Aging & Mental Health最新文献

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.

Objective: This study investigated gender differences in factors related to turnover intention among working family caregivers of people with dementia (PwD). Turnover intention was defined as an employee's stated willingness to leave the organization within a set timeframe. The analysis considered inter-role conflicts between caregiving and work, caregivers' physical and psychological status, caregiving demands/resources and work demands/resources.

Method: This web-based cross-sectional study included 1003 working caregivers for PwD (575 men, 428 women). Data were analysed using multiple linear regression models according to gender.

Results: For men, the factors significantly associated with higher turnover intention for caregiving were higher interference of caregiving with work, depressive mood, poor sleep quality, being the primary caregiver, being not satisfied with day services, and greater interpersonal conflict in the workplace. For women, the factors significantly associated with higher turnover intention for caregiving were higher interference of work with caregiving, poor perceived health status, more night-time nursing care days, and higher interpersonal conflict in the workplace.

Conclusion: Factors related to turnover intention for caregiving differed between men and women, suggesting that a gender-specific approach is important in preventing people from turnover and supporting them in balancing work and caregiving responsibilities.

Objectives: Older adults with personality disorders often present in mental health care with chronic and/or treatment resistant affective disorders. This study investigated symptom reduction and improvement of functioning by following an intensive, short-term, day treatment, schema therapy program for this patient group.

Methods: A pre-post treatment study evaluating a schema therapy day-treatment (20 wk, 12 hrs) for 30 older (≥60 years) adults with a personality disorder and a comorbid affective disorder. Outcomes measures are the Manchester Short Assessment of Quality of Life, the Young Schema Questionnaire-L2, the Inventory of Depressive Symptomatology-Self Report version, and the Geriatric Anxiety Inventory. Change in outcome measures were expressed as pre-post Cohen's d effect sizes as well as the proportion of patients that improved (reliable change according to Jacobson-Truax) or recovered (clinical significant change according to norm scores).

Results: Cohen's d effect sizes ranged between 1.15 and 1.63. The proportion of patients who recovered ranged from 23% (depression), 40% (schema severity), 43% (Quality of Life) to 57% (anxiety).

Conclusions: Pre-post effect sizes were comparable to younger age groups and larger compared to our previous study evaluating day-treatment based on cognitive-behavioral therapy. Considering these promising results and chronicity of late-life affective disorders, a well-designed randomized controlled trial is warranted.