Aging & Mental Health最新文献

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.

Objectives: Perceived discrimination is associated with racial cognitive health disparities. Links between discrimination and cognitive performance, like working memory, in everyday settings (i.e. ambulatory performance) require investigation. Depressive symptoms may be a mechanism through which discrimination relates to ambulatory working memory.

Method: Discrimination, retrospective and momentary depressive symptoms/mood, and aggregated and momentary working memory performance among older Black and White adults were examined within the Einstein Aging Study.

Results: Racially stratified analyses revealed that discrimination did not relate to Black or White adults' ambulatory working memory. Among Black adults, however, more frequent discrimination was associated with greater retrospectively reported depressive symptoms, which related to more working memory errors across two weeks (indirect effect p < 0.05). This path was not significant among White adults. Links between discrimination and momentary working memory were not explained by momentary reports of depressed mood for Black or White adults.

Conclusion: Depressive symptoms may play an important role in the link between discrimination and ambulatory working memory among Black adults across extended measurements, but not at the momentary level. Future research should address ambulatory cognition and momentary reports of discrimination and depression to better understand how to minimize cognitive health disparities associated with discrimination.

Objectives: Playfulness describes individual differences in (re)framing situations in a way that they are experienced as interesting, intellectually stimulating, or entertaining. We extended the study of playfulness to groups of middle- and higher age and examined the relations of four facets of playfulness (Other-directed, Lighthearted, Intellectual, and Whimsical) to indicators of positive psychological functioning.

Method: We collected self-report data from 210 participants aged between 50 and 98 years.

Results: The playfulness expressions in this age group were comparable to younger adults. We found that playfulness relates to life satisfaction, the PERMA domains of well-being, and character strengths with small-to-medium correlation effect sizes. The OLIW facets showed differential associations, with regression analyses revealing that particularly Other-directed is positively associated with positive psychological functioning.

Conclusion: Our findings highlight the importance of playful relationships across the lifespan. We discuss the findings regarding the role of playfulness for healthy aging.

Objectives: Perceived expectations for active aging (PEAA) reflect subjective exposure to social expectations about staying active and fit in old age, for example, by maintaining health and social engagement. We investigated whether motivational and personality factors were related to PEAA in the domains of physical health, mental health, and social engagement.

Method: We used a nationally representative sample of German adults (SOEP-IS) covering the entire adult life span (N = 2,007, age range 16-94 years) to test our pre-registered hypotheses.

Results: Multiple regression analyses indicated that motivation (i.e. life goals and health-related worries) was consistently associated with PEAA in the matching domains and mediated the effects of openness to experience on PEAA. No other personality trait was associated with PEAA.

Conclusion: Our findings suggest that individuals preferentially notice the expectations for active aging whose content relates to their personal concerns and goals.

Objectives: A large gap exists in the development of culturally sensitive interventions to reduce stress related to dementia care among Chinese Americans, one of the fastest growing minority populations in the United States. We developed and pilot tested the feasibility and preliminary efficacy of a peer mentoring program for Chinese American dementia caregivers.

Method: A pilot randomized controlled trial was conducted among 38 Chinese American caregivers in New York City. Four outcome variables-caregiving competence, loneliness, caregiver burden, and depressive symptoms-were measured at baseline and 3-month and 9-month follow-ups. The study protocol and preliminary results are available at clinicltrial.gov [NCT04346745].

Results: The feasibility of the intervention was high, as indicated by an acceptable retention rate, fidelity, and positive feedback from caregivers and mentors. Compared with the control group, the intervention group had greater reductions in scores for loneliness at 3-month follow-up and for caregiver burden and depressive symptoms at 9-month follow-up. We did not find significant differences in caregiving competence between the two groups.

Conclusion: The results indicated the high feasibility and potential efficacy of empowering existing human resources of experienced caregivers in the same ethnic community to improve the mental health of Chinese caregivers. Further research is needed to test the efficacy in a larger sample of this population.

Objectives: This study has three objectives: A) To investigate the relationship of ageism on older adults' civic activities; B) To analyze the influence of ageism on mental health; and C) To explore the impact of civic participation on older adults' mental health.

Method: This qualitative study included 782 older people from three different nationalities (Portuguese, Brazilian, and English) ranging in age from 65 to 88. All the interviews went through the process of content analysis.

Results: For the first objective, the findings encompass one high-level theme (Social and individual incompetence), which included social rejection (86%), reduced competence (84%), expectations of failure (83%), and not being able to contribute (77%). For the second objective, findings indicated two overarching categories: Perceived inability, including frustration and impotence (89%), incompetence (77%) and irrelevance (71%); and Perceived distress, including anger (81%), feelings of anxiety (68%); and emotional bursts (63%). For the third objective, the following two high-level themes emerged: Ego-oriented resources, which comprised the development of a sense of purpose (81%), learning cognitive skills (71%), and (A3) practising sense of agency (67%); and Social-oriented resources, encompassing feeling socially integrated (80%); and expressing emotionally (54%). Findings indicated that the most verbalized themes for the three objectives were the same across the three nationalities.

Conclusions: Ageism made it difficult for people to participate in civic life, which has been linked to better mental health. These findings emphasize the need to encourage inclusive civic involvement to improve older individuals' mental health.