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Social isolation and loneliness are concerns in gerontology. The impact of the human–animal interaction (HAI) on loneliness for older adults living alone is understudied. This scoping review explored the extent to which HAI is included in studies investigating social connectedness, specifically social isolation and loneliness, and if HAI bolsters healthy aging through increased perceived support. Following the PRISMA-ScR protocol, data from 58 articles were thematically categorized, identifying (a) existing inclusion of HAI; (b) definitions and descriptions of HAI; and (c) the relationships between HAI and loneliness outcomes, in social connectedness research. Studies including HAI (animal companions and animal-assisted interventions) have increased over time; many noting protection against loneliness and few noting health detriments. Older adults overwhelmingly consider interactions with companion animals as meaningful relationships, whether living at home or in care. Substantial knowledge gaps exist concerning the influence of HAI on perceived social connectedness for older adults living alone.
Preparing and filing taxes has become an increasingly digital task. Older adults need to file taxes to qualify for benefits, but little is known about how older adults in Canada manage tax preparation, nor about how they get help. We investigated delegation mechanisms provided by the Canada Revenue Agency, documenting workflows needed to set up delegation and identifying privacy and security risks. We conducted a semi-structured interview study (n = 19) with older adults, formal tax volunteers, and informal tax helpers to understand the challenges and experiences in tax delegation. Our results show that the CRA’s delegation mechanisms are lightweight and enable older adults to delegate tasks to others with minimal privacy and security risks. However, we found these lightweight mechanisms were not known about or used by the older adults who delegated to informal tax helpers, nor were they known about or used by any of the informal tax helpers we interviewed.
This study aimed to update normative data and establish cut-off scores for a fruit-based semantic verbal fluency (SVF) task among older Taiwanese adults as a method for detecting mild cognitive impairment (MCI). The task was chosen due to its familiarity and cultural neutrality for Mandarin-speaking populations.
Method:
SVF performance was evaluated in 245 healthy control participants and 360 individuals diagnosed with MCI. The influence of demographic variables was examined, and regression-based correction formulas were developed. Receiver operating characteristic (ROC) analyses determined optimal cut-off values according to established clinical classifications of MCI.
Results:
Age, education, and sex significantly influenced SVF performance. A demographically corrected 15th percentile threshold of 10 words was proposed for community screening. An optimal ROC-derived cut-off of 11.5 words yielded an AUC of .716 (95% CI: .68–.76), with sensitivity of 57.8% and specificity of 73.9%. SVF scores were significantly correlated with global cognition, memory, and processing speed.
Conclusions:
The fruit-based SVF task is a quick, culturally relevant tool for detecting early cognitive impairment. Revised norms and cut-off scores can improve MCI identification in Mandarin-speaking seniors.
Depression among middle-aged and older adults is a critical public health priority. Clarifying the dynamic evolution of depression is essential for establishing prevention and intervention strategies; however, relevant research is limited. The aim of this study was to elucidate the transition patterns underlying different depressive symptoms (DS) states.
Methods
Data from the China Health and Retirement Longitudinal Study were utilised in this study, which included participants aged ≥45 years with multiple DS assessments via the Center for Epidemiological Studies Depression Scale. Multi-state Markov models were employed to estimate transition probabilities and intensities between DS states, the total length of stay and mean sojourn time in each state and the hazard ratios (HRs) of factors.
Results
Among 19,991 participants (average follow-up: 7.3 years), the 10-year cumulative probabilities of transition from non-DS to depressive states increased by 19.4% in males and 31.8% in females. Mild DS was the most unstable state, with the highest transition intensities (males: 1.029; females: 0.970) and shortest sojourn time (males: 0.959 years; females: 1.022 years). Sex and age strongly influenced depressive state transitions. Compared to participants without chronic disease, those with ≥3 chronic diseases had a higher risk of developing mild DS (HR = 1.685, 95% Confidence Interval [CI]: 1.530–1.856) and transitioning to death from both the non-DS (HR = 2.905, 95% CI: 2.293–3.681) and severe-DS (HR = 3.429, 95% CI: 1.290–9.112) states, but a lower likelihood of recovery from mild DS (HR = 0.821, 95% CI: 0.749–0.900) and severe DS (HR = 0.730, 95% CI: 0.630–0.847). Compared to no participation in social activities, frequent participation was associated with a lower risk of progression to the mild-DS state (HR = 0.851, 95% CI: 0.785–0.920) and a greater likelihood of recovery from severe DS (HR = 1.169, 95% CI: 1.034–1.322). Being underweight was associated with an increased risk of mild-DS onset (HR = 1.338, 95% CI: 1.129–1.587) and transitioning to death from both the non-DS and mild-DS states, compared with individuals of normal weight.
