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Objectives:Suicidal behavior in late life differs in important ways from suicidal behavior that occurs earlier in the lifespan, suggesting the possibility of developmental differences in the etiology of suicidal behavior. This paper examines late life suicidal behavior within the context of lifespan developmental theory. Methods:This paper presents a conceptual framework for using lifespan developmental theory to better understand late life suicidal behavior. Results:We argue that the motivational theory of lifespan development, which focuses on control, is particularly relevant to late life suicide. This theory posits that opportunities to exert control over important aspects of one's life diminish in late life as a result of declines in physical functioning and other factors, and that successful aging is associated with adaptive regulation of this developmental change. Although continued striving to meet goals is normative throughout the lifespan, most individuals also increase the use of compensatory strategies in old age or when faced with a decline in functioning. We propose that individuals who do not adapt to developmental changes by altering their strategies for exerting control will be at risk for suicidal behavior in late life. This paper reviews evidence that supports the importance of control with respect to suicidal outcomes in older adults, as well as findings regarding specific types of control strategies that may be related to suicide risk in older adults with health-related limitations. Conclusion:Although suicidal behavior is not a normal part of aging, the application of lifespan developmental theory may be useful in understanding and potentially preventing suicide among older adults. [ABSTRACT FROM AUTHOR]

Objectives: Late-onset stress symptomatology (LOSS) is a phenomenon observed in older combat veterans who experience increased combat-related thoughts, feelings, and reminiscences corresponding with the changes and challenges of aging. Previously, we developed the LOSS Scale to assess LOSS. This paper describes the development and validation of a LOSS Scale short form (LOSS-SF) to screen veterans in various settings who may be actively re-examining their past wartime experiences. Method: Three studies examined the reliability and validity of the LOSS-SF in separate samples of male combat veterans age 55 and older (total N = 346). Veterans were administered measures via telephone and mail survey. Correlation and regression analyses examined the reliability and validity of the LOSS-SF. Results: The LOSS-SF exhibited strong internal consistency (alpha =.93), test-retest reliability (2 week interval on average; r =.88), and good concurrent validity with the LOSS Scale (r =.81). Convergent and divergent validity were supported by the pattern of correlations between the LOSS-SF and other construct measures. Conclusion: The LOSS-SF is a reliable and valid measure to quickly assess thoughts, feelings, and reminiscences about past combat experiences in older veterans and identify those veterans in distress who may benefit from psychological interventions.. [ABSTRACT FROM AUTHOR]

Objectives: This paper examined the psychological factors that influence the well-being of health professionals who work with people with dementia and the types of care (person-centred or task-oriented) provided to these patients. Methods: The literature was reviewed to identify the factors influencing the well-being of, and types of care provided by, health professionals working with people experiencing dementia. Results: Based on our review of the literature, we propose that approaches to care and the well-being of health professionals working with dementia patients are influenced by the characterisation of dementia as a terminal illness that typically occurs in older people. Drawing upon terror management theory, we argue that exposure to dementia patients is likely to promote awareness of one's own mortality and death-related anxiety. A theoretical model is presented which posits that health professionals working in dementia care draw on experiential avoidance to manage this anxiety. Both death anxiety, and coping strategies, such as experiential avoidance, used to manage this anxiety may influence health professionals' approaches to care of, and attitudes towards, dementia patients. We also suggest a bi-directional relationship between health professionals' approaches to care and well-being. Conclusion: Recommendations are made regarding future directions for research and implications for training of health professionals providing direct service or consultation in dementia care. [ABSTRACT FROM AUTHOR]

Objectives:This paper presents preliminary baseline data from a prospective study of nursing home adaptation that attempts to capture the complexity of residents' adaptive resources by examining psychological, social, and biological variables from a longitudinal conceptual framework. Our emphasis was on validating an index of allostasis. Method:In a sample of 26 long-term care patients, we measured 6 hormone and protein biomarkers to capture the concept of allostasis as an index of physiological resilience, related to other baseline resources, including frailty, hope and optimism, social support, and mental health history, collected via interview with the resident and collaterals. We also examined the performance of self-report measures reflecting psychosocial and well-being constructs, given the prevalence of cognitive impairment in nursing homes. Results:Our results supported both the psychometric stability of our self-report measures, and the preliminary validity of our index of allostasis. Each biomarker was associated with at least one other resilience resource, suggesting that our choice of biomarkers was appropriate. As a group, the biomarkers showed good correspondence with the majority of other resource variables, and our standardized summation score was also associated with physical, social, and psychological resilience resources, including those reflecting physical and mental health vulnerability as well as positive resources of social support, optimism, and hope. Conclusion:Although these results are based on a small sample, the effect sizes were large enough to confer some confidence in the value of pursuing further research relating biomarkers of allostasis to psychological and physical resources and well-being. [ABSTRACT FROM PUBLISHER]

Objective:The association between exposure to stressful life events (SLEs) and late-life depression is well-documented. However, the role of resilience as a buffer against the adverse mental health effects of SLEs in late life has not been convincingly demonstrated. In this paper, the moderating effect of resilience in the relationship between SLEs and depressive symptomatology in older Chinese adults is investigated. Method:A population sample of 385 community-dwelling older Chinese adults aged ≥60 years responded to questionnaires on resilience (Connor–Davidson resilience scale), depressive symptomatology (Geriatric Depression Scale, GDS-15) and SLEs. Results:Increased numbers of SLEs (β = 0.343,p< .001) and lower levels of resilience (β = –0.137,p< 0.001) were significantly associated with higher levels of depressive symptomatology. There was a significant interaction of resilience and number of SLEs on depressive symptomatology (p= 0.003). The sense of personal competence and optimism was the principal underlying resilience dimension moderating the relationship for both the young–old (aged 60–69) and the old–old (aged 70 and above). Conclusion:The finding of significant interaction supported the role of resilience in moderating the adverse effect of SLEs in terms of depressive symptoms among older Chinese adults. [ABSTRACT FROM PUBLISHER]

Objectives:This paper examines the mediating effect of child–grandparent conflict on the relationship between child trauma exposure and grandparenting stress. Methods:Data was collected from a sample of custodial grandparents who participated in kinship care or relative caregiving programs (n= 251). Grandparenting stress was measured with Parenting Stress Scale (Berry & Jones, 1995) modified for grandparents. A series of regression models and structural equation models (SEM) were used to test the relationship between the number of different types of child trauma exposures and grandparenting stress, and to examine the mediating effect of child–grandparent conflicts on the relationship. Results:Almost three-fourths (72%) of children had experienced at least one type of traumatic exposure. The SEM model shows that child's trauma exposure indirectly affected grandparenting stress, mediated by child–grandparenting conflicts though no direct path between the child's trauma exposure variable and grandparenting stress was found. A higher level of child–grandparent conflicts was also associated with a lower level of emotional well-being among custodial grandparents. Conclusion:Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents. [ABSTRACT FROM AUTHOR]

