Aging & Mental Health最新文献

Objectives: Higher education is associated with better health in later life may foster a stronger sense of control, and elevate expectations for aging. However, as age-related declines in health and functioning emerge, these expectations may become difficult to meet. Guided by Discrepancy Theory, which posits that psychological discomfort arises when internalized ideals diverge from lived realities, this study examines age-related patterns in positive and negative self-perceptions of aging (SPA), tested whether these patterns differ by education.

Method: Using three waves (2008/2010, 2012/2014, 2016/2018) of Health and Retirement Study data (N = 14,538), mixed-effects models estimated trajectories of positive and negative SPA across age and assessed moderation by education. Covariates included sociodemographic, psychological, and health-related factors.

Results: Positive SPA followed an inverse U-shaped trajectory. Negative SPA increased with age. Higher education was associated with pronounced curvilinear patterns in both SPA dimensions. Higher education was associated with lower levels of both positive and negative SPA with covariates adjusted. Sequential models suggest that subjective health may help explain the positive SPA pattern.

Conclusion: Interventions should consider both educational background and life stage when promoting healthy aging attitudes as more educated individuals may apply stricter internal standards when evaluating their own health and aging.

Objectives: To understand family carers' perceived benefits and challenges in a facilitator-led online multicomponent iSupport for dementia program.

Method: A qualitative evaluation study within a randomised controlled trial. Data were collected in monthly virtual peer support meetings over a 6-month period. Meetings lasting approximately 60 min were recorded and transcribed verbatim for analysis. iSupport facilitators' monthly records were also collected for analysis. A reflexive thematic analysis method was used to analyse the data.

Results: One hundred and six carers in the intervention group participated in this study. Four themes were identified: 1) Improved mental health; 2) Capabilities to provide person-centred care; 3) Seeking help from others to reduce stresses and burdens; and 4) Challenges to manage severely changed behaviours.

Conclusion: Carers in the iSupport program believed that engaging with the iSupport program, interactions with peers and iSupport facilitators enabled them to improve their mental health, self-care and capabilities to care for people with dementia. However, systemic factors, such as lack of respite care and specialist dementia care services, undermined their ability to manage the changed behaviours of people with dementia.

Objectives: To explore the characteristics of cognitive super-agers and determine which definition best explains variance in outcomes.

Method: 'Super-agers', defined as (i) performance in at least one cognitive domain comparable to adults in their 30s-40s and at least average performance in other domains (SA1), (ii) superior performance for age (SA2) or (iii) no cognitive decline over time (SA3), were compared with 'typical agers' in a sample of 1611 Australian adults aged 65-106. Logistic regression was used to determine which variables best discriminated between super-agers and typical agers for each definition. Separate generalised linear models were used to determine variance in functional, physical and psychosocial outcomes.

Results: SA1 (n = 459) and SA2 (n = 236) had higher education and occupational complexity, less hypertension and lower depression scores; SA3 (n = 266) had higher physical activity, lower depression and hearing impairment. All cohorts had greater brain volumes and white matter integrity. Super-ageing was associated with less functional impairment (10.1-16.1%, p < 0.001). SA1 and SA2 were associated with faster walking speed (5.4-6.4%, p < 0.001) and better psychological wellbeing (5-6.5%, p = 0.001-0.003).

Conclusion: This study demonstrates differences in factors associated with either superior cognition in older age or maintaining cognitive abilities. SA1 and SA2 were most strongly associated with positive outcomes.

Objectives: Population ageing presents a significant challenge to healthcare systems, as older adults typically have higher rates of healthcare utilization. This study investigates the association of depressive symptoms with healthcare utilization among community-dwelling older adults in Singapore, focusing on emergency department (ED) visits, frequent ED use, and inpatient hospitalizations.

Method: We analyze data from a nationally representative longitudinal cohort with participants' survey data linked to electronic medical records to measure healthcare utilization outcomes. The analysis sample included 4049 participants (mean age 72.3 years, 52.0% female). We utilize two-part models for ED visits and hospitalizations and logistic regression for frequent ED use.

