Aging & Mental Health最新文献

Objectives: This study sought to (1) identify the percentage of high-risk substance use or substance use disorder (SUD) and (2) examine the factors associated with high-risk substance use or SUD in adults aged 50 years and older receiving mental health treatment with a primary delirium or dementia diagnosis.

Method: This study used 7 years (2013-2019) of national administrative data on community mental health center patients aged 50 years and older with a primary delirium or dementia diagnosis receiving treatment in the United States (U.S.). To examine factors associated with the dependent variable (high-risk substance use or SUD), a multivariable binary logistic regression model was utilized.

Results: The sample included 77,509 individuals who were mostly aged 65 years and older (69.7%), and did not have co-occurring high-risk substance use or SUD (90.1%). Receiving treatment in a U.S. region other than the Northeast, being younger, male, not non-Hispanic White, and having multiple mental health diagnoses had greater odds of co-occurring high-risk substance use or SUD.

Conclusion: One in ten persons in this sample having high-risk substance use or SUD highlights the clinical necessity for screening and subsequent treatment for co-occurring high-risk substance use among persons receiving treatment for a neurocognitive disorder.

Objectives: Latinos are about twice as likely to develop cognitive impairment. Culturally, filial support and familismo are expected within Latino families. Yet approximately twenty percent of Latinos live alone in the United States. The purpose of this study is to explore the concerns and priorities of older Latinos living alone with cognitive impairment, using a precarity framework.

Method: We conducted 22 in-home interviews with older Latinos living alone with cognitive impairment, and we supplemented the interviews with interviews with members of the older adults' social circle and providers. Themes influencing the precarity of Latino older adults living alone were organized through the major areas of the precarity lens; 1) Limited awareness of cognitive impairment; 2) Self-management of cognitive impairment; and 3) Lacking tailored services for cognitive impairment.

Results: Latino culture permeated and intersected across the lived experiences of participants living alone with cognitive impairment. Precarity was prevalent in all participants' lives and was exacerbated by familismo combined with cognitive impairment.

Conclusion: Findings showed precarity in the experiences the participants shared. Participant narratives reveal how the Latino culture intersects with the experience of precarity while living alone with cognitive impairment, especially in reference to the role that family plays through the expectation of familismo. However, given the difficult demands of employment and raising their own families, familismo can become more like a goal than a practice. Further research is needed to better understand how to bridge the gap between the needs of these older Latino adults living alone with cognitive impairment, their families, and formal services.

Objectives: The study examined the mediating role of fall-related self-efficacy in the association between falls and mental health among older Korean Americans living in subsidized senior housing in the greater Los Angeles area. We focused on serious fall incidents (i.e. multiple falls or any fall with a fracture) and used symptoms of depression and anxiety as indicators of mental health.

Method: Survey data from 315 participants (M age = 79.4 years) were used to examine the direct effects of serious fall incidents on mental health symptoms, as well as indirect effects through fall-related self-efficacy.

Results: The mediating effect of fall-related self-efficacy was found to be significant in both models for depressive symptoms (B [SE] = 0.15 [0.07], bias-corrected 95% CI = [0.03, 0.31]) and anxiety symptoms (B [SE] = 0.11 [0.05], bias-corrected 95% CI = [0.02, 0.23]).

Conclusion: The mental health impact of serious fall incidents was shaped by older individuals' perceived concerns about falls and confidence in performance. The findings highlight the importance of addressing fall-related psychological responses in preventing falls and promoting mental health among senior housing residents.

Objectives: Resilience resources play a significant role in a caregiver's adaptation process. Previous studies have primarily focused on the effects of individual resilience resources. This study aimed to examine diverse patterns of how those multiple resources simultaneously operate in a caregiving situation with the person-centered approach.

Method: This study utilized data from the Health and Retirement Study. Participants were eligible if they completed the Left-Behind questionnaire at two consecutive timepoints (2014 and 2016; or 2016 and 2018) and provided care for their spouse with limitations in activities of daily living (n = 692).