Objectives: Depression is a significant mental health issue among older Australian adults. Research has indicated that insomnia is a key risk factor for the development of depressive symptoms in older adults, and that dispositional hope may be protective against the development of depressive symptoms in this population. This study examined whether dispositional hope and its dimensions, agency and pathways, moderated the relationship between insomnia symptoms and depressive symptoms among older Australian adults. Method: A community sample of 88 men (Mage = 71.11, SDage = 5.54) and 111 women (Mage = 70.25, SDage = 4.64), aged 65-94 years, completed the Insomnia Severity Index, Adult Dispositional Hope Scale, and Centre of Epidemiologic Studies Depression Scale. Results: After controlling for gender, age, relationship status, education level, method of participation, and perceived physical health, results supported the moderation models. The insomnia-depressive symptoms relation was significant for older adults with low and average (but not high) levels of dispositional hope, agency, and pathways. The Johnson-Neyman analyses indicated that the insomnia-depressive symptoms relation was significant for older adults who scored below 27.10 on dispositional hope, below 13.73 on agency, and below 13.49 and above 15.64 on pathways. Conclusion: The results of this study imply that interventions aimed at increasing dispositional hope, agency, and pathways among older adults who experience symptoms of insomnia may reduce their depressive symptoms. A cautionary note, however, is that very high scores on pathways among older adults who experience insomnia symptoms may be detrimental to their mental health. [ABSTRACT FROM AUTHOR]

Residents living with dementia in residential aged care facilities (RACFs) have reduced access to, and opportunities for, participation in meaningful activities. This leads to increased social isolation and disengagement. Intergenerational programs aim to overcome these issues. Allied health students piloted a live-intergenerational program (LIP), living onsite at a residential aged care facility (RACF) while volunteering for 30 h a month. The purpose of this study was to explore the impact and practicalities for implementing a LIP in an Australian RACF. This qualitative descriptive pilot study was undertaken to explore the diverse perspectives of various stakeholders. Qualitative data were collected during group discussions directed by the nominal group technique with live-in-students. Interviews were conducted with staff members, relatives, facility management and volunteers. All qualitative data were analysed thematically. Two overarching themes emerged. The first, community of care, indicated how care partners and the care context, organisational support and being a live-in-student supported the sustainability of the program. Live-in-students' accessibility promoted opportunities for occupational and social engagement of residents when staff was less available. The second, a collective based on belonging and shared doing, highlighted the program's potential impact and uncovered the development of a collective based on shared belonging. The LIP highlighted the potential for new dimensions to person-centred care. The pilot study demonstrated intergenerational contact within aged residential care supported the evolvement of a collective and promoted a social approach for ageing well. Further research is needed to identify the long-term impact of the LIP and explore the feasibility of expanding the program. [ABSTRACT FROM AUTHOR]

Overeating and obesity are major public health issues in the United States. Caregivers are at greater risk of engaging in poor health behaviors, such as emotional eating, to cope with the demands of caregiving. Using Heatherton and Baumeister (1991) Escape Theory, this study examines the associations between caregiver characteristics (i.e. age, gender, and BMI) and emotional eating, including the extent to which family strain mediates these associations. Data are from the MIDUS 3 dataset (N = 326) and include family caregivers of older adults and children with special health care needs (Mage = 62.88 years, SD = 10.28; 69.6% female). Female caregivers were more likely than male caregivers to engage in emotional eating. Age was significantly associated with emotional eating, where increased age was associated with less emotional eating. ANCOVA results indicated that obese caregivers were the most likely to engage in emotional eating. Results also indicated that family strain significantly mediated the association between caregiver age and emotional eating. Linear regression analyses indicated that female gender predicted emotional eating, although family strain did not mediate the association between gender and emotional eating. Similarly, after controlling for family strain as a mediator, higher BMI was still significantly associated with emotional eating, suggesting that BMI is a strong predictor of emotional eating among family caregivers regardless of present family strain. Interventions targeted at managing family strain, particularly for younger, female caregivers, could improve coping and decrease poor health behaviors. [ABSTRACT FROM AUTHOR]

Integrating behavioral health services into primary care is an important global initiative to improve access to mental health services. Within the Veterans Health Administration (VHA), Geriatric Patient Aligned Care Teams (GeriPACTs) are one model of integrated care for frail older adults to serve older Veterans with geriatric syndromes and increased probability of cognitive impairment. Understanding of the role of psychology in GeriPACT is limited. This study examines this role, describes the practice of these psychologists, and evaluates the integration of psychology into geriatric primary care. A mixed-methods design was used. Recruitment occurred through two VHA listservs for GeriPACT and Primary Care Mental Health Integration (PC-MHI) psychologists. Surveys examined referral processes, service access, clinical services provision, and use of psychotherapy modalities. Twenty psychologists participated. Structured follow-up interviews were conducted with five participants. A large minority of psychologists did not have FTE allotted for GeriPACT work they provided (40%). Sixty percent were assigned to one GeriPACT team. Twenty percent served four to seven GeriPACT teams. Eighty percent provided same-day services. Cognitive assessment was provided weekly by over sixty percent of providers who had FTE allotment to this role. Qualitative data provided a rich description of psychologists' perceptions of their role, team functioning, referral processes, visit structure, and other factors. Findings are discussed in the context of the World Health Organization's guidelines for integrating mental health into primary care. Data suggest a need for an integrated model that adapts to the special needs of older adults in primary care. [ABSTRACT FROM AUTHOR]

Older adults have been identified as a high-risk population for COVID-19, therefore it is crucial to understand how they perceived and reacted to the emergency. We examined age-related differences in emotions, cognitive attitudes, and behavioral responses to the COVID-19 crisis. Based on the Socioemotional Selectivity Theory, we expected to find a positive approach in older adults, which may translate into lower compliance with restrictive measures. Methods: We analyzed data (n = 306) from a nation-wide online survey conducted between April 1st and April 16th, 2020. We compared young (18–29 years), middle-aged (30–50 years), and older (65–85 years) adults' self-reported emotions, attitudes toward the emergency, and compliance with governmental rules. Results: Older adults showed lower negative emotions than young and middle-aged adults. Also, older adults were more confident about COVID-related information received, more favorable toward the restrictive measures, and perceived lower underestimation of the emergency compared to the other age groups. However, older people anticipated a longer time for the emergency to resolve. No age-related differences in compliance with the rules emerged. Conclusion: Older people showed a positive attitude toward the emergency. This attitude was confined in the here and now and did not extend to expectations for the future. Compliance with rules was high across our sample. However, less compliant individuals were also less confident in COVID-related information received by the media and official sources, suggesting the importance of providing precise and reliable information to promote adherence to restrictive measures. [ABSTRACT FROM AUTHOR]

