Aging & Mental Health最新文献

Objectives: The present study evaluated associations between social environment profiles and cognitive outcomes among generally healthy adults using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort (n = 19,793).

Method: Latent class analysis classified participants into social environment profiles based on social network size, social support, social cohesion, and social isolation. Three profiles emerged, which were labeled as representing weaker, intermediate, and stronger social environments (16.6%, 40.4%, and 42.9% of the sample, respectively). Scores on eight cognitive tests were combined into three domains: executive function, episodic memory, and prospective memory. Analyses of covariance assessed associations between the social environment profiles and executive function and episodic memory, while prospective memory was assessed with logistic regression.

Results: Significant associations between the social environment profiles and the three cognitive domains were observed among all statistical models (all p ≤ 0.001). Executive function and episodic memory scores significantly differed between all three profiles, while prospective memory differed between the weaker and stronger profile. The effect sizes of associations were weak, potentially reflecting the generally cognitively healthy sample.

Conclusion: The social environment is linked with cognitive functioning, but further research is needed to assess the clinical relevance and utility as a target for health promotion.

Objectives: Being socially integrated is vital to emotional well-being, partly because social connections provide purpose. Nevertheless, fewer have explored purpose in life as a potential mechanism linking social activity variety, one of the indicators of social integration, to mental health outcomes. This study examined purpose in life as a mediator in the relationship between earlier social activity variety and later depressive symptoms among U.S. adults aged 51 and above.

Method: We ran autoregressive cross-lagged panel models using data from 4931 participants in the 2008, 2012 and 2016 waves of the Health and Retirement Study (HRS). Social activity variety, purpose in life, and depressive symptoms were measured at all three waves.

Results: Our findings reveal that higher levels of social activity variety at Wave 1 were related to increases in purpose in life from Wave 1 to Wave 2, which, in turn, was related to lower levels of depressive symptoms at Wave 3.

Conclusions: These results suggest that purpose in life may serve as an important link between social activity variety and mental health outcomes in later life, offering new insights into how participation in a diverse range of social activities can reduce depressive symptoms through enhanced purpose in life.

Objectives: Alzheimer's disease (AD) remains a major global health challenge. The objective of this umbrella review is to synthesize Mendelian Randomization (MR) evidence evaluating the causal relationship between educational attainment (EA) and AD risk, thereby addressing the inherent limitations of observational studies.

Methods: We conducted a comprehensive literature search in PubMed, Embase, and Web of Science up to July 6, 2023. MR studies investigating the causal relationship between EA and AD risk were included. We assessed study quality using the STROBE-MR checklist and graded evidence strength. Due to heterogeneity in genetic instruments, a qualitative synthesis was performed.

Results: Eleven publications examining 41 distinct associations were included. Most studies reported a consistent protective effect of EA on AD risk. However, this protective effect was attenuated when mediated by cognitive traits, which independently protected against AD. Quality assessment revealed variability in adherence to reporting guidelines, notably concerning study pre-registration and broad generalizability.

Conclusion: Findings highlight a complex interplay between EA, cognitive traits, and AD risk, aligning with the cognitive reserve hypothesis. Ultimately, EA exhibits a protective effect against AD, largely mediated by cognitive traits, and likely explained by multiple structural and lifestyle mechanisms. Future research must prioritize longitudinal designs and gene-environment interactions.

Objectives: Older adults face an elevated risk of social isolation, loneliness, and poor psychological health. This mixed methods study evaluates a trial of an intervention app designed to protect against loneliness by raising older adults' awareness of their social relationships.

Method: A 4-week online mixed methods randomised 2 (condition: app use vs waitlist) x 3 (timepoint: baseline, 2 week, and 4 week wellbeing) trial, with follow up qualitative interviews. Older adults (N = 99, Mean Age = 68) completed a survey at three timepoints (baseline, two, and four weeks) reporting loneliness, depression, and anxiety. Forty-five post-trial interviews were conducted with the app users and analysed using reflexive thematic analysis.

