is linked with communication and decision-making challenges across the cancer care pathway and poor health outcomes. This meta-ethnographic review aimed to explore the experiences of people living with comorbid dementia and cancer (PLWCDC) when making decisions about their cancer care.

Method: Six databases were searched using terms pertaining to dementia, cancer, decision-making and qualitative experiences. Studies that qualitatively explored cancer care decision-making experiences from the perspective of people living with comorbid dementia and cancer were included.

Results: Searches yielded 3424 unique records, with ten articles meeting eligibility criteria. After quality assessment, collated data was synthesised using a reciprocal synthesis. This produced four higher-order themes: 'challenges of processing cancer-related information', 'issues of inaccessible information and uninformed consent', 'the role of relatives', and 'the importance of individualised and consistent care', drawn together by a core concept of delivering and receiving person-centred cancer care in an inflexible healthcare system.

Conclusion: Decision-making experiences were complex and multi-layered. Dementia negatively influenced understanding and retention of information. Poor consistency in staffing and complexity of information provided were overwhelming. PLWCDC were not always meaningfully involved in their cancer-care decisions. Individualised, consistent care is required to improve outcomes for this population.

Most people living with dementia are supported by their spouse and/or an adult child, yet little is known about how husbands and sons approach dementia caregiving. Using an exploratory mixed method design, this study examined male dementia carers': approach to help-seeking; motivations to step-into the carer role; expectations of formal services; and appraisal of carer-burden. Qualitative thematic analysis of (n = 32) semi-structured interviews with male carers suggested that masculinity norms shape the male approach to caregiving, summarised under two themes: 'Help-seeking: The way blokes do it'; and 'Sons approach caregiving differently to husbands'. Findings suggest that males typically seek help at crisis point and expect professionals to provide directive task-focused support to manage the crisis. Husbands were motivated to care, as a commitment to their marriage vows, while sons cared as a form of 'pay-back' to their parents. Husbands articulated functional carer-burden, while sons expressed emotional carer-burden. However, quantitative analysis of (n = 22) responses on the 12-item Zarit Burden Interview scale showed no significant difference in carer-burden scores between husbands and sons. These findings could inform the tailoring of formal services for male carers of people with dementia.

Objectives: The level of consumption and alcohol-related health effects differ between older men and women; but we do not know what role gender plays in interventions. This study explored gender-related differences and similarities in the experiences and needs of older adults participating in interventions to reduce alcohol use.

Method: Semi-structured interviews were conducted with 15 older adults who had participated in interventions in different settings.

Results: Differences in experiences showed that men felt more confident, while women experienced more shame and emotions in interventions. Regarding needs, men wanted to be heard and preferred a non-belittling approach, while women preferred attention to safety, emotions and their perspectives. In addition, both groups expressed a need for social support, mixed-gender group participation that included women, and a woman as the professional involved.

Conclusion: To conclude, both older men and women addressed the importance of social support and the presence of women in interventions in a group setting or with professional involvement. Attention to their needs was particularly important for older woman, while older men needed a listening ear.

Objectives: It has been indicated that spirituality may be associated with loneliness, while limited studies have considered the complicated nature of spirituality. Meanwhile, it remains unclear how multiple factors shape the levels of spirituality and loneliness. To fill these gaps, this study aimed to clarify the relationship between spirituality and loneliness by dividing spirituality into three dimensions and explore the multiple influential factors of spirituality and loneliness.

Method: Cross-sectional data from 244 Hong Kong people were collected. Most of them were aged 40 or older (97.95%), and half of them were caregivers (50.82%). Structural equation modeling (SEM) was used to examine the effects of different domains of spirituality on loneliness. The invariance of the effects of different domains of spirituality on loneliness across caregiver and non-caregiver groups was examined through Multigroup Analysis. Two-way ANOVA was used to determine whether the levels of spirituality and loneliness vary depending on multiple factors.

