Activities of daily living (ADL) functioning are important in the diagnosis of neurocognitive disorders (NCD), yet no standardized and validated instrument exist based on international classification ...systems.
We aimed to psychometrically evaluate the differentiated assessment of ADL and instrumental ADL (IADL) impairments due to NCD according to DSM-5 criteria (Instrument für die Erfassung von Alltagsbeeinträchtigungen bei Neurokognitiven Störungen; A-NKS).
We conducted a pilot study involving 92 participant-informant dyads of participants with mild or major NCDs, cognitively healthy individuals, and an informant, to test acceptability, internal consistency, and convergent validity with similar measures.
Both A-NKS versions demonstrated excellent internal consistency (α= 0.95 -0.99) and correlate with other instrumental ADL instruments (participant informant: Barthel Index: rs = -0.26, p≤0.05 rs = -0.30, p≤0.01; Amsterdam IADL: rs = 0.59, p≤0.01 rs = 0.48, p≤0.01; SIDAM ADL: rs = 0.46, p≤0.001 rs = 0.47, p≤0.001). Additionally, there are correlations with the scale autonomy of the WHOQOL-OLD (rs = -0.50, p≤0.001 rs = -0.37, p≤0.001) and physical, as well as cognitive activities (rs = -0.39, p≤0.001 rs = -0.50, p≤0.001). They were well-accepted by participants and informants.
The A-NKS is an instrument with acceptable psychometric properties to assess ADL due to neurodegenerative decline in healthy individuals, and those with mild or major NCD. Further research is needed to confirm reliability and validity and investigate the factor structure.
The aim of the study is to investigate psychosocial factors that are associated with positive and negative coping with stress, as well as with worries about and perceived threat by COVID-19 to enable ...us to provide adequate support for oldest-old individuals. A paper–pencil-based survey assessed COVID-19 worries and perceived threat, depression, anxiety, somatization, social support, loneliness, resilience, positive and negative coping in a sample of
n
= 197 oldest-old individuals (78–100 years). Linear multivariate and binary logistic regression analyses were conducted. Individuals with high levels of resilience were more likely to feel self-efficient when coping with stress. High levels of depression, anxiety and loneliness were associated with feeling more helpless when coping with stress. However, oldest-old individuals who felt lonely also experienced situations where they felt competent in stress coping. Being male and experiencing high levels of social support was more likely associated with high levels of worries due to COVID-19. Increased age and higher levels of depression were associated with lower levels of perceived personal threat, whereas higher somatization scores were more likely associated with higher perceived personal threat. Findings suggest that mental health factors may shape the way oldest-old individuals cope with pandemic-related stress. Resilience might be an important factor to take into account when targeting an improvement in positive coping with stress. Oldest-old individuals who have higher levels of depression, anxiety and feel lonely may be supported by adapting their coping skill repertoire to reduce the feeling of helplessness when coping with stress.
Purpose
Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially ...modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly primary care patients with a high risk of dementia. The main objectives are (a) to determine the role of the factors in this particular group and (b) to assess the proportion of fixed and potentially modifiable factors.
Method
A high-risk group of 1030 primary care patients aged between 60 and 77 years (52.1% females) were enrolled in “AgeWell.de,” a cluster-randomized, controlled trial. This paper refers to the baseline data. The multi-component intervention targets to decrease the risk of dementia by optimization of associated lifestyle factors. 8 fixed and 7 modifiable factors potentially influencing QoL served as predictors in multiple linear regressions.
Results
The highest proportion of explained variance was found in psychological health and age-specific QoL. In comparison to health-related QoL and physical health, the modifiable predictors played a major role (corr.
R
2
: 0.35/0.33 vs. 0.18), suggesting that they hold a greater potential for improving QoL.
Conclusion
Social engagement, body weight, instrumental activities of daily living, and self-efficacy beliefs appeared as lifestyle factors eligible to be addressed in an intervention program for improving QoL.
Trial registration
German Clinical Trials Register, reference number: DRKS00013555. Date of registration: 07.12.2017.
