Aging & Mental Health最新文献

Objectives: Few studies have examined the associations between social relationships and cognition in very old adults (80+ years). Moreover, limited research has considered structural and functional aspects of social relationships together when exploring their associations with cognition. Therefore, the present study aimed to investigate the associations between structural and functional social aspects and cognition in very old age.

Method: The sample comprised 518 two-wave participants of the NRW80+ Study, who showed no indication of dementia and an average age of 85 years at baseline (range: 80-97 years). They were assessed twice over an approximate 2-year interval. Multilevel linear growth curve analysis was employed to model cognitive development over very old age and to examine the associations between structural and functional aspects of social relationships and cognitive development. It was controlled for demographic and health characteristics.

Results: A larger social network size (ß = 0.05, 95% CI [0.02, 0.08], p = 0.002) and frequent compared with occasional, seldom, and no contact with others (ß = 0.16, 95% CI [0.03, 0.28], p = 0.013) were associated with higher global cognition in the fully-controlled model. Model comparisons further revealed that structural aspects better predicted global cognition in very old age compared to functional aspects (χ²(2) = 16.17, p < 0.001).

Conclusion: The findings underline the positive association between structural aspects of social relationships and global cognition in very old age. They also highlight the need for interventions promoting a socially active lifestyle to prevent cognitive decline in this vulnerable age group.

Objectives: Daily noteworthy events have implications for physical and mental health, but less is known about the role daily events have for self-reported cognition and whether the involvement of close social partners differentiates these associations. The current study examined how daily positive and negative noteworthy events relate to subjective memory and attentional difficulties and whether close social partners moderated associations.

Method: We used data from a 100-day microlongitudinal web-based study of 104 older adults (N_observations=7,051; M_age=63.13 years, SD_age=7.81, 88.46% Female). Participants reported on exposure to and valence of noteworthy events, involvement of close social partners, and subjective cognitive complaints at the end of each day.

Results: Logistic multilevel models revealed that days with a negative event were associated with increased odds of forgetting something and trouble concentrating whereas days with positive events were associated with decreased odds of trouble concentrating. Close social partner involvement did not moderate within-person associations.

Conclusion: Our results suggest that day-to-day events are correlates of cognitive complaints regardless of close social partner involvement in the events. Research should clarify the role of daily positive and negative events in personalized interventions and determine whether this person-centered approach to self-reported cognitive health helps inform diagnostic practices.

Objectives: The first aim of the study is to compare loneliness levels between widowed and non-widowed older adults. The second aim is to identify distinct loneliness patterns among widowed individuals and explore the impact of pre-spousal loss social support on loneliness during and after bereavement.

Method: Data from the Health and Retirement Study were utilized to compare loneliness levels between widowed (n = 137) and non-widowed (n = 2361) older adults (M_age = 69.01). T-tests and latent growth curve models were conducted to compare loneliness levels between the two groups. Growth mixture models were computed to identify distinct loneliness patterns among the widowed individuals. A multinomial logistic regression analysis was conducted to determine how pre-widowhood social support was associated with the obtained classes.

Results: The results revealed that widowed individuals reported significantly higher levels of loneliness at T2. Among widowed individuals, three distinct loneliness patterns were identified: Increased Loneliness (IL) group (n = 32); Low and Stable Loneliness (LSL) group (n = 88); and Decreased Loneliness (DL) group (n = 17). The IL and DL group were less likely to receive social support from spouse, children, and friends compared to the LSL group.

Conclusion: This study provides evidence of the protective effect of pre-widowhood social support on the psychological well-being of older adults after spousal loss.

Objectives: The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH).

Method: This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables.

Results: The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH.

Conclusion: CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults.

Objectives: This study examined the relationship between caring for a person with/without dementia and caregiver sleep quality, and analyzed the extent to which perceived benefits of caregiving and assessments of caregiver-recipient relationship quality explain the relationship between care recipient dementia status and caregiver sleep quality.

Method: Data were analyzed from caregivers for persons with no or probable dementia who participated in the 2017 National Study of Caregiving (NSOC) and National Health and Aging Trends Study. Caregiver sleep quality was measured using NSOC time diary interview. Perceptions of caregiving and relationship quality were assessed using 4-item surveys. We used multivariable logistic regressions to examine the association between care recipient dementia status and caregiver sleep quality controlling for covariates.

Results: The sample consisted of 1,374 caregivers (mean age = 62.3, SD = 14, 68.3% women, 69.4% non-Hispanic White). In multivariable models adjusting for caregiver and care recipient characteristics, being a caregiver for someone with dementia was associated with 23% lower odds of reporting "excellent/very good" sleep quality (OR: 0.77, 95%CI: 0.61-0.98, p = 0.032). Greater perception of caregiving benefits was associated with 8% greater odds of "excellent/very good" sleep quality (AOR: 1.08, 95%CI: 1.02-1.15, p = 0.013), but did not explain the relationship between dementia and caregiver sleep quality. Positive ratings of relationship quality explained the relationship between care recipient dementia status and caregiver sleep quality (AOR: 0.82, 95%CI: 0.65-1.05, p = 0.12).

Conclusion: Improving assessments of relationship quality and amplifying perceptions of caregiving benefits may reduce disparities in sleep quality between caregivers of persons living with or without dementia.

