Aging & Mental Health最新文献

Objectives: Efforts to improve quality of life (QOL) in dementia depend on its accurate conceptualization and assessment. We employed a data-driven network approach to examine the structure of relationships between individual QOL items. This approach allowed us to capture the complexity and multidimensional nature of QOL from the perspective of the person with dementia and their carer.

Method: Participants with dementia (n = 128) and carers completed the Quality of Life in Alzheimer's Disease questionnaire (QOL-AD), and measures of depressive symptoms, cognition, and functional abilities of the person with dementia, and carer burden. Gaussian graphical models with regularized partial correlations of QOL-AD items were estimated and compared, and item communities were detected.

Results: Central elements that emerged in both self and carer-reported networks included Ability to do Things for Fun, Energy, and Life as a Whole. Memory and Money were less central. Distinct differences were also evident between self- and carer-networks. Whilst Self as a Whole was relatively more central in the self-reported network, Ability to Do Chores and Family were more central in the carer-reported network. Moreover, different communities were detected in the networks, corresponding to domains including socioeconomic, daily, self-referential, and instrumental functioning, with differential correlations to key clinical outcome variables.

Conclusion: QOL in dementia is inherently multidimensional and differs when assessed from the viewpoint of the person living with dementia versus their carer. Network approaches offer the granularity required to ensure that targeted interventions can be tailored toward these complementary perspectives.

Objectives: Using data from the Health and Retirement Study (1992-2020), this study investigates how cognitive function and its longitudinal changes influence trajectories of depressive symptoms among oldest-old adults.

Method: Latent growth curve modeling (LGCM) was applied to examine changes in cognitive function and depressive symptoms across five time points (ages 90, 92, 94, 96, and 98+). The analytic sample consisted of 289 participants at baseline (age 90), with sample sizes ranging from 289 to 231 across subsequent age groups. In comparison, we conducted an additional LGCM longitudinal analysis for participants at an earlier baseline at age 60 (N = 17036), following them from 60 to 70 (n = 11915) and 80 years (n = 8942).

Results: The unconditional LGCM (without covariates) showed that higher baseline cognitive function was significantly associated with lower baseline depressive symptoms (β = -0.304, p < 0.001), but did not predict changes in depression over time. In the conditional model (including gender, education, self-rated health, and activities of daily living as covariates), higher education was associated with higher cognitive functioning but also with higher depression at baseline. In contrast, better ADL functioning and better perceived health significantly predicted higher cognitive functioning and lower depression at baseline. The intercept of depression predicted its own slope (β = -0.934, p < 0.001), indicating that Individuals with higher initial depressive symptoms experience a slower increase (or less worsening) in depression over time. For the 60-80 group, the intercept of cognition significantly predicted the intercept of depression (β = -0.380, p < 0.001), consistent with the 90-98+ group. However, longitudinal associations differed across age groups, indicating distinct developmental patterns between mid-to-late and very late adulthood.

Conclusion: This study emphasizes that although cognitive and emotional health are interrelated at baseline, changes in one domain do not reliably predict changes in the other among the oldest-old adults population. Instead, education, physical functioning, and self-rated health emerged as key predictors of both cognitive and emotional well-being. These findings highlight the importance of multidimensional assessments and targeted support to promote resilience and quality of life in extreme old age.

Objectives: Subjective cognitive decline (SCD) is an early indicator of cognitive impairment and dementia risk. Sleep quality, essential for cognitive health, often deteriorates with age. Intraindividual changes in sleep quality may be linked to concurrent changes in subjective cognition; this dynamic 'coupling effect' could inform strategies for prevention before objective impairments emerge but remains unexamined longitudinally. We investigated this interplay in older adults over multiple years.

Method: Utilizing the 'nlme' R package, we analyzed nine waves of sleep quality and subjective cognition data from the Transitions in Health and Relationships study (n = 131, ages 59-94 at baseline, 63% female) in hierarchical multilevel models, with random intercepts and slopes.

Results: Multilevel models indicated changes in sleep quality were positively associated with concurrent changes in subjective cognition, independent of baseline sleep quality, and sociodemographic covariates.

Conclusion: Findings highlight the importance of monitoring within-person sleep quality changes as a potential indicator of SCD in older adults. Further studies may help identify pathways to support cognitive health in aging populations.

