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The commentary in the International Psychogeriatrics journal discusses the challenges in identifying and comparing rates of adaptive and maladaptive loneliness among older adults. The authors highlight methodological barriers, such as the lack of consensus on temporal and severity characteristics that differentiate adaptive from problematic loneliness. They also address the need for clear terminology and standardized measures to facilitate comparisons across different studies. The commentary emphasizes the importance of understanding the temporal and severity boundaries of loneliness to develop effective prevention and treatment methods. [Extracted from the article]

Objectives: We examined the association between perceived discrimination and the risk of cognitive impairment with no dementia (CIND) and Alzheimer's disease and related dementias (ADRD) while considering the potential effects of nativity status. Design: A prospective analysis of discrimination and nativity status with dementia and cognitive impairment was conducted among Latinx adults aged 51 years and older who participated in the Health and Retirement Study. Setting: A national representative sample. Participants: A sample of 1,175 Latinx adults aged 51 years and older. Measurements: Demographics, cognitive functioning, perceived discrimination, and nativity status (US-born vs. non-US born) were assessed. Traditional survival analysis methods (Fine and gray models) were used to account for the semi-competing risk of death with up to 10 years of follow-up. Results: According to our results, neither everyday discrimination nor nativity status on their own had a statistically significant association with CIND/ADRD; however, non-US-born Latinx adults who reported no discrimination had a 42% lower risk of CIND/ADRD (SHR = 0.58 [0.41, 0.83], p =.003) than US-born adults. Conclusions: These results highlight the need for healthcare providers to assess for discrimination and provide support and resources for those experiencing discrimination. It also highlights the need for better policies that address discrimination and reduce health disparities. [ABSTRACT FROM AUTHOR]

Objectives: Wisdom is a personality trait comprising seven components: self-reflection, pro-social behaviors, emotional regulation, acceptance of diverse perspectives, decisiveness, social advising, and spirituality. Wisdom, a potentially modifiable trait, is strongly associated with well-being. We have published a validated 28-item San Diego Wisdom Scale, the SD-WISE-28. Brief scales are necessary for use in large population-based studies and in clinical practice. The present study aimed to create an abbreviated 7-item version of the SD-WISE. Method: Participants included 2093 people, aged 20-82 years, recruited and surveyed through the online crowdsourcing platform Amazon Mechanical Turk. The participants' mean age was 46 years, with 55% women. Participants completed the SD-WISE-28 as well as validation scales for various positive and negative constructs. Psychometric analyses (factor analysis and item response theory) were used to select one item from each of the seven SD-WISE-28 subscales. Results: We selected a combination of items that produced acceptable unidimensional model fit and good reliability (ω = 0.74). Item statistics suggested that all seven items were strong indicators of wisdom, although the association was weakest for spirituality. Analyses indicated that the 28-item and 7-item SD-WISE are both very highly correlated (r = 0.92) and produce a nearly identical pattern of correlations with demographic and validity variables. Conclusion: The SD-WISE-7, and its derived Jeste-Thomas Wisdom Index (JTWI) score, balances reliability and brevity for research applications. [ABSTRACT FROM AUTHOR]

The social distancing restrictions associated with the SARS-CoV-2/COVID-19 pandemic brought increased attention to issues of social isolation and loneliness among older adults (Vahia etal., 2020; Frenkel-Yosef I etal i ., 2020). The ubiquity of such changes with advancing age would seem to place older adults at increased risk for social isolation and loneliness, but empirical data show a more complex relationship between age and loneliness. Paradoxical trend for improvement in mental health with aging: A community-based study of 1,546 adults aged 21-100 years. Their findings suggest that low social loneliness might protect against (moderate) the adverse effects of negative life events on subjective well-being, whereas emotional loneliness may mediate the association of negative life events with lower subjective well-being. [Extracted from the article]

Allostatic load and the cannabinoid system: implications for the treatment of physiological abnormalities in Post-Traumatic Stress Disorder (PTSD). Post-traumatic stress disorder (PTSD) is a serious mental health condition with potentially severe deleterious effects on social, mental, and physical well-being. As with other biological dimensions of PTSD (Pitman I et al. i , 2006), key questions remain regarding the causal direction(s) between PTSD and neurocognitive functioning (Jacob I et al. i , 2019). For example, in an analyses of data from the National Health and Resilience in Veterans Study, Mota I et al. i (2016) found 9.9% of older Veterans experienced an exacerbation in PTSD symptoms with an average span of 3 decades since their most severe trauma. [Extracted from the article]

