Leisure activities and depressive symptoms in older adults with cognitive complaints

Quercetin Ameliorates Cognitive Impairment in Depression by Targeting HSP90 to Inhibit NLRP3 Inflammasome Activation

Cognitive dysfunction was a common symptom of major depressive disorder (MDD). In previous studies, psychological stress leads to activation and proliferation of microglial cells in different brain regions. Quercetin, a bioflavonoid derived from vegetables and fruits, exerts anti-inflammatory effects in various diseases. To demonstrate the role of quercetin in the hippocampal inflammatory response in depress mice. The chronic unpredictable stress (CUS) depressive mice model built is used to explore the protective effects of quercetin on depression. Neurobehavioral test, protein expression of NOD-like receptor thermal protein domain associated protein 3 (NLRP3) and heat shock protein 90 (HSP90), and cytokines (IL-6, IL-1β, MCP-1, and TNF-α) were assessed. Quercetin ameliorated depressive-like behavior and cognitive impairment, and quercetin attenuates neuroinflammation and by targeting HSP90 to inhibit NLRP3 inflammasome activation. Quercetin inhibited the increase of HSP90 levels in the hippocampus and reverses inflammation-induced cognitive impairment. Besides, quercetin inhibited the increased level of cytokines (IL-6, IL-1β, MCP-1, and TNF-α) in the hippocampus of the depressive model mouse and the increased level of cytokines (IL-6, IL-1β, and MCP-1) in microglia. The current study indicated that quercetin mitigated depressive-like behavior and by targeting HSP90 to inhibit NLRP3 inflammasome activation in microglia and depressive mice model, meanwhile ameliorated cognitive impairment in depression. Quercetin has huge potential for the novel pharmacological efficacy of antidepressant therapy.

Moderating role of depression in the association between leisure activity and cognitive function among the disabled older people

Background

This study delves into the complex interaction between leisure activities and cognitive function in older people with disabilities, with a particular emphasis on the moderating influence of depression. Despite the well-documented cognitive benefits of leisure activities among the older people, the intricate relationship between depression and the association between leisure activities and cognitive function in this specific demographic has been rarely reported.

Methods

Drawing on data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study meticulously examined a cohort of 713 participants aged 65-89 years. We constructed a moderation model to examine the impact of leisure activity on cognitive function in older people with disabilities, with depression levels as a moderating variable.

Results

We found a positive association between engagement in leisure activities and cognitive function, highlighting the potential cognitive advantages associated with leisure engagement among disabled older people. However, the present analysis also reveals a significant moderation effect of depression on this relationship, shedding light on the nuanced nature of this association. Specifically, elevated levels of depression emerge as a critical moderator, attenuating the otherwise favorable impact of leisure activities on cognitive function among older people contending with disabilities.

Conclusion

In conclusion, the findings provide a compelling rationale for tailored interventions that comprehensively target both leisure activity engagement and concurrent depression management, effectively fostering improvements in cognitive function among the cohort of disabled older people.

Factors associated with happiness among community-dwelling older adults: a systematic review

OBJECTIVES

To identify factors associated with self-reported happiness among community-dwelling older adults.

METHODS

A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302).

RESULTS

Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness.

CONCLUSIONS

The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults.

Therapeutic groups run for community-dwelling people with acquired brain injury: a scoping review

PURPOSE

Therapeutic group interventions are commonly provided in acquired brain injury (ABI) inpatient rehabilitation settings, but little is known about the extent of therapeutic groups run for community-dwellers with ABI. This paper seeks to review current literature concerning the nature of therapeutic groups run for community-dwellers with ABI and the involvement of occupational therapists.

MATERIALS & METHODS

A scoping review was conducted with systematic searching of relevant databases guided by Arksey and O'Malley's framework. Studies were included if they reported on therapeutic groups for community-dwellers with ABI. Articles were collated and summarised with key findings presented in narrative form with accompanying tables.

RESULTS

Seventy articles met inclusion. Groups are used as therapeutic change agents for community-dwellers with ABI and target a diverse range of participation barriers. Participants valued group programs that established safe environments, a sense of belonging, growth opportunities and social connections. Group accessibility needs to be improved, with better funding avenues available for service providers, as well as greater consumer involvement in group design and facilitation.

CONCLUSIONS

Groups are a valuable therapeutic modality supporting community-dwellers with ABI. Further research is warranted into the use of groups by occupational therapists working with community-dwellers with ABI.IMPLICATIONS FOR REHABILITATIONTherapeutic groups can support the development of social connections, community participation and help community-dwellers with ABI re-establish a positive self-identity.Conducting groups in community settings and involving consumers in group design and facilitation may enhance the group experience for participants.Occupational Therapists should be involved in the design and delivery of occupation-based and participation focused group-based programs.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study

BACKGROUND

Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB.