Results: The results showed that only personal and communal spirituality negatively affected loneliness (β=-0.42, p < 0.01), and this effect did not vary across caregiver and non-caregiver groups. Education had significant single effects on the personal and communal (F = 2.91, p < 0.05, η²=0.06), environmental (F = 4.03, p < 0.01, η²=0.08), transcendental (F = 3.06, p < 0.05, η²=0.06) domains of spirituality and overall spirituality (F = 4.57, p < 0.001, η²=0.09). Religion had significant single effects on the transcendental domain of spirituality (F = 84.86, p < 0.001, η²=0.26) and overall spirituality (F = 14.16, p < 0.001, η²=0.06). Education and religion had an interaction effect on the transcendental spirituality (F = 2.63, p < 0.05, η²=0.05) and overall spirituality (F = 2.35, p < 0.05, η²=0.05). Age and caregiving had an interaction effect on loneliness (F = 2.80, p < 0.05, η²=0.03).

Conclusion: Not all domains of spirituality equally affect loneliness, and the levels of spirituality and loneliness may be shaped by multiple factors. These findings underscore the complicated nature of spirituality and the importance of cultural sensitivity in understanding spirituality. Religious groups and older caregivers especially demand more appropriate instruction and support to improve spirituality and alleviate loneliness.

Objectives: Geriatric depression is an important mental health concern that generalist behavioral health clinicians are increasingly likely to encounter, yet the field lacks an adequate tool to assess providers' knowledge. This study evaluated the validity, reliability, and factor structure of the Later Life Depression Knowledge Questionnaire (LLD-KQ) as part of an ongoing effort to assess the psychometric properties of the scale.

Method: Psychologists (N = 800) from the southwestern United States were randomly selected to complete a survey that could be returned via postal service or online. Responses were used to examine the internal consistency, construct validity, divergent validity, and factor structure of the 25-item scale.

Results: Analysis of the returned surveys (n = 250) revealed that the LLD-KQ demonstrated adequate reliability and validity. Confirmatory factor analyses (CFA) supported a three-factor model with constructs of psychopathology, assessment/diagnosis, and treatment, although the differences between the three-factor and single-factor models were minimal.

Conclusion: The LLD-KQ demonstrates adequate psychometric properties and can be used in dissemination and implementation efforts, as well as in professional trainings, to assess clinical knowledge about later-life depression.

Objectives: This study aimed to examine how the current state and limitations of the English older adult care home sector, within the context of the cost of living crisis, influenced the psychological wellbeing of care home staff.

Method: Individual semi-structured remote qualitative interviews were conducted with 14 participants who worked in older adult care homes in England between June 2024 and January 2025. Data were analysed using reflexive thematic analysis.

Results: Analysis revealed six themes: (1) Coping with the demands of the job; (2) What helped and hindered work-related wellbeing support in care homes; (3) Working with societal stigma and a lack of recognition; (4) The influence of personal circumstances on resilience in a cost of living crisis; (5) The inequality of cost of living support within care homes; and (6) Systemic influences on the cost of living experience. Care home staff from lower socioeconomic backgrounds appeared to be disproportionately affected by the cost of living crisis. The availability and nature of support differed across care homes, with provision marked by inconsistency and inequity.

Conclusion: This study identified socioeconomic inequalities in the care home workforce which influence their experiences of financial strain and occupational demands. Inconsistent and inequitable support was found across care homes, highlighting the need for sector reform to address these differences and recognise the value of this workforce.

Objectives: The Dementia Public Stigma Scale (DPSS) is a brief, user-friendly tool for assessing public stigma related to dementia. While widely used in Western contexts, it has not been validated in China. This study aimed to rigorously translate, adapt, and validate the DPSS for use in Chinese populations, filling a critical gap in dementia research.

Method: The DPSS was translated into Chinese using a forward-backward protocol, followed by cultural adaptation and testing for translation equivalence. The finalized scale was administered to 314 participants. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the factor structure. Internal consistency (Cronbach's α) and test-retest reliability (ICC) were assessed.

Results: The Chinese DPSS demonstrated strong validity (KMO = 0.840, χ²(120) = 499.475, p < 0.001) and explained 67.68% of the cumulative variance. CFA confirmed the 5-factor model (CFI = 0.89, RMSEA = 0.08). Internal consistency ranged from 0.682 to 0.865, though the 'Fear' subscale showed lower reliability (α = 0.378). Test-retest reliability was excellent (ICC = 0.789-0.885).

Conclusion: The Chinese DPSS is a psychometrically robust tool for assessing dementia stigma. Its integration into public health initiatives can help tailor anti-stigma interventions in China.