Objectives: Although more older adults are living with autism spectrum disorder (ASD), research has focused mainly on younger individuals. Emerging evidence suggests that racial/ethnic disparities may further hinder timely diagnosis and care for older adults with ASD. This scoping review maps existing research on these disparities among older adults with ASD.

Method: A systematic database search was conducted from 01/15/2025 to 01/30/2025 across PubMed, PsycINFO, and Scopus. The PCC (Population, Concept, Context) framework was used to identify peer-reviewed, data-based studies published in English that focused on adults aged 60 years and older with ASD and explicitly addressed racial/ethnic disparities.

Results: Eight of 4,179 articles met the inclusion criteria. All included studies were observational, with the majority (n = 7) conducted in the United States. Racial/ethnic minority older adults with ASD face persistent disparities across the ASD care continuum. Black, Hispanic, and Asian/Pacific Islander older adults were less likely to be dually eligible for Medicare and Medicaid compared to their White counterparts. Additionally, racial/ethnic minority older adults with ASD showed a higher burden of physical and psychological comorbidities but lower likelihood of receiving treatment for their comorbidities. Racial/ethnic minority older adults with ASD had lower rates of outpatient service utilization and reduced access to supportive accommodations compared to their White counterparts.

Conclusion: Current research on racial/ethnic disparities among older adults with ASD remains limited; this research gap highlights an urgent need for more inclusive, population-specific studies to advance understanding and promote equity at the intersection of aging, autism, and healthcare access.

Objectives: With population aging and rising colorectal cancer (CRC), existential distress, defined as a profound psychological suffering associated with threats to meaning, identity, and purpose, has emerged as a critical yet underexplored aspect of older adults' cancer experience. This study explored the lived experience of existential distress among older Iranian adults with CRC.

Method: A qualitative descriptive phenomenological design was employed. Seventeen adults (≥65 years) with confirmed CRC were purposively recruited from a cancer center in northern Iran. Data were obtained through in-depth semi-structured interviews and analyzed with Colaizzi's seven-step method.

Results: Participants included 10 men and 7 women with a mean age of 68.94 ± 3.78 years, with diverse education, occupation, illness duration, and treatment. Three themes emerged: Inadequate Self-Realization, Confronting Uncertainty and Death, and Disruption of Meaningful Relationships. Inadequate self-realization involved diminished inner value and guilt for perceived family burdens. Confronting Uncertainty and Death encompassed being lost, fear of the unknown, and pervasive death presence. Disruption of Meaningful Relationships reflected stigma, social humiliation, and self-imposed isolation.

Conclusion: Older Iranians with CRC endure layered existential suffering shaped by personal beliefs and sociocultural values. Findings guide supportive cancer care addressing existential and spiritual needs, alongside physical care, highlighting psychosocial dimensions for culturally informed interventions.

Objectives: Loneliness and stress are determinants of late-life health, yet their within-person dynamics are insufficiently characterized.

Method: We extracted loneliness, stress, depressive symptoms, social contacts, self-rated health (SRH) and sociodemographics constituted covariates from three waves (2017, 2021, 2023) of the German Ageing Survey (DEAS). Linear mixed-effects models regressed stress on loneliness adjusted for covariates. To disentangle within- and between-person effects, predictors were decomposed into person-mean and person-mean-centered components. Interaction effects tested moderation by gender, depressiveness and SRH.

Results: Loneliness predicted stress within (ß =0.30, p < 0.001) and between persons (ß =0.39, p < 0.001). Random-slope variance indicated inter-individual heterogeneity (SD = 0.247); intercept-slope correlation (r = -0.815) suggested flatter slopes among high-stress individuals: individuals with lower baseline stress showed greater stress upon loneliness while high stress leads to a blunted stress response. This effect was moderated by depressiveness but not by gender or SRH: at high loneliness levels, the contribution of depressiveness to stress is diminished.

Conclusion: Increases in loneliness induce stress beyond depression and SRH on both intraindividual and interindividual levels: when individuals feel lonelier, they experience stress, and those who are chronically lonelier report overall higher stress levels. Targeting loneliness alongside stress-management strategies may reduce stress burden and improve well-being in aging populations.

Objectives: Older women in the U.S. report higher rates of poor mental health than older men. Increased physical activity is often recommended to older adults, as it is associated with improved neurocognitive function, mood regulation, and greater social participation. Functional fitness training has been shown to have several benefits for adults, but it is unknown if this exercise modality can have mental health benefits for older women.

