Psychological aging, depression, and well-being

Perceptions of Adulthood and Mental Health

BACKGROUND

In contrast to conventional definitions, the contemporary conceptualization of adulthood emphasizes psychological characteristics over sociodemographic milestones. At the same time, an increasing number of theorists propose that the way individuals view adulthood may have a significant impact on the mental health of both adolescents and adults. However, empirical examination of this hypothesis has been notably limited to date. The aim of this study is to explore the association between individuals' perceptions of adulthood and multiple dimensions of mental health.

METHOD

This study applied some adulthood markers and multiple mental health indexes (including well-being, optimism, Alexithymia, satisfaction with life, Goldberg's index of mental health, the dark triad, and dimensional personality disorders) to a community sample comprising 1772 individuals in Spain, spanning ages from 16 to 93 years.

RESULTS

The findings support the overarching hypothesis, as perceptions of adulthood display strong correlations with nearly every assessed index of mental health, particularly those that comprise a dimension of negative emotions. These associations persist even after accounting for age and socio-economic status, and in alignment with the psychological paradigm of adulthood, they show a notable consistency across various age groups.

CONCLUSIONS

This study establishes that such perceptions of adulthood represent a modifiable factor contributing to positive mental health. The implications of these findings for the formulation of public policies aimed at promoting mental health in the context of adulthood, as well as a number of future studies, are deliberated.

Notable dysthymia: evolving trends of major depressive disorders and dysthymia in China from 1990 to 2019, and projections until 2030

BACKGROUND

Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce.

METHODS

This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders.

RESULTS

From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining.

CONCLUSIONS

To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.

The Role of Place Attachment in the Relationship between Attitudes toward Aging and Subjective Well-Being among Community-Dwelling Older Adults in Taiwan

Subjective well-being presents a societal challenge for vulnerable older adults. This study aims to investigate the mediating role of place attachment in the relationship between attitudes toward aging and subjective well-being among community-dwelling older adults in Taiwan. Two waves of investigations were conducted to examine the interplay between attitudes toward aging, subjective well-being, and place attachment among older adults. In Wave I, 1190 participants were enrolled, revealing predominantly younger cohorts with substantial educational levels. The subsequent Wave II involved 483 participants, maintaining continuity in characteristics. Subjective well-being remained moderate across waves, with prevalent positive attitudes toward aging. Place attachment scores indicated moderate to high associations. After controlling for demographics, structural equation modeling (SEM) in both waves revealed significant positive associations: attitudes toward aging influenced well-being, attitudes toward aging were positively associated with place attachment, and place attachment was positively related to well-being. Mediation testing confirmed the mediating role of place attachment in the relationship between attitudes toward aging and well-being. These findings underscore the important role of place attachment. It is evident that improving attitudes toward aging is an effective intervention which can lead to a better sense of well-being by enhancing place attachment to empower civil society.

New horizon in improving ageing with improvisational theatre

Cognitive decline, mental health and mindset factors can all affect the autonomy and well-being of older adults. As the number of older adults across the globe increases, interventions to improve well-being are urgently needed. Improvisational theatre (improv) and improv-based interventions are well-suited to address this need. Studies have shown that participation in improv-based interventions has a positive impact on mental health indicators, including depressive symptoms, well-being and social connectedness, as well as cognitive skills such as attention and memory. In addition, improv-based interventions have been beneficial for people with dementia, improving positive affect, self-esteem and communication. In this article, we describe improvisational theatre, or improv, and the reasons it has emerged from a form of spontaneous theatre that involves playfulness and creativity to an important tool to effect behavioural change in individuals and groups. We then review the literature on the effects of improv in ageing populations, with a focus on social, emotional and cognitive functioning. Finally, we make recommendations on designing improv-based interventions so that future research, using rigorous quantitative methods, larger sample sizes and randomised controlled trials, can expand the use of improv in addressing important factors related to autonomy and well-being in older adults.

The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults

INTRODUCTION

Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly.

METHODS

This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge.

RESULTS

The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes.

CONCLUSION

Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Purpose

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association.

Materials and Methods

A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity.

Results

Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI.

Conclusion

This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

Turning Back the Clock: A Retrospective Single-Blind Study on Brain Age Change in Response to Nutraceuticals Supplementation vs. Lifestyle Modifications

BACKGROUND

There is a growing consensus that chronological age (CA) is not an accurate indicator of the aging process and that biological age (BA) instead is a better measure of an individual's risk of age-related outcomes and a more accurate predictor of mortality than actual CA. In this context, BA measures the "true" age, which is an integrated result of an individual's level of damage accumulation across all levels of biological organization, along with preserved resources. The BA is plastic and depends upon epigenetics. Brain state is an important factor contributing to health- and lifespan.

