Aging & Mental Health最新文献

Objectives: There is a knowledge gap on resilience and its impact on mental health of Africans who survive a stroke. We describe the trajectory of psychological resilience and its association with depression and quality of life (QoL) across the first poststroke year in Nigeria.

Method: Prospective observational study of 150 survivors of a first ever stroke. Resilience was ascertained at 3 time-points prospectively over 12 months using the 25-items Resilience Scale (RS). Depression and QoL were also assessed at baseline and follow-up, respectively using the centre for epidemiologic studies depression scale (CES-D 10) and health related quality of life in stroke patients (HRQOLISP-26). Associations were investigated using regression models and presented as adjusted odds ratios (OR) and Wald test coefficients within 95% confidence intervals (CI).

Results: Resilience improved across time points of measurement (p < 0.001). In multivariate logistic regression analyses adjusted for the effect of age, education, alcohol use, and hypertension, higher resilience was associated with male sex (OR = 5.3, 95% CI= 1.7, 17.2), younger age (OR = 4.8, 95% CI = 1.5,15.7), and baseline hypertension (OR= 0.2, 95% CI ≤ 0.1,0.8). In similarly adjusted mixed effect linear regression analyses, higher resilience was associated with improvement in depression (months 12= -4.2, 95% CI= -5.6, -2.8) and quality of life (months twelve = 5.2, 95% CI = 2.2, 8.2) overtime.

Conclusion: Resilience, which was associated with better mental health and wellbeing of stroke survivors, was less likely with hypertension. Results suggest an important role for control of vascular risk factors as part of resilience interventions to promote poststroke recovery.

Objectives: To examine (1) how visual green space quantity and quality affect depression among older adults; (2) whether and how the links may be mediated by perceived stress, physical activity, neighbourhood social cohesion, and air pollution (PM_2.5); and (3) whether there are differences in the mediation across visual green space quantity and quality.

Method: We used older adults samples (aged over 65) from the WHO Study on Global Ageing and Adult Health in Shanghai, China. Depression was quantified by two self-reported questions related to the diagnosis of depression and medications or other treatments for depression. Visual green space quantity and quality were calculated using street view images and machine learning methods (street view green space = SVG). Mediators included perceived stress, social cohesion, physical activity, and PM_2.5. Multilevel logistic and linear regression models were applied to understand the mediating roles of the above mediators in the link between visual green space quantity and quality and depression in older adults.

Results: SVG quantity and quality were negatively related to depression. Significant partial mediators for SVG quality were social cohesion and perceived stress. For SVG quantity, there was no evidence that any of the above mediators mediated the association.

Conclusion: Our results indicated that visual green space quantity and quality may be related to depression in older adults through different mechanisms.

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: This study examined whether changes in optimism in older adulthood are associated with subsequent health and wellbeing outcomes.

Method: Longitudinal data are from the Health and Retirement Study, a nationally representative sample of U.S. older adults (N = 12,998, 2006/2008 to 2014/2016 waves). To evaluate changes in optimism, we examined optimism assessed in 2010/2012 and adjusted for optimism assessed 4 years earlier in 2006/2008 in regression models, which, under the specified statistical models, is equivalent to assessing changes in optimism during the 4-year interval. We examined 35 outcomes assessed in 2014/2016, including: indicators of physical health, health behaviors, psychological distress, psychological wellbeing, and social factors.

Results: Increases in optimism (e.g. from the lowest to highest quartile) were favorably associated with several physical health outcomes such as a reduced risk of mortality (relative risk [RR] = 0.76; 95% confidence interval [CI]: 0.62, 0.94) and better self-rated health, but were not associated with specific disease outcomes (e.g. diabetes, stroke) or health behaviors. Increased optimism was also inversely associated with all psychological distress indicators and positively associated with multiple aspects of psychosocial wellbeing.

Conclusion: An optimistic mindset may be desirable in its own right. Increased optimism may also enhance health and wellbeing among older adults.

Objectives: The COVID Stress Scales (CSS) represent a widely used self-report measure of stress and anxiety-related responses to COVID-19. Although the CSS have been validated across various nations and languages, their psychometric properties have not been assessed at the factor- or item-level with older adults. We aimed to psychometrically evaluate the CSS in older adults.

Method: The CSS was examined with 486 North American older adults aged 65 years and older. Data were collected in January 2024 using Qualtrics Panels. Reliability was assessed using Cronbach's alpha and McDonald's omega coefficients, structural validity using confirmatory factor analysis, and discriminant validity using a social desirability measure. Item properties were examined using item response theory.

Results: The CSS demonstrated robust internal consistency and a defensible five- and six-factor structure, with the six-factor providing the most optimal model of measurement. All items adequately discriminated among respondents with varying levels of COVID-related stress.

Conclusion: This study is first to demonstrate that the CSS functions as a reliable and valid tool for evaluating COVID-related stress among older adults, a necessary step for supporting its use in assessing mental health impacts of pandemics in a population at high risk of negative post-infection outcomes.

Objectives: This study developed the Subjective Cognitive Function Decline Scale for Middle-aged South Koreans (SCFD-K), addressing the need for early detection of potential mild cognitive impairment. This study fills a gap in the existing research, which mainly targeted older demographics or generalized cultural differences.