Results: Latent profile analysis identified three distinct groups among spousal caregivers: (1) Lack of Resilience Resources (17%), (2) Low Psychological and Cognitive Resources, but Having Moderate Support (21%), and (3) Strong Resilience Resources (62%). Spousal caregivers having functional limitations (Odds = 0.37, p = 0.016) and greater depressive symptoms (Odds = 0.59, p = 0.000), and high ongoing caregiving stress (Odds = 0.37, p = 0.007) were less likely to be in 'Strong Resilience Resources' than 'Lack of Resilience Resources'.

Conclusion: The findings highlight the importance of taking a holistic view of resilience resources. It provides insights into potentially vulnerable groups and caregivers' adaptation process, thereby contributing to the development of interventions or policies aimed at enhancing the resilience resources of family caregivers.

Objectives: This study investigated the longitudinal association between coping ability and depressive symptoms from before to during and after the COVID-19 pandemic and whether engagement in meaningful activities plays a mediating role in this association.

Method: Individuals aged 75, 80, and 85 years (n = 1021) were interviewed in 2017-2018 (T1, pre-pandemic). Of these persons, 608 were interviewed in 2020 (T2, first wave) and 2021-2022 (T3, partly post-pandemic). Coping ability, depressive symptoms, and engagement in meaningful activities were assessed using the 10-item Connor-Davidson Resilience Scale, 10-item Center for Epidemiologic Studies Depression Scale, and 17-item activity subscore of the University of Jyväskylä Active Aging Scale, respectively. Structural equation modeling was used for the mediation analyses.

Results: Higher coping ability was associated with decreased depressive symptoms, partly mediated by higher activity scores between T1 and T2. From T2 to T3, higher coping ability reduced the depressive symptoms, but the activity scores did not mediate the changes during this period.

Conclusion: Good coping ability may help older people sustain good mental well-being. With good coping ability, active engagement in meaningful activities contributed to the low level of depressiveness during the early phases of the pandemic, when many social activities were restricted.

Objectives: Aging is associated with declines in theory of mind - the ability to infer the mental states of others. We examined whether priming theory of mind mindsets actively (Study 1) and passively (Study 2) improved older adults' performance.

Method: Across two studies, participants completed a novel question-and-answer theory of mind task using the television show Nathan for You^® in a mindset or no mindset condition. In Study 1, participants (N = 324, 18-84 years) completed a similar task related to a different show prior to the Nathan for You task (active mindset). In Study 2, young (N = 235; M_Age = 20.47) and older (N = 193, M_Age = 74.48) adults made continuous ratings of awkwardness of different episodes of Nathan for You before completing the question-and-answer task (passive mindset). We also measured executive function and episodic memory. In both studies, the same tasks were performed in reverse order for the control conditions (no mindset).

Results: Mindsets were associated with small-to-medium increases in theory of mind performance. Cognitive ability did not explain these improvements.

Conclusion: These findings suggest that theory of mind performance can be improved through motivation (e.g. mindsets); cognitive function (e.g. ability) does not moderate this relationship.

Objectives: To alleviate the high prevalence of depressive symptoms and dementia in older Americans (≥65 years), we developed a depression intervention, Caregiver-Provided Life Review (C-PLR), and taught family caregivers life review skills online compared to a synchronous group virtual training, and examined the feasibility and delivery impact (N = 20 dyads).

Method: In a cross-sectional, mixed-methods dyadic design, we recruited family caregiver-care recipient dyads nationwide, collected the pre- and post-intervention measures on care recipients' depression (primary outcome), life satisfaction, caregivers' burden, caregiving rewards, and dyads' relationship quality (secondary outcomes), and compared them using t-tests. We took fidelity scores to measure caregivers' feasibility of delivering life reviews adhering to the protocol.

Results: Care recipients' depressive symptoms declined significantly following the C-PLR intervention (p = 0.034) and caregivers' rewards increased from the pre- to post-period (p = 0.019). Caregivers' qualitative interviews supported the quantitative results that online-trained caregivers' ability to deliver the intervention with high adherence to protocol (15.9 ± 0.27 out of 16) without increasing caregiver burden.

Conclusion: This pilot study suggested that the C-PLR could make a positive impact on both caregivers' and care recipients' mental health. This innovative, cost-effective, and easily implemented activity can be used by any dyad regardless of whether they have any health-related deficits.