Objectives: Depressive symptoms and life satisfaction are closely related among the older adults. However, investigation of the dyadic influence of depressive symptoms and life satisfaction among Chinese older married couples is limited. The current study aimed to investigate the reciprocal effects of life satisfaction and depressive symptoms longitudinally among a sample of Chinese older married couples. Method: The current sample consisted of 1,877 older married couples from the China Family Panel Studies (CFPS). Depressive symptoms and life satisfaction were measured at the 2010 baseline and the 2014 assessment. Age, income, education, physical health, and length of marriage measured at baseline were included as the controlled variables. Data was analyzed with the longitudinal actor-partner interdependence models. Results: One's life satisfaction and depressive symptoms were significantly associated with his/her own life satisfaction and depressive symptoms longitudinally. In addition, higher levels of wives' depressive symptoms in 2010 were associated with higher levels of depressive symptoms and lower levels of life satisfaction among their husbands in 2014. Higher levels of husbands' life satisfaction in 2010 were associated with higher levels of wives' life satisfaction in 2014. Conclusion: The current study found both actor and partner effects in the long-term association between depressive symptoms and life satisfaction. Among these older married couples, husbands were the 'receivers' of their wives' depressive symptoms and the 'senders' of life satisfaction. Practitioners aiming to promote the well-beings of older married adults need to consider the dyadic influences given the significant partner effects found in the current study. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between care recipient (person with Alzheimer's disease) ability to perform daily tasks and caregivers' (CG) perceived burden and depression, guided by the caregiver identity theory. We also examine the mediating effect of CG abilities to meet their basic needs. Methods: This study utilizes the baseline data of the REACH II study. Spearman's rho (ρ) was used to test for relationships between burden, reported depression, and each ADLs and IADLs. To further explore the relationship between burden and each ADLs and IADLs, structural equation modeling was conducted using Mplus 8.0. Results: Reported CG total scores indicated increased perceived CG burden with greater number of assisted daily activities. CG depression scores were significantly predicted by reported burden scores and caregiver's ability to pay for basic needs. Importantly, 34.6% of variation in CG reported depressions scores were explained by reported burden scores. A multivariate regression model with reported burden scores, controlling for caregiver's ability to pay for basic needs, explained 36.6% of the variance in CG depression scores. Burden scores and CG ability to pay for basic needs significantly predicted depression scores. Results from the three models indicated that CG burden fully mediated the relationship between daily living skill scores and CG depression. Conclusion: Our study findings suggest the need to more closely examine the link between AD caregiving, financial instability, and mental health and bolster support for policies and programs that offer tangible supports and services to offset the costs of informal AD CG. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the associations between perceived crime-specific victimization risk, avoidance behavior, and their relationships with health of older adults. Method: A representative sample of 453 Chinese aged 60 and older from Kunming provided information on their socio-demographic characteristics, perceived crime victimization risk, avoidance behavior, physical and mental health. Results: Avoidance behavior was common among participants, with 61.4% avoiding unsafe areas and 42.2% avoiding social activities. Path analyses showed that perceived risk of vandalism was associated with avoiding participating in social activities, while perceived risk of attack was related to avoiding unsafe areas during the day. Meanwhile, avoiding social activities and perceived risk of vandalism were significant predictors of poor mental health, and avoiding unsafe areas was a salient predictor of poor physical health. Perceived risk of attack had an indirect effect on physical health through avoiding unsafe areas during the day. Conclusion: Study findings highlight the importance of addressing perceived victimization risk in encouraging social participation and mobility among older adults. [ABSTRACT FROM AUTHOR]

Objectives: The purposes of this study were to: (1) develop an empirical typology of the social networks in diverse groups of older Asian Americans using both structural and subjective criterion variables; and (2) examine the relationship of the social network types to the measures of the health and well-being (self-rating of health, mental distress, and life satisfaction). Method: The participants included 533 older Asian Americans (Chinese, Asian Indian, Korean, Vietnamese, and other Asians) who participated in the 2015 Asian American Quality of Life Survey in Central Texas. Latent profile analysis (LPA) was conducted using seven social network-related variables. The identified typologies were then regressed on the indicators of health and well-being (poor rating of health, probable mental distress, and dissatisfaction with life). Results: The LPA identified the model with four network types as being most optimal. The groups were named "diverse-integrated" (37.5%), "moderately diverse-integrated" (21.2%), "marginally restricted-noncongregant" (22.1%), and "restricted-congregant" (19.1%). The results suggested that compared to the "diverse-integrated" group, the "marginally restricted-noncongregant type" fared worse than "the restricted-congregant group" in that the former had greater odds of both mental distress and dissatisfaction with life while the latter had higher odds only for dissatisfaction with life. Conclusion: Unlike previous network studies, network types were shaped in the continuum of different social ties and subjective evaluation on strength of social ties. Certain ethnic groups were over-represented in specific network types. Such findings suggest the importance of understanding ethnic group variations in network vulnerabilities when considering interventions. [ABSTRACT FROM AUTHOR]

Objectives: Socioemotional selectivity theory (SST) contends that future time perspective is the central determinant of healthy older adults' prioritization of emotional gratification. We have shown elsewhere that individuals with Alzheimer's disease (AD) are disoriented to future time perspective. This study examined whether these same participants would prioritize emotional gratification despite having distorted time perspective. Method: Performance of individuals with Alzheimer's disease (AD) was compared against young, young-old, and old-old adults on a social activity preference card-sort task. We examined whether activity preferences differentially related to subjective wellbeing. Results: Multidimensional scaling revealed common dimensions along which groups considered social activities. The importance of these dimensions varied across healthy participant groups in ways predicted by SST. Dimensions related to knowledge acquisition were more important in youth than older age; emotional dimensions were more important to the older age groups. Despite AD, these individuals also prioritzed emotional gratification, suggesting that cognitive impairment is not a barrier to socioemotional selectivity. Preference for emotionally meaningful activities was positively associated with subjective wellbeing. Conclusion: Persons with AD are motivated towards emotionally meaningful ends and retain high levels of wellbeing. These findings have implications in the caregiving context for shaping social programs to better match goals and preferences. [ABSTRACT FROM AUTHOR]

Objectives: The role of social exclusion in depressive symptoms in older people has not been examined systematically. This study examines the associations of social exclusion, income poverty, and financial strain with depressive symptoms and evaluates the moderating effect of social support in the link between social exclusion and depressive symptoms. Method: Our sample consisted of 850 older people (65 years old or above) in Hong Kong randomly selected through a household survey. We used a logistic regression to evaluate the associations of social exclusion, income poverty, and financial strain with depressive symptoms, controlling for social support and social network variables, health indicators, and socio-demographic variables. Results: We found that social exclusion, income poverty, and financial strain are positively associated with depressive symptoms, but only social exclusion (OR: 2.13, 95% CI: 1.51–2.99, p < 0.001) and financial strain (OR: 1.54, 95% CI: 1.16–2.03, p < 0.01) maintain their significance after all other covariates are adjusted. Moreover, perceived social support negatively moderates the relationship between social exclusion and depressive symptoms. Conclusion: Social exclusion is significantly associated with depressive symptoms in older people, but this association can be moderated by social support. [ABSTRACT FROM AUTHOR]

