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: We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity.

Method: A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted.

Results: Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes.

Conclusion: About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.

Objectives: To gain insight into the longitudinal, reciprocal associations between depressive symptoms and sexual satisfaction as well as the potential moderating roles of gender and perceived importance of sexuality.

Method: We analyzed longitudinal data from 2113 participants of the Longitudinal Ageing Study Amsterdam (LASA) with an initial age range of 54-93 years, using Generalized Estimating Equations (GEE).

Results: There were no significant associations between baseline depressive symptoms and change in sexual satisfaction, nor between baseline sexual satisfaction and change in depressive symptoms. Gender and perceived importance of sexuality were moderators: in men higher depression scores were associated with a decrease in sexual satisfaction, whereas in women higher depression scores were associated with an increase in sexual satisfaction. In participants for whom sexual life was important, higher depression scores were associated with a decrease in sexual satisfaction. In participants for whom sexual life was not important, higher depression scores were associated with an increase in sexual satisfaction.

Conclusion: The associations between baseline depressive symptoms and change in sexual satisfaction as well as between baseline sexual satisfaction and change in depressive symptoms varied according to gender and importance ascribed to sexuality. Potential explanations might lie in the different roles sexual activity plays in sexual satisfaction in men and women.

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.

Objectives: This study aimed to investigate the impact of sensory impairments on well-being, depression symptoms, and relationship satisfaction among older adults, and to examine whether these associations vary by gender.

Method: The study analyzed a sample of 640 Danish individuals aged 60 and older. Multilevel modeling was conducted using PROC MIXED in SAS to assess the impact of sensory impairments on well-being, depression symptoms, and relationship satisfaction. A two-step approach was employed to evaluate the main effects and interaction terms of sensory impairments and gender, controlling for covariates such as age, education, and relationship length.

Results: Both vision and hearing impairments were significantly associated with lower well-being and higher depression symptoms in men and women. However, a gender difference was observed for the association between vision impairment and relationship satisfaction: greater vision impairment was associated with lower relationship satisfaction among men but not among women.

Conclusion: The findings add nuance to the understanding of how sensory impairments may affect older men and women, highlighting both gender similarities and differences. The study also discusses possible interpretations of the findings, suggesting that social and cultural factors may influence how sensory impairments affect mental and relational health outcomes differently for men and women.

Objectives: Late adulthood is marked by challenges that impact well-being. While perceived health, wisdom, and positive attitudes toward aging correlate with better mental health in later life, their interrelations are not well understood. This study explored if three-dimensional wisdom could buffer the negative impact of poor physical health on mental health, and if positive attitudes toward aging mediated the effects of wisdom and poor health on mental health.

Method: A survey of 500 Polish older adults aged 60-86 included the Personal Wellbeing Index, Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Attitudes to Aging Questionnaire, perceived health, and sociodemographic questions.

Results: Wisdom buffered the negative association between poor physical health on mental health and had a significantly stronger effect on mental health if perceived physical health was very poor. The relations of wisdom, poor health, and the interaction between wisdom and poor health on mental health were partially mediated by attitudes toward aging.

Conclusion: Wisdom seems to mitigate the negative effects of poor health on mental health, and wise older adults tend to have more positive attitudes toward aging, leading to better mental health outcomes. Those findings support the important role played by wisdom and attitudes toward aging in healthy aging interventions.

Objectives: Examine the feasibility, acceptability, and preliminary effects of the Telephone Acceptance and Commitment Therapy Intervention for Caregivers (TACTICs) on dementia caregivers' anxiety, depression, caregiver burden, suffering, and anticipatory grief.

Method: A 2-arm pilot randomized trial with dementia caregivers ≥ 21 years old with clinically elevated anxiety or anxiety-related functional interference. Two cohorts were recruited at the beginning and end of the first year of the COVID-19 pandemic. Intervention participants received 6 telephone sessions delivered by a non-licensed interventionist and control participants received readings and a list of dementia caregiver support groups in their area. Outcomes were measured at baseline, post-intervention, and at 3 and 6 months. Feasibility was measured by enrollment rates, completion rates, and adherence to TACTICs by interventionists. Acceptability was measured with participant satisfaction surveys.

