Aging & Mental Health最新文献

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.

Objectives: This repeated cross-sectional study aims to assess potential differences among behavioral health (BH) diagnoses for older adults. Differences in services across urban versus rural/remote areas may contribute to deeply entrenched barriers to improved BH for this population.

Method: Data were collected through complex care consultation reports (N = 5,123) between 2017-2021 as part of a multi-year evaluation of the Oregon Older Adult Behavioral Health Initiative, a statewide program addressing gaps in services for older adults and people with physical disabilities with behavioral health needs. Analyses of consumer BH diagnoses (N = 2,772) by urban and rural/remote area, physical disability status, and age were conducted.

Results: Urban consumers were more likely to receive a formal diagnosis of any BH condition compared to their rural/remote counterparts. While results appear to suggest rurality may be associated with decreased identification of a BH diagnosis, findings also appear to indicate that once received, diagnoses such as suicidality and hoarding may be more severe among older adults residing in rural and remote areas.

Conclusion: Results offer important insights for addressing the BH needs of older adults, particularly those residing in rural/remote regions. Policy change is warranted to mitigate the multiple, complex barriers to appropriate BH care of older, rural/remote adults.

Objectives: This study explores the experiences of older women who survived attempted intimate partner homicide (IPH)-a population largely overlooked in existing research. Guided by a life-course perspective, it examines how these women make meaning of their survival in later life, offering insight into their emotional needs and expanding the understanding of survivorship in older age.

Method: Using interpretative phenomenological analysis, in-depth, semi-structured interviews were conducted with 11 women over the age of sixty, all survivors of intimate partner homicide.

Results: Three key themes emerged: (1) Surviving an IPH attempt as a critical turning point and a chance for new life; (2) Surviving an IPH attempt as a continuum of the violent relationship dynamics; (3) The perception of coping at this point in life.

Conclusion: The findings suggest that survivorship is an ongoing process shaped by personal agency, age-related factors, and social, legal, and familial networks, carrying multiple meanings for participants that reflect both challenges and opportunities in their journey forward.

Objectives: Early detection of neuropsychiatric symptoms is critical for timely intervention in cognitive decline. Mild Behavioral Impairment (MBI) represents late-life behavioral changes preceding or accompanying neurodegenerative processes. This study aimed to translate, culturally adapt, and psychometrically validate the Persian version of the Mild Behavioral Impairment Checklist (MBI-C) in older Iranian adults.

Method: A cross-sectional study was conducted among 97 participants aged ≥55 years, recruited from outpatient clinics and hospitals in Tehran. Based on DSM-5 criteria, participants were classified into Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy controls. The MBI-C was translated through standardized forward-backward methods and expert review. Cognitive status and depressive symptoms were assessed with the Abbreviated Mental Test score (AMTs) and Geriatric Depression Scale (GDS-15).

Results: The Persian MBI-C showed excellent internal consistency (Cronbach's α = 0.89) and satisfactory reliability across five domains. MBI-C scores differed significantly across diagnostic groups (p < 0.001), negatively correlated with AMTs, and positively correlated with GDS scores (p < 0.001). ROC analysis indicated strong diagnostic accuracy for AD (AUC = 0.83) and good accuracy for MCI (AUC = 0.72).

Conclusion: The Persian MBI-C is a reliable and valid tool for assessing behavioral symptoms in older adults. Its clinical and research applicability is supported, with future studies needed to confirm predictive validity.

Older adults receiving home and community based services have been found more vulnerable to mental health distress and suicidal ideation due to loneliness and social isolation. This study evaluated the effectiveness of an eight-week standardized, manualized warm calling phone intervention intended to combat loneliness and social isolation by fostering reciprocally caring relationships. Natural helpers from the Aging Services Network, home-delivered meals (HDM) volunteers who had ongoing interactions with individuals at risk for suicide, were trained to provide supportive phone outreach. Using descriptive statistics and consensual qualitative research (CQR) methodology, results from 78 older adult experiences were explored based on data collected at one-month follow-up to assess what they may have liked, what could be improved, and any takeaways from the program. Five domains and nineteen categories emerged revealing older adults had lasting positive impacts from program participation. Particularly trained helper qualities contributed to these improvements; further, older adults reported key takeaways from the program, increased help-seeking behavior, as well as potential program improvements. Implications for practice and future research are provided.

