Aging & Mental Health最新文献

Objectives: We investigated the association of social participation with mental well-being among older people and whether purpose in life mediates the potential association.

Method: Cross-sectional (n = 1014) and longitudinal (n = 660, four-year follow-up) data comprised of three age cohorts (75, 80, and 85 years) of community-dwelling people. Life satisfaction was measured with the Satisfaction with Life Scale, depressive symptoms with the Centre for Epidemiologic Studies Depression Scale, and purpose in life with the Scales of Psychological Well-Being purpose in life subscale. Social participation was assessed with questions concerning the frequency of meeting close friends and acquaintances, and volunteering. The data were analyzed using structural equation modeling.

Results: Higher social participation was associated with higher life satisfaction and fewer depressive symptoms both cross-sectionally and after a four-year follow-up. Higher purpose in life mediated the associations of more social participation with higher life satisfaction and fewer depressive symptoms cross-sectionally. In the longitudinal data, the mediation effect was not observed.

Conclusion: Older people with frequent social participation who had a sense of purpose in their lives will likely have higher mental well-being than those with less social participation. Enabling and supporting them to conduct purposeful actions in social contexts may help maintain their mental well-being.

Objectives: People with dementia (PwD) and their care partners (CP) may have difficulties in emotion regulation, and individual differences in emotion regulation may be related to PwD's neuropsychiatric symptoms. This study explores whether there is self-awareness of PwD's difficulties in emotion regulation and whether CP's emotion regulation relates to the PwD's neuropsychiatric symptoms, potentially revealing bias or interpersonal effects.

Method: We used data from the Wish Outcome Obstacle Plan Study with a sample of 45 PwD and their spousal CP (n = 90 individuals). Multivariate linear regression models were used to investigate the associations between the CP-reported neuropsychiatric symptoms in PwD and self-reports of emotion regulation in both dyad members, net of sociodemographic and health factors. Separate analyses were conducted for each neuropsychiatric subsyndrome and each domain of difficulties in emotion regulation.

Results: Increasing severity of neuropsychiatric symptoms was associated with higher difficulties in emotion regulation in PwD (ß = 1.23, p < 0.05), but not with CP's difficulties in emotion regulation. When CP reported more severe neuropsychiatric symptoms in PwD, PwD reported that they had difficulties in accepting emotions, controlling impulses, goal-directed behaviors, and accessing emotion regulation strategies, but not in emotion awareness and clarification. Proxy-reports of hyperactivity and psychosis subsyndromes are significantly related to PwD's self-reported difficulties in emotion regulation.

Conclusion: PwD reported difficulties in emotion regulation at the early stage of dementia. Proxy-reported neuropsychiatric symptoms may capture PwD's emotion regulation capability and not be biased by CP's difficulties in emotion regulation.

Objectives: Social isolation and loneliness pose significant public health risks, especially among older adults experiencing age-related cognitive decline (ACD). This mixed methods feasibility study explored the potential of an online mindfulness-based dance/movement therapy (M-DMT) program to alleviate loneliness, enhance psychological well-being, and promote physical activity among older adults experiencing ACD during the COVID-19 pandemic.

Method: Sixteen participants engaged in a 12-week online group M-DMT program. Feasibility was assessed via enrollment and retention rates, attendance, adverse events, credibility/expectancy, participant perceptions, and satisfaction. Qualitative data were collected to capture participants' perspectives on the intervention's usefulness and perceived benefits. The intervention's preliminary impact on loneliness, depression, positive affect, psychological well-being, and physical activity was also examined.

Results: The study met all feasibility criteria, with 65% reporting post-intervention improvement. Significant reductions in loneliness and depression, along with enhanced positive affect and psychological well-being, were observed. Though physical activity increased, statistical significance was not achieved. Qualitative feedback highlighted improved social connectedness, overall quality of life, body awareness, kinematic strategy, and satisfaction with the program.

Conclusion: Online M-DMT holds promise in addressing well-being and loneliness challenges in older adults experiencing ACD. Further research is necessary to validate and expand upon these promising findings.

