Aging & Mental Health最新文献

Objectives: Most studies examining age differences in coping across adulthood come from cross-sectional studies and focus on the broader categories of problem- and emotion-focused coping. We aimed to establish a factor structure for coping items used in a national, longitudinal study of aging (MIDUS) and examine age patterns in coping strategies over 10 years.

Method: We performed exploratory and confirmatory factor analysis, and factorial invariance testing. Next we conducted a series of multilevel models for each coping factor with participants from waves II and III of the MIDUS study (N = 2,661, M_age = 55, 58% women, 84% White).

Results: We found a four-factor solution: instrumental action; denial/disengagement; positive reappraisal; focus and venting of emotions. Invariance was established across time and age. At baseline, age was positively associated with the use of three strategies, though younger adults used more focus and venting of emotions. There was an overall decrease over 10 years in use of all strategies, which was moderated by age. Positive reappraisal declined more steeply among midlife participants, whereas the remaining strategies declined more for older participants.

Conclusion: Results highlight the multi-dimensionality of MIDUS coping items and underscores the import of age in understanding changes in coping across midlife and older adulthood.

Objectives: Various dementia risk scores exist that assess different factors. We investigated the association between the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score and modifiable risk factors in the Lifestyle for Brain Health (LIBRA) score in a German population at high risk of Alzheimer's disease.

Method: Baseline data of 807 participants of AgeWell.de (mean age: 68.8 years (SD = 4.9)) were analysed. Stepwise multivariable regression was used to examine the association between the CAIDE score and additional risk factors of the LIBRA score. Additionally, we examined the association between dementia risk models and cognitive performance, as measured by the Montreal Cognitive Assessment.

Results: High cognitive activity (β = -0.016, p < 0.001) and high fruit and vegetable intake (β = -0.032, p < 0.001) correlated with lower CAIDE scores, while diabetes was associated with higher CAIDE scores (β = 0.191; p = 0.032). Although all were classified as high risk on CAIDE, 31.5% scored ≤0 points on LIBRA, indicating a lower risk of dementia. Higher CAIDE and LIBRA scores were associated with lower cognitive performance.

Conclusion: Regular cognitive activities and increased fruit and vegetable intake were associated with lower CAIDE scores. Different participants are classified as being at-risk based on the dementia risk score used.

Objectives: The primary purpose of this pilot study was to determine the feasibility and acceptability of a novel brief (six-session) motivational interviewing home-based intervention for hoarding disorder designed for rural older adults. The secondary aims were to examine the engagement of proposed mechanisms of change and the preliminary efficacy of symptom reduction.

Method: Fifteen rural-dwelling older adults were enrolled in the pilot trial for Project RECLAIM (Reduce Clutter and Increase Meaning). Engagement of proposed mechanisms of change was assessed weekly for reported engagement in sorting/discarding behaviors and from baseline to post-treatment on readiness for change and motivation. Symptom reduction was assessed from baseline to post-treatment on hoarding symptoms and general psychological functioning.

Results: Sixty percent of participants completed all six sessions of RECLAIM. Over the course of treatment, participants reported significant decreases in household clutter (d = -0.85) and object attachment (d = -1.01) and increases in positive affect (d = 0.71), readiness for change (d = 0.40) and motivation (d = 0.52), and sorting between sessions (ß = 3.82).

Conclusion: The significant reductions in hoarding symptoms after only six sessions of treatment suggest that a brief, in-home, intervention may be a viable option for symptom reduction, particularly for rural-dwelling older adults.

Objectives: The purpose of this investigation was to verify the association between mental health (MH) indicators with walking capacity in patients with PAD.

Methods: Two hundred and forty-six patients with PAD and claudication symptoms participated in this study. Physical function was assessed objectively with the 6-min walk test (6MWT) and subjectively using the Walking Impairment Questionnaire (WIQ). MH was assessed by the World Health Organization Quality of Life-Bref (WHOQOL-Bref) (six questions were selected - 1, 2, 10, 16, 19, and 26). Patients were divided into tertile groups according to their composite z-score for mental health (Low MH, Middle MH, and High MH).

