Aging & Mental Health最新文献

This study investigates the mediating roles of spiritual well-being, meaning in life, and religiosity in the relationship between loneliness and mental well-being among Turkish older adults who have experienced spousal loss. The sample consisted of 403 participants aged between 65 and 84 (M = 72, SD = 5.20), all of whom had lost their spouses. The findings revealed that spiritual well-being, a sense of meaning in life, and levels of religiosity significantly influenced the relationship between loneliness and mental well-being. Participants with stronger spiritual orientation, a greater sense of meaning in life, and higher levels of religiosity reported lower levels of loneliness and higher levels of mental well-being. These results highlight the crucial role of culturally shaped spiritual, religious, and meaning-oriented coping strategies in enhancing mental well-being. Furthermore, the findings underscore that healthy aging is a multidimensional process supported not only by physical health but also by psychological and spiritual integrity. The study also suggests that culturally sensitive interventions aimed at strengthening spiritual and existential resources may be effective in supporting the mental well-being of older adults who have experienced spousal loss.

Objectives: Given that Mild Cognitive Impairment (MCI) represents a transitional stage between normal aging and dementia, this study examined whether non-pharmacological interventions could effectively improve cognitive function and slow cognitive decline in Chinese community-dwelling older adults with MCI.

Method: This study was conducted to identify randomized controlled trials involving non-pharmacological interventions for preventing dementia in Chinese community settings. A comprehensive literature search was performed across 10 electronic databases through December 2024. Two reviewers independently assessed research quality using the Cochrane Risk of Bias Tool 1. Statistical analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs) to synthesize outcomes data.

Results: The included studies (n = 19) evaluated cognitive changes in response to non-pharmacological interventions, which showed significant cognitive improvements (MD: 2.08, 95% CI [1.30, 2.85], p < .001). Both multi-domain (n = 10) and single-domain interventions (n = 9) demonstrated cognitive benefits across 2705 MCI participants. Multi-domain interventions (MD: 3.39, 95% CI [2.03, 4.76], p < .001) showed greater benefits than single-domain approaches (MD: 1.41, 95% CI [0.87, 1.96], p < .001). Our findings also revealed significant beneficial effects on multi-domain interventions, including multiple exercises (MD = 5.40, 95% CI [3.90, 6.90]), combined multiple types of approaches (MD = 3.34, 95% CI [1.11, 5.58]), and multiple cognitive trainings (MD = 2.26, 95% CI [1.67, 2.84]).

Conclusion: Non-pharmacological interventions significantly enhanced cognitive function among Chinese community-dwelling older adults with MCI. Furthermore, multi-domain approaches demonstrated superior efficacy compared to single-domain strategies. Specifically, exercise-based interventions, combined modality programs, and cognitive training protocols all exhibited substantial effectiveness for improving cognitive outcomes in this population.

Objectives: This study examines the long-term relationship between loneliness and depressive symptoms in older U.S. adults over 16 years.

Method: Data were drawn from the Health and Retirement Study, specifically Waves 8 (2006) and 16 (2022). Two samples were created: (1) participants aged 60+ without depressive symptoms in 2006 (n = 790) to examine whether baseline loneliness predicts later depressive symptoms, and (2) participants not lonely in 2006 (n = 788) to examine whether baseline depressive symptoms predict later loneliness. Loneliness was measured using the Revised UCLA Loneliness Scale, and depressive symptoms were assessed with a modified 7-item CES-D scale. Descriptive statistics and logistic regression models were used.

Results: Older adults who reported loneliness in 2006 had nearly twice the odds of developing depressive symptoms by 2022 compared to their non-lonely counterparts (AOR = 1.98, 95% CI: 1.06-3.69). Baseline depressive symptoms also increased the likelihood of later loneliness (AOR = 1.70, 95% CI: 1.04-2.79). Additionally, cognitive impairment was associated with later loneliness, with women and individuals with poorer self-rated health at higher risk of developing depressive symptoms.

