Aging & Mental Health最新文献

Objectives: This study examines the long-term relationship between loneliness and depressive symptoms in older U.S. adults over 16 years.

Method: Data were drawn from the Health and Retirement Study, specifically Waves 8 (2006) and 16 (2022). Two samples were created: (1) participants aged 60+ without depressive symptoms in 2006 (n = 790) to examine whether baseline loneliness predicts later depressive symptoms, and (2) participants not lonely in 2006 (n = 788) to examine whether baseline depressive symptoms predict later loneliness. Loneliness was measured using the Revised UCLA Loneliness Scale, and depressive symptoms were assessed with a modified 7-item CES-D scale. Descriptive statistics and logistic regression models were used.

Results: Older adults who reported loneliness in 2006 had nearly twice the odds of developing depressive symptoms by 2022 compared to their non-lonely counterparts (AOR = 1.98, 95% CI: 1.06-3.69). Baseline depressive symptoms also increased the likelihood of later loneliness (AOR = 1.70, 95% CI: 1.04-2.79). Additionally, cognitive impairment was associated with later loneliness, with women and individuals with poorer self-rated health at higher risk of developing depressive symptoms.

Conclusion: The findings reveal a strong link between loneliness and depressive symptoms in later life, emphasizing the need for interventions that tackle both issues together.

Objectives: Caregivers of dementia patients often experience elevated stress and negative affect, yet daily fluctuations in these experiences and their relation to attachment style and relationship quality (RQ) remain underexplored.

Method: For 14 days, we assessed the daily experiences of 35 dementia caregivers, including their positive and negative affect, stress, attachment, and relationships.

Results: Results from multilevel modeling showed that more positive current RQ was related to lower daily stress. In contrast, a more negative RQ, combined with greater attachment anxiety and avoidance, correlated with increased negative emotions and stress.

Conclusion: These results underscore how the daily emotional lives of dementia caregivers in a primarily middle-to-late adulthood sample (mean age = 57.5 years) are formed by current relationship dynamics and attachment styles. These results point to possible intervention strategies that may improve caregiver well-being.

Objectives: This review synthesizes the current literature on the relationship between dementia worry (DW), or anxiety about dementia, and depressive symptoms.

Method: A comprehensive literature search was conducted between September and October of 2024. The following databases were searched: PubMed, PsycINFO, CINAHL, SCOPUS, and Web of Science. Studies were included if they were published in peer-reviewed journals, available in English, and included statistical analyses between DW and depressive symptoms. Articles were excluded if they did not measure DW and depressive symptoms or statistically analyze the relationship between them. Data on sample characteristics, study quality, measures, statistical analyses, and results were examined to inform conclusions.

Results: This review included 20 studies with 18 distinct samples, totaling 9,288 participants. Thirteen studies found significant relationships between DW and depressive symptoms, three were not significant, and three had mixed findings.

Conclusion: DW and depressive symptoms co-occur, but this relationship may vary based on sex and exposure to dementia. Conclusions were drawn based on the strengths (e.g. multiple covariates) and weaknesses (e.g. cross-sectional design) of each study reviewed. Implications for clinical practice and future research are discussed.

Objectives: Mild cognitive impairment (MCI) is considered a prodromal stage of Alzheimer's disease (AD) with a 10-15% annual conversion rate. This study aimed to explore the role of the personality traits Conscientiousness and Neuroticism in predicting conversion from MCI to AD, and worsening dementia severity.

Method: This retrospective, longitudinal study enrolled 69 older adults diagnosed with MCI. At the baseline assessment, the outcomes of interest were Folstein Mini-Mental State Exam (MMSE), Lawton Brody Instrumental Activities of Daily Living scale (LB-IADL), and Clinical Dementia Rating Sum of Boxes (CDR-SB).

Results: Lower baseline Conscientiousness significantly predicted conversion from MCI to probable AD (OR =0.945, p = 0.043). Higher baseline Conscientiousness was also associated with better cognitive performance at follow-up, as indicated by higher MMSE scores (B = 0.158, p = 0.001) and lower CDR-SB scores (B = -0.083, p = 0.008). In contrast, higher baseline Neuroticism significantly predicted poorer functional outcomes, reflected by higher LB-IADL scores at follow-up (B = 0.296, p = 0.006).

Conclusion: This study replicates prior findings by indicating that Conscientiousness and Neuroticism predict disease course in a clinic sample, using measures of disease transition, cognitive worsening and decline in instrumental ADLs. Conscientiousness is a brief measure that can be applied routinely in the real-world clinic setting.

Objectives: Older adults with pain are at risk for developing depression. Although personality traits, including internal locus of control (LOC) and conscientiousness, are linked to fewer depressive symptoms, their potential protective role among Mexican adults aged 50 and older with pain is not well understood.

Method: We used data from the Mexican Health and Aging Study (2015 and 2018) and included participants who reported frequent pain at both waves (n = 2274). LOC and conscientiousness were measured continuously in 2015, with higher scores indicating a more internal LOC or conscientious personality. We combined depressive symptoms from 2015 and 2018 to create four-level outcome: stable low/no depression (<5/<5), recently remitted (5+/<5), recent onset (<5/5+), and recurrently high (5+/5+). We used multinomial logistic regression models to assess the association between personality and depressive symptoms.

Results: A more internal LOC was associated with a lower risk of recurrently high depressive symptoms [relative risk ratio (RRR): 0.81, 95% confidence interval (CI): 0.72, 0.92). Greater conscientiousness was associated with lower risk of recent-onset [(RRR: 0.87, 95% CI: 0.76, 0.998) and recurrently high depressive symptoms (RRR: 0.87, 95% CI: 0.77, 0.97).