Background
Mounting evidence suggests that dementia can be prevented. Targeting several risk factors simultaneously constitutes a promising strategy for preserving cognitive function. The ...AgeWell.de‐study was a cluster‐randomized trial applying a multi‐domain intervention to preserve cognitive function in older adults at risk for dementia in Germany.
Method
Individuals with a Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score ≥ 9 points aged 60‐77 years were recruited. According to randomization of their general practitioner (GP) practice, patients received either a multi‐domain intervention (optimization of nutrition and medication, physical, social and cognitive activity, cardiovascular risk management, intervention in case of depressive symptoms and/or grief) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance, assessed using a composite score based on z‐scores of domain‐specific neuropsychological tests.
Result
Of 1,030 participants at baseline (intervention/control: n = 487/543), n = 819 (intervention/control: n = 378/441) completed the follow‐up assessment. Intervention and control group did not differ regarding global cognitive performance (β = 0·010, 95% CI: ‐0·085; 0·105) at follow‐up. However, post‐hoc analyses revealed beneficial effects for social cognition (β = 0·132, 95% CI: 0·012; 0·252) and health‐related quality of life (β = 0·194, 95% CI: 0·065; 0·323). The intervention improved global cognitive performance (β = 0·221, 95% CI: 0·015; 0·428), social cognition (β = 0·259, 95% CI: 0·024; 0·494) and health‐related quality of life (β = 0·421; 95% CI: 0·114; 0·728) in participants with low education, and reduced depressive symptoms in highly educated participants (β = ‐0·431; 95% CI: ‐0·781; ‐0·082). Younger participants benefitted from the intervention regarding social cognition (β = 0·174, 95% CI: 0·010; 0·337) and health‐related quality of life (β = 0·405, 95% CI: 0·241; 0·570).
Conclusion
No effect of the multi‐domain intervention on global cognitive performance was found for the overall sample. The intervention benefitted global cognitive functioning in individuals with low education and social cognition and health‐related quality of life across the sample. Further benefits regarding specific subgroups point towards the usefulness of tailored interventions.
•Widowhood was associated with subsequent higher depression severity.•Depression after widowhood was more pronounced within men than within women.•On an average, widowed men had higher depression ...severity than non-widowed men.•On an average, widowed and non-widowed women did not differ in depression severity.
Old age is accompanied by a higher risk of losing a spouse. This study aims to longitudinally investigate the effect of widowhood on depression severity with a special focus on sex differences. We examine depression before and after widowhood in men and women separately to investigate which sex is at greater risk after losing a spouse.
Data came from the AgeDifferent.de platform, which includes three pooled old age cohort studies. In order to examine factors associated with depression over time, we applied a linear hybrid mixed-effects regression model for the overall sample and analysed additional separate models for men and women.
Of 2470 respondents (mean age at baseline 79.2 (SD 3.64) years), 1256 were men. In total, 209 men and 332 women experienced spousal bereavement after baseline. In general, both sexes showed higher depression severity after widowhood. However, there were significant sex differences. Widowed men were more prone to subsequent depression than widowed women. In terms of depression severity, widowed men differed significantly compared to non-widowed men; however, this was not the case for women.
We harmonized three cohort studies which used different measurement scales for depression and different recruitment procedures.
Our study showed that although both genders suffer from losing a spouse, men are more prone to subsequently develop depressive symptoms. Raising the awareness among practitioners for sex-specific differences as well as developing tailored interventions for both widowed men and women should be considered.
BackgroundIn order to better understand trends in cannabis use, this study estimates independent and non-confounded age, period and cohort effects on 12-month cannabis use prevalence and ...frequency.MethodsData from seven waves of the German Epidemiological Survey of Substance Abuse (ESA) conducted between 1990 and 2009 were used. The total sample included 29 836 men and 34 877 women aged 18–65 years. Cross-classified random effects models were conducted to estimate fixed effects of age and random effects of periods and birth cohorts. Analyses were stratified by gender.ResultsWith regard to 12-month prevalence, substantial age variations were identified with a peak of cannabis use in young adulthood. The overall effects of periods and birth cohorts were not significant. With regard to frequency of use, there were no significant influences of either variable. The results were largely identical for men and women.ConclusionsThis study identified little variation in trend data of current cannabis use. When confounding influences of period and ageing are controlled, the widely reported increases in cannabis consumption in recent birth cohorts cannot be demonstrated.