Conclusion: The findings reveal a strong link between loneliness and depressive symptoms in later life, emphasizing the need for interventions that tackle both issues together.

Objectives: Caregivers of dementia patients often experience elevated stress and negative affect, yet daily fluctuations in these experiences and their relation to attachment style and relationship quality (RQ) remain underexplored.

Method: For 14 days, we assessed the daily experiences of 35 dementia caregivers, including their positive and negative affect, stress, attachment, and relationships.

Results: Results from multilevel modeling showed that more positive current RQ was related to lower daily stress. In contrast, a more negative RQ, combined with greater attachment anxiety and avoidance, correlated with increased negative emotions and stress.

Conclusion: These results underscore how the daily emotional lives of dementia caregivers in a primarily middle-to-late adulthood sample (mean age = 57.5 years) are formed by current relationship dynamics and attachment styles. These results point to possible intervention strategies that may improve caregiver well-being.

Objectives: This review synthesizes the current literature on the relationship between dementia worry (DW), or anxiety about dementia, and depressive symptoms.

Method: A comprehensive literature search was conducted between September and October of 2024. The following databases were searched: PubMed, PsycINFO, CINAHL, SCOPUS, and Web of Science. Studies were included if they were published in peer-reviewed journals, available in English, and included statistical analyses between DW and depressive symptoms. Articles were excluded if they did not measure DW and depressive symptoms or statistically analyze the relationship between them. Data on sample characteristics, study quality, measures, statistical analyses, and results were examined to inform conclusions.

Results: This review included 20 studies with 18 distinct samples, totaling 9,288 participants. Thirteen studies found significant relationships between DW and depressive symptoms, three were not significant, and three had mixed findings.

Conclusion: DW and depressive symptoms co-occur, but this relationship may vary based on sex and exposure to dementia. Conclusions were drawn based on the strengths (e.g. multiple covariates) and weaknesses (e.g. cross-sectional design) of each study reviewed. Implications for clinical practice and future research are discussed.

Objectives: Mild cognitive impairment (MCI) is considered a prodromal stage of Alzheimer's disease (AD) with a 10-15% annual conversion rate. This study aimed to explore the role of the personality traits Conscientiousness and Neuroticism in predicting conversion from MCI to AD, and worsening dementia severity.

Method: This retrospective, longitudinal study enrolled 69 older adults diagnosed with MCI. At the baseline assessment, the outcomes of interest were Folstein Mini-Mental State Exam (MMSE), Lawton Brody Instrumental Activities of Daily Living scale (LB-IADL), and Clinical Dementia Rating Sum of Boxes (CDR-SB).

Results: Lower baseline Conscientiousness significantly predicted conversion from MCI to probable AD (OR =0.945, p = 0.043). Higher baseline Conscientiousness was also associated with better cognitive performance at follow-up, as indicated by higher MMSE scores (B = 0.158, p = 0.001) and lower CDR-SB scores (B = -0.083, p = 0.008). In contrast, higher baseline Neuroticism significantly predicted poorer functional outcomes, reflected by higher LB-IADL scores at follow-up (B = 0.296, p = 0.006).

Conclusion: This study replicates prior findings by indicating that Conscientiousness and Neuroticism predict disease course in a clinic sample, using measures of disease transition, cognitive worsening and decline in instrumental ADLs. Conscientiousness is a brief measure that can be applied routinely in the real-world clinic setting.

Objectives: Older adults with pain are at risk for developing depression. Although personality traits, including internal locus of control (LOC) and conscientiousness, are linked to fewer depressive symptoms, their potential protective role among Mexican adults aged 50 and older with pain is not well understood.

