Aging & Mental Health最新文献

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.

Objectives: To explores how indirect media exposure to the October 7 massacre in Israeli communities and the State's failure to protect civilians affected the sense of security and institutional trust among older Israeli adults, and to examine the personal and social resources, that contribute to their coping and adaptation.

Method: Qualitative phenomenological approach, in-depth interviews were conducted with 16 Israeli residents aged 60 and above.

Results: Findings revealed two main themes: (1) The undermining of security: psychological distress and institutional distrust in the wake of October 7th; (2) Personal and social resources as pillars of coping and resilience in times of crisis. Each of them was divided into two sub-themes.

Conclusion: This study emphasized emotional distress and institutional erosion of confidence, and highlighted the moderating role of personal and social resources. Drawing on life experience, emotional regulation and social support, participants demonstrated resilience despite subjection to indirect trauma. Theoretical and practical implications are discussed, emphasizing the role of past experiences and social support in coping strategies.

Objectives: Recent evidence suggests residential surrounding greenness may benefit cognitive functioning. Although benefits have been widely studied in children and young adults, research involving mature and older adults, especially studies using objective greenness measures and comprehensive cognitive assessments, remains limited and shows mixed results. This study examines the effect of residential surrounding greenness on global and domain-specific cognition (memory, attention, language, executive functions) in community-dwelling mature and older adults. Also, moderating factors (age, gender, and education) are investigated.

Method: Satellite-based Normalized Difference Vegetation Index (NDVI) was measured at 100, 300, and 500 m buffers around residences, considering short-term (1-year) and long-term (20-year) exposure. Cognitive functioning was assessed using standardized neuropsychological tests. Linear and moderated regression models tested hypotheses.

Results: Findings reveal differentiated effects of residential greenness on cognition. Short- and long-term exposure were positively associated with language performance in subgroups, such as older participants and those with lower schooling. Conversely, greenness exposure was negatively associated with memory, particularly in males.

Conclusion: These findings highlight the complex relationship between residential greenness and cognition. Effects vary across cognitive domains and socioeconomic factors, underscoring the need for further investigation of mechanisms linking greenness exposure to cognitive functioning in aging populations.

Objectives: This study analyzes trends in suicide rates among individuals aged 65 and over in Turkey from 2007 to 2023 and examines associations with socio-economic factors between 2013 and 2022.

Method: Data were obtained from the Turkish Statistical Institute. Suicide rates per 100,000 were calculated by gender. Spearman correlation and the Joinpoint Regression Program (JRP) were used to explore associations with variables including poverty, labor force participation, unemployment, Gini coefficient, Consumer Price Index, minimum pension, and GDP.

Results: Between 2007 and 2023, 6,373 elderly suicides were recorded, with an average rate of 5.77 per 100,000. Male suicide rates (9.90) were significantly higher than female rates (1.67) (p < 0.001). The highest rate was observed among those aged 75 and over (6.95 per 100,000). Regionally, the Aegean had the highest rate (5.26), while Istanbul had the lowest (3.28). From 2013 to 2022, elderly suicide rates declined annually by 1.19% (p = 0.011). A significant negative correlation was found between labor force participation and suicide rates (r = -0.847; p = 0.008).

Conclusion: Although elderly suicide rates in Turkey have declined, the issue remains a serious public health concern, warranting continued research and targeted interventions.

Objectives: To evaluate whether discrepancy between patient and informant reports of memory deficits can be used as a proxy of impaired awareness of memory function in Mild Cognitive Impairment (MCI) and to determine its prognostic value in conversion to dementia.

Method: We conducted a longitudinal study including 128 older adults with memory complaints, diagnosed with MCI. At baseline, participants were assessed for central Alzheimer's Disease biomarkers, memory complaints (Subjective Memory Complaints scale, SMC) and cognition (MMSE). Participants were followed annually (mean follow-up time 43.3 months) to detect progression to dementia, defined by clinical assessment and Clinical Dementia Rating Scale.

Results: Self- and informant-reported SMC scores were used to create the variable 'SMC discrepancy', classifying participants as underreporters, overreporters and congruent reporters. Underreporters showed lower cognitive performance (p = 0.021), which did not translate into higher self-report SMC (p = 0.092). They had the highest informant-reported SMC (p < 0.001) and greater amyloid (p = 0.020), tau (p = 0.005) and p-tau (p = 0.034) burden. Underreporting of memory deficits was associated with a 4.31-fold increased risk of conversion to dementia (p = 0.001).

Conclusion: Patients' underreporting of memory deficits independently predicted disease progression. Informant-based reports were consistent with changes in AD biomarkers, suggesting that patients' underreporting was due to impaired awareness of memory deficits.