Objectives: Based on a gero-salutogenic approach, we investigated the stability of the sense of coherence over a time span of four years in active older individuals and long-term effects of this life orientation on three different indicators of positive aging—subjective well-being, psychological health and physical health. This is the first study to explore associations between gain in sense of coherence and future positive aging. Methods: Our longitudinal sample consisted of 125 physically active individuals (73.5% women) at the mean age of 71 years at follow-up (range: 64 to 87 years; response rate: 73.5%), who completed our questionnaire twice. There were no systematic differences between the follow-up responders and non-responders. Results: The sense of coherence increased over four years, disclosing a small effect size. The baseline sense of coherence had a substantial predictive value for future subjective well-being and psychological health, but not for physical health. Stepwise hierarchical regression analyses showed that both the baseline sense of coherence and gain in sense of coherence predicted future subjective well-being and psychological health. With respect to future physical health, only gain in sense of coherence was significant. Conclusion: Consistent with gero-salutogenic theory, the baseline sense of coherence is an effective predictor of future positive aging, and growth in sense of coherence within a time span of four years is reflected in improved positive aging. It is important to encourage experiences in older age that cultivate the three components of the sense of coherence—feelings of comprehensibility, manageability and meaningfulness. [ABSTRACT FROM AUTHOR]

Objectives: With over one-fifth of the world's older population, shrinking family size and increasing number of women in the workforce, elder care is a growing challenge for families in mainland China. This study explored the moderating effect of working status and gender on caregiving time and depressive symptoms among adult children caregivers in mainland China. Method: Participants were 660 adult children caregivers from a nationally representative sample of individuals aged 45 + (N = 13,204) who participated in the China Health and Retirement Longitudinal Study (CHARLS) Wave 2 (2013). Multiple linear regression was used to analyze the direct effect of caregiving time and the moderating effects of working status and gender on symptoms of depression among caregivers. Results: Significant main effect between caregiving time and depressive symptoms was found controlling for demographic covariates. The three-way interaction between working status, gender and caregiving time was also significant. Working status and gender moderate the effect of caregiving time on depressive symptoms: among employed men and women caregivers, spending more hours providing care predicted fewer depression symptoms. Unemployed men caregivers who spent more hours providing care showed highest level of depressive symptoms. Conclusion: The relationship between caregiving time and depressive symptoms was moderated by working status and gender. Future research is needed to explore factors that influence changes in caregivers' health and well-being over time. [ABSTRACT FROM AUTHOR]

Background: Population aging is a social and economic concern for China. It is essential to understand types of social support networks available to elderly people living in China. Objectives: The aim of this research was to identify network types among Chinese older adults and to examine the differential relationship of the network types, health outcomes and health-related behaviors. Methods: Secondary analysis of data compiled by the Chinese Longitudinal Healthy Longevity Survey (n = 9749) was extracted. Network types were derived through latent class analysis with Mplus 6.12 software. Statistical analysis included descriptive statistics, one-way ANOVA, multiple logistic regression and path analysis. Results: Four types of social networks were identified, these included private (16%), non-couple-focused (15%), couple-focused (47%) and diverse (22%). Compared with elders belonging to other networks, elders in diverse network possessed the healthiest status and the highest health-related behaviors score. Health-related behaviors played a role in mediating social network types to health outcomes was identified. Findings were aligned to the conceptual model pathway proposed by Berkman (2000). Conclusion: The findings demonstrate that types of social networks for elders are significantly correlated to health-related behaviors and health outcomes. Detail and understanding of the correlations are useful to inform healthcare practice and policy and to assist the development of appropriate interpersonal interventions. [ABSTRACT FROM AUTHOR]

Purposes: Responding to the growing needs of the largest aging population in the world, China has been experimenting interventions introduced from other countries to serve its older citizens. Using the life review approach, this study aimed to understand stress and coping experiences of a group of rural older adults living in public welfare housing, and to identify the effect of life review on their perceptions of quality of life. Methods: This study used an experimental research design with qualitative interviews. Analyses mainly focused on qualitative interview data of participants in the experimental group (n=24). Quantitative analyses were conducted to compare changes in the measure of quality of life between the experimental group and the control group (n=22). Results: Qualitative analyses indicated that salient life course stressors among rural Chinese old adults included financial strains, health concerns, and loss of loved ones. Such stressors were intertwined with historical and social changes they experienced in China. Coping strategies developed to survive a harsh young adulthood were used to deal with aging challenges and adaption to the welfare housing. Quantitative analysis found those who went through life review reported significant improvement in perceived quality of life compared to the control group. Discussion: Life review showed preliminary acceptability and effectiveness among the most disadvantaged and marginalized older group in China. It suggests this approach can be adapted to help understand life experience of older adults from different socioeconomic and cultural backgrounds, and to bring about positive changes in their wellbeing. [ABSTRACT FROM AUTHOR]

Background/Aims: Neuropsychiatric symptoms (NPS) in dementia pose great challenges for residents and staff in nursing homes. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) has recently in a randomized controlled trial demonstrated reductions in NPS. We explored the participating staff's experiences with the model and how it meets the challenges when dealing with the complexity of NPS. Methods: Three to six months after the end of the intervention, we interviewed 32 of the caregivers, leaders, and physicians participating in the trial, in five focus groups. We used thematic content analysis. Results: The analysis yielded two main themes: (1) a systematic reflection method enhanced learning at work; (2) the structure of the approach helped staff to cope with NPS in residents with dementia. Conclusion: TIME shifts the way of learning for the staff from a traditional to a more innovative and reflection-based learning through a process of learning how to learn at work. The staff's experienced increased coping in their approach to complex problems. Our results emphasise the importance of a structured and biopsychosocial approach to NPS in clinical practice. Future research should explore models for integrating situated learning in daily routines in nursing homes. [ABSTRACT FROM AUTHOR]

Objectives: Maintaining cognitive function is an essential aspect of successful aging. Widowhood is a salient life transition that can affect older adults' cognitive function. Leisure engagement has received increasing attention because it is still modifiable in later life to help prevent cognitive decline. Nonetheless, limited longitudinal studies have examined how widowhood influences cognitive function, and even fewer studies have tested the role of leisure activities in this relationship. Method: This study delineated the mechanism of widowhood, leisure activity engagement, and cognitive function among older adults using a national longitudinal dataset, the Health and Retirement Study, and its supplementary dataset, the Consumption and Activities Mail Survey, which repeatedly measured individuals' leisure activity engagement. Results: Findings showed no significant association between widowhood and cognitive function during a 4-year period. However, engagement in mental activities moderated the impact of widowhood on cognitive function. Specifically, the benefit of mental activity engagement on cognition was more pronounced among individuals who were recently widowed compared to those who were married. This implies a protective role of mental activities in the relationship between widowhood and cognitive function. Conclusion: Interventions with mentally stimulating activities at the community level to retain cognition among individuals in early phase widowhoodare suggested. Future studies are necessary to explore whether other factors such as changes in physical and mental health and intergenerational support from adult children during widowhood may further influence this mechanism among widowhood, leisure activities, and cognitive function. [ABSTRACT FROM AUTHOR]