Results: A significant interaction effect was found; participants using the app reported a significant reduction in depression scores between baseline and four-week follow-up. There was no significant effect on loneliness or anxiety scores. Interviews revealed ways app users were (1) Holding up a mirror to feelings about their social groups, (2) Re-appraising loneliness; and (3) Acting as analysts.

Conclusion: The digital intervention reduced reported depression by enhancing positive appraisal of social groups. Further work is required to understand how to overcome risks of reflection-based apps for loneliness.

Objectives: This two-wave longitudinal study examined whether changes in satisfaction with meaningful activities (MA) were associated with subsequent subjective memory complaints (SMC) among community-dwelling older adults between 2019 and 2021.

Method: Health surveys were conducted among local people at two time points: baseline (2019, before the COVID-19 pandemic) and follow-up (2021, during the pandemic). The participants were 275 community-dwelling older adults aged ≥65 years without cognitive decline at baseline. Satisfaction with MA was assessed using the Aid for Decision-Making in Occupation Choice and categorized as maintained/improved or decreased at follow-up. SMC was measured using four items developed by Tsutsumimoto and quantified according to the total number of complaints.

Results: Older adults who maintained or improved satisfaction with MA showed no significant increase in SMC (p = 0.30), whereas those who demonstrated decreased satisfaction experienced a significant increase in SMC (p = 0.02). In the generalized linear mixed-effects model adjusted for covariates, a significant association was observed between decreased satisfaction with MA and increased SMC scores (β = 0.32, 95% CI = 0.09-0.55, p < 0.01).

Conclusion: Maintaining and improving satisfaction with MA may be associated with a reduced risk of SMC increase in older adults.

Objectives: To determine the effects of Acceptance and Commitment Therapy (ACT) among informal caregivers of people with dementia (PwD) on anxiety, depression, and process measures and identify the optimal characteristics of effective interventions.

Method: Ten electronic databases were searched from the inception of the databases to 5 April 2025. Studies were included if they used a randomized controlled trial (RCT) or quasi-experimental design to assess the effect of ACT on informal caregivers of PwD. Two researchers independently screened eligible studies. The risk of bias was assessed by the Cochrane's and the Joanna Briggs Institute's tool.

Results: Thirteen studies (six RCTs and seven quasi-experimental studies) were included in this review. Results showed that ACT modified anxiety, depression, and experiential avoidance in informal caregivers of PwD. Subgroup analyses indicated that ACT interventions lasting 8 wk, lasting >60 min per session, and implementing four or five processes were more effective in reducing anxiety and depression.

Conclusion: ACT may be effective in reducing anxiety, depression, and experiential avoidance in informal caregivers of PwD. Future researchers are encouraged to further explore how ACT processes affect anxiety and depression to more effectively implement ACT for informal caregivers of PwD.

Objectives: Studies have shown the importance of neighborhood factors, such as residential segregation and green space, in associations with older adult brain health. In this qualitative study, we examine older adults' perceptions of their neighborhood, with a particular focus on residential diversity and segregation.

Method: We recruited participants from the longitudinal cohort at the UC Davis Alzheimer's Disease Research Center to participate in semi-structured interviews. Participants were interviewed and asked to describe features and perceptions of their neighborhood. Individual interviews lasted twenty-three minutes on average and were audio-taped, transcribed verbatim, and analyzed for recurring themes.

Results: A total of twenty-six participants were interviewed: 61.5% female, 50.0% non-Hispanic White and 50.0% Black/African American, mean age= 81.12, SD = 6.93 years.The most prominent themes were (1) Importance of public stores and similar third spaces; (2) Accessibility to green space, including parks and trees; (3) Staying active in the community, both physically and socially; (4) Neighborhood awareness and cohesion; and (5) Stereotypes, discrimination, and segregation.

Conclusion: These findings highlight the social and built environment factors that are important to older adults and that may potentially affect brain health. Future research should examine how salient themes might differ depending on older adults' cognition.

