Aging & Mental Health最新文献

Objectives: Transgender and gender nonconforming (TGNC) older adults experience significant behavioral health and healthcare disparities. Facilitators that contribute to positive behavioral healthcare experiences among this population, however, remain uncertain. In this study, we investigate facilitators contributing to positive or satisfactory behavioral healthcare experiences among a sample of TGNC older adults in the United States (US).

Method: Between September 2021 and January 2022, the first author conducted 47 semi-structured, individual interviews with TGNC adults aged 65 years or over in the US. Using an inductive grounded theory approach, we examined respondents' positive or satisfactory experiences with accessing and utilizing behavioral health services, support, and resources. Analyses were conducted using NVivo (Release 1.6) software.

Results: Findings underscore the importance of addressing the specific or unique needs of TGNC older patients to promote positive or satisfactory experiences in behavioral healthcare. Three themes emerged: (1) engaging with behavioral healthcare practitioners who offer compassionate, patient-centered care; (2) accessing and utilizing culturally tailored peer-support groups; and (3) receiving equitable access to gender-affirming care and social services.

Conclusion: These findings highlight opportunities for expanding and incorporating these identified facilitators into behavioral healthcare research and practice, especially when promoting gender affirmation in care for TGNC older patients.

Objectives: This study explores the preferences and willingness-to-pay (WTP) of carers for Meeting Centres (MCs) attributes in assisting individuals with mild to moderate dementia.

Method: Preferences from 108 carers, gathered through UK-wide MC networks, were collected using a Discrete Choice Experiment survey. The survey incorporated attributes derived from evidence synthesis and lay consultation. A regression model estimated preference weights and marginal WTP for a change in attributes one a time within the MC support 'package.'

Results: Carers preferred MCs offering a balanced mix of practical activities and emotional support, along with flexibility without booking requirements and low costs. Social opportunities and the frequency of the meeting were not prioritised. Respondents expressed a WTP of £43 to stay with 'My MC,' the preferred option, compared to transitioning to an alternative in-person MC, all else being equal. Various factors, including attendance modality, the relationship with the supported person, age, and gender, influenced carers' choices.

Conclusion: These findings offer valuable insights into carers' preferences, priorities, and WTP within MC support for those with mild to moderate dementia. Understanding these factors can guide the implementation and sustainability of MCs, ensuring alignment with carers' needs and preferences and, ultimately, enhancing support for individuals with dementia.

Objectives: The study aimed to evaluate the relative effectiveness of exercise combined with cognitive training (E&CT) in improving cognitive function compared to exercise alone.

Method: PubMed, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, and OpenGrey were systematically searched. Additional screenings were performed by reviewing citations of relevant articles. Studies were included if they met inclusion criteria. Both pairwise and network meta-analyses were performed using a random effects model in Stata 15.0.

Results: Totally, 46 trials from 54 literature (n = 2846) were eligible for inclusion in the meta-analysis. The network meta-analysis indicated that exercise alone was more efficacious than E&CT in improving global cognition and multicomponent exercise exhibited the highest likelihood (SUCRA value= 89.0%) of being the most effective type. Regarding memory function, E&CT presented greater potential than exercise alone, with the interactive modality ranking first (SUCRA value = 88.4%). Multicomponent exercise was identified as the top intervention for enhancing executive function. The overall quality of the included studies was rated as moderate, and the certainty of evidence ranged from low to high.

Conclusion: Multicomponent exercise emerged as the optimal intervention for improving global cognition and executive function. Nevertheless, for memory function, the interactive modality of E&CT demonstrated the highest probability of being the most effective choice.

Objectives: People living with dementia often experience behavioural and psychological symptoms of dementia (BPSD), which severely affect their well-being during the course of the disease. Particularly for BPSD outcomes, there is a high demand for increasing the evidence-based knowledge of non-pharmacological approaches, such as music-based interventions. Although previous reviews emphasize the potential effects of music-based interventions in people with dementia, they cover a wide range of different interventions and outcomes.

Method: Therefore, this systematic review (SR) and network meta-analysis (NMA) aims to not only investigate the efficacy of music-based interventions on BPSD, but also to compare the impact of different types of music-based interventions on outcomes. Preferred reporting items for SR and meta-analysis protocols (PRISMA-P) and the PRISMA NMA extension were followed. Several databases will be searched from inception to the date the search will be performed, for relevant randomized or non-randomized controlled trials comparing a music-based intervention with treatment as usual, active controls, or another music-based intervention. Multivariate pairwise meta-analyses will be conducted for each outcome. NMA based on a frequentist random-effects model will be used to estimate the comparative effects of each type of music-based intervention and related components across outcomes. Heterogeneity will be investigated by meta-regression models.

Conclusion: Based on our knowledge, this may be the first SR and NMA study to compare the efficacy of different types of music-based interventions. In addition, combined with our multivariate analysis approach, it will allow us to identify potential effect modifiers in music-based intervention for treating BPSD.

Objective: This population-based study aimed to evaluate the association of mental health and several sleep conditions with Social Frailty (SF) in a sample of Iranian middle-aged and older adults.

