Aging & Mental Health最新文献

Objectives: One of the reasons why people engage in reminiscences about their past is to maintain intimacy with deceased close others. Although previous research alerts to the negative effects of reminiscence for intimacy maintenance on mental health, little is known about its relation to individuals' reactions to loss (i.e. grief severity and personal growth). In two samples, we focus on time since loss and continuing bonds, to elucidate the role of reminiscence for intimacy maintenance in grief.

Method: The samples comprised 111 and 198 bereaved adults. All participants rated the frequency of reminiscence for intimacy maintenance and loss-related variables, such as time since loss, continuing bonds, and grief severity. Sample 2 additionally completed measures of personal growth, loss-centrality, and their interconnectedness with the deceased.

Results: Reminiscence on intimacy maintenance was positively related to grief severity. This relation was independent of time since loss and partly driven by externalized bonds. Internalized bonds mediated the relation between reminiscence for intimacy maintenance and grief severity (in sample 1) and personal growth (in sample 2).

Conclusion: Continuing bonds help explain why reminiscing for intimacy maintenance can be harmful in terms of grief severity but also fosters personal growth after the loss.

Objectives: To determine a pooled prevalence of depression and its influencing factors among nursing home residents.

Method: PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors.

Results: This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65).

Conclusion: The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.

Objectives: To systematically evaluate the effects of telehealth interventions on the caregiver burden and mental health of caregivers for people with dementia (PWD).

Method: Relevant randomized controlled trials (RCTs) of telehealth interventions on caregivers were extracted from nine electronic databases (PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, SinoMed, CNKI, WanFang, and VIP). The retrieval time was from inception to 26 July 2023.

Results: Twenty-two articles with 2132 subjects were included in the final analysis. The meta-analysis demonstrated that telehealth interventions exerted a significant effect in reducing caregiver burden (SMD: -0.14, 95 % CI: -0.25, -0.02, p = 0.02), depression (SMD = -0.17; 95%CI: -0.27, -0.07, p < 0.001) and stress (SMD = -0.20, 95%CI: -0.37, -0.04, p = 0.01). However, no statistically significant effect was observed on anxiety (SMD = -0.12, 95%CI: -0.27, 0.03, p = 0.12). Moreover, subgroup analysis showed that tailored interventions were associated with more evident reductions in depression (SMD = -0.26; 95%CI: -0.40, -0.13, p < 0.001) than standardized interventions (SMD = -0.08; 95%CI: -0.22, 0.06, p = 0.25). In addition, telehealth was effective in relieving depression in Internet-based (SMD = -0.17, 95%CI: -0.30, -0.03, p = 0.01) and Telephone-based group (SMD = -0.18, 95%CI: -0.34, -0.02, p = 0.03), while there was no significant difference in the Internet and Telephone-based group (SMD = -0.18, 95%CI: -0.54, 0.18, p = 0.32).

Conclusion: Telehealth could effectively reduce the burden and relieve the depression and stress of caregivers of PWD, while its effect on anxiety requires further research. Overall, telehealth has potential benefits in dementia care.

Objectives: Nearly 75% of persons living with dementia (PLWD) in the US live at home and are cared for by informal family members who have limited access to supportive and accessible services, indicating an increased need for these types of services (Alzheimer's Association, 2023). The Alzheimer's Association call centers offer free telephone care consultations, but it currently remains unclear which types of brief telephone support benefit caregivers. This study compares outcomes of participants who received traditional care consultation calls via the Alzheimer's Association National Helpline with care consultation calls from Helpline staff trained in Solution-Focused Brief Strategies (SFBS), a client-centered evidence- and resource-based approach.

Method: Sequential callers were randomly assigned to the "traditional" or "SFBS" care consultation groups and were assessed at the time of call (baseline) and post-call (T1). The outcomes of interest were general self-efficacy (GSE), self-efficacy in managing emotions (PROMIS), caregiver mastery, therapeutic alliance, and goal setting.

Results: Of over 500 callers, callers receiving the SFBS scored higher on therapeutic alliance and goal-setting metrics, such as greater sense of collaboration on goals (effect size = 0.280, p = 0.0005, significant with Bonferroni correction), mutual agreement with care consultant on goals (effect size = 0.418, p < 0.0001, significant with Bonferroni correction), and believing the way the problem was resolved was correct (effect size = 0.286, p = 0.0007, significant with Bonferroni correction) than those receiving the traditional care consultation. Both groups reported improvements in the PROMIS measure, but there were no differences between groups. There were no significant differences in GSE or caregiver mastery scores between groups.

Conclusion: This study provides evidence for the effectiveness of the integration of SFBS in dementia care consultation calls as part of telephone-based supportive services for dementia caregivers.

Objectives: Loneliness has been associated with psychotic-like experiences (PLEs) in the general population, but the mechanisms underlying this association are poorly understood. Theoretical models, corroborated by empirical findings, signify the key role of biased cognition in both loneliness and psychosis. This study tested whether two cognitive biases - Selective Attention to Threat (ATB) and External Attribution Bias (EAB) - account for the association between loneliness and PLEs.

Method: A convenience sample (n = 357) of middle-aged and older adults (aged 40+) was recruited online from the UK population. The parallel mediation model with two the aforementioned cognitive biases as mediators was tested.

