Aging & Mental Health最新文献

Objectives: Family dementia caregivers exhibit high rates of chronic psychological stress. We aimed to determine the impact of mentalizing imagery therapy (MIT), a mindfulness and guided imagery approach, on perceived stress and positive psychological traits. We further investigated the role of dispositional mindfulness on these effects.

Method: This analysis of secondary outcomes drew from a pilot randomized controlled trial (n = 46) of 4-week MIT versus a psychosocial support group for family dementia caregivers. Measures of perceived stress, resilience, and other positive psychological traits were administered at baseline, post-group, and four months. Longitudinal analyses were conducted with mixed linear models, and mediation analyses with bootstrapping, in R.

Results: MIT demonstrated statistically significant benefits relative to the support group for perceived stress, resilience, spiritual well-being, and other positive traits. Changes from baseline to post-group in mindfulness significantly mediated the relationships between group and most outcomes.

Conclusion: In this pilot trial, MIT reduced perceived stress and improved positive psychological traits. Mediation by dispositional mindfulness was demonstrated. Future research in larger samples should be aimed at confirming the benefits of short-term MIT on reducing stress and improving positive psychological traits, and studying the time course of mediation effects by mindfulness.

Objectives: Depression is increasingly prevalent among older adults in China, particularly in rural areas of China. Although social and built environments are recognized as key mental health factors, their interaction across urban and rural contexts remains understudied. This study explores the pathways linking social capital, built environments, and depressive symptoms among older Chinese adults.

Methods: Data were drawn from the 2016 wave of the China Family Panel Study (CFPS), including 3483 urban and 3812 rural adults aged 60 and above. The study examined the mediating and moderating roles of different levels of social capital in the relationship between neighborhood environments and depressive symptoms.

Results: Community-level social capital partially mediated the relationship between the neighborhood environment and depressive symptoms in both urban and rural settings. However, a compensatory relationship between community and society social capital, emerged only in urban areas, indicating significant urban-rural disparities.

Conclusion: This study supports the ecological model of health for older adults, emphasizing the impact of built and social neighborhood environments on depressive symptoms. The findings stress the importance of addressing mutiple levels of the social environement experienced by older adults. These results have practical implications for community development, particularly in urban areas where societal-level social capital may be limited.

Objectives: Lesbian, gay, and bisexual (LGB) and transgender and gender-diverse (TGD) people experience mental health disparities across the lifespan, yet little research has examined these trajectories into later adulthood; this study sought to fill this gap.

Method: We analyzed data from the Canadian Longitudinal Study on Aging (CLSA) using linear mixed models to compare longitudinal trajectories of mental health outcomes between gay/lesbian (n = 751), bisexual (n = 286), and heterosexual (n = 43,918) people, and between TGD (n = 24) and cisgender (n = 45,055) people.

Results: LGB adults reported significantly higher psychological distress and depression symptoms, and lower life satisfaction, compared to heterosexual people. Overall trajectory patterns were similar across groups, except bisexual adults showed distinct patterns whereby their rate of decline in psychological distress and depression slowed less at older ages, though baseline disparities persisted. TGD adults reported lower life satisfaction compared to cisgender men, though this finding should be interpreted cautiously. Across all participants, mental health outcomes followed quadratic patterns with age, declining into early older adulthood before leveling off. These disparities persisted across older adulthood but did not significantly change over time, suggesting stability in mental health differences rather than convergence or widening disparities. In contrast, no significant mental health disparities emerged between TGD and cisgender adults, though this finding likely reflects the small sample of TGD participants.

Conclusion: Our findings support minority stress theory, suggesting that cumulative exposure to minority stressors contributes to persistent disparities in LGBT older adults, while revealing complex age-related patterns that may reflect stress-resilience interactions over time.

Objectives: It is unknown whether psychological distress amongst culturally and linguistically diverse (CALD) unpaid carers differs to carers of non-CALD older Australians. This study aims to determine whether psychological distress was higher amongst primary CALD carers, and factors associated with higher psychological distress.

Method: Using the 2018 Survey of Disability, Ageing, and Carers, multivariable logistic regression modelling was used to measure the association between CALD carer status and psychological distress measured on the Kessler distress scale.

Results: The total sample comprised of 987 carers, and 163 were primary carers of older CALD Australians. Of the 163 carers, 69.3% were female and 58.8% were an adult child of the care recipient. Psychological distress was higher amongst carers of older CALD Australians compared with carers of older Australians (aO.R: 1.85, 95% C.I: 1.23-2.80), adjusting for socio-demographic variables. Factors associated with psychological distress amongst primary CALD carers included speaking as non-English language at home (aO.R: 1.85, 95% C.I: 1.23-2.80), and higher income (aO.R: 2.84, 95% C.I: 1.04-7.72).

Conclusion: Higher psychological distress amongst primary CALD carers may reflect competing burdens between employment and caregiving duties. More carer support and mental health services are needed to reduce psychological distress burden amongst this cohort of carers.

Objectives: This cross-sectional study investigates the mediating role of perceived social support and psychological well-being in the relationship between social media use and quality of life among older adults residing in nursing homes.

