Aging & Mental Health最新文献

Objectives: Older refugees encounter distinctive mental health concerns arising from the combined effects of aging, accumulated trauma, and forced migration. Although their numbers are increasing worldwide, their voices remain largely absent from mental health research and policy discussions. This study sought to examine how older refugees residing in Cairo understand psychological distress, resilience, and identity in the context of displacement later in life, and how broader social and structural conditions shape these experiences.

Methods: A qualitative approach informed by Interpretative Phenomenological Analysis (IPA) was adopted. Thirteen refugees aged between 60 and 84 years from Syria, Sudan, and South Sudan took part in in-depth, semi-structured interviews. Rigor was supported through reflexive analytic practices, bilingual verification of interview transcripts, and reporting procedures consistent with COREQ guidelines.

Results: Analysis revealed four interconnected themes: (1) lifelong experiences of trauma and loss; (2) resilience practices grounded in religious meaning-making and cognitive reinterpretation; (3) social support networks functioning as protective resources and sources of identity continuity; and (4) processes of identity renegotiation within contexts of cultural disruption. Although participants actively engaged in adaptation, their capacities were influenced by legal uncertainty, restricted service access, and the limitations of urban displacement environments.

Conclusion: Findings indicate that resilience among older refugees is fluid and deeply shaped by context. Mental health responses should emphasize community-based, culturally sensitive, and spiritually informed interventions that address structural constraints. Enhancing peer relationships, faith-related resources, and identity-supportive spaces may be essential for fostering psychosocial well-being in older refugee populations.

Objectives: Adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction, are associated with depression, substance use. While, prior research suggests ACEs influence memory, few studies have examined this relationship in a nationally representative sample of older US adults. This study explores associations between ACEs before 18 and mid- to late-life episodic memory.

Methods: We conducted a secondary analysis of Health and Retirement Study data to assess ACEs and episodic memory in adults aged 51 and older. ACEs were measured as cumulative exposure to early adversity (repeating school, trouble with police, parental substance use, physical abuse). Episodic memory was assessed using total recall (immediate + delayed word recall). Group differences were examined using t-tests and chi-square tests. Linear regression models tested associations between ACE exposure (0, 1, 2, ≥3) and memory scores, adjusting for sociodemographic, childhood, and psychosocial factors.

Results: Among 7568 participants, 2,768 (36.9%) reported ≥1 ACE; 187 (2.5%) reported ≥3. The mean total recall score was 10.31 ± 3.70. Exposure to ≥3 ACEs was associated with lower memory scores (β = -0.81, p < 0.05).

Conclusions: Experiencing ≥3 ACEs before 18 was linked to poorer episodic memory, underscoring the value of trauma-informed strategies to support brain health.

Objectives: Successful aging (SA) is a multidimensional process shaped by physical, psychological, and social factors. However, how psychosocial resources interact with physical health to influence SA remains insufficiently understood, particularly in non-Western contexts. This study examined whether positive psychosocial resources and psychological distress mediate the association between physical health and SA.

Method: The sample comprised 538 community-dwelling adults aged 60 years and older from Northeast Brazil. Latent constructs were assessed using validated instruments: physical health (pain, physical functioning, chronic conditions), psychological distress (depression, anxiety, perceived stress), and positive psychosocial resources (self-esteem, resilience, social support). SA was measured using the Successful Aging Scale. Analyses included confirmatory factor analysis (CFA) and parallel mediation modeling with bias-corrected bootstrapping, controlling for demographic covariates.

Results: CFA demonstrated good model fit. Physical health was positively associated with psychosocial resources and negatively with psychological distress. Positive psychosocial resources fully mediated the physical health-SA relationship, whereas psychological distress showed no significant mediating effect. The direct effect of physical health on SA was nonsignificant.

Conclusion: Physical health alone is insufficient to explain successful aging. Psychosocial resources play a critical role in translating health conditions into positive aging outcomes.

Objectives: Cognitive Stimulation Therapy (CST) is a group intervention for people living with dementia (PLWD), with evidence supporting its benefits for quality of life, cognitive performance, social interaction, and cost-effectiveness.

