Aging & Mental Health最新文献

Objectives: Age-friendly communities (AFC) promote inclusive and accessible environments that ensure older adults' quality of life and dignity, yet their impact on informal caregivers is unclear. We examined whether AFC modify the association between caregiving and depressive symptoms.

Method: Using Japan Gerontological Evaluation Study 2016 data, we analyzed 10,315 older adults across 145 communities. Participants were classfied as caregivers or non-caregivers. The AFC scale assessed community-level age-friendliness in three domains: age-friendly physical environments (barrier-free outdoor spaces, buildings, and transportation), social engagement and communication (community participation, volunteering, and information use), and social inclusion and dementia-friendliness (respect and inclusion for older adults and people with dementia). Multilevel analysis (individuals nested within communities) examined the cross-level interactions of caregiving and community-level age-friendliness on depressive symptoms, assessed using the Geriatric Depression Scale-15.ResultsCaregivers comprised 7.1% of participants and reported higher depressive symptoms than non-caregivers. Social inclusion and dementia-friendliness moderated the caregiving-depressive symptoms association, whereas social engagement and communication amplified this association. Age-friendly physical environments showed no modifications.

Conclusion: Inclusive and dementia-friendly AFC aspects may mitigate caregivers' depressive symptoms, while community's physical environments and social interactions may not. Age-friendly initiatives should explicity include informal caregivers as beneficiaries and prioritize inclusive and supportive features.

Objectives: Despite the high prevalence of mental health problems in older adults, help seeking by this population is low. Although several barriers to help seeking have already been identified in this population, little is known about the extent to which beliefs related to the Common Sense Model of Self-Regulation predict help seeking in this population. This study examined the extent to which beliefs predicted intentions and behaviour in relation to seeking formal and informal help after controlling for several known barriers (stigma, clinical, and systemic barriers). A secondary objective was to explore which beliefs about symptom characteristics correlated with formal help seeking.

Method: 390 community dwelling older adults aged 60 years and older were surveyed on their beliefs, barriers to help seeking, and help seeking intentions and behaviour for formal and informal sources of help.

Results: Beliefs predicted both formal and informal help seeking after controlling for other barriers. Beliefs also predicted intentions to seek formal but not informal sources of help. Specific beliefs around treatment effectiveness were important in encouraging help seeking intentions and behaviour related to formal sources of help.

Conclusions: Help seeking interventions that target unhelpful beliefs, especially around treatment effectiveness may improve uptake of help in older adults experiencing mental health concerns.

Objectives: The demographic trend towards an ageing society is accompanied by an increase in age-related illnesses, with late-life depression (LLD) being one of the most common mental illnesses in the oldest-old (≥ 80 years). As activity participation potentially prevents LLD, this study examines sex-specific differences in the relationship between activity participation and LLD risk.

Method: Data were derived from the prospective multicenter cohort study AgeCoDe/AgeQualiDe with 9 follow-ups (FU). LLD was assessed using the 15-item Geriatric Depression Scale (GDS-15, cut-off score 6). Activity participation was first assessed at FU1 based on 14 physical, social and cognitive activities (5-point ordinal scale). Statistical analyses included descriptive statistics, Mann-Whitney U-tests and Cox regressions estimating incident LLD from FU2 to FU9. Time at risk began at FU1, where activity participation was first assessed.

Results: Analyses included n = 2,305 at FU1; mean age 81.0; 64% women. Men reported significantly more physical activity (U = 569,468, p = 0.010), women more cognitive activity (U = 658,426, p = 0.002). A higher activity participation at FU1 was associated with a lower risk of LLD with HR = 0.97, 95% CI [0.95, 0.98]. Particularly, participation in physical activities reduced LLD risk with HR = 0.96, 95% CI [0.93, 0.98], which could not be shown for social and cognitive activities. Analyses could not confirm a sex-dependent association.

Conclusion: Activity participation, especially in physical activities, appears preventive for LLD in the oldest-old. Contrary to the hypothesis, these associations did not differ between men and women.

