Aging & Mental Health最新文献

Objectives: Few digital health interventions for dementia caregivers, especially for racial and ethnic minorities, include long-term follow-ups. This study assessed the feasibility of two-year follow-up of the Wellness Enhancement for Caregivers (WECARE) intervention for Chinese American dementia caregivers, examined the changes in psychosocial health and explored future strategies.

Method: A mixed-method study was conducted two years after the initial WECARE intervention trial. Participants completed an online survey and phone interviews. Quantitative and qualitative data were analyzed complementarily.

Results: Eighteen of 24 participants completed the survey and 15 participated in interviews. Caregivers reported deteriorating conditions of care-recipients and increased caregiving burden, but their depressive symptoms and life satisfaction remained lower compared to baseline. Participants highlighted sustained benefits of WECARE, including stress management, improved communication, and a sense of community through group chats. They expressed a need for ongoing social and information support.

Conclusion: This study demonstrates the feasibility of long-term evaluation for digital interventions like WECARE and emphasizes the need for continuous support. Sustained benefits underscore the potential of culturally tailored digital health interventions for underserved dementia caregivers. Future efforts should integrate ongoing resource access to enhance caregivers' long-term well-being.

Objectives: This study examined the factor structure of the short-form Korean version of the Need for Cognition Scale (K-NfC-S) among older adults in South Korea.

Method: Drawn from the 2020 Korean Media Panel Study, a total of 2,281 adults aged 65 years and older were analysed. We measured the need for cognition using the 15-item K-NfC-S. The sample was randomly assigned to distinguish between Sample 1 (n = 1,117) for exploratory factor analysis (EFA) and Sample 2 (n = 1,164) for confirmatory factor analysis (CFA). We conducted EFA and CFA using SPSS version 26.0 and AMOS 26.

Results: EFA results showed that the K-NfC-S demonstrated a two-factor structure of positively and negatively phrased items. However, CFA results revealed that both the one-factor model with correlated uniqueness among positively phrased items (TLI = 0.945, CFI = 0.972, RMSEA = 0.051) and the one-factor model with only positively phrased items (TLI = 0.924, CFI = 0.939, RMSEA = 0.072) exhibited good fit.

Conclusion: The findings suggest that method effects may influence the factor structure of the K-NfC-S among older adults. This study highlights the importance of using appropriate methodological approaches for measuring the need for cognition, with implications for future research.

Objectives: To explore patient and care partner experiences of receiving an amyloid scan result, with a focus on how clinician disclosure practices influenced patient and care partner emotional responses to the scan result and/or diagnosis.

Methods: Semi-structured interviews with 38 people with mild cognitive impairment or dementia and 62 care partners who experienced the disclosure of results from an amyloid PET scan as part of the CARE-IDEAS study. We used thematic analysis to analyze interview transcripts.

Results: We identified four aspects of the disclosure process that could influence patient and care partner emotional experiences of the scan result/diagnosis: (1) mode of delivery, (2) presence of a care partner, (3) clarity of the scan result explanation, and (4) discussion of post-scan treatment and support options.

Conclusions: Emotional experiences of an amyloid scan result can vary depending on how results are communicated. These findings support previous efforts to develop standard disclosure protocols. Scan results should be delivered in person with the care partner present. Clinicians should give a clear explanation of the result and its implications in an empathetic manner. Options for treatment and support should be discussed for all patients.

Objectives: Transgender and gender nonconforming (TGNC) older adults experience significant behavioral health and healthcare disparities. Facilitators that contribute to positive behavioral healthcare experiences among this population, however, remain uncertain. In this study, we investigate facilitators contributing to positive or satisfactory behavioral healthcare experiences among a sample of TGNC older adults in the United States (US).

Method: Between September 2021 and January 2022, the first author conducted 47 semi-structured, individual interviews with TGNC adults aged 65 years or over in the US. Using an inductive grounded theory approach, we examined respondents' positive or satisfactory experiences with accessing and utilizing behavioral health services, support, and resources. Analyses were conducted using NVivo (Release 1.6) software.

Results: Findings underscore the importance of addressing the specific or unique needs of TGNC older patients to promote positive or satisfactory experiences in behavioral healthcare. Three themes emerged: (1) engaging with behavioral healthcare practitioners who offer compassionate, patient-centered care; (2) accessing and utilizing culturally tailored peer-support groups; and (3) receiving equitable access to gender-affirming care and social services.

Conclusion: These findings highlight opportunities for expanding and incorporating these identified facilitators into behavioral healthcare research and practice, especially when promoting gender affirmation in care for TGNC older patients.

Objectives: The current study aimed to evaluate the relationship between subjective cognitive complaints (SCC) and compensatory strategy (CS) use in a diverse sample of non-Latinx White (NLW), Black, and Latinx American older adults.

Method: 807 older adults (M_age = 65.38, 62.7% female) were recruited through Amazon's Mechanical Turk (MTurk) and Qualtrics Panel to complete questionnaires on SCC and CS use. Kruskall-Wallis tests were used to evaluate differences in SCC across groups given non-normal distributions. Analysis of variance (ANOVA) was used to evaluate group differences in CS use. The PROCESS macro for SPSS was used to examine whether demographic factors moderated the relationship between SCC and CS use.

Results: NLWs reported higher levels of SCC and greater overall use of CS in comparison to Latinx and Black individuals. Several demographic and psychosocial factors including age, ethno-racial group, education, and anxiety level were found to be associated with CS use. Education was found to moderate the association between SCC and CS use.

