Aging & Mental Health最新文献

Objectives: Financial inclusion has been linked with health outcomes. However, the association between financial inclusion and sleep problems (SP) is limited in old age and the mediators of this association are largely unknown. This study examines the association of financial inclusion with SP among older adults in Ghana. It also explores how food insecurity and emotional pain explain this association.

Method: A multi-stage cluster sample (N = 1201) from the AgeHeaPsyWel-HeaSeeB study was analyzed. We measured financial inclusion using the eight-item Financial Instrument Questionnaire Scale, and SP was assessed using nighttime/daytime challenges over the last 30 days. To estimate the associations, we fitted multiple OLS models and employed bootstrapping procedures using the PROCESS macro.

Results: Data from 1201 individuals aged 50 years or older were analyzed (mean age, 66.1 years; 63.3% female). After adjustment, financial inclusion was negatively associated with SP (B = -0.079, p < 0.01), food insecurity (B = -0.076, p < 0.001), and emotional pain (B = -0.033, p < 0.01). These associations were significant in males and females. In the mediation models, food insecurity (63.9%) and emotional pain (24.1%) significantly explained the association between financial inclusion and SP.

Conclusion: Reducing SP in old age may require interventions addressing financial hardship, food insecurity, and emotional pain.

Objectives: Older adults may be particularly vulnerable to the negative effect of distress on cognition, thus explaining cognitive behavioral therapy's (CBT's) diminished efficacy for generalized anxiety disorder (GAD) in later life. Emotion-centered Problem Solving Therapy (EC-PST) may address this and other barriers to skill acquisition.

Method: This single-arm pilot aimed to determine the feasibility of 6-session EC-PST to achieve clinically significant improvements in anxiety and/or worry symptoms in adults aged 55+ with GAD. Secondary analyses also examined reductions in depressive symptoms and assessed participant satisfaction with treatment components.

Results: Sixteen adults aged 58 to 83 years old with current GAD were enrolled. Fourteen participants completed treatment. Twelve participants (85.7%) had a clinically significant pre- to post-treatment reduction in anxiety and/or worry symptoms. Additionally, nine (64.2%) had a clinically significant reduction in depressive symptoms. Qualitative feedback indicated a high level of satisfaction based on themes of reduced avoidance, increased confidence in managing anxiety, and feeling more in control of life problems.

Conclusion: Findings support feasibility and acceptability of EC-PST for GAD in middle-aged and older adults that is worthy of follow up in a randomized controlled trial given the limited options for evidence-based therapy in later life anxiety.

Objectives: The aim of this study was to assess the effectiveness of a dementia awareness and stigma reduction program among the Arab minoritized population in Israel. Specifically, we examined changes in knowledge, stigma, perceived susceptibility, and support sources following community-based informational sessions conducted by trained Arab student facilitators.

Methods: A mixed-methods approach was used. A pre-post design with 1349 participants was employed for the quantitative component, assessing changes in subjective and objective knowledge, stigma, perceived susceptibility, and support sources. The qualitative component included in-depth interviews with 40 student facilitators to explore their experiences and insights. Data were analyzed using descriptive statistics, regression analyses, and thematic content analysis.

Results: The findings revealed significant increases in dementia knowledge, positive emotional reactions, and use of formal support sources. However, no significant changes were observed in perceived susceptibility, negative emotional reactions, or behavioral discrimination. Qualitative findings highlighted facilitators' role in challenging misconceptions, fostering engagement, and addressing cultural barriers to dementia discussions.

Conclusion: The program effectively enhanced dementia knowledge and encouraged community dialogue but had limited impact on deep-seated stigma. Future initiatives should incorporate sustained interventions and culturally tailored messaging to further promote dementia awareness and reduce stigma in minoritized communities.

Background and objectives: The current study's model, derived from The Developmental Model of Adaptation, investigated the associations of past influences, closeness to parents, and two assessments of current influences (religiosity and social support) on the wellbeing (depressive symptomatology and life satisfaction) of very old adults.

Research design and methods: Cross-sectional data came from a convenience sample of 154 cognitively intact, community-dwelling, Oklahoma centenarians. SPSS was employed to assess descriptive statistics and associations among all constructs; Mplus was employed to test a mediational path model linking closeness to parents on life satisfaction and depressive symptomatology through religiosity and social support.

Results: Social support was a current influence significantly associated with depressive symptomatology and life satisfaction, whereas religiosity only associated with life satisfaction - not depressive symptomatology. A significant indirect effect of closeness to parents through social support to life satisfaction was found.

Conclusion and implications: The noteworthy finding of a positive indirect effect from closeness to parents on satisfaction with life through social support highlights the association of positive relationships with parents and the wellbeing for very old adults. This finding supports utility of reminiscence therapy and evidence-based programming focusing on strong parent-child relationships.

Objectives: Research highlights the lack of knowledge of assessment and management of delirium in health care staff. A range of educational approaches have been reported to address this deficit. A detailed review of the literature is useful to examine the approaches used and their impact. The objective of this review is to explore the effectiveness and impact on practice of educational interventions for the management of delirium in care settings for older adults.

Method: A mixed methods systematic review was conducted, adopting the PRISMA reporting guidelines. Four databases were searched: CINAHL, PsychInfo, Medline and ProQuest. The articles were screened independently for inclusion and selected studies were quality appraised using MMAT. Narrative synthesis was conducted on quantitative studies and thematic analysis on qualitative studies (total n = 22).

Findings: Most studies found some improvement in knowledge of delirium after intervention. Improvements were noted in screening and assessment practice, although questions remained over screening competence. In terms of identifying facilitators for education, two main themes were developed including 'active learning' and 'change facilitators and inhibitors'.