METHODS

This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants.

RESULTS

The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB.

DISCUSSION

This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Television watching, reading, cognition, depression and life satisfaction among middle-aged and older populations: A group-based trajectory modelling analysis of national data

This retrospective cohort study aimed to identify heterogeneous cognition, depression, and life satisfaction trajectory groups, and to examine the independent contributions of watching television and reading to these trajectories among middle-aged and older adults. A sample was taken from the Taiwan Longitudinal Study on Aging (TLSA) with measures of cognition, depression, life satisfaction, watching television, and reading during 12 years of follow-up (N = 4440). Group-based trajectory models and multinomial logistic regressions were used. The findings showed that the cohort was separated into three global cognition groups of low-cognition (n = 376), declining-cognition (n = 805), and maintained-cognition (n = 2718); three episodic memory groups of high-declining (n = 540), middle-stable (n = 2066), and improving groups (n = 1293); three depression groups of low-to-low (n = 2571), median-to-high (n = 960), and high-to-high groups (n = 368); and three life satisfaction groups of low- (n = 1133), middle- (n = 977), and high-level groups (n = 1789). Also, the findings demonstrated that after adjusting for covariates, those who did not watch television or read at the baseline had independently significantly increased odds of having lower global cognitive function, higher depression, and lower life satisfaction over time versus those who watched television or read almost every day. Based on the findings obtained, group-based trajectories of cognition, depression, and life satisfaction scores identified distinct subgroups among TLSA participants. Moreover, the findings suggest that healthcare providers need to develop more targeted population interventions to ensure successful aging. Healthcare providers can encourage older adults, particularly new retirees, to participate in leisure activities (i.e., watching television and reading) to reduce prevalence rates of cognitive impairment and depression.

Depression: Determinants That Influence the Mental Health of Older People (60 Years +) in Botswana

Correlates of depression in older people were explored in this study. The prevalence of depression was also calculated. Data were collected using a cross-sectional study stratified by district in urban and rural Botswana using the Patient Health Questionnaire. A snowballing technique was utilized to recruit older participants (N = 378; age = 71.8; SD = 9.1) with low to high incomes. Univariate and multivariate analyses were used to investigate the associations among demographics, individual, social, and environmental factors, and depression. The prevalence of depression and social impairment in older people was 7.8% and 20.6%. The correlates significantly associated with depression in Model 2 were education, income earned, resilience, and self-esteem (F (6, 358) = 19.5, p < .001; R2 = 23%) after adjusting for all influencing factors. Self-perceived health was associated with depression in Model 3 [F (11,340) = 12.5, p < .001; R2 = 28%]. In the final model, resilience, quality of life (QOL), and leisure were significantly associated with depression (p < .001), followed by anxiety, somatic symptoms, and social impairment (p < .05) [F (20,214) = 9.2, p < .001; R2 = 46%]. Findings provide preliminary information on the determinants of depression for further review by the research community. Stakeholders should also take cognizance of these correlates during their practice to curb depression in older people.

The Lifetime of Experiences Questionnaire: Psychometric Properties and Relationships With Memory Function in an Iranian Elderly Sample

This study aimed to validate the Persian version of the Lifetime of Experiences Questionnaire (LEQ) and examine the relationship between life experience and memory function. To this end, two studies were conducted. Study one examined the factor structure, internal consistency, and convergent and discriminant validity of the Persian version of LEQ with 247 healthy elderly individuals (M age = 70.17, SD = 4.42; 55.9% women). The exploratory factor analysis yielded a five-factor solution, including Knowledge, Physical, Socialization, Artistic, and Leisure dimensions, which accounted for 42.42% of the explained variance. The internal consistency of the LEQ was in the acceptable range (α = 0.703). Also, the LEQ and its subscales (except the Artistic subscale) had a negative relationship with geriatric depression and a positive relationship with a healthy lifestyle, supporting the measure's convergent and discriminant validity. In the second study, we examined the relationship between LEQ (total and subscales score) and memory function using Pearson correlation and moderating analysis with 149 participants (M age = 70.37, SD = 4.29; 55.03% women). The results demonstrated that the LEQ total and subscales scores correlated positively with episodic memory. In the same vein, LEQ total score and Knowledge subscale showed a positive correlation with semantic memory. The results of moderation analysis showed that LEQ subscales have a different role in memory decline. The knowledge subscale as a content component moderates the effect of age on semantic memory (B = 0.005, t = 2.021, p = 0.045), while the mid-life non-specific activities, which are based on life stages, moderate the effect of age on episodic memory (B = 0.007, t = 3.348, p = 0.001). In conclusion, our results indicated that the Persian version of the LEQ is a valid and reliable instrument for measuring experiences and activities throughout life, which can be used in professional clinical and research settings in the aging context with Iranian elderly samples. Furthermore, our findings suggest that various life experiences can be considered cognitive reserves in old age.