Objectives: Loneliness and social isolation (L&SI) are associated with physical and cognitive decline in older adults. Walk 'n' Talk for your Life (WTL) is a community-based program of socialization, health education, falls prevention exercise and walking for community-dwelling older adults. This qualitative study was done to gain further insight into the experience and impacts of the WTL on seniors' L&SI. Methods: One-on-one semi-structured interviews were conducted with sixteen participants who had completed the WTL. Interview questions focused on eliciting a better understanding of how the WTL impacted participants' feelings of L&SI. Content analysis was used to classify the qualitative data. Results: This qualitative evaluation helped to obtain a richer understanding of WTL participants' reasons for loneliness and the benefits of the program on participants' experience of L&SI. Participants felt WTL helped motivate them to socialize and reduced their feelings of loneliness by providing a sense of 'belonging' which appeared to be mediated by the group exercise/walking component of the program. Discussion/Conclusions: This study provides insight into participants' experiences of L&SI. Further research in a broader population of older adults is mandated to determine the efficacy of community exercise programs in reducing L&SI. [ABSTRACT FROM AUTHOR]

Objective: Relocation for the purpose of receiving care may be one of the more challenging transitions for older adults. The purpose of this study was to facilitate a family life review (FLR) session aimed at enhancing family relationships and assisting older adults in coping with the challenges associated with a relocation. Methods: Fourteen dyads comprised of older adults who relocated to an assisted living facility (ALF) and a chosen family member or friend participated in a FLR session and semi-structured follow up interview. Data were analyzed using the constant comparative method and triangulated with descriptive statistics. Results: Emergent themes suggested participating in FLR influenced families by raising emotions, systemically thinking, and navigating the relocation. FLR facilitated positive connections, enhanced existing relationships, and promoted self-acceptance. Families indicated mutual storytelling was enjoyable and reminded them of the urgency to share their story. FLR allowed dyads to reflect and thus prompted a renewed perspective on some of the more challenging components of the relocation transition. Conclusion: Study findings provide insight into how families organize individual and interpersonal narratives and use these narratives during transitional times. FLR can aid families in making a smoother and fulfilling move to an ALF and other late life transitions. [ABSTRACT FROM AUTHOR]

Objectives: This review examines differences in the use of emotion regulation (ER) strategies among younger and older adults. Method: A systematic review using search terms related to ageing and ER identified 23 relevant studies. Narrative synthesis was adopted to analyse the findings. Results: Generally, greater use of situation selection and attentional deployment was identified among older adults, although these relationships were dependent on contextual/moderator variables. While older adults employed greater levels of situation modification in response to negative stimuli, there was considerable variation in age differences across specific situation modification subtypes. Available evidence pointed to an absence of age differences in the cognitive change strategy of cognitive reappraisal. The use of relatively less-cognitively demanding cognitive change subtypes (e.g. acceptance) was, under particular circumstances, greater among older adults. Findings regarding the response modulation strategy of expressive suppression were equivocal. Conclusion: Adult development is not characterised by straightforward shifts in preferences for use of different ER strategies. Moderator variables appear to be of central importance in shaping the emergence of age differences in ER. Systematically examining interactions of age with individual difference variables and situational factors in samples including oldest-old adults will be important for advancing knowledge regarding developmental differences in ER. [ABSTRACT FROM AUTHOR]

Objectives: Improving the design and targeting of interventions is important for alleviating loneliness among older adults. This requires identifying which correlates are the most important predictors of loneliness. This study demonstrates the use of recursive partitioning in exploring the characteristics and assessing the relative importance of correlates of loneliness in older adults. Method: Using exploratory regression trees and random forests, we examined combinations and the relative importance of 42 correlates in relation to loneliness at age 68 among 2453 participants from the birth cohort study the MRC National Survey of Health and Development. Results: Positive mental well-being, personal mastery, identifying the spouse as the closest confidant, being extrovert and informal social contact were the most important correlates of lower loneliness levels. Participation in organised groups and demographic correlates were poor identifiers of loneliness. The regression tree suggested that loneliness was not raised among those with poor mental wellbeing if they identified their partner as closest confidante and had frequent social contact. Conclusion: Recursive partitioning can identify which combinations of experiences and circumstances characterise high-risk groups. Poor mental wellbeing and sparse social contact emerged as especially important and classical demographic factors as insufficient in identifying high loneliness levels among older adults. [ABSTRACT FROM AUTHOR]

Objective: General practitioners (GPs) play a major role in the assessment of dementia but it is still unrecognized in primary care and its management is heterogeneous. Our objective is to describe the usual practices, and their determinants, of French GPs in this field. Methods: GPs’ characteristics and practices when facing cognitive decline were collected through a telephone interview and a postal questionnaire. A descriptive analysis of all study variables was conducted. The study of quantitative explanatory variables was done by testing the equality of means and the choice of qualitative variables was based on the chi-square independence test or Fischer test. Results: Hundred two GPs completed the study. GPs were in majority men, working in urban areas. Mean age was 54.4 years old. GPs’ feeling of confidence and self-perception of follow-up of national recommendations is linked with their practices. Performing a clinical interview to assess cognitive impairment is linked with good communication skills. GPs feel less confident to give information about resources for dementia. The main reason alleged for underdiagnosis is the limited effectiveness of drug therapy. Conclusions: This study underlines the importance of GPs’ feeling of confidence when managing cognitively impaired patients with dementia, and the need of increasing training in the field of dementia, which could improve the awareness of GPs about diagnosis and available resources. [ABSTRACT FROM AUTHOR]

Objective: Parental bonding is cited as a determinant of mental health outcomes in childhood, adolescence and early-mid adulthood. Examination of the long-term impact for older adults is limited. We therefore examine the long-term risk of perceived poor parental bonding on mental health across the lifespan and into early-old age. Methods: Participants (N = 1255) were aged 60-64 years of age and drawn from the Australian Life Histories and Health study. Quality of parental bonding was assessed with the Parental Bonding Instrument (PBI). Self-reported history of doctors’ mental health diagnoses and current treatment for each participant was recorded. Current depression was assessed with the Centre for Epidemiologic Studies Depression-8 (CESD-8). Due to known gender differences in mental health rates across the lifespan, analyses were stratified by sex. Results: A bi-factor analysis of the PBI in a structural equation framework indicated perceived Poor Parental Quality as a risk for both ever and current depression for both sexes. For males, Over-Protective Fathers were a risk for ever and current depression, whilst overall Poor Parental Quality was a risk for reporting current depression treatment. Whilst a number of the risks associated with current depression and treatment were attenuated when controlling for current mood, parental quality remained a significant risk for having reported a lifetime diagnosis for depression and anxiety for men. Conclusion: Our results extend the existing literature base and demonstrate that mental health risk attributed to poor perceived parental quality continues across the life-course and into early-old age. [ABSTRACT FROM AUTHOR]