Objectives: Support for people with dementia in their communities is neither robust nor consistent in the UK, often bolstered by third sector/grass-roots initiatives facing formidable challenges in sustaining long-term. The Get Real with Meeting Centres project explored factors involved in sustaining one such form of community-based support. This is the second of two linked articles outlining learning from this realist evaluation of Meeting Centres (MCs) for people with dementia and carers, which focusses on findings regarding their operational and strategic running.

Method: Semi-structured interviews and focus group discussions were conducted with 77 participants across three MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using soft systems methodology and realist logic of analysis.

Results: Forty-two 'context-mechanism-outcome' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding three key areas for MC sustainability: External relationships and collaboration; Internal relationships and practices; and Finances and funding.

Conclusion: Collaboration is essential to sustaining community-based initiatives such as MCs, particularly between local community and regional level. MCs need to be vigilant in mitigating pressures that create 'mission drift', as targeting a gap in the care pathway and maintaining a person-centred ethos are central to MCs' appeal. Stable, ongoing funding is needed for stable, ongoing community dementia support. More formal recognition of the value of social model community-based initiatives, helped by improved data collection, would encourage more robust and consistent community dementia support.

Objectives: To determine a pooled prevalence of depression and its influencing factors among nursing home residents.

Method: PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors.

Results: This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65).

Conclusion: The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.

Objective: This population-based study aimed to evaluate the association of mental health and several sleep conditions with Social Frailty (SF) in a sample of Iranian middle-aged and older adults.

Method: This cross-sectional study was conducted using data from the Ardakan Cohort Study on Aging (ACSA). SF was assessed by five questions: inability to help others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to (HALFT). Based on the responses, the participants were divided into three groups: social robust (a score of 0), pre-SF (a score of 1-2), and SF (a score of ≥3). Mental health factors included depression and anxiety. Within the domain of sleep conditions, considerations included sleep duration, quality, subjective sleep health, and daytime sleepiness. The logistic regression models were employed to analyze the data.

Results: A total of 5782 subjects participated in the study, with females comprising 50.7% of the sample. This study revealed the total prevalence of pre-SF and SF were 76.4 and 9.3%, respectively. After adjusting for age, sex, marital status, education, number of comorbidities, and mental health, in the age group of 50-60 years, anxiety (borderline and abnormal compared to normal, OR = 1.49, 95% CI: 1.05-2.11 and OR = 1.98, 95% CI: 1.26-3.12, respectively) were associated with SF. Similarly, in the age group of 60 years and above, only depression was associated with SF (OR = 2.24, 95% CI: 1.45-3.44).

Conclusion: These findings imply that mental health might contribute to SF in the middle-aged and older Iranian population.

Objectives: People living with dementia often experience behavioural and psychological symptoms of dementia (BPSD), which severely affect their well-being during the course of the disease. Particularly for BPSD outcomes, there is a high demand for increasing the evidence-based knowledge of non-pharmacological approaches, such as music-based interventions. Although previous reviews emphasize the potential effects of music-based interventions in people with dementia, they cover a wide range of different interventions and outcomes.

Method: Therefore, this systematic review (SR) and network meta-analysis (NMA) aims to not only investigate the efficacy of music-based interventions on BPSD, but also to compare the impact of different types of music-based interventions on outcomes. Preferred reporting items for SR and meta-analysis protocols (PRISMA-P) and the PRISMA NMA extension were followed. Several databases will be searched from inception to the date the search will be performed, for relevant randomized or non-randomized controlled trials comparing a music-based intervention with treatment as usual, active controls, or another music-based intervention. Multivariate pairwise meta-analyses will be conducted for each outcome. NMA based on a frequentist random-effects model will be used to estimate the comparative effects of each type of music-based intervention and related components across outcomes. Heterogeneity will be investigated by meta-regression models.