Depressive Symptoms, Leisure Activity Engagement, and Global Cognition in Non-Hispanic Black and White Older Adults

OBJECTIVES

Prior research indicates that depressive symptoms disproportionately affect cognition in non-Hispanic Blacks relative to non-Hispanic Whites. Depressive symptoms have been linked to worse global cognition in older adulthood through lower leisure activity engagement, but less is known regarding the distinct types of activities that drive these associations and whether associations involving depressive symptoms, leisure activities, and cognition differ across racial groups.

METHODS

This cross-sectional study used data from the Michigan Cognitive Aging Project (n = 453, 52.80% Black, Mage = 63.60 years). Principal components analysis identified 6 subtypes of leisure activities (cognitive, creative, community, physical, children, and games). Mediation models examined whether distinct leisure activity subtypes mediated the association between depressive symptoms and performance on a comprehensive neuropsychological battery and whether race moderated these associations.

RESULTS

There were no racial differences in the level of depressive symptoms after adjusting for sociodemographic, socioeconomic, and health covariates. Only lower cognitive activity engagement mediated the negative association between depressive symptoms and global cognition. Multigroup models revealed that this indirect effect was only evident in Blacks, who showed a stronger negative association between depressive symptoms and cognitive activity engagement than Whites. After accounting for indirect effects, a direct effect of higher depressive symptoms on worse cognition remained and did not differ across racial groups.

DISCUSSION

Depressive symptoms may disproportionately affect cognition among Blacks through a greater negative impact on engagement in cognitively stimulating activities that have been shown to promote cognitive reserve. Additional research is necessary to identify other mechanisms linking depressive symptoms and cognition.

Effectiveness of intergenerational participation on residents with dementia: A systematic review and meta-analysis

Aim

This meta‐analysis evaluated the effectiveness of intergenerational program participation for long‐term care institution residents with dementia.

Design

A systematic review and meta‐analysis.

Methods

Ten electronic databases were systematically searched until August 2020: CINAHL, the Cochrane Library, EBSCO, EMBASE, Ovid Medline, ProQuest, Psychology and Behavioral Sciences Collection, PubMed, Scopus, and Web of Science. The Joanna Briggs Institute tool (JBI tool) was used for the quality appraisal of the included publications, and Review Manager 5.3 was used for the meta‐analysis.

Results

Thirteen articles were identified (1993–2015). Intergenerational program participation could improve the pleasure level and significantly reduce disengagement behaviours of residents with dementia. The intergenerational program intervention caused no apparent improvement in their quality of life, depression levels, and engagement levels.

Activity Engagement and Cognitive Performance Amongst Older Adults

Research supporting cognitive reserve theory suggests that engaging in a variety of cognitive, social, and physical activities may serve as protective factors against age-related changes in mental functioning, especially if the activities are cognitively engaging. Individuals who participate in a variety of cognitive activities have been found to be more likely to maintain a higher level of cognitive functioning and be less likely to develop dementia. In this study, we explore the relationship between engaging in a variety of activities and cognitive performance amongst 206 healthy older adults between the ages of 65–85. Age and years of education were found to be the most significant predictors of a global composite representing cognitive performance, consistent with previous work linking these variables to age-related changes in cognition and the cognitive reserve. We interpret these results to suggest that age and education are better predictors of global cognitive performance in older adults than self-reported activity engagement.

Effects of occupational balance on subjective health, quality of life, and health-related variables in community-dwelling older adults: A structural equation modeling approach

Occupational balance is an important variable associated with health and quality of life. This study aimed to investigate the influence of occupational balance on health, quality of life, and other health-related variables using structural equation modeling. We analyzed data from 208 adults over 55 years old. Mean age of the participants was 70.21 years (SD 7.22). The research model for analysis was based on the results of previous studies addressing occupational balance and related variables such as stress, leisure satisfaction, life satisfaction, subjective health, quality of life, and participation. General fit indices of the final model were acceptable (x2/df = 1.708, p < .001, RMSEA = .058, TLI = .923, CFI = .929, and SRMR = .067). Although the size of effect was small to medium (.157-.249), occupational balance was identified as an independent variable directly or indirectly affecting subjective health, quality of life, and health-related variables in the final model. Our results showed that it is possible to improve subjective health and quality of life by promoting better occupational balance. Further studies developing an intervention program based on occupational balance are required to confirm the feasibility of the intervention and its effect on older adults' health and quality of life in real-life circumstances.