Conclusion: Inconsistent with prior studies, our study found that NLWs reported the highest levels of SCC. CS were used across all racial/ethnic groups, but the frequency of CS use may be impacted by education level. While all education groups increased their CS in response to higher levels of SCC, this increase was more substantial for those with lower levels of education. Future work should consider individuals' cultural and educational background when examining SCC and/or developing CS-based intervention for the aging population.

Objectives: Little is known about the heterogeneity and transitions between psychological adaptation patterns in Chinese older internal migrants. This study addressed two questions: (a) Do distinct patterns of psychological adaptation exist among Chinese older internal migrants? (b) If so, what factors predict different trajectories?

Method: The study drew on two waves of data and involved 405 older internal migrants into Nanjing, China. First, a latent transition analysis was performed to visualize the different patterns of psychological adaptation. Second, an ecological model of resilience was used to identify the factors explaining the differences between adaptation patterns.

Results: Three main trajectories of psychological adaptation among Chinese older internal migrants over time were: recovery, stability and deterioration. Adaptation trajectories were associated with age, gender, length of stay, psychological resilience, self-esteem, family support, social participation, and living with a spouse.

Conclusion: Chinese older internal migrants undertake heterogeneous psychological adaptation trajectories, and their positive adaptation is closely associated with coping resources. Our data may provide references for the identification of vulnerable older internal migrants, as well as the making of targeted interventions.

Objectives: Changes in personality and behavioral symptoms are a core clinical criterion for the diagnosis of dementia. This study examines the association between caregiver-rated personality traits and multiple measures of neuropsychiatric symptoms.

Method: Caregivers of individuals with dementia (N = 191) or cancer (N = 137) provided premorbid and concurrent personality trait ratings using the Big Five Inventory-2. Caregivers also completed the Mild Behavioral Impairment Checklist, Neuropsychiatric Inventory Questionnaire, and Revised Memory and Behavior Problems Checklist.

Results: In the combined sample, high concurrent neuroticism was associated with emotional dysregulation (r = 0.51), low agreeableness with impulse dyscontrol (r=-0.40), and low conscientiousness with decreased motivation (r=-0.42). Associations were similar across neuropsychiatric symptom scales, similar across cancer and dementia, but stronger with concurrent than premorbid personality ratings, and stronger for the individuals with mild than moderate-severe dementia.

Conclusion: Personality was associated with neuropsychiatric symptoms, including with the measure for mild behavioral impairment. Personality had stronger associations when concurrently assessed, indicating that personality traits co-develop with neuropsychiatric symptoms. The associations were similar across cancer and dementia, suggesting transdiagnostic processes not limited to dementia. Neuropsychiatric symptoms are partly an expression of personality; accounting for personality traits could help with diagnosis and disease monitoring, tailoring interventions, and fostering person-centered care.

Objectives: Hemoglobin (Hgb) is associated with cognitive function, with low and high levels of Hgb leading to impaired cerebral oxygenation and perfusion. Yet, current studies focused on understanding the association between Hgb and cognitive function without consideration for each cognitive domain. Thus, this study aims to identify and visualize potentially interactive associations between Hgb and specific cognitive domains among older adults.

Method: This is a secondary data analysis using Wave II data from the National Social Life, Health, and Aging Project (NSHAP) and included 1022 older adults aged between 65 and 85 years. The network structure of three different models was estimated to understand the association between specific cognitive domains and Hgb in a mixed graphical model using the R-package 'mgm'. Model 1 did not adjust for any covariates, Model 2 adjusted for age and gender, and Model 3 adjusted for all covariates.

Results: Among all cognitive domains, the visuospatial (edge weight = 0.06-0.10) and memory domains (0.04-0.07) were associated with Hgb in all three models Though not present in Model 3, the attention domain was associated with Hgb in Model 1 and Model 2 (0.08-0.11). In addition, the predictability of Hgb was the highest (8.1%) in Model 3.

Conclusion: Findings from this study suggest that cognition should be considered as a multidimensional construct, and its specific cognitive domain should be carefully assessed and managed in relation to Hgb among older adults.

Objectives: Self-compassion may be a psychological resource for living well with dementia, but research is limited by the lack of a validated self-compassion measure for people with dementia. This study aimed to explore the SCS-SF's psychometric properties as well as correlates of self-compassion for people with dementia.

Method: A total of 207 people with dementia were recruited to a cross-sectional survey involving the SCS-SF and measures of well-being, self-esteem, and depression. Data analyses (n = 193) included internal consistency reliability, correlational analyses, Exploratory Factor Analysis (EFA), plus ANOVAs and t-tests.

Results: Self-compassion significantly correlated positively with well-being and self-esteem, and negatively with depression. Reliability and preliminary construct validity of the SCS-SF was supported. EFA suggested two underlying factors formed by positive and negative components of self-compassion. The negative factor explained more variance and showed stronger correlations with total self-compassion, well-being, self-esteem, and depression compared to the positive factor. Self-compassion significantly differed based on age but not gender, dementia subtype or time since diagnosis.

Conclusion: The SCS-SF shows potential as a valid and reliable measure of self-compassion for people with dementia, but further research is needed. The SCS-SF may measure two distinct constructs, which possibly play different roles in relation to well-being in dementia: self-compassion and self-criticism. Clinicians and researchers may wish to interpret these factors separately.