Conclusions
Our study revealed a continuous population shift towards depressive states and identified the mild-DS state as a critical intervention state owing to its instability. In addition to sex and age, modifiable factors, including chronic disease conditions, social activity participation and weight status, significantly influenced DS-state transitions, offering actionable insights for precision prevention strategies.
Due to frailty, chronic health issues, limited mobility, dependence on assistive devices, and polypharmacy, the geriatric population is more susceptible to the adverse effects of earthquakes. The aim of this study was to determine the factors affecting the quality of life of older adults who experienced the Kahramanmaraş-centered earthquakes in Türkiye on February 6, 2023.
Methods
This cross-sectional interview-based study was conducted with 340 older adults who experienced the earthquakes on February 6, 2023, and visited outpatient departments in Gaziantep. Data were gathered using a demographic form, Modified Fried Frailty Index, and WHO Quality of Life Instrument for Older Adults.
Results
Participants’ average age was 71.37 ± 6.56 years, and 56.6% were women. Among them, 20.9% lost a first-degree relative, 15.3% were injured, and 45.3% were displaced. WHOQOL-OLD scores differed significantly by age, marital status, education, chronic illness, polypharmacy, living arrangements, and frailty.
Conclusions
This study highlights the factors influencing the quality of life of older adults in Türkiye after an earthquake. Living with a spouse and having primary or secondary education improved quality of life, while chronic illnesses and displacement had negative impacts. These findings emphasize the importance of considering the specific needs of older adults in disaster preparedness and response.
Psychological distress can occur even without a depression diagnosis. Many older adults have functional limitations that hinder daily activities, yet their emotional needs often go unrecognized. This study examined whether functional impairment is associated with psychological distress in older adults and whether this relationship varies by depression-diagnosis status. Data came from the 2023 Behavioral Risk Factor Surveillance System for U.S. adults aged 65 and older (N = 95,325). Functional impairment was defined as having 14 or more days in the past month when poor health limited usual activities. Psychological distress was measured by days of poor mental health and a binary indicator of high distress. Survey-weighted regression analyses tested main and interaction effects of functional impairment and depression diagnosis while adjusting for sociodemographic and behavioral factors. Functional impairment was linked to greater distress. Predicted estimates showed the highest distress among those with both impairment and a depression diagnosis (about 11 poor mental health days). Those with impairment only averaged about 6 days, those with a diagnosis only about 8, and those with neither condition about 3. Functional impairment may reveal hidden distress in older adults without diagnosed depression. Adding physical-function indicators to screening could help identify vulnerable individuals earlier.
The clinical presentation and course of illness of older-age bipolar disorder (OABD) are highly variable. In addition, the presentation and course of bipolar disorder (BD) differ between females and males. This study aims to carry out a network analysis of older people with symptoms compatible with BD. Using a sample from the MentDis_ICF65+ study, a symptom network analysis was conducted according to gender and age in 555 people over 65 in the Community of Madrid (Spain). The network was estimated using the InsingFit package that implements a procedure called eLasso. These results reveal differences in the strength, closeness, and betweenness of the networks according to gender and for the age groups 65–74 and 75–84. Females present a network that is much more sparse, with a lower density, and consisting of two sub-networks: one composed of TALK (more talkative than usual) and RACIN (a flight of ideas, racing thoughts) and the other of PAINF (activities with painful consequences), SLEEP (the decreased need for sleep), GRAND (inflated self-esteem), and AGIT (psychomotor agitation). In the case of men, a denser network is obtained, with greater connections between all the symptoms, being the edge with greater weight than the one integrated by RACIN and GRAND. In relation to age, it is possible to observe changes in the model between the two age groups. These network differences support viewing OABD dimensionally and emphasize considering gender and age to improve understanding and personalize treatments for older adults with bipolar disorder symptoms.