•Most of the oldest old continuously lived in a restricted social network.•Persons with a restricted social network were more likely to develop depression.•Risk of depression was particularly high ...for elderly with social loss experiences.•An integrated social network may buffer the negative effects of loss on depression.
Loss experiences and bereavement are common among the oldest old. This study aims to investigate the effects of loss experiences and the social network type on depression in old age.
As part of the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative population-based cohort study, 783 persons aged 75+ years were assessed via standardized interviews including the Practitioner Assessment of Network Type Instrument (PANT) and the Center for Epidemiologic Studies-Depression Scale (CES-D). Effects of loss experiences and network type on depression were analysed cross-sectionally (baseline survey) using logistic regressions. Effects over time were analysed longitudinally (follow-up1 and follow-up2) using hybrid techniques.
More than half of the elderly (57%) continuously lived in a restricted network. Only 12.1% lived in an integrated network. Although 30.9% had a change in their network, no significant association with loss experiences was found. Nevertheless, loss experiences (OR 7.56 (1.60–35.72)) and a restricted social network (OR 4.08 (1.52–10.95)) appeared to be the significant predictors of depression.
Our study captures only a selected time window of the individual life and loss experience was only assessed at the time of the baseline survey.
Our findings revealed that elderly individuals, who experienced social loss or lived in restricted social networks, were more likely to develop depression compared to individuals who lived in integrated social networks or without loss experiences. The social integration of elderly individuals is an urgent issue that should be addressed in order to reduce depression in old age.
The aim of this study was to investigate the mediating role of the Big 5 personality traits (extraversion, neuroticism, openness, agreeableness, conscientiousness) in the association between early ...traumatization and depressive symptoms in early adulthood (20–25-year-olds) in a German population-based sample.
A total of 3176 participants from the German National Cohort (NAKO) baseline with an age between 20 and 25 years were included in this investigation. The sum score of the 9-item-version of the Patient Health Questionnaire was used for assessment of depressive symptoms. A structural equation model was built to test the paths between childhood trauma, Big 5 personality traits and depressive symptoms.
Overall, 10.7 % of the young adult sample had a PHQ-9 sum score of ten or higher. The final mediation model fitted well for young adults. We found evidence for a partial mediating effect of Big 5 personality traits.
We only adjusted for age, sex, and year of data collection and did not include biological factors in the model.
Young adults with early trauma experiences have a risk for developing depressive symptoms in young adulthood. Personality traits, especially neuroticism, partially mediated the association between early trauma and depressive symptoms for young adults and should be recognized in preventive strategies.
•There is a direct effect between trauma and later depressiveness for young adults.•Personality traits, especially neuroticism, partially mediate this association.•Big 5 personality traits and trauma could explain 45 % of the PHQ-9-variance.
Purpose
The present study aims to investigate the prospective effect of depressive symptoms on overall QoL in the oldest age group, taking into account its different facets.
Methods
Data were derived ...from the multicenter prospective
AgeCoDe/AgeQualiDe
cohort study, including data from follow-up 7–9 and
n
= 580 individuals 85 years of age and older. Overall QoL and its facets were assessed using the
WHOQOL-OLD
instrument. The short form of the
geriatric depression scale
(
GDS-15
) was applied to assess depressive symptoms. Cognitively impaired individuals were excluded. Linear mixed-effects models were used to assess the effect of depressive symptoms on QoL.
Results
Depressive symptoms were significantly associated with overall QoL and each of the different facets of WHOQOL-OLD, also after adjustment for time and sociodemographic characteristics such as age, gender, education, marital status, living situation, and cognitive status. Higher age and single as well as divorced marital status were also associated with a lower QoL.
Conclusion
This work provides comprehensive longitudinal results on the relationship between depressive symptoms and QoL in the oldest age population. The results underscore the relevance of tailored and targeted care planning and the development of customized interventions.