Objectives: Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. Addressing potential shortcomings of previous research, we examined the effect of a whole-ecology PA intervention program on NH residents’ depressive symptoms using generalized linear mixed-models (GLMMs). Method: We used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning (n = 163, Mage = 83.1, 53-100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale-Residential) by using gamma distribution. Results: Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilization in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. Conclusion: Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents’ depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated variation across different old-age groups in the association between intergenerational support and elderly life satisfaction in China, taking into account both exchange patterns and different types of support. Method: Using the first two waves (2010 and 2012) of China Family Panel Studies, we applied the fixed-effect approach to examine the moderating effect of age separately for exchange patterns and different types of intergenerational support. The sample included 3989 elderly people. Results: There were age differences in the association between intergenerational support and elderly life satisfaction, for both exchange patterns and different types of support. Particularly, there was significant difference between the young-old (61–70) and the oldest-old (85+) in terms of the association. Conclusion: Theoretically, this study helps to elaborate on social exchange and equity theories by introducing explanations from socio-emotional selectivity theory. It further highlights how policies for elderly care should be developed considering the diverse needs, characteristics and goals of elderly people rather than treating them as a singular homogenous group, in particular in relation to different old-age groups. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the relationships between social capital and preferences for aging in place among older urban adults in eastern China. Method: Quota sampling was used to recruit 456 respondents aged 60 and older from Gusu District, Suzhou City, in 2015. Random-effects logistic regression was used to test the proposed model. Results: Respondents who had better quality family social capital, a higher level of social trust, and more organization memberships were more likely to choose to live in local communities, even after we controlled for individual characteristics. Discussion: The findings highlight the important role of both family and community social capital in influencing preferences for aging in place among older adults in urban China. This is particularly important for developing long-term care systems for older adults living in naturally occurring retirement communities. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the mental health of a cohort of 262 female and 168 male grandparents across the first two years of their transition to grandparenthood, with particular focus on the impact of providing childcare for the grandchild. Method: Baseline assessments were made during the pregnancy with the first grandchild, and subsequent assessments were at one and two years after the birth. The influence of demographic and psychosocial variables which could be expected to influence change in mental health from baseline was explored. Results: The lack of change in mental health measures in this cohort was more prominent than change. Specifically, there was a small significant decrease in anxiety over the first year for females, and a small significant increase in depression for males. Other variables, not unique to the transition to grandparenthood such as physical health and adverse life events, were strongly associated with changes in mental health. Notably, more time spent babysitting the grandchild was associated with improvement in mental health. Conclusion: The transition to grandparenthood did not have any substantial adverse impact on five well-validated measures of mental health, in contrast to earlier American findings of adverse effects which implied that childcare was burdensome. [ABSTRACT FROM AUTHOR]

Background: Children born of war are a phenomenon of every conflict. At the end of World War II and thereafter, approximately 400,000 children were fathered by foreign soldiers and born to local women in Germany. Quantitative research on psychosocial consequences of growing up as German occupation child (GOC) has been missing so far. Methods: This study examines adult attachment and its association with current depression in GOC (N= 146) using self-report instruments: Adult Attachment Scale, Patient Health Questionnaire. Data were compared to a birth-cohort-matched representative sample of the German population (BCMS;N= 786). Results: GOC differ in both attachment dimensions (less comfortable with closeness/intimacy, lowered ability to depend on others) and adult attachment (more dismissive and fearful) compared to BCMS. Insecure adult attachment is associated with current depression. Conclusion: GOC grew up under difficult circumstances (e.g. poverty, adverse events, and stigmatization). Even decades later they display more insecure attachment in current relationships. Findings underline the complex and long-term impact of their developmental conditions on attachment and current mental health. [ABSTRACT FROM PUBLISHER]

Objectives: Aggressive behaviors by patients with dementia present risk to health care workers and patients. An information processing model, developed to study aggressive behaviors among children, was applied to study aggression among older hospital patients with dementia. Hypotheses were that delirium and mental health or depression history, would relate to increased risk of aggressive behaviors. Method: Electronic medical records were sampled for one year (n = 5008) and screened using the EMERSE search engine and hand review for dementia (n = 505) and aggressive behavior in individuals with dementia (n = 121). Records were reviewed for mental health history and presence of delirium. Results: Regression analyses found interaction effects representing delirium and mental health or depression history associated with greater risk of aggressive behavior. Significant main effects were found for both dementia and mental health or depression history. Of the lowest risk group, 12% of patients exhibited aggression compared to 24%–35% of those with delirium, mental health or depression history, or the combination of these risk factors. Conclusion: Delirium is the leading correlate of aggressive behaviors in hospitalized patients with dementia, and delirium or history of mental health diagnosis may lead to increased risk of aggressive behaviors in this setting. [ABSTRACT FROM AUTHOR]

Background: Older patients suffering from a combination of psychiatric disorders and physical illnesses and/or dementia are called Double Care Demanding patients (DCDs). Special wards for DCDs within Dutch nursing homes (NHs) and mental health care institutions (MHCIs) offer a unique opportunity to obtain insight into the characteristics and needs of this challenging population. Methods: This observational cross-sectional study collected data from 163 DCDs admitted to either a NH or a MHCI providing specialized care for DCDs. Similarities and differences between both DCD groups are described. Results: Neuropsychiatric symptoms were highly prevalent in all DCDs but significantly more in MHCI-DCDs. Cognitive disorders were far more present in NH-DCDs, while MHCI-DCDs often suffered from multiple psychiatric disorders. The severity of comorbidities and care dependency were equally high among all DCDs. NH-DCDs expressed more satisfaction in overall quality of life. Conclusions: The institutionalized elderly DCD population is very heterogeneous. Specific care arrangements are necessary because the severity of a patient's physical illness and the level of functional impairment seem to be equally important as the patient's behavioural, psychiatric and social problems. Further research should assess the adequacy of the setting assignment and the professional skills needed to provide adequate care for elderly DCDs. [ABSTRACT FROM AUTHOR]

