Aging & Mental Health最新文献

Objectives: To examine how sensory impairments are associated with loneliness and quality of life (QoL) over time, and to assess the mediating roles of depressive symptoms and activity participation.

Method: A longitudinal study including 83,459 participants who took part in at least two waves of the Survey of Health, Ageing and Retirement in Europe (2011-2022). Mixed-effects linear regression models were used, adjusting for socio-demographic and health-related factors.

Results: Sensory impairments were associated with increased loneliness and reduced QoL. For vision impairment (VI), loneliness increased (coef. = 0.13, 95% CI: 0.11; 0.15) and QoL decreased (coef. = -1.01, 95% CI: -1.10; -0.92). Hearing impairment (HI) showed similar patterns (loneliness: 0.11, 95% CI: 0.08; 0.14; QoL: -0.76, 95% CI: -0.88; -0.64), while dual sensory impairment (DSI) showed the strongest associations (loneliness: 0.30, 95% CI: 0.26; 0.33; QoL: -2.18, 95% CI: -2.32; -2.04). Depressive symptoms were the most prominent mediator, while activity participation mediated only the associations with VI and DSI. Associations were strongest for HI and loneliness, and DSI and QoL, in women. Loneliness associations were most pronounced in Northern and Western Europe.

Conclusion: Addressing depressive symptoms may be key to mitigating loneliness and reduced QoL in older adults with sensory impairments.

Objectives: This systematic review aimed to explore the available support and identify the unique needs of young and young adult carers of individuals with dementia.

Method: A systematic review following PRISMA guidelines was conducted. Electronic databases, including PubMed, Web of Science, PsycINFO, CINAHL, and Ovid, along with Google Scholar for grey literature, were searched. A narrative synthesis approach was used to analyse the findings of the included studies. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results: Seven studies met the predefined inclusion criteria and were included in the narrative synthesis. Findings revealed that young and young adult carers often lack knowledge of available support services and face challenges navigating the healthcare system. Caregiving responsibilities were found to hinder educational and career aspirations, leading to social isolation and strained relationships. The support received from family, friends, and teachers was often inconsistent and inadequate. A significant finding was the lack of differentiation between young and young adult carers in the existing research, despite their distinct social care support needs.

Conclusion: The limited research highlights a critical gap in the literature regarding the support and needs of young and young adult carers of people with dementia. The lack of distinction between these two groups, who receive different social care support, emphasises the need for further research to better understand their unique experiences. There is an urgent need for targeted education and support programmes that address the distinct developmental needs and challenges of this population, promoting their well-being and safeguarding their personal and educational aspirations.

Objectives: Decision-making involvement is important for maintaining a sense of self and quality of life in people with dementia. To date, few studies have explored the factors behind this relationship. We explored whether decision-making benefits quality of life by enabling fulfilment of basic psychological needs: autonomy, competence, and relatedness.

Method: We analysed one-year longitudinal data from 787 people recently diagnosed with dementia from the DETERMIND cohort. Path analysis examined cross-sectional and longitudinal associations between decision-making involvement and quality of life. Parallel mediation analysis tested whether psychological needs explained this relationship. Cognitive impairment was tested as a moderator of longitudinal associations.

Results: At baseline, decision-making involvement was positively associated with quality of life, fully mediated by satisfaction of all three psychological needs. Despite declines in cognitive function, decision-making involvement remained high and quality of life stable over one year. No significant longitudinal associations were found between decision-making involvement and quality of life.

Conclusion: Decision-making involvement may support quality of life through psychological needs fulfilment. Stability in decision-making and quality of life suggests resilience among people with dementia in early stages. Supporting psychological needs through tailored interventions and decision-aid tools may have the potential to enhance quality of life as dementia progresses.

Objectives: Acquiring caregiving knowledge and skills may reduce informal caregivers' burden and enhance positive feelings, yet evidence on the impact of the learning across caregiving domains is limited. We examined the association between learning experiences in caregiving knowledge/skills and caregivers' negative and positive outcomes.