Objectives: We investigated the association of social participation with mental well-being among older people and whether purpose in life mediates the potential association.

Method: Cross-sectional (n = 1014) and longitudinal (n = 660, four-year follow-up) data comprised of three age cohorts (75, 80, and 85 years) of community-dwelling people. Life satisfaction was measured with the Satisfaction with Life Scale, depressive symptoms with the Centre for Epidemiologic Studies Depression Scale, and purpose in life with the Scales of Psychological Well-Being purpose in life subscale. Social participation was assessed with questions concerning the frequency of meeting close friends and acquaintances, and volunteering. The data were analyzed using structural equation modeling.

Results: Higher social participation was associated with higher life satisfaction and fewer depressive symptoms both cross-sectionally and after a four-year follow-up. Higher purpose in life mediated the associations of more social participation with higher life satisfaction and fewer depressive symptoms cross-sectionally. In the longitudinal data, the mediation effect was not observed.

Conclusion: Older people with frequent social participation who had a sense of purpose in their lives will likely have higher mental well-being than those with less social participation. Enabling and supporting them to conduct purposeful actions in social contexts may help maintain their mental well-being.

Objectives: People with dementia (PwD) and their care partners (CP) may have difficulties in emotion regulation, and individual differences in emotion regulation may be related to PwD's neuropsychiatric symptoms. This study explores whether there is self-awareness of PwD's difficulties in emotion regulation and whether CP's emotion regulation relates to the PwD's neuropsychiatric symptoms, potentially revealing bias or interpersonal effects.

Method: We used data from the Wish Outcome Obstacle Plan Study with a sample of 45 PwD and their spousal CP (n = 90 individuals). Multivariate linear regression models were used to investigate the associations between the CP-reported neuropsychiatric symptoms in PwD and self-reports of emotion regulation in both dyad members, net of sociodemographic and health factors. Separate analyses were conducted for each neuropsychiatric subsyndrome and each domain of difficulties in emotion regulation.

Results: Increasing severity of neuropsychiatric symptoms was associated with higher difficulties in emotion regulation in PwD (ß = 1.23, p < 0.05), but not with CP's difficulties in emotion regulation. When CP reported more severe neuropsychiatric symptoms in PwD, PwD reported that they had difficulties in accepting emotions, controlling impulses, goal-directed behaviors, and accessing emotion regulation strategies, but not in emotion awareness and clarification. Proxy-reports of hyperactivity and psychosis subsyndromes are significantly related to PwD's self-reported difficulties in emotion regulation.

Conclusion: PwD reported difficulties in emotion regulation at the early stage of dementia. Proxy-reported neuropsychiatric symptoms may capture PwD's emotion regulation capability and not be biased by CP's difficulties in emotion regulation.

Objectives: Social isolation and loneliness pose significant public health risks, especially among older adults experiencing age-related cognitive decline (ACD). This mixed methods feasibility study explored the potential of an online mindfulness-based dance/movement therapy (M-DMT) program to alleviate loneliness, enhance psychological well-being, and promote physical activity among older adults experiencing ACD during the COVID-19 pandemic.

Method: Sixteen participants engaged in a 12-week online group M-DMT program. Feasibility was assessed via enrollment and retention rates, attendance, adverse events, credibility/expectancy, participant perceptions, and satisfaction. Qualitative data were collected to capture participants' perspectives on the intervention's usefulness and perceived benefits. The intervention's preliminary impact on loneliness, depression, positive affect, psychological well-being, and physical activity was also examined.

Results: The study met all feasibility criteria, with 65% reporting post-intervention improvement. Significant reductions in loneliness and depression, along with enhanced positive affect and psychological well-being, were observed. Though physical activity increased, statistical significance was not achieved. Qualitative feedback highlighted improved social connectedness, overall quality of life, body awareness, kinematic strategy, and satisfaction with the program.

Conclusion: Online M-DMT holds promise in addressing well-being and loneliness challenges in older adults experiencing ACD. Further research is necessary to validate and expand upon these promising findings.

Objectives: Support for people with dementia in their communities is neither robust nor consistent in the UK, often bolstered by third sector/grass-roots initiatives facing formidable challenges in sustaining long-term. The Get Real with Meeting Centres project explored factors involved in sustaining one such form of community-based support. This is the second of two linked articles outlining learning from this realist evaluation of Meeting Centres (MCs) for people with dementia and carers, which focusses on findings regarding their operational and strategic running.

Method: Semi-structured interviews and focus group discussions were conducted with 77 participants across three MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using soft systems methodology and realist logic of analysis.

Results: Forty-two 'context-mechanism-outcome' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding three key areas for MC sustainability: External relationships and collaboration; Internal relationships and practices; and Finances and funding.

Conclusion: Collaboration is essential to sustaining community-based initiatives such as MCs, particularly between local community and regional level. MCs need to be vigilant in mitigating pressures that create 'mission drift', as targeting a gap in the care pathway and maintaining a person-centred ethos are central to MCs' appeal. Stable, ongoing funding is needed for stable, ongoing community dementia support. More formal recognition of the value of social model community-based initiatives, helped by improved data collection, would encourage more robust and consistent community dementia support.

Objectives: To determine a pooled prevalence of depression and its influencing factors among nursing home residents.

Method: PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors.

Results: This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65).

Conclusion: The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.