Conclusion: Whilst interventions were successful in increasing knowledge, there is still work to be done in increasing screening competence and incorporating active learning strategies into education about delirium.

Objectives: This study examines the relationship between depression and cognitive performance in older adults and explores how cognitive reserve (CR) - measured through a composite score of education, occupational complexity, and cognitive activities, as well as each individual component - moderates this relationship over a 4-year period.

Method: Data from 32,325 participants aged 50+ in the Survey of Health, Aging, and Retirement in Europe (SHARE) were analyzed. Cognitive performance was measured using memory, numeracy, and verbal fluency tests at baseline and after four years. Depressive symptoms were assessed with the EURO-D scale, and CR was evaluated through education, occupational complexity, and cognitive activity engagement. Moderation analyses were conducted using a bias-corrected bootstrap approach with 5,000 resamples.

Results: Lower and average CR levels were linked to a stronger negative association between depression and cognitive performance, while higher CR showed no adverse effects. Education and cognitive activities significantly reduced the impact on cognitive function, whereas occupational complexity had no significant effect.

Conclusion: Cognitive reserve, particularly through education and cognitive activities, moderates the impact of depression on cognitive performance in older adults. Public health strategies should promote CR-enhancing activities to protect cognitive health in later life.

Objective: To investigate the association between visual impairment (VI)-including self-reported near and distance vision and common ophthalmologic conditions-and dementia in a nationally representative sample of older Brazilian adults.

Methods: This study is a secondary analysis using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which surveyed 5,249 individuals aged 60 years and older. Dementia was identified using an algorithm based on cognitive and functional performance. Visual status was assessed through self-report, distinguishing near and distance VI, along with self-reported diagnoses of ophthalmologic conditions. Logistic regression models adjusted for sociodemographic, clinical, and lifestyle variables were used.

Results: Dementia was identified in 364 participants (6.9%). Distance VI was associated with dementia (adjusted OR: 1.68; 95% CI: 1.56-2.44), and there was a significant linear trend between worse self-reported distance vision and greater odds of dementia (p = 0.003). Neither near VI nor any specific ophthalmologic conditions (cataract with/without surgery, glaucoma, macular degeneration, or diabetic retinopathy) were associated with dementia in the adjusted models.

Conclusion: In this nationally representative sample, self-reported distance VI was associated with dementia. This finding may indicate both a modifiable risk factor and an early marker of cognitive decline, warranting longitudinal research.

Objectives: Depressive symptoms and subjective cognition are linked in older adults, but traditional measures have numerous limitations that may be addressed by ecological momentary assessment (EMA). This study examined whether baseline depressive and cognitive measures correspond to daily EMA ratings and evaluated concurrent and lagged relations between mood and subjective cognition.

Method: Fifty-five community-dwelling older adults (31% Black/African American; 44 cognitively healthy, 11 mild cognitive impairment) completed a four-week daily EMA survey assessing mood and subjective cognition. Baseline measures included a global cognitive composite and self-reported depressive symptoms, functional independence, and cognitive decline. Cumulative link mixed models examined associations between baseline and EMA measures and concurrent and lagged EMA relations.

Results: EMA mood correlated with baseline depressive symptoms, while EMA subjective cognition was most strongly associated with functional independence rather than objective cognition or self-reported cognitive decline. EMA mood and cognition were reciprocally associated concurrently. In lagged models, worse EMA subjective cognition predicted worse next-day mood, whereas the reverse association was not statistically significant. Lagged effects were attenuated after accounting for temporal trends and prior-day EMA values.

Conclusion: EMA provides low-burden insights into mood and subjective cognition, supporting its utility for naturalistic assessment in older adults.

Objectives: Pets may be beneficial for people living with dementia but understanding of longitudinal benefits is limited. This study investigated whether having a pet was associated with differences over time in 'living well', cognition, functional ability, depression or loneliness.

Method: This study utilised 3 assessment timepoints from the IDEAL Programme, a longitudinal cohort study of people with mild-to-moderate dementia. The relationships between having a pet, a dog, and caring for a pet (vs no pet/no dog/not caring) and outcome changes were assessed using mixed effects models with data from 1,532 people with dementia at baseline, 1,173 at 12-months and 846 people at 24 months.

Results: People with dementia with a pet had slower decline in informant-rated well-being, satisfaction with life, and self-rated functional ability over time than those with no pet. Those with a dog had slower decline in self-rated quality of life and functional ability, cognitive function, and informant-rated well-being and functional ability than those with a different pet or no pet.

Conclusion: Having a pet may be beneficial for people living with dementia, with dogs offering additional benefits. Enabling people living with dementia to have a pet could help them maintain their independence and ability to live well for longer.

The aim of this study was to assess emotional stress and its associated factors in older people with type 2 diabetes mellitus (DM2), including blood glucose control.

This cross-sectional study was conducted between August 2023 and February 2024, and included 147 participants aged 60 years or older attending primary care centers in Brazil. Participants were interviewed at two public community pharmacies while collecting insulin and diabetes supplies. Emotional stress was assessed using the Diabetes Distress Scale (DDS), with a mean score of ≥3 indicating a high level of emotional stress. Poisson regression was used to assess the factors associated with emotional stress.

The prevalence of emotional stress was 22.5%. Complications from DM2 (prevalence ratio [PR]: 3.19; 95% confidence interval [95%CI]: [1.69-6.03]), symptoms of hypoglycaemia (PR: 2.17; 95%CI: [1.10-64.26]) and being single (PR: 2.95; CI: [1.43-6.07]) were associated with emotional stress.

These results indicate the need for the comprehensive management of patients with DM2 to ensure individualised care according to physical and psychosocial needs. The prevalence of emotional stress was high and correlated with DM2-associated complications, symptoms of hypoglycaemia, and being single.