Longer life expectancy and growing income inequality have prompted an increasing interest in understanding the impact of ageing on nutritional requirements in order to optimise intakes, increase the number of years lived in good health and reduce morbidity and associated health and social care costs. Food insecurity reduces access to nutritious and healthy food. Understanding the evidence base on the impacts of food insecurity and the maintenance of food security for older people is crucial to informing policy and intervention. The increase in numbers of older people experiencing food insecurity is a public health emergency and is associated with under and malnutrition. Food insecurity can be experienced at any stage of the life course but has been more widely studied with families and children where poverty is a major driver. Food insecurity in later life has been less well explored by academics, but differs from that experienced in earlier years due to additional complexities, as physical and cognitive health amplify the impact of poverty. Additionally, factors which can appear to be relatively small in impact can act in a cumulative way to push people towards food insecurity. This review will draw on research about older people’s food practices, contexts and experiences in relation to food insecurity in later life and offers a model of food insecurity that has the potential to guide focused public health efforts in order to support the older population to be food secure.
Patients’ involvement in the decision-making process is essential for shared decision-making and optimal patient-centered care. However, when there are concerns about a patient’s cognition and judgmen, the complexity of providing patient-centered care increases. It is often necessary to evaluate patients’ decision-making capacity (DMC) to determine whether they are able to make a particular decision or whether to rely on their previously expressed wishes or the patient’s caregivers.
Methods
In this article, we present a case of an older adult with colon cancer who presented to the emergency room.
Results
We describe how multidisciplinary care can enhance the evaluation of DMC and improve quality of care for older patients with advanced cancer.
Significance of results
Multidisciplinary discussions and good communication skills are essential for navigating these complex situations, reducing potential harm and maximizimizing quality of life.
How people experience their own ageing may impact how likely they are to remain engaged with life. This study examined (1) biologically based risk factors in the form of self-reported health and cognition, and (2) age-related stereotypes and frequency of perceived ageism as predictors of engagement with life and number of ‘close’ social connections in older adulthood. We aimed to move beyond studies focusing on direct links between ageism and psychosocial functioning by examining the extent to which ageism could act as a moderating factor, amplifying negative associations between established risk factors and engagement with life. Data were obtained from a community-based sample of 287 South Australians aged 65–103 years (M = 76.41, SD = 7.13; 54.4 per cent female) who participated in a telephone survey. Hierarchical multiple linear regressions were run using Stata v15.1. Overall, frequency of perceived ageism in this community sample was low. More positive age-related stereotypes were related to more ‘close’ social connections, but not greater engagement with life. Counter to expectations, an interaction of frequency of perceived ageism with health indicated that higher engagement with life was associated with more frequent perceived ageism, but only among those in poorer health. No other moderating effects were observed. The findings are discussed in terms of possible underlying mechanisms linking ageism, stereotypes and engagement, including the likelihood that our results in part reflect reverse causality, with those with both greater physical limitations and who remain broadly engaged being at greater risk of experiencing ageism.
Social relationships provide opportunities to exchange and obtain health advice. Not only close confidants may be perceived as sources of health advice, but also acquaintances met in places outside a closed circle of family and friends, e.g., in voluntary organizations. This study is the first to analyze the structure of complete health advice networks in three voluntary organizations and compare them with more commonly studied close relationships. To this end, we collected data on multiple networks and health outcomes among 143 middle-aged and older adults (mean age = 53.9 years) in three carnival clubs in Germany. Our analyses demonstrate that perceived health advice and close relationships overlap only by 34%. Moreover, recent advances in exponential random graph models (ERGMs) allow us to illustrate that the network structure of perceived health advice differs starkly from that of close relationships. For instance, we found that advice networks exhibited lower transitivity and greater segregation by gender and age in comparison to networks of close relationships. We also found that actors with poor physical health perceive less individuals as health advisors than those with good physical health. Our findings suggest that community settings, such as voluntary associations, provide a unique platform for exchanging health advice and information among both close and distant network members.
Everyday functional capacity in older adults is influenced by several factors, with prior studies finding that cognition mediates the relationship between depression and everyday functioning. However, these studies utilized samples with low depression severity and used only one type of functional assessment. We aimed to examine whether cognition mediates the relationship between depression and functioning in older adults with a history of treatment-resistant depression.
Method:
Data from 383 participants enrolled in the OPTIMUM Neuro study were analyzed. Participants completed a neuropsychological assessment battery, depression severity interview, self-/informant-rated functioning measures and a performance-based functioning measure. Linear regression was used to determine whether depression scores predicted cognitive domain and everyday functioning scores. Cognitive domain scores predicted by depression were then tested as mediators between depression and functioning.