Specifically, they published a widely cited study regarding inter-rater reliability of physician's capacity determinations in regard to capacity to consent to medical treatment (Marson I etal. i , 1997). The right to individual self-governance (autonomy) is one of the core values of contemporary Western ethics. As noted elsewhere by Marson I etal. i (1994) "It is precisely in these more equivocal cases that physicians are asked to render competency opinions and in which it is critical that experienced physicians demonstrate judgment consistency" (p. 12). The percentage of "incompetent" ratings for the AD group varied from 90% by "physician 1" to 0% by "physician 5", and the overall agreement rate for determinations of competence in the AD group was only 56%. [Extracted from the article]

Objectives: This study of loneliness across adult lifespan examined its associations with sociodemographics, mental health (positive and negative psychological states and traits), subjective cognitive complaints, and physical functioning.Design: Analysis of cross-sectional data.Participants: 340 community-dwelling adults in San Diego, California, mean age 62 (SD = 18) years, range 27-101 years, who participated in three community-based studies.Measurements: Loneliness measures included UCLA Loneliness Scale Version 3 (UCLA-3), 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation Scale, and a single-item measure from the Center for Epidemiologic Studies Depression (CESD) scale. Other measures included the San Diego Wisdom Scale (SD-WISE) and Medical Outcomes Survey- Short form 36.Results: Seventy-six percent of subjects had moderate-high levels of loneliness on UCLA-3, using standardized cut-points. Loneliness was correlated with worse mental health and inversely with positive psychological states/traits. Even moderate severity of loneliness was associated with worse mental and physical functioning. Loneliness severity and age had a complex relationship, with increased loneliness in the late-20s, mid-50s, and late-80s. There were no sex differences in loneliness prevalence, severity, and age relationships. The best-fit multiple regression model accounted for 45% of the variance in UCLA-3 scores, and three factors emerged with small-medium effect sizes: wisdom, living alone and mental well-being.Conclusions: The alarmingly high prevalence of loneliness and its association with worse health-related measures underscore major challenges for society. The non-linear age-loneliness severity relationship deserves further study. The strong negative association of wisdom with loneliness highlights the potentially critical role of wisdom as a target for psychosocial/behavioral interventions to reduce loneliness. Building a wiser society may help us develop a more connected, less lonely, and happier society. [ABSTRACT FROM AUTHOR]

Compassion, Spirituality, Loneliness, Well-being, Depression, Aging, Corrigendum Keywords: Compassion; Spirituality; Loneliness; Well-being; Depression; Aging; Corrigendum EN Compassion Spirituality Loneliness Well-being Depression Aging Corrigendum 587 587 1 11/09/23 20231001 NES 231001 The above article (Thomas I et al. i , [1]) was published with a few incorrect item numbers in the Results section and Table 1. Abbreviated San Diego Wisdom Scale (SD-WISE-7) and Jeste-Thomas Wisdom Index (JTWI) - CORRIGENDUM. [Extracted from the article]

The article focuses on the effects of loneliness and social isolation on cognitive functioning in older adults. It mentions social isolation and loneliness each affect cognitive functioning, health, and mortality, but the two constructs are not synonymous; and both affect health, and mortality.

Background:The aim of this research was to compare associations of self-perceived successful aging (SPSA) among Young-Old (Y-O; age 50–74 years) versus Old-Old (O-O; 75–99 years) community-dwelling adults. To our knowledge, this is the first study to compare respondents’ self-perceptions of successful aging among O-O relative to Y-O adults.Methods:Participants included 365 Y-O and 641 O-O adults. The two age groups were compared in terms of the association of SPSA with other preselected measures including sociodemographic information, physical and mental functioning, objective and subjective cognitive functioning, emotional health, and positive psychological constructs.Results:The O-O group reported higher levels of SPSA than the Y-O group. In multiple regression modeling examining predictors of SPSA in each group, there was a tendency toward lower associations in the O-O group overall. Most notably, the associations between physical and mental functioning with SPSA were significantly lower in the O-O versus Y-O group. There were no associations with SPSA that were significantly higher in the O-O versus Y-O group.Conclusion:The lower predictive power of physical and mental functioning on SPSA among O-O relative to Y-O adults is particularly noteworthy. It is apparent that SPSA is a multidimensional construct that cannot be defined by physical functioning alone. Continuing to clarify the underlying factors impacting SPSA between groups may inform tailored interventions to promote successful aging in Y-O and O-O adults. [ABSTRACT FROM PUBLISHER]