Conclusion: Based on our knowledge, this may be the first SR and NMA study to compare the efficacy of different types of music-based interventions. In addition, combined with our multivariate analysis approach, it will allow us to identify potential effect modifiers in music-based intervention for treating BPSD.

Objectives: Social isolation and loneliness among older adults present serious public health challenges linked to increased dementia risk. This systematic review analyzes interventions addressing social isolation and loneliness in older adults and their cognitive effects to inform future dementia prevention programs.

Method: We systematically searched databases (PUBMED, PsycINFO, SCOPUS, EBSCO, and SAGE Journals) from February to May 2023 and updated from August to November 2023 using terms like social isolation, loneliness, intervention, and cognitive outcome. We included studies that assessed cognitive outcomes (such as global cognition or specific domains) and non-cognitive outcomes (including depression, well-being, and functionality). Study quality was assessed using Cochrane's RoB 2, ROBINS-I, and other appraisal tools, with results synthesized narratively.

Results: Nine studies (1025 participants) were included, with a high risk of bias in most randomized trials (except one) and a low-to-moderate risk in non-randomized studies. Six studies showed improved cognitive function post-intervention, five of which involved technology. Two studies demonstrated reduced loneliness and improved cognition.

Conclusion: Technological interventions promise to reduce social isolation and loneliness, positively impacting cognitive function. Despite this, these interventions did not directly impact social isolation, which requires future and larger studies to understand more in-depth the role of these approaches for individuals with social isolation. The interventions promoting social interactions could lead to higher social identification, well-being, and interest in life. Multidomain interventions, including technology, are effective. Limitations include study scarcity and heterogeneity, highlighting the need for more robust research on interventions to alleviate social isolation and loneliness and enhance cognitive function.Systematic Review Registration PROSPERO CRD42023460933.

Objectives: Deterioration in vision is an important dementia risk factor yet few studies have examined objectively measured changes in visual acuity over time. Visual decline may also reduce social engagement, highlighting the need to examine visual changes in concert with broader social function.

Method: The relationship between change in visual acuity (logMAR) and cognitive decline was examined in 2,281 participants from the PATH study using hierarchical linear regression. Step 2 determined whether social network significantly enhanced model fit. Exploratory mediation analysis examined the indirect effect of vision change on overall cognition via social networks.

Results: Adjusted models showed deterioration in visual acuity significantly predicted poorer cognition across domains (MMSE, β = -0.08, p ≤ 0.001; TMT B-A, β =  0.09, p = 0.004; SDMT, β = -0.07, p ≤ 0.001). Model 2 significantly improved model fit for overall cognition only (MMSE, F^change(1,1421)= 6.03, p = 0.014). The indirect effect of social network was marginally significant (β = -0.004, SE = 0.002, BCa 95%CI = -0.0088, -0.0002).

Conclusion: Deterioration in visual acuity significantly predicted multi-domain cognitive decline highlighting the importance of visual screening and treatment for vision loss. Social engagement partially mediated the relationship between vision change and overall cognition suggesting psychosocial factors may help to reduce the impact of visual decline.

Objectives: This study aimed to examine (a) the association of cognitive function with community- and with individual-level cognitive and structural social capital, and (b) the cross-level interaction effects of social capital on cognitive function among older adults in China.

Method: Quota sampling was used to collect data from 800 respondents living in 20 communities in Tianjin and Shijiazhuang, China, in 2020. Multilevel analysis was conducted to examine the hypotheses.

Results: Individual-level structural social capital was significantly associated with better cognitive function. Furthermore, individual-level cognitive social capital was negatively associated with cognitive function among older adults with low community-level structural social capital, whereas the above association was positive among those with high community-level structural social capital. Following the same pattern, the associations between community-level structural social capital and cognitive function varied by individual-level cognitive social capital.

Conclusion: This research highlights the protective role of individual-level structural social capital in Chinese older adults' cognitive function. It also delivers in-depth insights into the varying associations between social capital and cognitive function across different communities or individuals. Future research and practices should focus on cultivating social capital at both levels, and pay attention to the cross-level interactions of social capital.