Aging & Mental Health最新文献

Objectives: Dignity of patients with early-stage dementia (PwESD) is a core value of person-centered care. To evaluate the effectiveness of the intervention programs targeted at this population, a reliable tool that would measure dignity in PwESD is needed. Based on a qualitative analysis of how PwESD perceive and experience dignity, this study aims to determine the adequacy of the Czech version of the Patient Dignity Inventory (PDI-CZ) for this patient population.

Method: The sample from two outpatient clinics in Czechia included home-dwelling individuals aged 60 years or older with mild dementia. In the first interview (T1), there were 21 respondents; 10 of whom participated in the second interview (T2) that was conducted after 12 months. The qualitative material was analyzed using a deductive approach based on the PDI-CZ domains.

Results: Thematic analysis shows that the PwESD thematized all domains of the PDI-CZ in their interviews and their views of dignity were stable over time. Some experiences were not considered in the PDI-CZ (such as lowered support of the society, lowered ability to advocate for oneself, or feeling of not suitable living conditions).

Conclusion: When developing a revised version of the tool, items that reflect missing views of dignity should be included.

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: Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link.

Method: Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days.

Results: Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships.

Conclusion: The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

Objectives: Social isolation and loneliness among older adults present serious public health challenges linked to increased dementia risk. This systematic review analyzes interventions addressing social isolation and loneliness in older adults and their cognitive effects to inform future dementia prevention programs.

Method: We systematically searched databases (PUBMED, PsycINFO, SCOPUS, EBSCO, and SAGE Journals) from February to May 2023 and updated from August to November 2023 using terms like social isolation, loneliness, intervention, and cognitive outcome. We included studies that assessed cognitive outcomes (such as global cognition or specific domains) and non-cognitive outcomes (including depression, well-being, and functionality). Study quality was assessed using Cochrane's RoB 2, ROBINS-I, and other appraisal tools, with results synthesized narratively.

Results: Nine studies (1025 participants) were included, with a high risk of bias in most randomized trials (except one) and a low-to-moderate risk in non-randomized studies. Six studies showed improved cognitive function post-intervention, five of which involved technology. Two studies demonstrated reduced loneliness and improved cognition.

Conclusion: Technological interventions promise to reduce social isolation and loneliness, positively impacting cognitive function. Despite this, these interventions did not directly impact social isolation, which requires future and larger studies to understand more in-depth the role of these approaches for individuals with social isolation. The interventions promoting social interactions could lead to higher social identification, well-being, and interest in life. Multidomain interventions, including technology, are effective. Limitations include study scarcity and heterogeneity, highlighting the need for more robust research on interventions to alleviate social isolation and loneliness and enhance cognitive function.Systematic Review Registration PROSPERO CRD42023460933.

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.

Objectives: To evaluate and rank the effectiveness of specific non-pharmacological treatments (NPTs) in improving the global cognitive function in individuals with Alzheimer's disease (AD) and to examine the dose-response relationship.

Method: We conducted a systematic search in PubMed, MEDLINE, Embase, PsycINFO, CENTRAL, WOS, and CNKI from their inception to 15 February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes using random effects models.

Results: We included 68 studies involving 5053 participants in this meta-analysis. The treatments with the highest cumulative probabilities for improving global cognitive function were transcranial direct current stimulation (tDCS), followed by physical exercise (PE), and repetitive transcranial magnetic stimulation (rTMS). Additionally, cognitive stimulation (CS), cognitive training CT), multidisciplinary program (MD), and reminiscence treatment (RT) also significantly improve the global cognitive function of people with AD. A non-linear dose-response association was observed for tDCS, PE, rTMS, CS, and CT with global cognitive improvement. Notably, no minimal threshold was identified for the beneficial effects of PE on cognition. The estimated minimal doses for clinically relevant changes in cognition were 33 min per week for tDCS, 330 MET-min per week for PE, and 8000 pulses per week for rTMS.

Conclusion: tDCS, PE, and rTMS are the better effective NPTs for enhancing global cognitive function in individuals with AD. Properly dosing these treatments can yield significant clinical benefits. Our findings support the clinical utility of low-dose exercise in improving cognition in people with AD.

Objective: Vietnam is an LMIC in Asia that is experiencing rising cases of Alzheimer's disease and related dementias (ADRD). Many Vietnamese adults at risk of ADRD have experienced early-life war exposures, which may have negative impacts on their cognitive function in later years.

Methods: Our study uses the Vietnam Health and Aging Study (VHAS) to investigate the impact of early-life war exposure on cognitive function in later life while also considering variations in social engagement. The sample consists of 2352 adults aged 60 and older from northern and central Vietnam. Cognitive function, measured by questions from the Mini Mental State Examination (MMSE), and self-rated memory are our dependent variables and five measures related to social engagement serve as independent variables.

Results: Our results show an association between PTSD symptoms and poorer cognitive function (0.0704, p < 0.05) and self-rated memory (OR = 0.904, p < 0.001; 95%). Similar results are also found among for individuals with lower level of social engagement. Furthermore, several sociodemographic factors exhibit attenuated effects on cognitive function due to variations in social engagement.

Conclusion: Social engagement is generally beneficial for cognitive health amongst those with early-life war exposure, but it does not necessarily attenuate the effects of trauma.

Objective: This study aimed to map the existing scientific research about solitude in older adults, focusing on its conceptualizations, associated factors, and impacts.

Method: A scoping review was conducted, searching Scopus, Web of Science, PubMed, and Academic Search Complete databases for publications from 1985 until December 2023.

Results: Twenty-four studies were included. The main findings suggest a wide-ranging conceptualisation of solitude, with most studies (n = 16) adopting neutral definitions such as "being alone, without communicating with others"; and a subset of studies adopting definitions that alluded to "positive solitude" (as the choice of being with oneself, underscoring potential benefits). Individual characteristics were identified as key associated factors of solitude. Both positive impacts and negative impacts were reported.

Conclusion: The variability in conceptualisation and impacts likely stems from methodological and theoretical differences in approaching solitude. This underscores the need for additional research to establish a widely accepted conceptual framework. Such consensus could enhance the understanding of the conditions contributing to positive and negative impacts associated with solitude and inform 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: To examine in-depth experiences of loneliness and freedom after late-life divorce from an intergenerational familial/dyadic perspective in a family-oriented society that also values self-determination. Considering the expansion of late-life divorce, it is important to understand its consequences for the family wellbeing.

Method: According to phenomenology tradition, data was collected through 51 semi-structured qualitative interviews, comprised from 7 family units (n = 33) including all/most family members and 9 parent-child dyads (n = 18), using thematic-analysis and dyadic interview-analysis principles. Analyzing family units enables a more complex examination of the phenomena, providing a holistic view of family life.

Results: Loneliness and freedom experienced simultaneously was the most common. A gap was identified between generations regarding benefits and costs of late-life divorce. Whereas most divorcees emphasized the benefits of freedom, most of their adult-children mainly described the disadvantages of loneliness, perceiving both loneliness and freedom as negative.

Conclusion: Late-life divorce is a complex experience comprised of both loneliness and freedom. Each generation experiences the benefits and costs of late-life divorce differently. Unique aspects of freedom and loneliness at old age in a socio-cultural context located between self-determination and family-oriented are discussed, including strategies of coping with loneliness. Implications for families and professionals are presented.