METHODS AND OBJECTIVE

Quantitative electroencephalography (qEEG)-derived brain BA (BBA) is a suitable and promising measure of brain aging. In the present study, we aimed to show that BBA can be decelerated or even reversed in humans (N = 89) by using customized programs of nutraceutical compounds or lifestyle changes (mean duration = 13 months).

RESULTS

We observed that BBA was younger than CA in both groups at the end of the intervention. Furthermore, the BBA of the participants in the nutraceuticals group was 2.83 years younger at the endpoint of the intervention compared with their BBA score at the beginning of the intervention, while the BBA of the participants in the lifestyle group was only 0.02 years younger at the end of the intervention. These results were accompanied by improvements in mental-physical health comorbidities in both groups. The pre-intervention BBA score and the sex of the participants were considered confounding factors and analyzed separately.

CONCLUSIONS

Overall, the obtained results support the feasibility of the goal of this study and also provide the first robust evidence that halting and reversal of brain aging are possible in humans within a reasonable (practical) timeframe of approximately one year.

Interplay between aging and other factors of the pathogenesis of age-related macular degeneration

Age-related macular degeneration (AMD) is a complex eye disease with the retina as the target tissue and aging as per definition the most serious risk factor. However, the retina contains over 60 kinds of cells that form different structures, including the neuroretina and retinal pigment epithelium (RPE) which can age at different rates. Other established or putative AMD risk factors can differentially affect the neuroretina and RPE and can differently interplay with aging of these structures. The occurrence of β-amyloid plaques and increased levels of cholesterol in AMD retinas suggest that AMD may be a syndrome of accelerated brain aging. Therefore, the question about the real meaning of age in AMD is justified. In this review we present and update information on how aging may interplay with some aspects of AMD pathogenesis, such as oxidative stress, amyloid beta formation, circadian rhythm, metabolic aging and cellular senescence. Also, we show how this interplay can be specific for photoreceptors, microglia cells and RPE cells as well as in Bruch's membrane and the choroid. Therefore, the process of aging may differentially affect different retinal structures. As an accurate quantification of biological aging is important for risk stratification and early intervention for age-related diseases, the determination how photoreceptors, microglial and RPE cells age in AMD may be helpful for a precise diagnosis and treatment of this largely untreatable disease.

Psychological factors substantially contribute to biological aging: evidence from the aging rate in Chinese older adults

We have developed a deep learning aging clock using blood test data from the China Health and Retirement Longitudinal Study, which has a mean absolute error of 5.68 years. We used the aging clock to demonstrate the connection between the physical and psychological aspects of aging. The clock detects accelerated aging in people with heart, liver, and lung conditions. We demonstrate that psychological factors, such as feeling unhappy or being lonely, add up to 1.65 years to one’s biological age, and the aggregate effect exceeds the effects of biological sex, living area, marital status, and smoking status. We conclude that the psychological component should not be ignored in aging studies due to its significant impact on biological age.

A Protection Motivation Theory Approach to Understanding How Fear of Falling Affects Physical Activity Determinants in Older Adults

OBJECTIVES

This study applied an extended Protection Motivation Theory to investigate the relative importance of fear of falling (FoF) among motivational and intentional determinants of physical activity (PA) behavior.

METHODS

Older U.S. adults (N = 667, 65+) were surveyed using online research panels and completed measures of self-efficacy and response efficacy (coping appraisal), perceived vulnerability and perceived severity (threat appraisal), FoF, autonomous motivation, intention, physical health, and past PA level.

RESULTS

Our structural equation model showed that past PA level and health predicted intention via cognitive constructs. PA and health predicted FoF and motivation via threat and coping appraisal. FoF did not directly predict intention.

DISCUSSION

Results from this sample provide support for the predictive effects of threat appraisal on fear. However, findings suggest that FoF may not be of great importance for the formation of PA intention compared with an established habit of being physically active and a subsequently fostered coping appraisal and motivation.