Objectives: Social determinants of health (SDoH), including structural racism and economic marginalization, shape mental health outcomes but are frequently conceptualized at a level too broad for direct clinical intervention. In contrast, health-related social needs (HRSNs), such as food insecurity and housing instability, represent more proximal and actionable targets within clinical and community-based settings. Despite growing recognition of their importance, the relationship between HRSNs and depression among structurally marginalized older adults remains under explored. This study seeks to evaluate the association between HRSNs and depressive symptoms among low-income White as well as racially and ethnically minoritized older adults.

Method: Cross-sectional analysis of baseline data from a randomized controlled trial (Feb 2020-May 2022). Participants included 134 adults aged ≥50 years with depressive symptoms (PHQ-9 ≥ 5), cognitively intact, and either self-identified as a person of color or had income <200% of the federal poverty level.Depression was assessed via PHQ-9. HRSNs were measured using the CMS Accountable Health Communities screening tool. Multiple linear regression models adjusted for age, gender, race/ethnicity, and comorbidity.

Results: Participants had a mean age of 70.8 years; 84.3% were female. Fifty-two percent were Black or African American; 41% were low-income White. Food insecurity (31.1%) and transportation barriers (22.7%) were common. Total HRSNs were associated with higher PHQ-9 scores in unadjusted models (p = 0.0035), but not after adjustment. Food insecurity remained independently associated with depression (B = 2.81, p = 0.001).

Conclusion: Food insecurity is linked to greater depressive symptoms. Implementing screening and referral systems for HRSNs may improve mental health care for marginalized older adults.

Objectives: While various psychological factors increase Parkinson's disease (PD) risk, delirium's role remains unexplored. This study examined whether delirium is associated with PD incidence and identified potential modifying factors.

Method: We conducted a matched cohort study using UK Biobank data, including 6,254 patients with first-time delirium and 31,270 matched unexposed individuals. Cox proportional hazards models assessed PD risk following delirium, evaluating effect modification by age, sex, education, BMI, depression, frailty, and polygenic risk scores.

Results: During follow-up (median: 1,011 days for exposed vs 1,678 days for unexposed), 2% of delirium patients developed PD vs 1% of controls. Delirium was associated with significantly increased PD risk (HR: 3.97; 95% CI: 2.97-5.33). Education level significantly modified this association, with higher education linked to greater risk (College: HR 6.57; Non-college: HR 3.70). Age, sex, BMI, frailty, and polygenic risk scores did not significantly alter the association.

Conclusion: Delirium is a significant and potentially modifiable risk factor for PD, highlighting the clinical importance of its prevention and management, particularly in highly educated individuals.

Objectives: This randomized controlled trial compared flywheel-based resistance training with traditional resistance training on depressive symptoms in sedentary older women.

Method: Twenty-nine women aged ≥60 years without clinical depression were randomized (blocks of 2 and 4) to flywheel (n = 14) or traditional resistance training (n = 15) for 8 weeks (six exercises, twice weekly) at the Federal University of Viçosa, Brazil. Flywheel devices provide inertial resistance and eccentric overload by storing and releasing kinetic energy. Depressive symptoms were the primary outcome. Allocation was concealed with sealed envelopes; outcome assessors and the principal investigator were blinded.

Results: Twenty-eight participants completed the protocol; one dropout in the traditional group required multiple imputation. Adjusted depressive symptom scores were 2.7 ± 2.7 in the flywheel group (↓2.5 points) and 2.0 ± 2.8 in the traditional group (↓2.0 points), with no between-group difference (p = 0.193). The effect size was small (ηp² = 0.03) and statistical power was low (1-β = 0.25). All adverse events were mild (grade 1); no serious events occurred.

Conclusion: Both flywheel and traditional resistance training showed potential to reduce depressive symptoms in sedentary older women. Larger trials are warranted.

Trial registration: ClinicalTrials.gov NCT05910632.