Conclusion: Interventions to modify LOC and conscientiousness may be helpful in pain management by mitigating comorbid depressive symptoms.

Objectives: This study explored the social out-of-home participation experiences of people with dementia and their informal caregivers from a capability-based approach.

Method: Twelve dyadic interviews with people with dementia living in the community and their informal caregivers were conducted. Data were inductively coded using a reflexive thematic analysis approach.

Results: All participants with dementia experienced changes in activities, social interactions or out-of-home mobility, captured in the overarching theme of 'social participation: a changing world'. Four subthemes captured the primary strategies participants used to navigate these changes: (1) creating a sense of comfort and safety in nearby, quiet, and familiar places; (2) pursuing a sense of social identity through meaningful connections; (3) accepting support to maintain independence; and (4) finding a balance, as described by informal caregivers, between their own social needs and those of their spouses. These themes highlight the agency of people with dementia in shaping their social participation amid changes in capabilities and environments.

Conclusion: This study contributes to a more nuanced understanding of social participation in dementia, emphasising the importance of supportive environments that recognise both capabilities and needs can enable continued engagement and foster social health.

Objectives: This study examines the relationship between religious attendance and depressive symptoms among older adults in the United States, focusing on the potential mediating role of church-based social ties.

Method: Longitudinal data from the Health and Retirement Study (2010-2018) were analyzed, including 10,467 respondents over age 50 at baseline. Associations between religious attendance (2010), church-based social ties (2012), and depressive symptoms (2014-2018) were assessed using a series of regression models. Mediation analysis was conducted using generalized structural equation models with bootstrapped confidence intervals.

Results: More frequent religious attendance in 2010 predicted fewer depressive symptoms in 2014, 2016, and 2018. Church-based friendship, but not church-based relatives, significantly mediated these associations.

Conclusion: Religious attendance may protect against later-life depressive symptoms by fostering church-based friendships. Faith-based organizations might consider promoting such connections to support older adults' mental health.

Objectives: The study examined the dynamics among social isolation, loneliness, sleep disturbance, and depressive symptoms in older Korean-American residents of subsidized senior housing. Building upon the well-established link between social isolation and depressive symptoms, we hypothesized three indirect effect models with (1) loneliness as a sole mediator, (2) sleep disturbance as a sole mediator, and (3) loneliness and sleep disturbance as serial mediators.

Methods: Survey data from 318 participants (M age = 79.5 years, SD = 6.66) were used to examine the direct and mediation effect models.

Results: We confirmed that social isolation independently predicted depressive symptoms and found partial support for the mediation models. Among the three mediation pathways proposed, significance was found in the sole mediation by loneliness (B [SE] = 0.86 [0.29], bias-corrected 95% CI = [0.31, 1.47]) and the sequential mediation by loneliness and sleep disturbance (B [SE] = 0.12 [0.06], bias-corrected 95% CI = [0.03, 0.25]). The alternative path, where sleep disturbance precedes loneliness, was not significant, confirming the robustness of the proposed serial path.

Conclusion: Findings underscore the importance of addressing both loneliness and sleep disturbances as interconnected factors in interventions aimed at alleviating the mental health impacts of social isolation.

Objectives: Living with comorbid dementia and cancer is linked with communication and decision-making challenges across the cancer care pathway and poor health outcomes. This meta-ethnographic review aimed to explore the experiences of people living with comorbid dementia and cancer (PLWCDC) when making decisions about their cancer care.

Method: Six databases were searched using terms pertaining to dementia, cancer, decision-making and qualitative experiences. Studies that qualitatively explored cancer care decision-making experiences from the perspective of people living with comorbid dementia and cancer were included.

Results: Searches yielded 3424 unique records, with ten articles meeting eligibility criteria. After quality assessment, collated data was synthesised using a reciprocal synthesis. This produced four higher-order themes: 'challenges of processing cancer-related information', 'issues of inaccessible information and uninformed consent', 'the role of relatives', and 'the importance of individualised and consistent care', drawn together by a core concept of delivering and receiving person-centred cancer care in an inflexible healthcare system.

Conclusion: Decision-making experiences were complex and multi-layered. Dementia negatively influenced understanding and retention of information. Poor consistency in staffing and complexity of information provided were overwhelming. PLWCDC were not always meaningfully involved in their cancer-care decisions. Individualised, consistent care is required to improve outcomes for this population.

Most people living with dementia are supported by their spouse and/or an adult child, yet little is known about how husbands and sons approach dementia caregiving. Using an exploratory mixed method design, this study examined male dementia carers': approach to help-seeking; motivations to step-into the carer role; expectations of formal services; and appraisal of carer-burden. Qualitative thematic analysis of (n = 32) semi-structured interviews with male carers suggested that masculinity norms shape the male approach to caregiving, summarised under two themes: 'Help-seeking: The way blokes do it'; and 'Sons approach caregiving differently to husbands'. Findings suggest that males typically seek help at crisis point and expect professionals to provide directive task-focused support to manage the crisis. Husbands were motivated to care, as a commitment to their marriage vows, while sons cared as a form of 'pay-back' to their parents. Husbands articulated functional carer-burden, while sons expressed emotional carer-burden. However, quantitative analysis of (n = 22) responses on the 12-item Zarit Burden Interview scale showed no significant difference in carer-burden scores between husbands and sons. These findings could inform the tailoring of formal services for male carers of people with dementia.