Results:
Higher depression symptoms predicted poorer performance on all measures of functioning as well as the cognitive domains of attention, executive functioning, and immediate memory. Immediate memory partially mediated the relationship between depression and a performance-based measure of functioning, while attention and executive functioning partially mediated the relationship between a self-report measure of functioning and depression.
Conclusions:
The relationship between depression severity and poorer functional performance was partially mediated by attention, executive functioning, and immediate memory, with results differing based on the measure of functioning used. Our findings suggest that there may be additional non-cognitive factors influencing this relationship and highlight the importance of using multiple methods to assess functional performance.
Distributional learning enables listeners to form phonetic categories by extracting statistical regularities from speech input. Younger Cantonese speakers can acquire the Mandarin level-falling (T1–T4) contrast through distributional learning, with bimodal exposure facilitating category formation and unimodal exposure suppressing it, and with fine-grained pitch sensitivity predicting success. However, aging is associated with declines in pitch sensitivity and phonetic boundary formation, which may disrupt this process. This study examined whether Cantonese-speaking older adults exhibit distributional learning of Mandarin T1–T4 and whether individual cognitive factors predict learning success. Sixty-four participants completed a pretest–training–posttest procedure with bimodal or unimodal exposure. While older adults improved in tone discrimination, no group differences emerged. Further analysis showed that those with lower pitch-related auditory memory failed to learn from unimodal input. On the other hand, fine-grained pitch perception abilities did not predict learning outcomes. These results suggest that older adults may rely on alternative learning mechanisms, such as memory-based strategies, when exposed to ambiguous input distributions. The findings indicate a shift from perceptual encoding to memory-driven processing in aging and highlight the limits of passive statistical learning in older adulthood.
Prior research indicates that both structural and functional networks are compromised in older adults experiencing depressive symptoms. However, the potential impact of abnormal interactions between brain structure and function remains unclear. This study investigates alterations in structural–functional connectivity coupling (SFC) among older adults with depressive symptoms, and explores how these changes differ depending on the presence of physiological comorbidities.
Methods
We used multimodal neuroimaging data (dMRI/rs-fMRI) from 415 older adults with depressive symptoms and 415 age-matched normal controls. Subgroups were established within the depressive group based on the presence of hypertension, hyperlipidemia, diabetes, cerebrovascular disease, and sleep disorders. We examined group and subgroup differences in SFC and tracked its alterations in relation to symptom progression.
Results
Older adults with depressive symptoms showed significantly increased SFC in the ventral attention network compared with normal controls. Moreover, changes in SFC within the subcortical network, especially in the left amygdala, were closely linked to symptom progression. Subgroup analyses further revealed heterogeneity in SFC changes, with certain physiological health factors, such as metabolic diseases and sleep disorders, contributing to distinct neural mechanisms underlying depressive symptoms in this population.
Conclusions
This study identifies alterations in SFC related to depressive symptoms in older adults, primarily within the ventral attention and subcortical networks. Subgroup analyses highlight the heterogeneous SFC changes associated with metabolic diseases and sleep disorders. These findings highlight SFC may serve as potential markers for more personalized interventions, ultimately improving the clinical management of depression in older adults.
While ageing in place emphasises autonomy and the preference of older adults to remain in familiar environments, and ageing and place shifts attention to their movement across multiple locations, both frameworks have paid insufficient attention to the role of social networks in shaping the spatial practices of ageing. In this article, we propose ageing in networks as a complementary approach that foregrounds relationality. Rather than supplanting place-based models, ageing in networks highlights how older adults navigate spaces—both near and far—through their social ties, and how these ties mediate access to emotional and practical support. Drawing on original survey data from 1,199 residents aged 60–92 in two Singaporean public housing areas (Hougang and Taman Jurong), we examine how older adults mobilise both strong and weak ties—including friends, co-workers, and digitally mediated contacts—across everyday sites such as hawker centres, markets, malls, and churches. These connections often span neighbourhoods, suggesting that older adults are not merely attached to their residential areas but are actively sustaining dispersed, networked geographies of care and companionship. Crucially, we find that expansive social ties can buffer the challenges of living alone. We argue that social isolation, more than spatial isolation, poses the greater risk to older adults’ well-being.