Objective:To investigate the prevalence of the behavioral and psychological symptoms of dementia (BPSD) and associated factors in residents in long-term care (LTC) facilities. Method:We conducted a cross-sectional survey of older residents with dementia or similar symptoms (n= 312) using a questionnaire for care staff in 10 selected LTC facilities in Hokkaido, Japan. The questionnaire included sociodemographic characteristics, health conditions, living environments, and a brief questionnaire form of the Neuropsychiatric Inventory for assessing BPSD. Results:We revealed that the prevalence of BPSD in LTC facilities (percentage of people exhibiting at least one BPSD) in residents with dementia or similar symptoms was 64%. Having Alzheimer's disease, an imbalance between activities of daily living and cognitive function, poor relationships with other residents, and persistent requests in daily life were significantly associated with having BPSD. Conclusion:The prevalence of BPSD in LTC facilities was relatively low compared with other countries. The factors found to relate to BPSD may provide useful information for developing care methods to address BPSD in LTC residents. [ABSTRACT FROM AUTHOR]

Objective:Being oriented toward the future has been associated with better future health. We studied associations of future orientation with life expectancy and the percentage of life with disability. Method:We used the Panel Study of Income Dynamics (n= 5249). Participants’ average age in 1968 was 33.0. Six questions repeatedly measured future orientation, 1968–1976. Seven waves (1999–2011, 33,331 person-years) measured disability in activities of daily living for the same individuals, whose average age in 1999 was 64.0. We estimated monthly probabilities of disability and death with multinomial logistic Markov models adjusted for age, sex, race/ethnicity, childhood health, and education. Using the probabilities, we created large populations with microsimulation, measuring disability in each month for each individual, age 55 through death. Results:Life expectancy from age 55 for white men with high future orientation was age 77.6 (95% confidence interval 75.5–79.0), 6.9% (4.9–7.2) of those years with disability; results with low future orientation were 73.6 (72.2–75.4) and 9.6% (7.7–10.7). Comparable results for African American men were 74.8 (72.9–75.3), 8.1 (5.6–9.3), 71.0 (69.6–72.8), and 11.3 (9.1–11.7). For women, there were no significant differences associated with levels of future orientation for life expectancy. For white women with high future orientation 9.1% of remaining life from age 55 was disabled (6.3–9.9), compared to 12.4% (10.2–13.2) with low future orientation. Disability results for African American women were similar but statistically significant only at age 80 and over. Conclusion:High future orientation during early to middle adult ages may be associated with better health in older age. [ABSTRACT FROM AUTHOR]

In spite of previous evidence regarding the function of national songs as a contextual stimulus, their effect on the emotional state of older adults living with different levels of posttraumatic stress disorder (PTSD) symptoms has not be been examined. Following the 2014 Israel–Gaza conflict, we examined the emotional effects of listening to happy national songs (songs of Independence Day) and sad national songs (Memorial Day songs) on young (N= 144, mean age = 29.4) and older adults (N= 132, mean age = 68.5). Respondents were exposed to happy or sad national songs, and completed measures of exposure to missile attacks, related PTSD symptoms, and positive and negative emotions. Sad national songs were related to higher negative affect among young adults who were lower on PTSD symptoms, but not among their older counterparts. In contrast, sad national songs were related to higher negative affect among older adults who were higher on PTSD symptoms, but not among their young counterparts. These findings support the strength and vulnerability model, as they demonstrate that relative to young adults, older adults are generally more capable to withstand negative stimuli, yet are more sensitive to negative stimuli when they suffer from chronic vulnerability, as in the case of higher level of PTSD symptoms. [ABSTRACT FROM AUTHOR]

Objectives:This study explored the social care and support needs of people with dementia and visual impairment, and the barriers and facilitators for meeting these needs. Method:Twenty-six semi-structured interviews were conducted: 21 joint and 5 individual interviews with the person with dementia and visual impairment (n=4) or their family/paid carer (n=1). Interviews were analysed thematically. Results:Three themes are presented. (1)Social care needs: having dementia can reduce an individual's ability to cope with their visual impairment, and lead to increased dependency and reduced daily stimulation. (2)Barriers to using technology to meet social care needs: difficulties were reported with learning to use unfamiliar technology and the cost of visual impairment aids, and for some, the presence of dementia made visual impairment aids unusable and vice versa. (3)Familiarity as a facilitator for meeting social care needs: living at home or taking furnishings and ornaments into a new home facilitated independence, and continuity of paid carers/volunteers facilitated the caring relationship between the individual and staff/volunteer. Conclusion:Care workers will better serve older people if they are aware of the social care and support needs that arise from having both dementia and visual impairment. [ABSTRACT FROM AUTHOR]

Objectives:Interventions based on self-management of well-being (SMW) theory have shown positive effects, but additional questions remain: (1) Are improvements in well-being, as induced by the interventions, mediated by improved self-management ability (SMA)? (2) Do the interventions show ceiling effects? (3) Is a particular format of SMW intervention (individual, group, or self-help) more effective? Method:Data of three randomized controlled trials were pooled. The greater part of the sample (N= 445) consisted of single older females. A bootstrap analysis was performed to test for mediation. Regression analyses with interaction effects were performed to test for ceiling effects. Controlled and transformed effect sizes (proportion of maximum change) were calculated to compare formats. Results:There was a full significant mediation of well-being by SMA. A significant interaction (ceiling) effect was found on well-being, but not on SMA. The controlled effect sizes of the raw scores were small to medium (.04–.49), and were small to large after transformation (.41–.73). None of the intervention formats was more effective. Conclusion:Support for SMW theory was found, i.e. increasing self-management ability lead to improved well-being. Some ceiling effect was found. We conclude that various SMW interventions formats can improve self-management abilities and well-being with medium effects. [ABSTRACT FROM AUTHOR]

Objectives:Using the stress-coping framework, this study examined whether worry about not having a caregiver in old age was associated with depressive symptoms among widowed Chinese older adults, including the moderating effects of self-perceived family support. Method:Using a sample of 5331 widowed adults aged 60 years old or older from the 2006 National Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of depressive symptoms on worry about not having a caregiver. We also tested moderation effects of family support. Results:Individuals who were worried about not having a caregiver reported significantly higher levels of depressive symptoms. Feeling that their children are filial, having instrumental support from children, and having only daughters moderated the effects of worry about not having a caregiver on depressive symptoms. Conclusion:Our findings indicate the detrimental effects of worry about not having a caregiver on the psychological well-being of widowed older adults. This study also highlights some forms of family support that may help reduce such negative effects of widowhood. [ABSTRACT FROM AUTHOR]

