Aging & Mental Health最新文献

Objectives: Ambivalent feelings in a partner relationship, characterized by simultaneous positive and negative emotional experiences, can significantly influence individuals' mental health. Traditionally measured indirectly, this study introduces the Partner Ambivalence Scale (PAS), developed for directly capturing the complexity of ambivalent emotions. This study aimed to analyze the psychometric properties of the PAS, and assess the effects of ambivalent feelings on partner relationship quality and depressive symptomatology.

Method: 390 individuals (60% women), 40 years or older (M = 60.88, SD = 10.7), and in a partner relationship, participated. Data collected included ambivalent feelings in couples, marital satisfaction, frequency of arguments, and depressive symptoms.

Results: The exploratory factor analysis of the PAS yielded a one factor structure explaining 59% of the variance of ambivalent feelings. Higher ambivalent feelings were associated with lower marital satisfaction, higher frequency of disagreements, and higher depressive symptoms. Even when controlling for covariates, ambivalent feelings contributed significantly to the explanation of depress on.

Conclusion: The PAS demonstrates good psychometric properties, making it suitable for use with middle-aged and older adults. Ambivalent feelings toward the partner are significant for understanding partner relationship quality and mental health and may increase vulnerability to depressive symptoms during middle and older age.

Objectives: Engagement in a greater number and more diverse activities is associated with higher levels of well‑being. One reason may be that these activities provide opportunities for a variety of social interactions. To examine the importance of the social nature of daily activity, the current study examines the unique association between social activity variety and later depressive symptoms, after adjusting for non‑social activity variety.

Method: Using data from the Health and Retirement Study (HRS), we included 5,160 adults in a cross‑sectional analysis from 2008 and 3,081 adults in a longitudinal analysis spanning 2008 to 2012, all of whom completed questionnaires on social activity participation and depressive symptoms.

Results: Cross‑sectional findings indicated that social activity variety was related to lower severity of depressive symptoms, but not likelihood of having any depressive symptoms, after adjusting for health, sociodemographic covariates, and non‑social activity. Longitudinal results showed that participants with consistently high levels of social activity variety over four years experienced fewer depressive symptoms at follow‑up compared to those with low levels, even after adjusting for baseline depressive symptoms.

Conclusion: Findings suggest that participation in a greater variety of social activities can be a protective factor against the severity of depressive symptoms.

Objectives: To assess if future time perspective (FTP) moderates the relationship between heart failure (HF) caregiver coping style and preparedness to make a surrogate medical decision.

Method: Cross-sectional data was analyzed to assess associations among three different coping styles (i.e. avoidance, active, minimizing), FTP, and odds of feeling prepared to make a medical decision on behalf of a loved one with heart failure.

Results: A total of 231 caregivers were included in analyses. No significant interaction effects emerged among coping style and FTP on odds of feeling prepared to make a surrogate medical decision. Caregiver burden was significantly and inversely related to feeling prepared across each coping style model. Reports of having the provider present for the medical wishes conversation was significantly related to odds of feeling prepared across each coping style model.

Conclusion: FTP did not appear to moderate the relationship between coping styles and preparedness to make a medical decision on behalf of a loved one with heart failure. Future research should continue to explore possible characteristics that can be targeted to improve feelings of decision-making preparedness among caregivers of loved ones with HF.

Objectives: Based on the Caregiving Stress Theory and Cognitive Theory of Stress and Coping, this study examined whether increase in caregiving stressors had an impact on subsequent increase in different forms of elder abuse. Additionally, this study evaluated how these relationships were influenced by caregiver (CG) coping strategies.

Method: A group of 800 Chinese primary family CGs and their care recipients (CRs) with mild cognitive impairment or mild-to-moderate dementia were analyzed. Participatory dyads were assessed and followed for 2 years. Structural Equation Models were used to test the associations among caregiving stressors, CG coping strategies, and elder abuse.

Results: Increase in caregiving stressors (ie CR decreased cognitive function, neuropsychiatric symptoms, and functional impairment) significantly increased the level of subsequent physical abuse, psychological abuse, and neglect. In addition, the associations between caregiving stressors and different forms of elder abuse as stated above was mediated by CG dysfunctional coping strategies.

Conclusion: This study highlights the varying impact of caregiving stressors on different types of elder abuse and emphasizes the role of CG coping strategies in mediating these relationships. The findings provide valuable insights for the development of intervention protocols targeting both caregiving stressors and CG coping strategies to prevent elder abuse.

Objectives: Post-discharge adverse events, such as falls, hospitalizations, and death, are more prevalent among older adults with dementia, compared to their cognitively intact counterparts. This study aimed to test the association between physical resilience and post discharge adverse events in a sample of older adults with dementia.

Method: Through phone calls with caregivers over one year, we obtained data on physical resilience and post-discharge adverse events through caregiver report among a sample of 314 recently discharged older adults with dementia. We performed negative binomial regression (falls and hospitalizations) and logistic regression (death), controlling for covariates.

Results: Greater physical resilience at one month post discharge was significantly associated with less falls, hospitalizations, and death within one year.

Conclusion: This study highlights a particular patient profile, recently discharged older adults living with dementia who have low physical resilience, that could be targeted for intervention when discharged from the hospital.