Results: The High MH group presented higher scores (p < 0.05) for the WIQ (distance = 26.8 ± 25.6, speed = 25.4 ± 17.3, and stairs = 33.6 ± 27.5), claudication onset distance (161.6 ± 83.6 m), and total walking distance (352.9 ± 79.6 m) compared to Low MH (WIQ distance = 14.8 ± 16.2, 17.7 ± 13.0, and stairs = 22.7 ± 20.7). Additionally, the High MH group presented a longer claudication onset distance (115.5 ± 70.5 m), and total walking distance in 6MWT (306.6 ± 83.2 m), and higher scores in the total walking distance compared to Middle MH (309.5 ± 93.6 m) (p < 0.05).

Conclusion: In patients with PAD, MH was positively associated with walking capacity. Based on these results, treatments that can improve mental health, through different mechanisms, can also positively influence the ability of these patients to walk.

Objectives: To gain insight into the longitudinal, reciprocal associations between depressive symptoms and sexual satisfaction as well as the potential moderating roles of gender and perceived importance of sexuality.

Method: We analyzed longitudinal data from 2113 participants of the Longitudinal Ageing Study Amsterdam (LASA) with an initial age range of 54-93 years, using Generalized Estimating Equations (GEE).

Results: There were no significant associations between baseline depressive symptoms and change in sexual satisfaction, nor between baseline sexual satisfaction and change in depressive symptoms. Gender and perceived importance of sexuality were moderators: in men higher depression scores were associated with a decrease in sexual satisfaction, whereas in women higher depression scores were associated with an increase in sexual satisfaction. In participants for whom sexual life was important, higher depression scores were associated with a decrease in sexual satisfaction. In participants for whom sexual life was not important, higher depression scores were associated with an increase in sexual satisfaction.

Conclusion: The associations between baseline depressive symptoms and change in sexual satisfaction as well as between baseline sexual satisfaction and change in depressive symptoms varied according to gender and importance ascribed to sexuality. Potential explanations might lie in the different roles sexual activity plays in sexual satisfaction in men and women.

Objectives: The objective of this paper is to explore how telephone-delivered mindfulness training impacts family conflict and communication within the informal dementia caregiving team, including primary caregivers, their care partner, and the care recipient.

Method: Primary caregivers and their care partners participated in an eight-week telephone-delivered mindfulness-based intervention (MBI). This study used mixed methods and a pre-post design to evaluate the intervention's effect on family satisfaction, perceived support, and family conflict.

Results: Both family satisfaction and perceived informational support increased significantly, and qualitative analysis revealed four key themes illustrating how the mindfulness intervention served to positively impact family conflict and communication among participating caregivers.

Conclusion: This study provides preliminary evidence for the beneficial effects of an MBI on family functioning among rural African American caregivers of people with Alzheimer's disease and related dementias.

Objective: Social participation is essential for the health of older adults. Formal volunteering can reduce loneliness and is associated with numerous positive health outcomes. Older adults have limited resources to meet their social and well-being needs. We explore factors contributing to the well-being of middle-aged and older adults who engage in formal volunteering using a qualitative social network approach.

Methods: Between 2022 and 2023, qualitative semi-structured interviews were conducted with 28 members of social clubs in Germany, aged 45-80 (mean age 62 years). Thirteen participants were retired. Eight interviewees were female and twenty were male. Participants created unstructured egocentric network maps of individuals or organisations important to their well-being. Participants reflected on their social networks using these maps, which allowed for deeper insights into changing network dynamics. The data were analysed using thematic analysis.

Results: We developed six themes: intrapersonal, interpersonal and social network characteristics affecting well-being, self-fulfilment, feeling indispensable and unfulfilled expectations. Formal social participation, particularly through volunteering, contributed significantly to the well-being.