Objectives: This study investigated the interplay between perceived discrimination and polygenic propensity on depressive symptoms cross-sectionally and longitudinally.

Method: Data were from the English Longitudinal Study of Ageing (N = 4950). Perceived discrimination (2010-11) and depressive symptoms (CES-D, 2010-17) were assessed. Depressive symptoms polygenic scores (PGS) were calculated using summary statistics from the Social Science Genetic Association Consortium. Linear-mixed models were used to investigate associations.

Results: Discrimination was perceived by 1869 (37.75%) participants. It was associated with greater baseline depressive symptoms (B = 0.631, 95% confidence interval(CI) 0.529,0.732, p < 0.001) though this difference decreased over time (B=-0.061, 95% CI -0.100,-0.022, p = 0.002). Those with higher depressive symptoms PGS had greater depressive symptomology at baseline (B = 0.136, 95% CI 0.089,0.184, p < 0.001) but this did not influence symptom trajectories (B=-0.003, 95% CI -0.021,0.015, p = 0.778). No significant interactions between discrimination and PGS were observed for baseline or later depressive symptoms, suggesting that the relationship between perceived discrimination and depressive symptoms was not moderated by genetic risk.

Conclusion: Perceived discrimination and depressive symptoms PGS were related to depressive symptomology. However, there was no interaction between these variables on depressive symptoms at baseline or longitudinally. This suggests that perceived discrimination and genetic risk operate independently to influence depressive symptomology.

Objectives: eHealth and self-management interventions for informal caregivers of people with dementia show promising positive results for various health outcomes. However, their successful implementation in practice remains inconsistent. The aim of this study is to gain insight into facilitating factors and barriers of the implementation of eHealth interventions with a self-management approach for informal caregivers of people with dementia.

Method: This narrative review included a systematic search of the databases PsycINFO, PubMed and Web of Science. Papers were screened against the inclusion criteria and then the text of eligible papers was qualitatively analyzed both manually and by computer assisted software. Findings were then mapped into the Consolidated Framework for Implementation Research (CFIR).

Results: Twenty papers were selected and seven themes emerged from the qualitative analysis: (1) Organizational, financial, and structural considerations in healthcare; (2) Characteristics of the eHealth interventions; (3) Attitudinal perspectives; (4) Awareness, familiarity and confidence; (5) Resource allocation and support; (6) Personal characteristics of the informal caregivers; and (7) Wider context factors to eHealth intervention implementation. Mapping the findings into the CFIR framework revealed that little is known about the implementation process.

Conclusion: The alignment of eHealth interventions with current policy objectives and digital progress underlines their importance in real-world application.

Objectives: To examine six-month effects of Montessori training on behaviours, independence, and caregiver distress in Memory Care Units.

Method: Data were collected at baseline and 6 months post-training from 262 residents across 31 nursing homes. Measures included the Barthel Index, AGGIR grid, and Neuropsychiatric Inventory (NPI). In parallel, 125 caregivers from 25 of these nursing homes completed a Montessori implementation grid. Repeated measure ANOVAs and Fisher's tests assessed training effects, and correlational tests assessed outcomes as associated with degree of Montessori implementation.

Results: NPI severity (F = 4.66, p = 0.03, η² = 0.02) and caregiver distress (F = 14.4, p < 0.001, η² = 0.05) significantly reduced with small-to-moderate effect size. Independence declined overall, though 52% of residents remained stable or improved on AGGIR scores.

Conclusion: These preliminary findings suggest potential benefits of Montessori training, but the design limits causal inference and highlights the need for controlled studies.

Objectives: Caring takes place in different locations and involves different relationship types with the care recipient. Although these aspects appear to be important for health, they have only been loosely addressed in research.

Methods: We used information on caring from the Survey of Health, Ageing and Retirement in Europe (SHARE) and distinguished between care provided to spouses, parents (in-law), children, other relatives or non-relatives. We investigated cross-sectional (n = 62.717) and longitudinal associations (n = 41.947) between mental health, assessed by the EURO-D depression scale, and caring.