Objectives: The aims of this study were to identify a community typology in older Korean Americans and to examine how the typology is associated with feelings of loneliness and mental distress. We hypothesized that distinct community groups would be identified and that they would be differentially associated with mental health and background characteristics.

Method: Data were drawn from a survey with older Korean Americans aged 60 and older, collected during 2017-2018 in diverse locations (n = 2138). To identify a community typology, a series of latent profile analyses (LPA) were conducted using 15 community-related variables in three domains (neighbourhood characteristics, social cohesion, ethnic attachment).

Results: Based on model evaluation criteria, an LPA model with five community groups was identified as the best fit. The five groups were identified as "safe/integrated" (10%), "safe/distant" (10%), "moderate integration" (38%), "marginal" (31%), and "vulnerable" (11%). After examining descriptive characteristics of the identified groups, regression models of loneliness and mental distress were estimated. Using the safe/integrated group as reference, the marginal and vulnerable groups were consistently associated with elevated feelings of loneliness and mental distress.

Conclusions: The results suggest the need to understand community profiles and their relationships with health/well-being among older immigrants.

Objectives: Korean-American primary family caregivers of individuals with Alzheimer's disease and related dementias (ADRD) may face unique stress, attributable to the distinctive characteristics of Korean-Americans, including their immigration history, culture, and language. Using narrative inquiry, we explored caregiving experiences, focusing on stress, and identified factors contributing to stress among Korean-American family caregivers providing in-home care to individuals with ADRD.

Method: We conducted one-on-one, semi-structured interviews with 15 Korean-American family caregivers of individuals with ADRD. We analyzed the participants' stress in the context of temporality (i.e. timelines of their caregiving), sociality (i.e. cultural and familiar contexts), and place (i.e. various life settings).

Results: The majority of participants were female (73%), Korean-born immigrants (93%), and had relatively high levels of education with an average of 16 years of education. We found that 1) caregivers' stress continued but varied along the ADRD caregiving trajectory, 2) cultural expectations and relationship dynamics amplified stress levels, and 3) maintaining a Korean identity while living in the United States limited caregivers' social connections.

Conclusion: Our findings highlight the nuances of stress among Korean-American ADRD family caregivers. Specific support needs should be addressed in the development of culturally tailored stress reduction interventions for this understudied population.

Objectives: Prescriptive views of aging (PVoA) are normative age-based expectations about age-appropriate behavior for older adults, e.g. that they should stay fit/active (active aging norms) but also behave altruistically toward younger generations (altruistic disengagement norms). We aimed at examining age differences in endorsement of active aging and altruistic disengagement and investigated predictors of endorsement.

Method: In the AGEISM Germany survey, a representative sample of N = 1,915 German participants was recruited, covering a wide age range (M_age=56.57 years, 16-96 years). Cross-sectional data was collected via computer-assisted telephone interviews.

Results: Active aging was more strongly endorsed than altruistic disengagement. Endorsement of both PVoA was higher in older age groups - even more pronounced for altruistic disengagement. Endorsement of both norms was positively associated with positive age stereotypes. Furthermore, active aging was predicted by age centrality whereas altruistic disengagement was predicted by negative age stereotypes. Age was still a robust predictor of PVoA even after entering additional predictors.

Conclusion: Although associated, prescriptive age norms (i.e. beliefs how older people should behave) and descriptive age norms (i.e. beliefs about how older adults and the aging process are like) represent partly independent belief systems, highlighting the importance to assess & further investigate predictors and consequences of PVoA, which become more prevalent with age.

Objectives: Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers.

Method: A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated.

Results: In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [-2.643, .,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € -392, 95% CI [-1.254, -26], largely due to lower supportive care costs, mean difference = €-252, 95% CI [-1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers.

Conclusion: FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted.

Objectives: A significant gap currently exists in the availability of reliable and scientifically rigorous measures for evaluating resilience among older Arabic-speaking populations. The primary objective of this study was to assess the psychometric properties of an Arabic adaptation of the 15-item Resilience Scale of Older Adults (RSOA) in a sample of Arabic-speaking Egyptian older adults.

Method: Using a cross-sectional design and a convenience sample of 539 Egyptian older adults, with 60.7% aged between 65 and 75 years (50.3% females), participants completed an online Google form-based anonymous questionnaire, including sociodemographic information, the RSOA, and the 10-item CD-RISC. To ensure accurate translation, the forward-backward translation method was employed. Confirmatory factor analysis (CFA) and gender invariance in the RSOA were analyzed. McDonald's ω and Cronbach's α were calculated to assess internal consistency.

Results: The results demonstrate that the Arabic RSOA and its subscales exhibit high internal consistency, with McDonald's ω and Cronbach's α values ranging from 0.83 to 0.93. CFA analysis revealed that the four-factor model fit of RSOA was acceptable. Measurement invariance was supported across genders. Furthermore, both genders exhibited no significant differences in all four RSOA dimensions. Convergent validity was supported by demonstrating that the four RSOA sub-scores and total scores correlated positively and significantly with the 10-item CD-RISC.

Conclusion: While further cross-cultural validation involving other Arab countries and communities is necessary, this study suggests that the Arabic RSOA may be used to measure resilience among broader Arabic-speaking older adults in clinical and research contexts.