The body acquires knowledge through interactions with the world. This knowledge resides in the body and shapes our physical, social and emotional experiences. Older adults possess extensive embodied knowledge, but its expression can be suppressed by environmental and social change, such as relocating to a residential care home (RCH). Dancing is more than movement; it is an embodied activity that involves complex interactions among the body, space, time and other people. Dance has been shown to benefit older adults, yet existing research often focuses on physical and cognitive outcomes, with limited attention to dance as an embodied lived experience, especially in an RCH context. This study explores six older adults’ lived experiences of dancing. Its interpretative phenomenological analysis reveals that participants possessed a vast reserve of embodied knowledge which emerged when they participated in synchronised seated dance. Two superordinate themes – embodied musicality and rekindled connections to the lifeworld – detail how older adults expressed embodied knowledge during dance, becoming connected with their body, space, time and others, nurturing a sense of self. Dancing also helped participants navigate the changes in their body and environment, enriching their living experience in an RCH. The findings contribute to the broader field of dance research, demonstrating how seated dance facilitates accessing and expressing embodied knowledge later in life, and to the limited research on dance in RCHs, positioning dance as a meaningful mode of self-expression and continuity for older adults, supporting their transition to these settings with rich emotional experiences.
Recent literature has shown that appetite loss during ageing can lead to negative health outcomes in older adults, particularly malnutrition and mortality. However, its association with functional decline and the mechanisms driving this relationship are not well explored. This review summarises the current evidence regarding the potential effects of appetite loss on frailty and functional outcomes. Despite the limitations due to heterogeneous methodologies, including study designs, population characteristics and appetite assessments, most studies indicate that older adults with poor appetite tended to exhibit poor physical performance and increased functional limitations. Furthermore, the simultaneous weight loss in individuals experiencing appetite loss was associated with a higher risk of functional impairments. Finally, emerging evidence connects reduced appetite to biomarkers of ageing, including epigenetic alterations, chronic inflammation and the upregulation of GDF-15. Therefore, loss of appetite is a potential earlier marker of loss of function that deserves further investigation. Adopting a geroscience perspective may enhance our understanding of appetite loss during ageing and foster the development of effective interventions.
Cognitive and behavioral factors contribute to the mitigation of stress-related health outcomes in later life. Given that stress management interventions for older adults are an important target for healthcare, there is a need for a relatively short and standardized assessment tool to comprehensively measure stress and coping in later adulthood while minimizing the burden on participants. The Stress Assessment Inventory (SAI), a 123-item measure designed to assess stress and coping resources in younger adults.
Objective
The objective of this study was to examine the psychometric properties of the SAI in 294 older adults.
Methods
The SAI was evaluated on its dimensionality, reliability, and validity.
Findings
A shortened SAI is proposed for older adults, with good internal consistency and criterion validity. The Revised SAI was found to have a three-factor model that captures Adaptive Cognitive Resources, Maladaptive Behavioral and Cognitive Habits, and Adaptive Health Habits.
Discussion
The current study supports the use of the Revised SAI in community-dwelling older adult populations as a comprehensive tool to assess stress and coping for use by researchers and healthcare professionals.
We evaluated performance-based differences in neuropsychological functioning in older adults (age 65+) across the dementia continuum (cognitively intact, mild cognitive impairment, and dementia) according to recent cannabis use (past six months).
Method:
A sample of 540 older adults from a well-characterized observational cohort was included for analysis. Participants completed a standardized questionnaire assessing cannabis use in the six months prior to the study visit and completed a comprehensive neuropsychological assessment. We used traditional cross-sectional analyses (multivariate, univariate) alongside causal inference techniques (propensity score matching [PSM]) to evaluate group differences according to recent cannabis use status. We also examined whether cannabis-related problem severity, a risk factor for cannabis use disorder (CUD), was associated with cognitive outcomes among those reporting recent cannabis use.
Results:
Approximately 11% of participants reported using cannabis in the prior six months, with the median user consuming cannabis two to four times per month. Participants with recent cannabis use performed similarly across all five domains of neuropsychological functioning compared to those with no cannabis use. Among older adults reporting recent cannabis use, those with elevated risk for CUD demonstrated lower memory performance.
Conclusions:
These preliminary results are broadly consistent with other findings indicating that low-frequency cannabis use among older adults, including those along the dementia continuum, is generally well tolerated from a cognitive perspective. However, among older adults who used cannabis, elevated symptoms of CUD may negatively impact memory performance. Future research should explore how variations in cannabis use patterns, individual characteristics, and clinical phenotypes influence cognitive outcomes.