Method: We used data from the Mexican Health and Aging Study (2015 and 2018) and included participants who reported frequent pain at both waves (n = 2274). LOC and conscientiousness were measured continuously in 2015, with higher scores indicating a more internal LOC or conscientious personality. We combined depressive symptoms from 2015 and 2018 to create four-level outcome: stable low/no depression (<5/<5), recently remitted (5+/<5), recent onset (<5/5+), and recurrently high (5+/5+). We used multinomial logistic regression models to assess the association between personality and depressive symptoms.

Results: A more internal LOC was associated with a lower risk of recurrently high depressive symptoms [relative risk ratio (RRR): 0.81, 95% confidence interval (CI): 0.72, 0.92). Greater conscientiousness was associated with lower risk of recent-onset [(RRR: 0.87, 95% CI: 0.76, 0.998) and recurrently high depressive symptoms (RRR: 0.87, 95% CI: 0.77, 0.97).

Conclusion: Interventions to modify LOC and conscientiousness may be helpful in pain management by mitigating comorbid depressive symptoms.

Objectives: This study explored the social out-of-home participation experiences of people with dementia and their informal caregivers from a capability-based approach.

Method: Twelve dyadic interviews with people with dementia living in the community and their informal caregivers were conducted. Data were inductively coded using a reflexive thematic analysis approach.

Results: All participants with dementia experienced changes in activities, social interactions or out-of-home mobility, captured in the overarching theme of 'social participation: a changing world'. Four subthemes captured the primary strategies participants used to navigate these changes: (1) creating a sense of comfort and safety in nearby, quiet, and familiar places; (2) pursuing a sense of social identity through meaningful connections; (3) accepting support to maintain independence; and (4) finding a balance, as described by informal caregivers, between their own social needs and those of their spouses. These themes highlight the agency of people with dementia in shaping their social participation amid changes in capabilities and environments.

Conclusion: This study contributes to a more nuanced understanding of social participation in dementia, emphasising the importance of supportive environments that recognise both capabilities and needs can enable continued engagement and foster social health.

Objectives: This study examines the relationship between religious attendance and depressive symptoms among older adults in the United States, focusing on the potential mediating role of church-based social ties.

Method: Longitudinal data from the Health and Retirement Study (2010-2018) were analyzed, including 10,467 respondents over age 50 at baseline. Associations between religious attendance (2010), church-based social ties (2012), and depressive symptoms (2014-2018) were assessed using a series of regression models. Mediation analysis was conducted using generalized structural equation models with bootstrapped confidence intervals.

Results: More frequent religious attendance in 2010 predicted fewer depressive symptoms in 2014, 2016, and 2018. Church-based friendship, but not church-based relatives, significantly mediated these associations.

Conclusion: Religious attendance may protect against later-life depressive symptoms by fostering church-based friendships. Faith-based organizations might consider promoting such connections to support older adults' mental health.

Objectives: The study examined the dynamics among social isolation, loneliness, sleep disturbance, and depressive symptoms in older Korean-American residents of subsidized senior housing. Building upon the well-established link between social isolation and depressive symptoms, we hypothesized three indirect effect models with (1) loneliness as a sole mediator, (2) sleep disturbance as a sole mediator, and (3) loneliness and sleep disturbance as serial mediators.

Methods: Survey data from 318 participants (M age = 79.5 years, SD = 6.66) were used to examine the direct and mediation effect models.

Results: We confirmed that social isolation independently predicted depressive symptoms and found partial support for the mediation models. Among the three mediation pathways proposed, significance was found in the sole mediation by loneliness (B [SE] = 0.86 [0.29], bias-corrected 95% CI = [0.31, 1.47]) and the sequential mediation by loneliness and sleep disturbance (B [SE] = 0.12 [0.06], bias-corrected 95% CI = [0.03, 0.25]). The alternative path, where sleep disturbance precedes loneliness, was not significant, confirming the robustness of the proposed serial path.

Conclusion: Findings underscore the importance of addressing both loneliness and sleep disturbances as interconnected factors in interventions aimed at alleviating the mental health impacts of social isolation.