Objectives: Caring for community-residing patients with heart failure can affect caregivers’ emotional wellbeing. However, few studies have examined caregivers’ well-being longitudinally, or identified factors associated with positive and negative outcomes. The objective of this longitudinal cohort study was to examine changes in caregivers’ well-being over time, and to identify patient and caregiver factors associated with positive and negative outcomes. Method:Fifty caregiver/heart failure patient dyads were recruited from an acute care facility and followed in the community. All participants completed surveys at hospital admission and 3, 6 and 12 months later. Caregivers completed assessments of depression symptoms and positive affect and standardized measures to capture assistance provided, mastery, personal gain, social support, participation restriction, and patients’ behavioral and psychological symptoms. From patients, we collected demographic characteristics and health-related quality of life. Individual Growth Curve modelling was used to analyze the data. Results: Caregivers’ negative and positive emotions remained stable over time. Depression symptoms were associated with higher participation restriction in caregivers. Positive affect was associated with more personal gain and more social support. Patients’ health-related quality of life and their behavioral and psychological symptoms were not significantly associated with caregivers’ emotional outcomes. Conclusion:Interventions should be offered based on caregivers’ needs rather than patients’ health outcomes, and should focus on fostering caregivers’ feelings of personal gain, assisting them with securing social support, and engaging in valued activities. [ABSTRACT FROM AUTHOR]

Objective:The current investigation examined the relationship between cognitive impairment and sense of self in Alzheimer's disease (AD). Method:Forty-nine participants with dementia associated with AD were recruited through memory clinics in Victoria, Australia. The 26 participants of the healthy control sample were recruited from a retirement village. Self was measured via theReflectiveSelf-Function Scale– a theory of mind indicator that provides personal and social self-reflection scores. Cognitive assessment included measures of new learning, executive function, and speed of information processing. Results:A reduction in sense of self in mild AD was demonstrated in both personal and social domains, as compared to healthy adults of a similar age. With a focus on specific cognitive impairment relationships, new learning was found to predict personal self-reflection, whereas speed of information processing predicted social self-reflection capacity. Conclusion:Findings suggest that deficits in new learning ability contribute to a reduced ability of people with early AD to understand their mental world and interpret thoughts, feelings, and beliefs about themselves. This impaired capacity to self-reflect will be intrusive in daily activities that require monitoring of current self-performance. Furthermore, with reduced speed of information processing found to impact on ability to reflect on social relations, individuals with AD are placed at risk of reduced ability to understand their social world, including communicating and interacting with others. Notwithstanding the overall group findings, individual variability was evident which reinforces the need for person-centred care in dementia. [ABSTRACT FROM AUTHOR]

Objectives: Previous research has shown that marital communication is key to couples' successful illness adjustment. However, little is known about couples' experiences of health conditions characterised by communication difficulties such as acquired hearing, vision, and dual-sensory loss. The aim of this review was to identify the effect of sensory loss, and associated communication difficulties, on couples' relational and psychosocial adjustment. Method: A systematic search was conducted to identify studies investigating the social, psychological, and relational impact of sensory loss on couples. Results: Twenty-four articles met the criteria for inclusion in the review. Significant heterogeneity in the measurements and design of the quantitative studies prevented statistical data synthesis. All but two studies reported some effect of sensory loss on couples' psychosocial or relational wellbeing. Higher levels of marital satisfaction were found to buffer against adverse psychological outcomes. Results of quantitative and qualitative studies were synthesised to form an integrative model illustrating the associations between sensory loss and couples' relational and psychosocial wellbeing. Conclusions: Although this review reports an association between sensory loss and couples' relational and psychosocial wellbeing, the results should be viewed with caution given that relatively few studies on couples' experiences of acquired sensory loss exist, and many have methodological limitations. [ABSTRACT FROM AUTHOR]

Objectives:As the opposite end of the continuum from social integration, social isolation may put individuals at a greater risk of poor mental health. Conceptualizing living alone as an objective and structural indicator of social isolation and loneliness as subjective perceptions of social isolation, the present study hypothesized that the relation between living alone and depressive symptoms would be mediated by the feelings of loneliness. Using older Korean Americans as the target population, the mediation model was examined in consideration of the contextual factors such as demographics (age, gender, education, perceived income, and length of stay in the USA), health (chronic conditions and functional disability), and general social integration (size of social network and community social cohesion). Method:Date were drawn from surveys with 209 older Korean Americans in Central Texas (Mage= 69.6, SD = 7.5). Multivariate regression models of depressive symptoms were entered in the following order: (1) demographics, (2) health, (3) living alone, (4) social network/community social cohesion, and (5) loneliness. The mediation effect of loneliness in the relationship between living alone and depressive symptoms was separately examined using the bootstrapping method. Results:Loneliness was found to mediate the relation between living alone and depressive symptoms (indirect effect = 1.03, 95% CI = .05–2.08). Conclusion:The results suggest that subjective perceptions of loneliness may explain the mechanism through which objective social isolation presents risks for depressive symptoms in older Korean Americans. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective of this work is to report the observed changes in psychological well-being in a sample of long-term medically hospitalized patients, after attending a cognitive stimulation program. The secondary aim is to determine if the observed changes were related to previous cognitive level. Methods: Inclusion criteria for study participation were to be a long-term care hospital inpatient, to be 65 years old or older, and to be cognitively preserved or with mild cognitive impairment. A total of 176 participants were included and distributed in two groups: Cognitive Stimulation Group (N = 123) and Non-Cognitive Stimulation Group (N = 53). Measures were applied just before the beginning of the program and just when it finished, two months later. Participants of the Non-Cognitive Stimulation Group were re-assessed again after two months. Results: No differences were found between the two groups in the measures assessed at baseline. After treatment, participants of the Cognitive Stimulation Group improved significantly more in psychological well-being (p <.001) than the ones of the Non-Cognitive Stimulation Group. When unimpaired and mild cognitively impaired participants of the Cognitive Stimulation Group were studied separately, both groups improved their psychological well-being, but the unimpaired experienced a greater effect. Conclusion: Cognitive stimulation plays a role in the improvement of psychological well-being of elderly medically hospitalized patients unimpaired or with mild cognitive impairment. The improvements in psychological well-being were related to the previous cognitive status and to the number of sessions that had been attended. [ABSTRACT FROM AUTHOR]

Objective: Family carers of people with dementia have higher than average rates of suicidal ideation, but there has been no research on homicidal ideation in this population. The aim of this study was to explore thoughts of homicide in family carers of people with dementia. Method: A descriptive qualitative approach was taken. Twenty-one Australian carers (7 men, 14 women) participated in individual, in-depth interviews and the transcripts were analysed thematically. Results: Seven themes were identified in the data – active thoughts of homicide; understanding homicidal thoughts in others; passive thoughts of death; euthanasia; homicidal thoughts in other caregiving situations; abuse; and disclosing thoughts of harm. Two of the 21 participants had actively contemplated the homicide of their care recipient, four expressed a passive desire for the care recipient's death, and four reported physically or verbally abusing the care recipient. Only one carer had previously disclosed these experiences. Conclusion: Homicidal ideation is a real and significant phenomenon among family carers of people with dementia. Service providers and health professionals are encouraged to identify and support carers contemplating homicide, but to do so in a way that recognises the broader social context of carer burden. [ABSTRACT FROM AUTHOR]