Objectives: To examine the associations between sensory impairments and cognitive impairment (CI), and how these associations differ by nativity over 12 years of follow-up among Mexican American 75 years and older with moderate to high cognitive function at baseline.

Method: Dual sensory impairment (DSI) included vision impairment (VI), difficulty in recognizing a friend at arm's length, across the room, or across the street); and hearing impairment (HI), inability to hear and understand a speech without seeing a person talk, in a quiet room. Participants were grouped into No VI-No HI, HI only, VI only, and Yes VI-Yes HI by nativity. CI was defined as scoring <21 on the Mini-Mental State Examination.

Results: US-born and foreign-born participantsin the Yes VI-Yes HI group and US-born in the VI only group had greater odds of CI over time than those without VI and without HI (OR = 2.64, 95%CL = 1.23-5.68, OR = 5.71, 95%CL = 2.78-11.73; and OR = 2.09, 95%CL = 1.28-3.43, respectively), after controlling for covariates.

Conclusion: US-born and foreign-born Mexican American older adults with DSI were at high risk of developing CI over time. Addressing hearing and vision impairments may counteract CI over time.

Objectives: Elder abuse has become a neglected public health issue and represents one of the most significant challenges for the older population. In response, this study identified risk factors for elder abuse based on the clinical and sociodemographic characteristics of a sample of older adults.

Method: A cross-sectional study with a correlational scope was conducted to evaluate 543 older adults from northeastern Colombia. The Elder Abuse Scale, Barthel Index, Montreal Cognitive Assessment, State-Trait Anxiety Inventory (STAI), and Yesavage Geriatric Depression Scale were applied. Data analysis was performed using binomial logit models.

Results: The identified risk factors for physical abuse included being single, symptoms of depression, and expected cognitive performance. For psychological abuse, depressive symptoms, being divorced/separated or in a common-law relationship, being female, and high trait anxiety test scores were identified as risk factors. For neglect, being a Jehovah's Witness, having depressive symptoms, living in urban areas, and having a suspected neurocognitive disorder were identified as risk factors. Lastly, the risk factors for financial abuse were suspected neurocognitive disorder, depressive symptoms, being in a common-law relationship or single, and being employed.

Conclusion: Overall, the protective factors highlighted were not practicing religion, functional independence, and living with relatives in urban areas.

Objectives: Financial inclusion has been linked with health outcomes. However, the association between financial inclusion and sleep problems (SP) is limited in old age and the mediators of this association are largely unknown. This study examines the association of financial inclusion with SP among older adults in Ghana. It also explores how food insecurity and emotional pain explain this association.

Method: A multi-stage cluster sample (N = 1201) from the AgeHeaPsyWel-HeaSeeB study was analyzed. We measured financial inclusion using the eight-item Financial Instrument Questionnaire Scale, and SP was assessed using nighttime/daytime challenges over the last 30 days. To estimate the associations, we fitted multiple OLS models and employed bootstrapping procedures using the PROCESS macro.

Results: Data from 1201 individuals aged 50 years or older were analyzed (mean age, 66.1 years; 63.3% female). After adjustment, financial inclusion was negatively associated with SP (B = -0.079, p < 0.01), food insecurity (B = -0.076, p < 0.001), and emotional pain (B = -0.033, p < 0.01). These associations were significant in males and females. In the mediation models, food insecurity (63.9%) and emotional pain (24.1%) significantly explained the association between financial inclusion and SP.

Conclusion: Reducing SP in old age may require interventions addressing financial hardship, food insecurity, and emotional pain.

Objectives: Older adults may be particularly vulnerable to the negative effect of distress on cognition, thus explaining cognitive behavioral therapy's (CBT's) diminished efficacy for generalized anxiety disorder (GAD) in later life. Emotion-centered Problem Solving Therapy (EC-PST) may address this and other barriers to skill acquisition.

Method: This single-arm pilot aimed to determine the feasibility of 6-session EC-PST to achieve clinically significant improvements in anxiety and/or worry symptoms in adults aged 55+ with GAD. Secondary analyses also examined reductions in depressive symptoms and assessed participant satisfaction with treatment components.

Results: Sixteen adults aged 58 to 83 years old with current GAD were enrolled. Fourteen participants completed treatment. Twelve participants (85.7%) had a clinically significant pre- to post-treatment reduction in anxiety and/or worry symptoms. Additionally, nine (64.2%) had a clinically significant reduction in depressive symptoms. Qualitative feedback indicated a high level of satisfaction based on themes of reduced avoidance, increased confidence in managing anxiety, and feeling more in control of life problems.

Conclusion: Findings support feasibility and acceptability of EC-PST for GAD in middle-aged and older adults that is worthy of follow up in a randomized controlled trial given the limited options for evidence-based therapy in later life anxiety.