Results: About 8% of men and 10% of women provided care inside (mostly for spouses) and 3% of men and 8% of women outside the household (mostly for parents). Caring for primary relatives was associated with increased depressive symptoms, particularly for females caring inside the household. Respondents providing care to their cohabiting spouse experienced an increase in depressive symptoms even in the long run (Men: Coef. 0.213, 95% CI 0.09-0.33; Women: Coef. 0.265, CI 0.15-0.38).

Conclusion: The relationship type is one important aspect associated with carer mental health. More attention is needed on gender differences in caring, mental health of carers of primary relatives and long-term effects of spousal care inside the household.

Objectives: Providing care to an individual with chronic illness is associated with chronic stress and adverse health outcomes. The link between family caregiving and allostatic load (AL), the cumulative biological burden of chronic stress, is unclear. A scoping review was conducted to examine the extent and nature of existing literature on AL in family caregivers of adults with chronic illness.

Method: This scoping review was guided by the framework proposed by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews checklist. Peer-reviewed articles published between 2007 and 2025 were identified in CINAHL, APA PsycINFO, and Web of Science with BIOSIS Previews and MEDLINE. Studies met eligibility criteria if they included biological measurement of AL, calculated as an index of multiple biomarkers, in family caregivers of adults living with chronic illness.

Results: A total of 10 articles met the eligibility criteria. The findings suggested that, compared to non-caregivers, family caregivers had significantly higher AL and were more likely to experience future illness and disability. Most studies revealed associations among caregiver burden, subjective stress, and elevated AL.

Conclusion: The findings suggested that family caregiving is associated with allostatic overload and long term health outcomes. Further research is needed to better understand longitudinal changes in AL during and after a caregiving episode.

Objectives: Poverty and poor financial functioning are risk factors for depression, but risk mechanisms are incompletely understood. The current study tested a model in which low financial well-being (FWB) functions as a chronic stressor, increasing emotional distress during daily life, the cumulative burden of which leads to increases in depressive symptomatology.

Method: In the Understanding America Study, adults aged 50-85 years in the United States (N = 706) completed measures of FWB and depressive symptoms twice over a two-year period. Between these assessments, participants completed up to 42 mood reports during a week of ecological momentary assessment.

Results: Lower baseline FWB predicted greater momentary emotional distress, as well as longitudinal increases in depressive symptoms. Momentary emotional distress mediated the relation between baseline FWB and depressive symptom changes. FWB was moderately stable over time.

Conclusion: Among mature adults, lower FWB may contribute to development of depressive symptomatology via momentary emotional distress. Replication of these novel results is needed. Interventions aimed at increasing FWB or decreasing stress-reactivity are discussed as potential means to prevent or treat depression.

Objectives: This study explored how older men with hypogonadism perceive and navigate sexual aging, masculinity, and identity shifts within a conservative Middle Eastern context.

Method: A qualitative phenomenological approach was used to conduct in-depth semi-structured interviews with 18 men aged 60-75 receiving outpatient care in southwestern Saudi Arabia. Data were analyzed thematically following Braun and Clarke's six-phase method.

Results: Four themes emerged: (1) Still a Man-men reaffirmed masculine identity through social and familial roles; (2) The Vanishing Body-physical decline triggered feelings of loss and shame; (3) Silent Suffering-cultural taboos inhibited emotional expression and help-seeking; and (4) Negotiating a New Normal-men adapted through relational support and selective disclosure. These narratives reveal both the vulnerabilities and adaptive capacities associated with sexual aging.

Conclusion: Hypogonadism influences not only physical health but also masculine identity and emotional well-being in later life. Clinicians should integrate culturally sensitive, gender-informed discussions of sexual health into routine geriatric care and develop supportive environments that facilitate disclosure and identity adaptation among older men.