Depression among older adults is a significant public health issue that often goes underrecognized, despite its profound impact on their quality of life and mental well-being. With advancing age, many individuals encounter challenges such as loneliness, chronic illness, and bereavement, which heighten their vulnerability to depressive symptoms. These symptoms are not only detrimental to overall health but are also strongly associated with an increased risk of suicidal behaviours. Although these suicidal behaviours are preventable, much research should be done to disentangle development pathways in older adults.

The aim of this research is to identify the symptomatic profiles of depression in the elderly population and to relate this profile to suicidal outcomes.

We utilized data from the “Edad con Salud” cohort study, a longitudinal household survey conducted on a nationally representative sample in Spain (aged 18+ years). Participants who could not be personally interviewed and those under 50 years old were excluded, resulting in a final sample of 3,533 participants (54.31% female, age = 66.42(10.27)). Suicidal behaviours and depressive symptoms were assessed using the Composite International Diagnostic Interview (CIDI 3.0). A Latent Class Analysis (LCA) was performed at base level to identify participant profiles based on 8 depressive symptoms. We followed this with a survival analysis to assess differences between profiles in the progression of suicidal ideation and attempts in the different waves. Finally, Cox regression was used to examine the impact of sociodemographic and clinical covariates on suicidal behaviours.

The three-cluster model provided the best fit. The first class (72.52%) included most participants without depressive symptoms; the second class (13.67%) included participants with three symptoms (depressive mood, diminished interest or pleasure and fatigue); and the third class (13.81%) included participants with all eight symptoms (see Image 1). Survival analysis revealed significant differences between the groups over time for both suicidal ideation (χ2=1332, p < .01) and suicide attempts (χ2=215, p < .01), with the third group having the highest number of cases. Cox regression indicated that suicidal ideation was associated with the second (HR = 5.38) and third classes (HR = 59.8), age (HR = 0.97), and loneliness (HR = 0.91), among other variables. Suicide attempts were associated with the second (HR = 6.08) and third classes (HR = 25.3), age (HR = 0.92), and loneliness (HR = 1.02).

Image 1:

Participants with depressive symptoms, even at a subclinical level, have an increased risk of suicidal behaviours, especially when other risk factors such as loneliness are present.

None Declared

Cognitive impairment is central to psychosis and strongly linked to functional outcomes. The Brief Assessment of Cognition (BAC) app is a tablet-based, automated tool for assessing key cognitive domains but has not been validated in Spanish-speaking populations or across illness stages.

A total of 402 participants (117 with first-episode psychosis [FEP], 125 with schizophrenia, and 160 controls) completed the BAC app along with clinical and functional assessments. We evaluated internal consistency, group differences, convergent and discriminant validity, and the effects of sex, age, and education. Normative percentiles were derived from controls.

The BAC app showed good internal consistency across groups (α = 0.76–0.87) and effectively differentiated individuals with psychosis from controls (area under the curve [AUC] = 0.862), with performance declining from controls to FEP to schizophrenia. Discrimination between FEP and schizophrenia was limited (AUC = 0.649). BAC App correlated positively with estimated intelligence quotient and functional capacity, and negatively with symptom severity, particularly in FEP. Performance varied by age, sex, and education, supporting the need for stratified normative data.

The BAC app showed strong reliability and validity for cognitive assessment in Spanish-speaking individuals with psychosis. Its brevity, automated scoring, and normative data support its clinical and research applications for cognitive screening, monitoring, and treatment evaluation.

This study aims to generate country-specific norms for two episodic memory tasks and a verbal fluency test among middle-aged and older adults using nationally representative data from nine low-, middle-, and high-income countries.

Data from nine countries in Africa, Asia, Europe, and Latin America were analyzed (n = 42,116; aged 50 years or older). Episodic memory was assessed with the word list memory (three trials of immediate recall) and word list recall (delayed recall). Verbal fluency was measured through the animal naming task. Multiple linear regression models with country-specific adjustments for gender, age, education, and residential area were carried out.

Both age and education showed high influence on test performance (i.e. lower cognitive performance with increasing age and decreasing years of education, respectively), while the effect of sex and residential area on cognitive function was neither homogeneous across countries nor across cognitive tasks.

Our study provided sex-, age-, education-, and residential area-specific regression-based norms that were obtained from one of the largest normative study worldwide on verbal recall and fluency tests to date. Findings derived from this study will be especially useful for clinicians and researchers based at countries where cognitive norms are limited.

The Emerald project's focus is on how to strengthen mental health systems in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). This was done by generating evidence and capacity to enhance health system performance in delivering mental healthcare.

A common problem in scaling-up interventions and strengthening mental health programmes in LMICs is how to transfer research evidence, such as the data collected in the Emerald project, into practice.

To describe how core elements of Emerald were implemented and aligned with the ultimate goal of strengthening mental health systems, as well as their short-term impact on practices, policies and programmes in the six partner countries.

We focused on the involvement of policy planners, managers, patients and carers.

Over 5 years of collaboration, the Emerald consortium has provided evidence and tools for the improvement of mental healthcare in the six LMICs involved in the project. We found that the knowledge transfer efforts had an impact on mental health service delivery and policy planning at the sites and countries involved in the project.

This approach may be valid beyond the mental health context, and may be effective for any initiative that aims at implementing evidence-based health policies for health system strengthening.

Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA.

The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed.

Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain.

Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.