Method: This cross-sectional study involved 934 informal caregivers (mean 58.4 years) of family members aged ≥65 years, via an internet-based questionnaire. The Japanese version of the Caregiver Reaction Assessment (CRA-J) evaluated assessed five domains: impact on schedule, caregivers' self-esteem, lack of family support, impact on health, and impact on finances. Learning experiences were measured in seven areas: knowledge of diseases, living support, medical practice/devices management, mental support, physical care, safety management, and social resources.

Results: Oveall, 24.1% reported learning about caregiving in at least one area. Multivariable regression analysis indicated that learning experiences were associated with higher caregiver's self-esteem, but not CRA-J total scores and other domains. Learning other than knowledge of diseases exhibited associations with higher caregiver's self-esteem.

Conclusion: Learning caregiving knowledge and skills was related to the caregiver's self-esteem. Providing opportunities for care knowledge and skill acquision may strenghen caregivers' positive perception of their role.

Objectives: To validate the 11-item Neglect and Abuse Scale (NAS) in Arabic and establish its psychometric robustness within a sample of community older adult.

Method: A cross-sectional study was conducted involving 539 Arabic-speaking older adults from Egypt. The total sample was divided randomly into two subsamples (1/3 for the EFA and 2/3 for the CFA).

Results: The initial analysis of the unidimensional structure indicated poor fit. Consequently, an EFA using oblimin rotation was conducted, which revealed a clear two-factor structure, explaining 54% of the variance. The first factor captured neglect-related experiences (e.g. being deceived, neglected, or denied rights), while the second factor reflected more overt forms of abuse (e.g. physical or verbal assault, betrayal, sexual harassment). A CFA, conducted on the solution obtained in the EFA, demonstrated acceptable fit. Reliability assessments indicated a commendable level of internal consistency. Sex invariance results showed no significant differences between male and female participants in the measurement characteristics. Concurrent validity analysis indicated a moderate negative correlation between the NAS scores and resilience and quality of life scores.

Conclusion: This research provides a reliable and valid instrument for identifying and assessing elder neglect and abuse among Arabic-speaking communities, thereby supporting effective prevention and intervention strategies.

Objectives: This scoping review presents an overview of quality indicators (QIs) available for the monitoring of best practices in the assessment and management of behavioral and psychological symptoms of dementia (BPSD) in hospitalized older adults.

Method: The literature study followed the Joanna Briggs Institute methodology for scoping reviews. A conventional database search (Medline, Embase, PsycINFO, Cochrane, CINAHL, and Web of Science) was conducted in January 2024, and a grey literature search in February 2024. Articles published from 2013 onward were included if they reported potential QIs for monitoring best practices with regards to BPSD, or similar manifestations in the context of delirium, in hospitalized older adults.

Results: The review included 25 publications, reporting a total of 88 potential QIs: 23 structural indicators, 38 process indicators, and 27 outcome indicators. The QIs retrieved cover elements pertaining to the screening and reporting, assessment, management, impacts, hospitalization outcomes, and resources invested for BPSD in acute care.

Conclusion: While this study generated an exhaustive list of QIs for the monitoring of best practices in the assessment and management of BPSD in hospitalized older adults, further research is needed to optimally operationalize these indicators before they can be successfully implemented in acute care settings.

Trial registration: Protocol was registered on the Open Science Framework platform on December 22, 2023. (https://osf.io/r4hwz/).

Objectives: This study explores a sequential mediation model in which self-esteem and aging anxiety mediate the relationship between perceived age stigma and emotional isolation among older adults aged 65 and over in South Korea.

Method: Secondary analysis of cross-sectional data from 600 nationally representative older adults in the 2020 Ewha Study of Intergenerational Issues (ESoII) was conducted using structural equation modeling (SEM) and bootstrapping to assess sequential mediation effects.