Individuals with bipolar disorder (BD) may exhibit attentional deficits, however, the extent of impairment and long-term fluctuations in performance in attention are relatively unknown. We investigated the relationship between sustained attention and affective symptoms over time among BD patients. We also examined whether global differences in attentional capacity differed among BD versus normal comparison (NC) subjects. Participants included 106 outpatients with BD and 66 NC subjects who were administered symptom rating scales and a measure of sustained attention (Continuous Performance Test- Identical Pairs). Measures were repeated 6, 12, and 26 weeks post-baseline. Compared to NC subjects, participants with BD showed impairment in sustained attention across time. Within patient increases in manic symptoms were associated with increased false alarms; both manic and depressive symptoms were associated with worse discrimination. Neither manic nor depressive symptoms were related to hit rates. Our results indicate that the ability to inhibit a response to near miss stimuli (i.e., those that are close to but not identical to the target) is globally impaired among BD patients relative to NC subjects, as well as state-dependent, covarying with affective symptoms. Psychosocial interventions requiring high levels of attentional capacity may need to be adapted according to patients’ current symptomatology. (JINS, 2014, 20, 1–8) [ABSTRACT FROM PUBLISHER]

Background: Informed consent is a key element of ethical clinical research. Patients with serious mental illness may be at risk for impaired consent capacity. Corrective feedback improves within-session comprehension of consent-relevant information, but little is known about the trajectory of patients' comprehension after the initial enrolment session.Aims: To examine whether within-session gains in understanding after feedback were maintained between study visits and to examine stability of decisional capacity over time.Method: This was a longitudinal, within-participants comparison of decisional capacity assessed at baseline, 1 week, 3 months, 12 months and 24 months in 161 people with schizophrenia or bipolar disorder.Results: Within-session gains from corrective feedback generally dissipated over each follow-up interval. Decisional capacity showed a general pattern of stability, but there was significant between-participant heterogeneity. Better neuropsychological performance was associated with better decisional capacity across time points. Positive symptoms of schizophrenia did not predict any aspects of decisional capacity, but general psychopathology, negative symptoms and depression evidenced some modest associations with certain subdomains of decisional capacity.Conclusions: Informed consent may be most effectively construed as an ongoing dialogue with participants at each study visit. [ABSTRACT FROM AUTHOR]

In a psychosocial treatment study, knowing which participants are likely to put forth adequate effort to maximize their treatment, such as attending group sessions and completing homework assignments, and knowing which participants need additional motivation before engagement in treatment is a crucial component to treatment success. This study examined the ability of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) Effort Index (EI), a newly developed measure of suboptimal effort that is embedded within the RBANS, to predict group attendance in a sample of 128 middle-aged and older adults with schizophrenia. This study was the first to evaluate the EI with a schizophrenia sample. While the EI literature recommends a cutoff score of >3 to be considered indicative of poor effort, a cutoff of >4 was identified as the optimal cutoff for this sample. Receiver Operating Characteristics curve analyses were conducted to determine if the EI could predict participants who had high versus low attendance. Results indicated that the EI was successfully able to discriminate between group attendance, and this measure of effort appears to be most valuable as a tool to identify participants who will have high attendance. Of interest, overall cognitive functioning and symptoms of psychopathology were not predictive of group attendance. (JINS, 2013, 19, 1–8) [ABSTRACT FROM PUBLISHER]

This study assesses the relationship of social desirability response bias with self-reported physical, mental and cognitive health, successful ageing, and socio-demographic attributes among 1,860 older women at the University of California, San Diego's Clinical Center for the Women's Health Initiative and the Sam and Rose Stein Institute for Research on Aging. The women were aged between 57 and 91 years and lived in the San Diego community. Measures included a ten-item MarloweDSCrowne Social Desirability Scale, and self-report scales of physical, mental and cognitive health, successful ageing and wellbeing, as well as standard socio-demographic attributes. Bivariate correlation and multiple regression models indicated that social desirability scores negatively associated with self-reported levels of hostility, anxiety, perceived stress and self-reported cognitive failures, and that they predicted additional variance in multiple regression analyses above models containing socio-demographic predictors alone. On the other hand, even the strongest associations were what are generally considered 'small effects' (r<0.30). Overall, while the findings support the general validity of most of the self-report measures in studies of normal and successful ageing, consideration of social desirability response bias in the interpretation of self-reports of low levels of some key constructs (anxiety, hostility, stress, self-perceived cognitive deficits) is warranted. [ABSTRACT FROM AUTHOR]