Method: We conducted focus group interviews (FGIs) among 36 participants and with nine experts to answer basic questions related to cognitive decline, after which we developed a draft scale using the Delphi with another 15 experts. To examine the reliability and validity of the scale, an online survey of 2,000 people was conducted.

Results: An exploratory factor analysis identified four distinct factors, which are language, visuospatial function, personality/emotion, and memory, with a total of 20 items (Cumulative variance ratio = 57.76), and a confirmatory factor analysis validated the four-factor structure with a good model fit (CFI = 0.932, TLI = 0.921, RMSEA = 0.057, and SRMR = 0.042) and acceptable internal consistency (Cronbach's α = 0.735-0.907).

Conclusion: This analysis established the SCFD-K as a reliable and valid tool for assessing cognitive decline among middle-aged South Koreans. The findings have key cultural implications and inform proactive interventions and shaping future healthcare strategies in South Korea.

Objectives: Few studies have examined the bidirectional association between loneliness and functional limitations longitudinally. The current study aimed to explore the causal relationship between loneliness and functional limitations over time (2008 to 2016; T1-T3) using data from the Health and Retirement Study (HRS).

Method: Including 7,046 older American adults (M = 69.17, SD = 10.32) from the HRS, a random intercept cross-lagged panel model (RI-CLPM) was computed to examine carry-over and spill-over effects over time. The RI-CLPMs enable separating the within-person fluctuation from the between-person differences.

Results: The results revealed greater levels of loneliness and a greater number of functional limitations have bidirectional associations at the within-person level from 2012 to 2016. A significant between-person level association was also observed between loneliness and functional limitations, such that greater loneliness levels and greater degree of functional limitations were correlated at the between-person level.

Conclusion: This finding that loneliness and functional limitations shape one another in later life will benefit policymakers, healthcare providers, and researchers in developing targeted interventions and support systems for older adults. Designing interventions addressing both aspects concurrently will enable breaking the potential cycle of negative consequences of loneliness and health among older adults.

Objectives: Aging brings memory changes that can be concerning for some older adults. Whereas in-person memory interventions can positively impact knowledge, mental health, and behavioural outcomes, self-guided e-learning programs may offer scalable and accessible alternatives to in-person programming. The current study aimed to evaluate efficacy of an e-learning program compared to no treatment.

Method: The trial was registered at ClinicalTrials.gov (NCT03602768). As part of a larger, multi-arm, controlled trial, healthy older adults (ages 60-84, 71% female) were randomized into an intervention or a delayed-start control condition. Data collection personnel were masked to participant grouping. Outcome measures were completed through telephone interviews and online questionnaires at baseline, immediate post-intervention, and 6- to 8-week follow-up.

Results: Among 115 analyzed participants, there were larger improvements over time in memory knowledge, memory strategy acquisition and daily use, and self-reported memory satisfaction and ability in the group that completed the intervention than in the control group. There was no interaction effect for health-promoting behaviors. Intention-to-treat analyses showed attenuated but largely similar findings.

Conclusion: This self-guided e-learning memory program demonstrated similar clinical outcomes provided by in-person, facilitator-led programs. It may serve as an effective first-line treatment for older adults presenting with memory concerns in clinical settings.

Objectives: This study was conducted to determine the effect of Cognitive Stimulation Therapy (CST) on apathy, loneliness, anxiety, and activities of daily living of individuals with Alzheimer's disease.

Method: The study was conducted in a daily care center between January 2023 and January 2024 in a randomized control study. A total of 52 people, 26 intervention and 26 control groups, were enrolled in the study and formed the sample of the study. Demographic Information Form, Apathy Evaluation Scale (AES-C), Geriatric Anxiety Scale (GAS), UCLA Loneliness Scale Short Form (UCLA-SF), and Functional Impairment in Dementia Scale (DAD) were used in the study.

Results: After the intervention, it was found that the intervention group's levels of apathy, loneliness and anxiety were significantly reduced compared to the control group. In the intra-group comparisons, it was found that there was a significant difference between the pre-test and post-test scores of the AES-C, UCLA-SF, GAS of the individuals in the intervention group after the application of CST, and between the pre-test and pre-test scores of the DAD (p < 0.05).

Conclusion: CST was found to be effective in reducing apathy, loneliness and anxiety levels and increasing daily living activities in older people with Alzheimer's disease.

Objectives: Mounting evidence signals that cohabitation operates as an alternative to remarriage in later life. However, others have maintained that cohabitation is an incomplete institution marked by less favorable outcomes than remarriage. We appraise these two frameworks by examining the well-being of remarried and previously married cohabiting older adults.

Method: Drawing on the 2010-2020 Health and Retirement Study, we assessed whether remarried and previously married cohabiting older adults differed in their depressive symptoms and loneliness. We also tested whether the association between relationship quality and well-being varied by union type.

Results: Among women, cohabitors reported higher levels of depressive symptoms than their remarried counterparts. In contrast, union type was not appreciably associated with men's depressive symptoms. Meanwhile, among men, cohabitors reported less loneliness, on average, than did those in remarriages. No corresponding union-type differential emerged among women. Additionally, the association between relationship quality and psychological well-being did not differ by union type for both men and women.

Conclusion: Our study largely aligns with the notion that cohabitation functions as an alternative to remarriage in later life. The growth of cohabitation among older adults, coupled with its distinct purpose during this life stage, underscores the importance of advancing this nascent line of inquiry into its role in older adults' well-being.