Association of Hearing Loss with Physical, Social, and Mental Activity Engagement

This article aims to evaluate a hearing loss intervention versus an aging education intervention on activity engagement in the Aging and Cognitive Health Evaluation in Elders pilot (ACHIEVE-P). Forty adults (70-84 years) with hearing loss recruited from the Atherosclerosis Risk in Communities Study and de novo participated. Participants were randomized 1:1 to a best practices hearing intervention or a successful aging intervention. Hearing was measured with pure-tone audiometry. The Community Healthy Activities Model Program for Seniors questionnaire measured self-reported time engaging in activities at baseline and 6-month follow-up. At baseline, greater hearing loss was associated with reduced time per week on mental activities (-3.0 hours per 10 dB of hearing loss, 95% confidence interval: -5.8, -0.2). Mental activity engagement increased (mean: +1.3 hours, SD = 6.6) for the hearing intervention group but decreased (mean: -1.1 hours, SD = 4.8) for the aging education group (Cohen's d : 0.41). Hearing loss may be associated with reduced engagement in mental activities. Whether hearing loss treatment impacts activity will be studied in the full-scale ACHIEVE trial.

Effectiveness of board game activities for reducing depression among older adults in adult day care centers of Taiwan: a quasi-experimental study

Depression is common in older adults and is associated with an increased risk of cognitive impairment. To clarify the possible roles of board game use in psychosomatic health promotion, this study evaluated the effects of board game activities in reducing depression in older adults. This was a quasi-experimental study. Purposive sampling was used to select 150 participants aged 65 years and above with intact mental functions who were currently residing in adult day care centers. Seventy-five participants who participated in 12 sessions of selected board game activities were assigned to the experimental group, and 75 participants who adhered to their ordinary activities were allocated to the control group. Structured questionnaires were used for data collection. The board game activities showed promising effects on the depression levels of the investigated older adults living in adult day care centers. Therefore, one possible beneficial effect of board game activities may be reduced depression in older adults. The results of this study provide support for the mediating role of board game activities in the mental health of long-term care elders. Incorporating board game activities into social work may help to make it more diverse and innovative.

Effects of a lifestyle development program designed to reduce the risk factors for cognitive decline on the mental health of elderly individuals

BACKGROUND

The incidence of Alzheimer's disease (AD) along with depression is high in the elderly. In the present study, a program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline was applied to the participants to evaluate its effect on the mental health of these individuals.

METHODS

The participants were randomly assigned to an intervention group and a control group. The program was conducted during 7 months in the intervention group, and it had seven times of group activities, performed once a month for about 1 h, and individual activities to reduce the risk factors for cognitive decline, performed every day. To evaluate the effects of the program on the mental health of the participants, the Geriatric Depression Scale (GDS) and Philadelphia Geriatric Center Morale Scale (PGC) were used. These two scales were applied twice to the intervention and control groups.

RESULTS

The GDS score revealed no change in the score in the intervention group before and after the 7-month program implementation; however, in the control group, the score was significantly higher after program implementation than that before. The PGC score revealed no change in the intervention group before and after 7-month program implementation; however, in the control group, the score was significantly lower after program implementation than that before. Additionally, it revealed no change in the GDS score in the depression-prone control group before and after 7-month program implementation; however, in the depression-prone intervention group, the GDS score was significantly lower after program implementation than that before.

CONCLUSIONS

The intervention program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline is expected to maintain mental health in elderly individuals.

Leisure activities and disability in activities of daily living among the oldest-old Chinese population: evidence from the Chinese Longitudinal Healthy Longevity Study

Introduction: To investigate the independent and joint effects of leisure activities on disability in activities of daily living (ADL) among the oldest-old Chinese population (aged ≥ 80 years).

Results: A total of 3696 participants with ADL disability were identified during the median follow-up period of 3.1 years. Compared to the participants who “never” watched TV or listened to the radio and who “never” kept domestic animals or pets, those who engaged in these activities “almost every day” had a significantly lower ADL disability risk (adjusted hazard ratios were 0.74 and 0.66, respectively; both P < 0.001). Furthermore, participants engaging in multiple leisure activities showed a reduced risk of ADL disability (P for trend < 0.001).