Results: A mediation effect between loneliness and PLEs via ATB (ab₁ = 0.441, 95% CI = [0.264, 0.646]) and EAB (ab₂ = 0.354, 95% CI [0.124, 0.627] was established. This model remained significant after controlling for the current symptoms of anxiety and depression.

Conclusion: Greater loneliness was associated with a higher rate of PLEs in the sample of middle-aged and older adults. This association was fully explained by ATB and EAB, independent of the current symptoms of anxiety and depression.

Objectives: Women are twice as likely to be diagnosed with major depressive disorder as men. Yet suicide rates are four times higher in men than women, increasing to six times when comparing older men to older women. Investigators have begun researching if depression presents differently in individuals who adhere to masculine norms, leading to the conceptualization of masculine depression. Despite validity evidence for the Male Depression Risk Scale-22 (MDRS-22) in mixed-age samples, few studies have investigated the possibility of age-related differences in masculine depression. The present study aimed to test for age invariance of the MDRS-22.

Method: Age invariance for the MDRS-22 was tested via a multi-group confirmatory factor analysis with groups of younger (18-64 years) and older (65+ years) males (N = 469).

Results: Age invariance for the MDRS-22 was not established, ΔX² = 451.47, Δdf = 16, p < 0.001.

Conclusion: Results of the study indicate that masculine depression may present differently between younger and older men. To fully understand the construct of masculine depression, it is important to investigate how symptoms may present in individuals of all ages. Overall, the study highlights the importance of investigating how masculine depression may present differently in older men.

Objectives: This study investigates the correlation between self-reported sensory impairment, cognitive function, digital technology use, and social participation among older adults in South Korea.

Method: Data from the 2020 National Survey of Older Koreans, comprising a nationally representative sample of 7849 individuals aged 65 years or older, were analyzed. A serial mediation analysis (Model = 6) was conducted using the PROCESS macro for SPSS.

Results: Following adjustment for covariates, cognitive function and digital technology use serially mediated the relationship between self-reported sensory impairment and social participation among older adults (B = -0.0020, SE = 0.0005, 95% confidence interval [CI] = [-0.0030, -0.0010]). Specifically, self-reported sensory impairment exhibited a negative correlation with cognitive function (B = -0.3277, SE = 0.0753, p < .001), which was positively associated with digital technology use (B = 0.0763, SE = 0.0056, p < .001), subsequently linking to enhanced social participation (B = 0.0784, SE = 0.0037, p < .001).

Conclusion: Through cross-sectional analysis, this study confirms that self-reported sensory impairment in older adults may precede cognitive decline, hindering digital technology use and reducing social participation. Early diagnosis and treatment are crucial in preventing cognitive decline, while age-friendly digital devices may alleviate cognitive burden and promote social engagement.

Objectives: Playfulness describes individual differences in (re)framing situations in a way that they are experienced as interesting, intellectually stimulating, or entertaining. We extended the study of playfulness to groups of middle- and higher age and examined the relations of four facets of playfulness (Other-directed, Lighthearted, Intellectual, and Whimsical) to indicators of positive psychological functioning.

Method: We collected self-report data from 210 participants aged between 50 and 98 years.

Results: The playfulness expressions in this age group were comparable to younger adults. We found that playfulness relates to life satisfaction, the PERMA domains of well-being, and character strengths with small-to-medium correlation effect sizes. The OLIW facets showed differential associations, with regression analyses revealing that particularly Other-directed is positively associated with positive psychological functioning.

Conclusion: Our findings highlight the importance of playful relationships across the lifespan. We discuss the findings regarding the role of playfulness for healthy aging.

Objectives: People with dementia (PwD) and their care partners (CP) may have difficulties in emotion regulation, and individual differences in emotion regulation may be related to PwD's neuropsychiatric symptoms. This study explores whether there is self-awareness of PwD's difficulties in emotion regulation and whether CP's emotion regulation relates to the PwD's neuropsychiatric symptoms, potentially revealing bias or interpersonal effects.

Method: We used data from the Wish Outcome Obstacle Plan Study with a sample of 45 PwD and their spousal CP (n = 90 individuals). Multivariate linear regression models were used to investigate the associations between the CP-reported neuropsychiatric symptoms in PwD and self-reports of emotion regulation in both dyad members, net of sociodemographic and health factors. Separate analyses were conducted for each neuropsychiatric subsyndrome and each domain of difficulties in emotion regulation.

Results: Increasing severity of neuropsychiatric symptoms was associated with higher difficulties in emotion regulation in PwD (ß = 1.23, p < 0.05), but not with CP's difficulties in emotion regulation. When CP reported more severe neuropsychiatric symptoms in PwD, PwD reported that they had difficulties in accepting emotions, controlling impulses, goal-directed behaviors, and accessing emotion regulation strategies, but not in emotion awareness and clarification. Proxy-reports of hyperactivity and psychosis subsyndromes are significantly related to PwD's self-reported difficulties in emotion regulation.

Conclusion: PwD reported difficulties in emotion regulation at the early stage of dementia. Proxy-reported neuropsychiatric symptoms may capture PwD's emotion regulation capability and not be biased by CP's difficulties in emotion regulation.