Conclusion: Formal volunteering can aid successful role substitution and compensation, especially after retirement. This may prevent loneliness and increase well-being in older age.

Objectives: Population ageing raises major public health and psychosocial challenges. Particularly, lesbian, gay, and bisexual (LGB) older people may face increased vulnerabilities and marginalization when compared to their non-LGB (heterosexual) counterparts, which may entail more risks for their mental health. The aim of this study was to comparatively evaluate the levels of protective - social support, spirituality, and resilience and stress factors - loneliness and ageism - among LGB and non-LGB older adults, and their impact on psychological distress (PD).

Method: A sample of 647 people aged 60 years or older (M = 66.01; SD = 4.93) was collected, 368 non-LGB and 279 LGB. Participation was carried out through an online survey in Portugal.

Results: LGB older adults had lower scores on all protective factors, except on social support from friends, and higher levels on all stress factors, except on hostile ageism, compared to non-LGB older adults. Further, resilience and loneliness were the main predictors of PD regardless of the sexual orientation. Stress factors explained the levels of PD over and above the effects of protective factors, both among LGB and non-LGB older adults.

Conclusion: Psychological distress in aging presents different protective and stressful factors according to the sexual orientation of older adults. More comparative studies are suggested in the intersection between ageing and sexual orientation.

Objectives: This study aimed to evaluate the effects of a multicomponent psychotherapy programme for people with mild Alzheimer's dementia (AD) and their caregivers on depression and related neuropsychiatric symptoms.

Method: The cognitive behavioural therapy (CBT)-based treatment consisted of 25 weekly sessions, including behavioural activation, behaviour management, interventions for the caregiver, reminiscence, couples counselling, and cognitive restructuring. 41 participants and their caregivers were randomised to either the CBT or the control group, which received treatment-as-usual (TAU). Follow-ups took place at 6 and 12 months posttreatment. The primary outcome was depression in the patient with AD. The secondary outcomes were apathy, other neuropsychiatric symptoms, functional abilities, quality of life, and quality of the relationship with the caregiver.

Results: Linear mixed models revealed a statistically significant superiority of CBT regarding clinician-rated depression at the 12-month follow-up with large effect sizes (within-subject d = 1.22, between-subject d = 1.00). Effect sizes were only moderate for self-rated depression and small for informant-rated depression. There was also a significant advantage for CBT regarding clinician-rated apathy, relationship quality, and informant-rated quality of life (QoL) but not for the other neuropsychiatric symptoms or self-rated QoL.

Conclusion: The results are very encouraging and support an adequately powered multicentre study.

Trial registration: ClinicalTrials.gov NCT01273272. Date of registration: 3 Jan 2011.

Objectives: People with dementia have several unmet needs during the syndrome progression. More unmet needs are related to hospitalizations, injuries, and death. Little is known about the care needs for people living with dementia in Brazil. This study aims to translate and adapt the Johns Hopkins Dementia Care Needs Assessment (JHDCNA 2.0), a tool design to identify the dementia-related needs of people with dementia and their caregivers, to Brazilian Portuguese, and to verify psychometric properties.

Method: JHDCNA 2.0 underwent a translation, back-translation, and cultural adaptation. Preliminary psychometric testing of the Brazilian version (JHDCNA-Br 2.0) included pilot testing and experts' assessment, analyses of reliability, evidence based on test content and relations to other variables. We conducted 140 in-home interviews to assess several sociodemographic and health aspects and to be able to complete the JHDCNA-Br 2.0.

Results: The JHDCNA-Br 2.0 is reliable and has evidence based on test content and on relations to other variables for people living with dementia and caregivers. Preliminary results suggest high prevalence of unmet needs.

Conclusion: JHDCNA-Br 2.0 is a reliable and valid tool. The availability of this tool brings new opportunities to the study of dementia care, taking into consideration cultural aspects and may help inform future approaches to dementia care delivery to support persons and families affected by these conditions.