Results: Perceived age stigma was not directly associated with emotional isolation. However, it was negatively associated with self-esteem, which in turn was negatively associated with aging anxiety. Aging anxiety showed a positive association with emotional isolation. A significant sequential mediating effect of self-esteem and aging anxiety was observed in the pathway from perceived age stigma to emotional isolation.

Conclusion: These findings highlight the importance of disrupting the internalization of perceived age stigma among older adults and underscore the protective role of self-esteem in mitigating aging anxiety. Interventions aimed at enhancing self-esteem and alleviating aging anxiety may help reduce emotional isolation in later life.

Objectives: Research extensively examines spousal caregiving in dementia, but it remains unclear how both partners perceive the support that caregivers receive from their spouses with Alzheimer's disease (AD). We present a qualitative investigation of pleasant and stressful experiences in both partners when such support occurs.

Method: Seventy-two couples managing mild-to-moderate AD responded to open-ended prompts about their pleasant and stressful experiences when people living with AD (PLWD) provided support to their spousal caregivers. We applied descriptive content analysis to examine these responses.

Results: PLWD had pleasant experiences when perceiving their support to caregivers enhanced caregivers' well-being and promoted their own feelings of self-worth. Caregivers had pleasant experiences when support they received promoted their own well-being, reflected PLWD's preserved capabilities, and made PWLD happy. Regarding stressful experiences, PLWD noted that at times they could not help as much as they wished or were expected to, which, for some, promoted their sense of uselessness or a lack of caregiver appreciation. Caregivers had stressful experiences primarily due to frustration with the poor quality of support they received.

Conclusion: Findings inform the development of dyadic interventions for facilitating, while addressing the challenges of, mutual, changing support dynamics among spouses coping with AD.

Objectives: This paper evaluates the association between social network size and cognitive decline in older adults, approximately 61 years and older, with or without depressive symptoms and/or loneliness.

Method: This study is a secondary data analysis of the Chicago Health and Aging Project (CHAP), which is a population-based cohort study. Data collection occurred in three-year cycles from 1993 to 2012, consisting of a maximum of up to six cycles, including baseline. Mixed effects regression models were conducted to evaluate the relationship between social network size and cognitive decline.

Results: The study sample is comprised of 10,569 participants. Among participants experiencing baseline loneliness, having a social network size of nine or more individuals at baseline was associated with a slower annual rate of global cognitive decline (β = 0.016 (SE = 0.007), p = 0.019) than participants with a network size below nine at baseline. Participants experiencing moderate to severe depressive symptoms at baseline and a network size of nine or more at baseline also had a slower rate of global cognitive decline (β = 0.014 (SE = 0.006), p = 0.014) compared to participants with a network size below nine at baseline.

Conclusion: Developing approaches for maintaining and improving social network size in individuals experiencing loneliness and depression may reduce Alzheimer's disease risk.

Objectives: to conduct a meta-synthesis of the experiences of caregivers of people with dementia receiving Acceptance and Commitment Therapy (ACT).

Method: this study conducted a meta-synthesis of qualitative research that focused on caregivers' experiences. Eleven databases were used to retrieve literature on implementations of ACT published up to December 2024. Qualitative and mixed-methods studies published in Japanese, Chinese, and English were included. The studies were selected by screening titles, abstracts, and full texts. The quality of each study was assessed independently by two researchers. Meta-aggregation was used to synthesize findings.

Results: six studies were published between 2017 and 2023, including one qualitative and five mixed-methods studies. ACT was found to have a positive influence on caregivers, including changed cognition, improved action capacity, and reduced negative emotions. Caregivers were found to be receptive to ACT but also perceived some barriers and limitations.

Conclusion: The mechanisms identified in this study align with the six core processes of the ACT model, which promote psychological flexibility. Despite some barriers to participation, ACT shows promise as a supportive intervention when culturally and practically adapted, future improvements for implementing ACT may include flexible arrangements regarding the time and location.