Method: This study aimed to develop a CST Implementation Plan for Chile, using the Consolidated Framework for Implementation Research (CFIR) to identify necessary adaptations to the local context. Contextual variables were analyzed through a participatory approach involving stakeholders in Santiago and Valparaíso.

Results: Six focus groups discussions were conducted across both cities, involving (1) people living with dementia and their caregivers, (2) healthcare professionals, and (3) decision makers. Based on input from a total of twenty-eight participants, fifteen implementation activities were generated, of which twelve were selected based on relevance and feasibility, resulting in a final set of essential actions.

Conclusion: The CST Implementation Plan includes concrete activities tailored to the Chilean context, based on an analysis of barriers and facilitators identified by stakeholders. Its implementation seeks to establish CST as a viable therapeutic option for healthcare teams and professionals, contributing to improved quality of life for people living with dementia and their caregivers.

Objectives: The COVID-19 pandemic has exacerbated loneliness among older adults. This study evaluates the relationship between loneliness, depression, and suicidal ideation in this population during the early pandemic by utilizing data from the All of Us (AoU) Research Program.

Method: We analyzed cross-sectional data from 17,084 individuals aged ≥65 enrolled in the AoU Research Program who completed a COVID-19 related survey in May 2020. Participants were categorized into loneliness quartiles based on their UCLA Loneliness Scale Short Form-8 scores. Descriptive statistics and chi-square tests assessed demographic differences. Poisson regression models with robust standard errors tested associations between loneliness quartiles and both depression and suicidal ideation, adjusting for age, gender, race, ethnicity, education, marital status, employment status, housing status, health insurance status, and social support.

Results: Among 17,084 participants (mean age 72.0 years [SD 5.3], 55% female, 89% White), we found a clear stepwise pattern: as loneliness increased, so did the risk of depression and suicidal ideation. Compared to the lowest loneliness quartile, those in the highest loneliness quartile were approximately 25 times more likely to experience moderate-to-severe depression (adjusted relative risk [aRR] = 25.09, 95% CI: 16.63-37.84) and 44 times more likely to report suicidal ideation (aRR = 44.31, 95% CI: 19.69-99.71). Intermediate loneliness levels (quartiles 2-3) also showed elevated risks (depression aRRs: 2.45, 7.33; suicidal ideation aRRs: 4.03, 11.87).

Conclusion: Increasing levels of loneliness were associated with greater risk of depression and suicidal ideation among older adults during the early pandemic, underscoring the need for targeted loneliness interventions for this vulnerable population.

Objectives: Positive aspects of caregiving (PAC) are assumed to protect against caregiver suffering, but evidence is lacking. Two studies examined this assumption through testing the reciprocal causality between PAC and burden/depression, and exploring the mechanisms linking these constructs.

Methods: MethodsIn Study One, 99 dementia caregivers were interviewed six months apart. In Study Two, 45 caregivers provided 620 diaries across eight weeks.

Results: In Study One, baseline burden predicted increased depressive symptoms, whereas baseline depressive symptoms predicted less PAC. Although burden was unrelated to PAC concurrently, burden was found to strengthen PAC after depression was controlled for (statistical suppression). Contrary to prevailing assumption, PAC predicted neither burden nor depression. In Study Two, 213 of the 620 diaries contained narratives linking burden to PAC. Supporting the PAC-enhancing role of burden, four mechanisms were extracted using thematic analysis, describing unrelenting caregiving stress enriching the significance of their work and pressuring them to learn, to push beyond boundaries, and to transform thinking.

Conclusion: Chronic hardship may be a breeding ground for positive meanings, yet also increasing depression, undermining positivity. Consequently, burden has a direct positive effect, but an indirect negative effect via depression, on PAC. A conceptual model depicting such complex dynamics is proposed.

Objectives: Older adults with mild cognitive impairment (MCI) or dementia face elevated mental health risks. Mind-body interventions (MBIs) offer a promising approach, yet the psychosocial mechanisms supporting their benefits remain unclear. This scoping review examined (1) how MBIs influence mental health in aging-related MCI or dementia and (2) contextual factors shaping implementation.

Methods: Following Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was conducted across PsycINFO, PubMed, AgeLine, Scopus, and ProQuest Dissertations. Data from eligible studies were charted and synthesized using a logic model linking MBI typologies, population-specific adaptations, psychosocial mechanisms of change, mental health outcomes, and implementation barriers/facilitators.