Conclusions: Frequently watching TV or listening to the radio and keeping domestic animals or pets was associated with a lower risk of ADL disability among the oldest-old Chinese population.

Methods: We included 12,331 participants (aged ≥ 80 years) (mean [SD] age: 89.5 [7.0] years) who managed to perform ADL independently at baseline in the Chinese Longitudinal Healthy Longevity Survey 1998-2014 waves. Cox proportional hazards models were used to examine whether leisure activities were associated with ADL disability.

Leisure Activities and All-Cause Mortality Among the Chinese Oldest-Old Population: A Prospective Community-Based Cohort Study

OBJECTIVE

To investigate associations between leisure activities, examining each activity separately and in combination, and all-cause mortality among the Chinese oldest-old (≥80 years) population.

DESIGN

Prospective cohort study.

SETTING

Community-living, the oldest-old from 22 provinces in China.

PARTICIPANTS

We included 30,070 Chinese individuals aged ≥80 years (mean age: 92.7 years) from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014.

MEASUREMENTS

Cox proportional hazards models were used to estimate relationships between leisure activities and all-cause mortality, adjusting for covariates including sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders.

RESULTS

During 110,278 person-years of follow-up, 23,661 deaths were documented. Participants who engaged in watching TV or listening to the radio, playing cards or mah-jong, reading books or newspapers, gardening, keeping domestic animals or pets, or attending religious activities "almost every day" had a significantly lower mortality risk (adjusted hazard ratios ranged from 0.82 to 0.89; P < .01 for all) than did participants who "never" engaged in those activities. Furthermore, engagement in multiple leisure activities was associated with a reduced risk of all-cause mortality (P for the trend < .001).

CONCLUSIONS AND IMPLICATIONS

Frequent participation in leisure activities might help decrease the risk of death in the Chinese oldest-old population. This finding has important implications for public health policy and encourages the incorporation of a broad range of leisure activities into the daily lives of oldest-old individuals.

A Long-Term Exercise Intervention Reduces Depressive Symptoms in Older Korean Women

Despite its prevalence and significance, late life depression is underrecognized and undertreated. This study aimed to investigate the effect of a long-term exercise intervention on depressive symptoms in older Korean women. Thirty older women were assigned to exercise (n = 15, age of 80.8 ± 3.8 years) or control group (n = 15, age of 78.6 ± 3.2 years). The exercise group underwent a resistance exercise plus walking two times weekly on nonconsecutive days for 6 months. Post-intervention change in depressive symptoms was regarded as the primary outcome. Secondary outcomes included changes in body composition and physical performance. Repeated measures analysis of variance showed significant group by time interactions for depressive symptoms (F(1,23) = 37.540, p < 0.001), percent body fat (F(1,23) = 6.122, p = 0.021), lean body mass (F(1,23) = 5.662, p = 0.026), waist circumference (F(1,23) = 4.330, p = 0.049), handgrip strength (F(1,23) = 10.114, p = 0.005), 6-min walking (F(1,23) = 28.988, p < 0.001), and 2.44-m Up & Go (F(1,23) = 28.714, p < 0.001). The current findings support regular exercise as a therapeutic strategy to promote overall and mental health in older Korean women with depressive symptoms.

Linking depressive symptoms and cognitive functioning: The mediating role of leisure activity

OBJECTIVES

Greater depressive symptoms are associated with cognitive decline in older adulthood, but it is not clear what underlying factors drive this association. One behavioral pathway through which depressive symptoms may negatively influence cognitive functioning is through activity engagement. Prior research has independently linked greater depressive symptoms to both lower leisure and physical activity and independently linked both lower leisure and physical activity to lower cognition. Therefore, depressive symptoms may negatively influence cognition by reducing engagement in beneficial leisure and/or physical activities that help to maintain cognition.

METHODS

The current study examined associations between depressive symptoms, leisure activity, physical activity, and global cognitive functioning using longitudinal data from the Washington Heights-Inwood Columbia Aging Project (n = 5,458 older adults). A multilevel structural equation model estimated the between-person and within-person effects of depressive symptoms on global cognition through leisure and physical activity.

RESULTS

Leisure activity, but not physical activity, mediated the association between depressive symptoms and global cognition between- and within-persons. When individuals reported high depressive symptoms, they also reported fewer leisure activities, which was associated with lower global cognition.

CONCLUSION

These findings highlight behavioral pathways through which depressive symptoms may negatively influence cognitive functioning. Findings support the view that perhaps depressive symptoms act as a risk factor for cognitive impairment by reducing leisure activity engagement. (PsycINFO Database Record (c) 2020 APA, all rights reserved).