Results: Our findings indicate that higher depressive symptoms were significantly associated with increased odds of ED visits and hospitalizations within the subsequent 12 months. Each unit increase in the depressive symptoms score was linked with 5% higher odds of at least one ED visit and 6% higher odds of hospitalization. Furthermore, depressive symptoms were significantly associated with a 13% increase in the odds of frequent ED use defined as ≥4 visits, or a 10% increase when frequent ED use was defined as ≥3 visits.

Conclusion: This study adds to the existing literature by providing robust evidence on the longitudinal association between depressive symptoms and healthcare utilization. These findings highlight the need for proactive identification and management of depressive symptoms in older adults to potentially reduce future healthcare burden.

Objectives: Using 2011-2014 National Health and Nutrition Examination Survey (NHANES) data, the research aims to explore the association of anemia and cognitive dysfunction in older patients with hypertension.

Method: The study included 2005 older participants aged ≥60 years. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning subtest, the Animal Fluency Test (AFT) and the Digit Symbol Substitution Test (DSST). Multivariate logistic regression analysis and a weighted restricted cubic spline (RCS) curve were employed to examine the potential association between hemoglobin levels and cognitive dysfunction.

Results: Anemia was associated with higher odds of cognitive dysfunction in hypertensive older adults (OR = 1.663, 95% CI: 1.082-2.557, p = 0.022). Higher level of hemoglobin was associated with reduced odds of cognitive dysfunction (OR = 0.880, 95% CI: 0.782-0.991, p = 0.036). Hemoglobin levels below 13.67 g/dL were significantly associated with increased odds of cognitive impairment.

Conclusion: This study indicates the existence of an association between anemia and cognitive dysfunction among hypertensive older adults. Hemoglobin levels may serve as a predictor of cognitive decline, with 13.67g/dL as a potential threshold for intensive cognitive monitoring in high-risk older populations with hypertension.

Objectives: Cognitive Stimulation Therapy (CST) is widely used in UK dementia care to support cognitive and social functioning. Music therapy (MT) also shows cognitive benefits for people living with dementia (PLwD) but is not routinely available through the NHS due to limited cost-effectiveness evidence. This study evaluated the combined use of CST and MT compared to CST alone, providing a realistic assessment of the added value of MT within standard care.

Method: A decision analytic model was constructed using a cost utility framework with a healthcare perspective, over a three-month time horizon. It compared CST+MT with CST alone for community-dwelling people with moderate dementia. The clinical effectiveness outcome was cognitive improvement measured by MMSE score. Model parameters were informed by existing literature and clinical trial data where available.

Results: Over a three-month period, MT+CST was more effective than CST alone in improving cognitive function but was not cost-effective due to higher initial costs, including setup and equipment. However, when cognitive benefits were assumed to persist over six months, CST+MT became cost-effective.

Conclusion: MT combined with CST may offer cost-effective cognitive benefits for PLwD over a six-month period. The model provides valuable evidence for decision-makers considering the broader adoption of MT.

Objectives: The convergence of climate change and population ageing poses a global health challenge, especially in LMICs, where older adults face unique vulnerabilities. Evidence on mental/cognitive impacts is fragmented and geographically skewed, hindering policy. We systematically synthesised quantitative evidence on these impacts in older adults.

Method: Following PRISMA/PROSPERO guidelines, we searched Scopus, EBSCOHost, ScienceDirect, and Web of Science (Jan 2000-June 2025) for studies linking climate exposures (e.g. thermal stress, disasters) to mental/cognitive outcomes in older adults (>60 years). Two reviewers extracted data and assessed bias. Findings were narratively synthesised due to heterogeneity.

Results: We included 28 quantitative studies. Thermal stress (heat/cold) was robustly linked to increased depressive symptoms. Acute disasters were consistently associated with higher psychological distress, anxiety, and PTSD. An emerging link between heat exposure and cognitive impairment has been identified, although some studies suggest that older adults exhibit greater psychological resilience post-disaster than younger cohorts. Key pathways (physical health, sleep, social support) were identified. Critically, the evidence is profoundly concentrated in East Asia (primarily China), with significant data gaps in Africa and South Asia.