Results: Ninety-eight studies met the inclusion criteria. Mental health findings were heterogeneous: several MBIs improved depression, anxiety, stress, quality-of-life, and/or well-being, whereas others yielded null effects. Adaptations associated with better outcomes included shortened, simplified sessions and caregiver involvement. Engagement, group connectedness, and skilful instruction emerged as recurrent mechanisms of change. Barriers included cognitive load, health comorbidities, and logistical obstacles; facilitators included flexible, user-centred formats and technology-supported reminders.

Conclusion: MBIs appear feasible and potentially beneficial for the mental health of older adults with MCI or dementia, when tailored to cognitive and contextual needs. Mechanism-focused trials are needed to confirm efficacy and support scalable implementation.

Objectives: We aimed to identify lonely older U.S. military Veterans' social connection needs and barriers, to inform interventions to improve connection.

Methods: Semi-structured qualitative interviews were conducted with older Veteran men who screened positive for loneliness on the 3-item UCLA loneliness scale. Interviews assessed Veterans' current social connections, barriers to social connection, desired changes or improvements to connection, and efforts Veterans have made so far to improve connection and their impacts. Team-based rapid qualitative analysis was used.

Results: Twelve interviews were completed and analyzed. There was significant variety in types of current social connection experiences, barriers to connection, desired changes, and efforts to improve connection that Veterans identified. Barriers to connection included difficulty relating to others due to military background or different interests; functional and sensory impairments; and mental health challenges. Veterans expressed desires for improvement in close confidants and romantic relationships, personal growth, social activities, and social networks. Veterans reported making a variety of efforts to improve connections, with mixed results.

Conclusions: Older Veteran men report heterogeneous and unique social connection needs and barriers for which they struggle to find support. These findings can guide development of multidimensional, flexible interventions to improve social connection in older Veteran men.

Objectives: Previous studies link early childhood and current parent-child relationship quality to caregiving burden in mid-to-late-stage dementia dyads. However, little is known about how midlife parent-child relationships affect caregiver burden in early-stage cognitive impairment. Using Parker's parental bonding framework, this study examined early and current relationship factors in mitigating caregiver burden in adult children.

Method: In a cross-sectional survey study, participants (n = 144 adult children of parents living with early-stage cognitive impairment) completed the Parental Bonding Inventory to assess "care" and "overprotection," which were combined to conceptualize "optimal parenting." The Perceived Partner Responsiveness Scale assessed perceived parental support, and the Zarit Burden Interview assessed caregiver burden.

Results: Participants who identified more early care, less overprotection, and optimal parenting from their parents reported greater current perceived support from their parents, but not greater caregiving burden. Greater current perceived support, however, was associated with lower burden.

Conclusion: Supporting parental bonding theory, current greater parent-child relationship quality was associated with greater early parental relationship quality and lower burden. Surprisingly, early parent-child relationship quality was not associated with burden. Future research identifying factors that buffer caregiver burden, e.g. current perceived parental support, can inform targeted interventions to support midlife adults caring for parents living with early-stage cognitive impairment.

Objectives: This study examines the relationship between cognitive synchrony and social participation and whether income moderates this relationship among married couples.

Method: Longitudinal data from 1,029 married couples from the Health and Retirement Study collected from 2004 to 2020 were analyzed. Synchronized cognitive trajectories were estimated by modeling husbands' and wives' cognitive growth curves together. An Actor-Partner Interdependence Model with moderation was then used to examine how each spouse's trajectories and their synchrony linked to both partners' social participation, and whether these links differed by household income.

Results: Two spouses' cognitive function aligned at baseline, changed in parallel over time, and fluctuated together across survey waves. However, significant results for synchronized trajectories were limited, with only residual synchronization predicting husbands' social participation. Husbands' social participation was shaped by both partners' cognition trajectories, whereas wives' participation was predicted by their own trajectories. The link between cognitive synchrony and social participation was stronger in higher-income couples.

Conclusion: Cognitive functioning plays a more salient role in shaping husbands' participation in social participation than that of wives, and the role is more pronounced in higher-income couples. The findings offer unique income moderation and gender-specific insights into dyadic health research.