Method: This cross-sectional study was conducted using data from the Ardakan Cohort Study on Aging (ACSA). SF was assessed by five questions: inability to help others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to (HALFT). Based on the responses, the participants were divided into three groups: social robust (a score of 0), pre-SF (a score of 1-2), and SF (a score of ≥3). Mental health factors included depression and anxiety. Within the domain of sleep conditions, considerations included sleep duration, quality, subjective sleep health, and daytime sleepiness. The logistic regression models were employed to analyze the data.

Results: A total of 5782 subjects participated in the study, with females comprising 50.7% of the sample. This study revealed the total prevalence of pre-SF and SF were 76.4 and 9.3%, respectively. After adjusting for age, sex, marital status, education, number of comorbidities, and mental health, in the age group of 50-60 years, anxiety (borderline and abnormal compared to normal, OR = 1.49, 95% CI: 1.05-2.11 and OR = 1.98, 95% CI: 1.26-3.12, respectively) were associated with SF. Similarly, in the age group of 60 years and above, only depression was associated with SF (OR = 2.24, 95% CI: 1.45-3.44).

Conclusion: These findings imply that mental health might contribute to SF in the middle-aged and older Iranian population.

Objectives: Older care recipients have different types of care networks, varying from spouse-only to large mixed care networks, that add to different levels of wellbeing. Applying Self-Determination Theory (SDT) to the care context, we argue that the care network composition may foster or hamper the three basic needs for wellbeing: relatedness, autonomy and competence.

Method: Data are from ten observations between 1992 and 2022 of the Longitudinal Aging Study Amsterdam (N = 18,434 observations from 4,837 older Dutch adults). Five care network types are used: no care, partner, informal, formal or privately paid care. Mixed-hybrid-multilevel regression analysis of depressive symptoms as measure of wellbeing is applied on care network type and loneliness, mastery and care sufficiency as indicators of the three basic needs for wellbeing.

Results: Receiving care from a partner care network is, compared to the formal care network, the most negatively associated with depressive symptoms, followed by informal care and privately paid care. Differences in care network types existed in loneliness and care sufficiency, but not in mastery, and in part explained the association between care network types and depressive symptoms. Results of between and within effects are comparable.

Conclusion: Using a rich data set and advanced methodology support the hypotheses that formal care networks hamper wellbeing due to insufficient care and increased loneliness, in particular compared to partner and informal care. The role of mastery was less important, possibly because it does not measure care related level of control.

Objectives: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months.

Method: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data.

Results: In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times.

Conclusion: Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality.

Objectives: Depression is one of the main causes of disability worldwide and makes a major contribution to the global disease burden, especially in developing countries. It is also one of the most prevalent psychiatric disorders in the older people and a significant risk factor for both disability and death. Despite the fact that little research has been done on it among those who live in sub-Saharan Africa, especially Ethiopia, the aim of this study was to fill the above-mentioned gap among older people.

Method: A community-based cross-sectional study was conducted from April to June 2023. A total of 607 older people were included using the multistage sampling technique. An interview-administered questionnaire was used to assess depression using the Geriatric Depression Scale item 15 with a cut-off ≥5. For statistical analysis, the binary logistic regression model was employed.

Results: The mean age of the study participants was 72.45 (SD ±9.08) years. The prevalence of depression was found to be 45%. Age 80 years and above, 70-79 years, widowed, retired, known chronic disease, and poor social support were associated factors with depression.

Conclusion: Compared to other studies conducted in different regions of Ethiopia, the prevalence of depression in this study was found to be high, at 45%. The results of this study may be taken as providing health professionals, health policymakers, and other pertinent stakeholders' early warning signs and guidance on how to take efficient control measures and conduct periodic monitoring among older people.

Objectives: The current study aimed to evaluate the relationship between subjective cognitive complaints (SCC) and compensatory strategy (CS) use in a diverse sample of non-Latinx White (NLW), Black, and Latinx American older adults.

Method: 807 older adults (M_age = 65.38, 62.7% female) were recruited through Amazon's Mechanical Turk (MTurk) and Qualtrics Panel to complete questionnaires on SCC and CS use. Kruskall-Wallis tests were used to evaluate differences in SCC across groups given non-normal distributions. Analysis of variance (ANOVA) was used to evaluate group differences in CS use. The PROCESS macro for SPSS was used to examine whether demographic factors moderated the relationship between SCC and CS use.

Results: NLWs reported higher levels of SCC and greater overall use of CS in comparison to Latinx and Black individuals. Several demographic and psychosocial factors including age, ethno-racial group, education, and anxiety level were found to be associated with CS use. Education was found to moderate the association between SCC and CS use.

Conclusion: Inconsistent with prior studies, our study found that NLWs reported the highest levels of SCC. CS were used across all racial/ethnic groups, but the frequency of CS use may be impacted by education level. While all education groups increased their CS in response to higher levels of SCC, this increase was more substantial for those with lower levels of education. Future work should consider individuals' cultural and educational background when examining SCC and/or developing CS-based intervention for the aging population.