Method: A systematic literature search was conducted among CINAHL, Global Health, PsycInfo, SportsDiscus, and Web of Science databases with no publication date restrictions for articles describing the mental health outcomes of functional fitness interventions among samples that included women aged 60+ years of age.

Results: Twenty-one articles from 12 countries were analyzed and assessed for risk of bias. Fifteen articles (71%) aligned with our research hypothesis that functional fitness training incurs statistically significant mental health benefits for older women, with outcomes such as reduced anxiety and/or depression and improved general mental health, social functioning, and/or quality of life. Moderate-intensity functional fitness exercise appeared to be as beneficial as high-intensity.

Conclusion: Few studies analyzed their results by sex/gender and most studies did not utilize samples of healthy, community-dwelling adults, so recommendations for future research are discussed.

Objectives: Social inclusion is increasingly recognized as a determinant of well-being. However, in people with Mild Cognitive Impairment (MCI), evidence on factors promoting or hindering social inclusion remains conceptually inconsistent. This scoping review aims to examine how social inclusion is defined in the MCI literature, identify key facilitators and barriers, and explore its impact on well-being.

Method: Following the PRISMA guidelines, a systematic search was conducted in PubMed, ScienceDirect, and Scopus for peer-reviewed studies published in English. Thirty-one studies were analyzed using thematic synthesis.

Results: The findings highlight the absence of a shared definition of social inclusion. Key facilitators include physical and cognitive activities, social and family support, access to inclusive technologies, and community-based programs. Major barriers are cognitive and physical decline, digital illiteracy, stigmatization, and social or geographic isolation. Across studies, higher levels of social inclusion were associated with greater cognitive resilience and psychological well-being.

Conclusion: Social inclusion appears to play a protective role in the wellbeing of people with MCI. Promoting inclusive practices through digital literacy, participatory care, and supportive environments may reduce social exclusion and help delay cognitive decline. Future research should clarify conceptual definitions and develop consistent tools to assess social inclusion in this population.

Objectives: The primary goal of this study was to understand attitudes and experiences of a culturally tailored dementia intervention for Vietnamese family caregivers of people living with dementia (PLWD) from the perspectives of family caregivers and other stakeholders.

Method: We conducted semi-structured qualitative interviews with 53 stakeholders (i.e. family caregivers, interventionists and their supervisors, and other staff and local officials) with direct or indirect knowledge of the intervention, which was delivered in the home over three months by local interventionists. Directed content analysis of the qualitative interview data was performed to identify themes and sub-themes.

Results: The process-oriented themes suggest that caregivers and interventionists encountered multiple barriers during the intervention process, and amid these challenges, face-to-face intervention was highly preferred among caregivers, and among multiple intervention components, some worked better for caregivers than others. The outcome-oriented themes highlight that participating in the intervention benefited not only caregivers but also health professionals, particularly the interventionists.

Conclusion: Results highlight the need for further cultural modifications in problem-solving and mood management components, and the potential of the blended format of face-to-face and phone interventions to better fit the sociocultural context and cognitive capacity of most Vietnamese caregivers.

Objectives: Although social support is a major dimension of well-being, there is a lack of appropriate tools to assess it in older adults with neurocognitive disorders. This study aims to provide a validation of an adapted version of the Perceived Social Support Questionnaire (PSSQ) for this population. A secondary objective was to investigate whether psychosocial and cognitive outcomes varied according to the category of persons perceived as available (family, professionals, friends, residents).

Method: 113 nursing home residents with neurocognitive disorders were administered the adapted PSSQ and a full clinical examination.

Results: Factor analysis confirmed the structure in two factors (availability and satisfaction with social support). The adapted PSSQ showed satisfactory internal consistency (ω = 0.83-0.84) and good divergent (ps ≥ 0.113) and convergent validity (ps ≤ 0.048). Family members were the most frequently perceived as available. Participants who perceived professionals as available showed a higher level of institutional adaptation (p = 0.005) and tended to report fewer anxiety symptoms (p = 0.069). Those who identified family as available were more satisfied with social support (p < 0.001) and had higher quality of life (p = 0.009).

Conclusion: With good psychometric qualities, the adapted PSSQ is a quick and easy-to-administer tool allowing assessment of social support for residents with moderate to severe cognitive impairment.