Objectives: This study explored transdiagnostic temperamental profiles, based on Effortful Control (EC), Behaviour Inhibition System (BIS) and Behaviour Activation System (BAS). The clinical relevance of these profiles was investigated by examining differences in psychopathology.

Method: The objectives were examined in 305 older adult psychiatric inpatients (M = 66.71; SD = 4.77). Temperamental dimensions were measured by the BIS/BAS-scale and Effortful Control scale, while psychopathology was assessed with the SCL-90-R, ADP-IV, Utrecht Coping List and Young Schema Questionnaire.

Results: Through a two-step cluster analysis, we identified two distinct profiles: a resilient group (n = 130) characterized by high EC, low BIS and BAS, and an overcontrolled/dysregulated group (n = 175) characterized by lower EC, high BIS and rather high BAS. We could not corroborate an undercontrolled profile. Compared to the resilient profile, individuals with the overcontrolled/dysregulated profile reported more dysfunctional characteristics, including increased clinical symptoms, personality disorders, maladaptive coping styles and schemas.

Conclusion: These findings highlight the protective role of high EC against psychopathology. Future research should explore the effectiveness of (neurocognitive) interventions aimed at improving top-down regulatory abilities such as EC in less resilient older adults. Understanding temperament-based profiles can inform transdiagnostic assessment and treatment approaches for older adults.

Objectives: Older adults in nursing homes represent a highly vulnerable group regarding suicidal ideation. Despite its prevalence, validated screening tools adapted to institutionalized older adults are scarce. This study aimed to validate the Paykel Suicide Scale (PSS) by assessing its psychometric properties of in a Spanish sample of institutionalized older adults.

Method: A total of 231 participants aged 60-97 years (M = 78.99, SD = 8.83) from nine long-term care facilities completed the PSS alongside other measures of suicidal ideation (SSI), hopelessness (BHS), and life satisfaction (SWLS). Factor structure, internal consistency, convergent validity, and measurement invariance by age group were tested.

Results: The unidimensional model of the PSS showed acceptable fit indices (CFI = 0.991, SRMR = 0.078; RMSEA = 0.089 [0.037-0.146]), with high internal consistency (ordinal α = 0.917). Items 1 and 2 discriminated across all levels of suicidal ideation, while Items 3-5 were informative at higher severity. The PSS correlated significantly with suicidal ideation (r > 0.58), hopelessness (r = 0.33), and life satisfaction (r = -0.37). Measurement invariance was supported across age groups (60-80 vs. 81+ years).

Conclusion: The Paykel Suicide Scale is a brief, valid, and reliable screening instrument for suicidal ideation among institutionalized older adults and is recommended for use in residential care settings.

Objectives: Subjective cognitive decline (SCD) and mild behavioral impairment (MBI) are preclinical indicators of Alzheimer's disease and may negatively affect health-related quality of life (HRQoL). We examined the independent and combined effects of SCD, MBI, and depressive symptoms on HRQoL in cognitively unimpaired older adults.

Method: Ninety individuals aged >50 years were recruited from a psychiatric outpatient clinic. Participants completed the Geriatric Depression Scale-15 (GDS-15), Subjective Memory Complaints Questionnaire (SMCQ), and SF12 while informants completed the MBI-Checklist (MBI-C). Participants were categorized by SCD and MBI status. Group differences were examined using ANOVA, and hierarchical regression analyses models adjusting for sociodemographic.

Results: SCD and MBI were independently associated with lower Physical Component Summary (PCS-12) scores, with depressive symptoms partially mediating these relationships. Mental Component Summary (MCS-12) was primarily predicted by depressive symptoms. Impulse dyscontrol predicted poorer physical HRQoL, and affective dysregulation lower mental HRQoL.

Conclusion: SCD and MBI contribute to diminished HRQoL even without overt cognitive impairment, with depression acting as a mediator. Evaluating SCD alongside MBI provides a clearer understanding of early cognitive-behavioral changes and their burden on well-being. Findings underscore the need for integrated screening and early interventions in at-risk older adults.