Conclusion: Climate change poses a significant threat to older adults' mental and cognitive health. The severe geographic research imbalance, neglecting low- and middle-income settings-especially sub-Saharan Africa and South Asia-represents a major global health failure. Future research and funding must prioritise these high-risk, low-evidence regions and shift towards the development and testing of interventions.

Objectives: Maintaining functional ability is central to healthy aging. However, prior research overlooks psychosocial adaptation and relies on retrospective assessments. This study examined intrinsic capacity, environmental resources, and functional ability under varying agency and belonging among 312 Hong Kong older adults (aged 65-86) using momentary assessment.

Method: A seven-day intensive longitudinal study was conducted in 2024. Intrinsic capacity included cognition, affect, locomotion, sensory capacity, and vitality. Environmental resources measured perceived walking accessibility. Functional ability assessed daily meaningful activities, physical activity intensity, and life space. Agency and belonging were housing-related control beliefs and sense of community. Direct associations and moderation models were tested.

Results: Intrinsic capacity positively associated with all functional ability dimensions. Environmental resources linked positively to meaningful activities but negatively to life space. These links were generally weaker with high agency and belonging, except high belonging strengthened one relationship, revealing nuanced psychosocial adaptation mechanisms.

Conclusion: Agency and belonging emerged as key psychosocial resources buffering functional decline, highlighting their value as targets for prevention and intervention efforts promoting healthy aging.

Objectives: . Population aging raises concerns about older adults' mental health. Self-perceptions of aging, activity restriction, and behavioral activation are key factors for well-being. This study aimed to (a) identify profiles based on these factors, (b) examine their relationship with psychological distress (depression, anxiety) and loneliness, and (c) explore psychosocial correlates of profile membership.

Method: Participants were 316 adults aged 65+ (M = 72.15; SD = 5.47; 75.3% women). Latent profile analysis identified profiles based on negative self-perceptions of aging [measured with the ATOAS], activity restriction [ARS-OA], and behavioral activation [BADS-SF]. Differences in depression [CES-D], anxiety [GAI], and loneliness [SELSA-S] were examined with Kruskal-Wallis tests. Multinomial logistic regression identified psychosocial correlates of profile membership. The study was approved by the University Ethics Committee.

Results: Three profiles emerged: engaged, vulnerable, and limited. Depression symptoms differed across all profiles, while anxiety and loneliness were higher in vulnerable and limited compared to the engaged group. Better physical functioning, cognitive status, and perceived control predicted membership in the engaged profile.

Conclusion: The emerged profiles were linked to distinct patterns of psychological distress and loneliness. The engaged profile showed the most adaptive outcomes. Integrating cognitive and behavioral factors may improve understanding and intervention in later-life distress.

Objectives: Family caregivers of people with dementia often experience ambivalent feelings toward their relative, which have been linked to higher depressive and anxiety symptoms, guilt, and greater reports of behavioral and psychological symptoms of dementia (BPSD). Most previous studies have relied on explicit reports, which may not fully capture conflicted emotions. This study assessed caregivers' implicit ambivalence using an evaluative priming task and examined its associations with explicit ambivalence, depressive and anxiety symptoms, guilt, and BPSD.

Method: Ninety-four family caregivers completed an evaluative priming task in which the name of their relative with dementia preceded positive and negative target words. The task yielded an implicit ambivalence index and allowed classification of caregivers as implicitly ambivalent, implicitly negative, implicitly positive, or undifferentiated.

Results: Explicit and implicit ambivalence were both associated with depressive and anxiety symptoms, although they were not intercorrelated. Implicitly ambivalent caregivers reported higher depressive and anxiety symptoms and greater reactivity to memory-related BPSD than the other groups, whereas guilt was exclusively related to explicit ambivalence.

Conclusion: Both explicit and implicit ambivalence are linked to caregivers' emotional distress; however, only explicit ambivalence appears to evoke guilt by challenging caregivers' perceptions of meeting moral or social standards.