Schizophrenia is associated with executive dysfunction. Yet, the degree to which executive functions are impaired differentially, or above and beyond underlying basic cognitive processes is less clear. Participants included 145 matched pairs of individuals with schizophrenia (SCs) and normal comparison subjects (NCs). Executive functions were assessed with 10 tasks of the Delis-Kaplan Executive Function System (D-KEFS), in terms of “achievement scores” reflecting overall performance on the task. Five of these tasks (all measuring executive control) were further examined in terms of their basic component (e.g., processing speed) scores and contrast scores (reflecting residual higher order skills adjusted for basic component skills). Group differences were examined via multivariate analysis of variance. SCs had worse performance than NCs on all achievement scores, but the greatest SC-NC difference was that for the Trails Switching task. SCs also had worse performance than NCs on all basic component skills. Of the executive control tasks, only Trails Switching continued to be impaired after accounting for impairments in underlying basic component skills. Much of the impairment in executive functions in schizophrenia may reflect the underlying component skills rather than higher-order functions. However, the results from one task suggest that there might be additional impairment in some aspects of executive control. (JINS, 2010, 17, 000–000) [ABSTRACT FROM PUBLISHER]

Schizophrenia is associated with executive dysfunction. Yet, the degree to which executive functions are impaired differentially, or above and beyond underlying basic cognitive processes is less clear. Participants included 145 matched pairs of individuals with schizophrenia (SCs) and normal comparison subjects (NCs). Executive functions were assessed with 10 tasks of the Delis-Kaplan Executive Function System (D-KEFS), in terms of “achievement scores” reflecting overall performance on the task. Five of these tasks (all measuring executive control) were further examined in terms of their basic component (e.g., processing speed) scores and contrast scores (reflecting residual higher order skills adjusted for basic component skills). Group differences were examined via multivariate analysis of variance. SCs had worse performance than NCs on all achievement scores, but the greatest SC-NC difference was that for the Trails Switching task. SCs also had worse performance than NCs on all basic component skills. Of the executive control tasks, only Trails Switching continued to be impaired after accounting for impairments in underlying basic component skills. Much of the impairment in executive functions in schizophrenia may reflect the underlying component skills rather than higher-order functions. However, the results from one task suggest that there might be additional impairment in some aspects of executive control. (JINS, 2010, 17, 000–000) [ABSTRACT FROM AUTHOR]

Informed consent is key to ethical clinical research and treatment, but partially rests on the ability of individual patients or research participants to use disclosed information to make a meaningful choice. Although the construct of decisional capacity emerged from legal and philosophical traditions, several investigators have begun examining the relationship of specific neuropsychological abilities to decisional capacity. This line of research may foster development of better consent procedures, as well as aid in refining the construct of decisional capacity toward a form that better reflects the underlying neurocognitive processes. We conducted a systematic search of the published literature and thereby identified and reviewed 16 published reports of empirical studies that examined the relationship between specific neuropsychological abilities and capacity to consent to research or treatment. Significant relationships between neuropsychological scores and decisional capacity were present across all the reviewed studies. The degree to which specific neuropsychological abilities have particular relevance to decisional capacity remains uncertain, but the existing studies provide a solid basis for a priorihypotheses for future investigations. These ongoing efforts represent an important conceptual and empirical bridge between bioethical, legal, and neuropsychological approaches to understanding meaningful decision-making processes. (JINS, 2007, 13, 1047–1059.) [ABSTRACT FROM AUTHOR]

We propose a new model for geriatric psychiatry to help meet the needs of a rapidly growing population of older adults. This positive old age psychiatry would focus on recovery, promotion of successful ageing, neuroplasticity, prevention, and interventions to enhance positive psychological traits such as resilience, social engagement and wisdom. [ABSTRACT FROM AUTHOR]

It is becoming clear that post-traumatic stress disorder (PTSD) is not simply a psychiatric disorder, but one that involves pervasive physiological impairments as well. These physiological disturbances deserve attention in any attempt at integrative treatment of PTSD that requires a focus beyond the PTSD symptoms themselves. The physiological disturbances in PTSD range over many systems, but a common thread thought to underlie them is that the chronic effects of PTSD involve problems with allostatic control mechanisms that result in an excess in what has been termed "allostatic load" (AL). A pharmacological approach to reducing AL would be valuable, but, because of the large range of physiological issues involved - including metabolic, inflammatory, and cardiovascular systems - it is unclear whether there exists a simple comprehensive way to address the AL landscape. In this paper, we propose that the cannabinoid system may offer just such an approach, and we outline evidence for the potential utility of cannabinoids in reducing many of the chronic physiological abnormalities seen in PTSD which are thought to be related to excess AL.