Results: TACTICs was feasible and acceptable with 96% enrollment, 98.6% adherence, 65.5% completion, and a mean satisfaction score of 9.35 out of 10 (SD 0.91). The TACTICs group showed clinically relevant reductions in anxiety post-intervention (SRM 4.1, 95% CI [2.4,5.8]), however reductions were not significantly different from the control group (p = 0.98).

Conclusion: Implementation of TACTICs during the COVID-19 pandemic was feasible and acceptable. The preliminary outcomes were not as strong as expected. The results will inform the design of future trials with larger samples.

Objectives: This scoping review aims to map out the coping strategies among Persons with Mild Cognitive Impairment (PwMCI) and Persons with Mild Dementia (PwMD), identifying the facilitators and the barriers to the use of the strategies.

Method: We conducted a systematic search of peer-reviewed studies in PubMed, CINAHL, EMBASE, and PsycINFO. Under the guidance of the Coping Circumflex Model, we identified coping strategies and then conducted thematic synthesis.

Results: Our review of 17 studies revealed 13 themes for coping strategies among PwMCI and PwMD, categorized into problem-solving, positive emotional, problem avoidance, and negative emotional strategies. The strategies included utilization of reminders, active engagement in daily tasks, acceptance, and concealing memory problems. The themes for facilitators and barriers encompassed social interactions, assistance from informal care partners, support from professionals, and the influence of emotion.

Conclusion: The review revealed the practical types of coping strategies and the influence of context on their use and development, highlighting the need for personalized coping strategies. These insights are crucial for developing tailored interventions to improve quality of life in PwMCI and PwMD. Future research should focus on how PwMCI and PwMD develop their effective coping strategies, considering their trajectory of cognitive decline.

Objectives: Due to the limited effectiveness of pharmacological treatment, there is a growing need to explore non-pharmacological psychosocial interventions such as music therapy when treating the behavioural and psychological symptoms of dementia (BPSD).

Method: We randomised 57 nursing home residents into individual active music therapy plus standard care (aMT), individual receptive music therapy with tactile sound vibration plus standard care (rMT), or the standard care control group (CG). A trained music therapist provided 12 sessions over 6 weeks. The outcomes (BPSD; depression; quality of life; medical system usage; activities of daily living; music therapy engagement) were measured at baseline (0 week), post-intervention (6 weeks), and follow-up (12 weeks).

Results: The results indicated small beneficial effects for BPSD in aMT and rMT at follow-up, a small beneficial effect for total musical engagement in aMT and rMT, a small negative effect for verbal communication in rMT, and a small beneficial effect for medical usage in the CG.

Conclusion: Both aMT and rMT methods showed promise for managing BPSD and increasing engagement during music therapy. rMT may be more suited for advanced stages of dementia. Future studies should evaluate the appropriateness and effectiveness of each intervention according to disease severity.

Objectives: This study aimed to evaluate the results of sleep hygiene education via a comprehensive geriatric assessment.

Method: A cross-sectional research was conducted on insomnia outpatients at a tertiary hospital, and all participants received sleep hygiene education as well as a comprehensive geriatric assessment. Sleep parameters were assessed before and four weeks after education.

Results: The study included 141 participants. A significant improvement was obtained in all four scales' scores before and after education (PSQI score 11 [8-13] vs. 5 [3-9], p < .001; SHI score 12 [8-16] vs. 4 [1-8], p < .001; ESS score 6 [3-8] vs. 2 [0-6], p < .001; Jenkins SS score 15 [10-19] vs. 7 [5-11], p < .001). Female gender ratios, as well as the presence and risk of malnutrition, differed between groups with and without the PSQI score improvement. In the regression analyses, female gender and the presence of malnutrition or malnutrition risk were evaluated as possible factors affecting the PSQI responses (respectively, OR: 3.48, CI 95%: 1.21-10.00, p = .020; OR: 0.29, CI 95%: 0.09-0.949, p = .041).

Conclusion: Sleep hygiene education and interdisciplinary interventions are crucial in the management of sleep disorders in older adults.