Method: The sample comprised 302 individuals aged 60 and above living in six official nursing homes in Istanbul. Data were collected using a socio-demographic questionnaire, the Psychological Well-Being Scale, the Multidimensional Scale of Perceived Social Support, and the Quality of Life Scale for the Elderly. Analyses were conducted using SPSS 25, and mediation hypotheses were tested using the PROCESS Macro (Model 4) with 5,000 bootstrap samples.

Results: The mediation analyses revealed a significant complete mediation association between social media use and quality of life through perceived social support (B = -0.5417, SE = 0.2588, 95% CI [-1.1030, -0.0867]) and psychological well-being (B = -3.2602, SE = 0.5360, 95% CI [-4.3560, -2.2456]).

Conclusion: These findings suggest that social media use affects quality of life not only directly but also indirectly by enhancing social support and psychological well-being, highlighting the importance of digital connectivity for older adults in institutional care settings.

Objectives: Engage is an empirically-supported brief behavioral intervention for later-life depression yet to translate from randomized controlled trials to implementation. This study evaluated a real-world implementation demonstration of Engage across a geriatric mental health care setting.

Method: The exploration, preparation, implementation, sustainment framework guided this demonstration. Interprofessional case managers received training and ongoing consultation in Engage and applied it with older adults with depression over four months. Upon completion of the implementation trial, providers participated in a 1-h focus group to provide feedback about training, treatment perceptions, and facilitators and barriers to implementation. Focus group transcripts were double-coded using thematic analysis to extract themes informed by the Consolidated Framework for Implementation Research (CFIR).

Results: Thirteen themes emerged from focus groups (N = 21 provider participant respondents) related to CFIR constructs of innovation adaptability, innovation design, critical incidents, compatibility, access to knowledge and information, need, and capability. Findings suggest that Engage is feasible and fits the needs of providers, patients, and the healthcare system. Implementation barriers included depressive symptom burden, patient complexity, and therapist concerns related to self-efficacy and previous experiences.

Conclusion: Provider feedback can inform and strengthen implementation of evidence-based psychotherapies such as Engage.

Objectives: To examine feasibility, acceptability, and preliminary effectiveness of a mindfulness training in lonely older adult caregivers for family members with Alzheimer's disease and related dementias using mobile health technology.

Method: This was a two-arm randomized controlled trial: 55 caregivers were randomized to a 14-day (a) smartphone-based mindfulness training (Headspace mobile app; n = 24) or (b) active control (Breathing app; n = 31). Loneliness was assessed using end-of-day diary surveys pre- and post-training.

Results: A total of 50 caregivers completed the training and pre- and post-training assessments (91%), and all who completed the post-training assessment reported they were satisfied or very satisfied with the program. A secondary aim was to examine whether the mobile health mindfulness training intervention reduced loneliness. A mixed effect linear model using end-of-day survey-sampled loneliness showed a non-significant decline in loneliness among participants in the mindfulness group (p = .27). Participants who used the breathing app demonstrated a significant decrease in loneliness (p = .00).

Conclusion: The 14-day breathing training may have provided a more targeted approach to improving subjective loneliness in this population. Overall, these results demonstrate that older caregivers can use technology to improve experiences of loneliness.

Objectives: Chronic kidney disease (CKD) is associated with several disorders that compromise the physical, mental and social health. The aim of the present study was to investigate the effects of resistance training with cluster-set method (RT-CS) on quality of life (QoL) and depression symptoms in older subjects with CKD.

Method: The QoL was evaluated by the Short Form Health Survey 36 questionnaire, and depression by the Beck Depression Inventory (BDI). Sixty-eight subjects with CKD on maintenance hemodialysis (age: 57.55 ± 4.06 years) were selected and randomly distributed into a control group without RT (CG, n = 26); traditional RT group (RT, n = 26); and RT cluster-set group (RT-CS, n = 26) with 15 s pause every four repetitions. Subjects completed 24 wk of RT, three times a week, 1 h and 30 min before the hemodialysis session.

Results: It was found that both the RT and the RT-CS group improved QoL, while only RT-CS displayed reduced depression symptoms. The minimally clinically important difference revealed that more subjects from the RT-CS were responsive to decrease of depression and functional capacity.

Conclusion: This highlights the importance of RT-CS as an intervention to mitigate the effects of low QoL and depression in older subjects with CKD.

Objectives: The aim of this study was to examine the association between major dietary patterns and sleep quality, mental health and status of mood among Iranian older adults.

Method: This cross-sectional study included 400 healthy older adults between 60-84 years with mean BMI of 28.86 kg/m². Dietary intake was assessed using validated and reliable food frequency questionnaire (FFQ). Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality, -DASS-21 was used to assess depression, anxiety and stress and the profile of mood states (POMS) questionnaire was utilized to evaluate the status of mood.

Results: It was found that there is a favorable significant association between Mediterranean diet and PSQI score, depression, anxiety, stress and status of mood (p < 0.05). In contrast, there was a significant association between adherence to traditional diet and poorer sleep quality, anxiety and stress (p < 0.05). Adhering to an unhealthy diet was also associated with higher risk of depression (p < 0.001).

Conclusion: In older adults, adhering to a dietary pattern with high amounts of vegetables, fruits and healthy fats may be more beneficial for their mental health. While higher consumption of refined grains and tea may be associated with higher risk of depression and anxiety.