Optimizing future well-being with artificial intelligence: self-organizing maps (SOMs) for the identification of islands of emotional stability

In this article, we present a deep learning model of human psychology that can predict one’s current age and future well-being. We used the model to demonstrate that one’s baseline well-being is not the determining factor of future well-being, as posited by hedonic treadmill theory. Further, we have created a 2D map of human psychotypes and identified the regions that are most vulnerable to depression. This map may be used to provide personalized recommendations for maximizing one’s future well-being.

Fundamental Clock of Biological Aging: Convergence of Molecular, Neurodegenerative, Cognitive and Psychiatric Pathways: Non-Equilibrium Thermodynamics Meet Psychology

In humans, age-associated degrading changes, widely observed in molecular and cellular processes underly the time-dependent decline in spatial navigation, time perception, cognitive and psychological abilities, and memory. Cross-talk of biological, cognitive, and psychological clocks provides an integrative contribution to healthy and advanced aging. At the molecular level, genome, proteome, and lipidome instability are widely recognized as the primary causal factors in aging. We narrow attention to the roles of protein aging linked to prevalent amino acids chirality, enzymatic and spontaneous (non-enzymatic) post-translational modifications (PTMs ^SP), and non-equilibrium phase transitions. The homochirality of protein synthesis, resulting in the steady-state non-equilibrium condition of protein structure, makes them prone to multiple types of enzymatic and spontaneous PTMs, including racemization and isomerization. Spontaneous racemization leads to the loss of the balanced prevalent chirality. Advanced biological aging related to irreversible PTMs ^SP has been associated with the nontrivial interplay between somatic (molecular aging) and mental (psychological aging) health conditions. Through stress response systems (SRS), the environmental and psychological stressors contribute to the age-associated “collapse” of protein homochirality. The role of prevalent protein chirality and entropy of protein folding in biological aging is mainly overlooked. In a more generalized context, the time-dependent shift from enzymatic to the non-enzymatic transformation of biochirality might represent an important and yet underappreciated hallmark of aging. We provide the experimental arguments in support of the racemization theory of aging.

The Effect of Social Media Use on Depressive Symptoms in Older Adults with Self-Reported Hearing Impairment: An Empirical Study

Older people with hearing impairment are more likely to develop depressive symptoms due to physical disability and loss of social communication. This study investigated the effects of social media on social relations, subjective aging, and depressive symptoms in these older adults based on the stimulus-organism-response (S-O-R) framework. It provides new empirical evidence to support improving the mental health and rebuilding the social relations of older people. A formal questionnaire was designed using the Wenjuanxing platform and distributed online through WeChat; 643 valid questionnaires were received from older people with self-reported hearing impairments, and SmartPLS 3.28 was used to analyze the data. The results show that (1) social media significantly impacts the social relations of older people with hearing impairment (social networks, β = 0.132, T = 3.444; social support, β = 0.129, T = 2.95; social isolation, β = 0.107, T = 2.505). (2) For these older people, social isolation has the biggest impact on their psychosocial loss (β = 0.456, T = 10.458), followed by the impact of social support (β = 0.103, T = 2.014); a hypothesis about social network size was not confirmed (β = 0.007, T = 0.182). Both social media (β = 0.096, T = 2.249) and social support (β = 0.174, T = 4.434) significantly affect the self-efficacy of hearing-impaired older people. (3) Both subjective aging (psychosocial loss, β = 0.260, T = 6.036; self-efficacy, β = 0.106, T = 3.15) and social isolation (β = 0.268, T = 6.307) significantly affect depressive symptoms in older people with hearing impairment. This study expands the theories of social media aging cognition, social support, and social networks and can provide practical contributions to the social media use and mental health of special persons 60 years and older.

Baseline beliefs about medication are associated with outcomes of antidepressants in inpatients with first-diagnosed depression under supervised therapeutic compliance

The aim of the present study was to explore the effect of baseline beliefs about medication on therapeutic outcomes of antidepressants in inpatients with first-diagnosed depression under supervised therapeutic compliance. Ninety-seven inpatients with first-diagnosed depression were included to collect their baseline demographic data to evaluate the Hamilton depression rating scale (HAMD) scores and the beliefs about medicine questionnaire-specific (BMQ-S) scores at baseline and the end of the eight-week treatment. Additionally, we explored the relationship between inpatients’ medication beliefs and therapeutic effect of antidepressants. The inpatients were divided into remitted depression and unremitted depression groups according to outcomes at the end of the eight-week treatment. There was no significant difference in the baseline HAMD between the two groups (P > 0.050). The scores on the BMQ-S of the unremitted group were significantly lower than those of the remitted group (P < 0.001). The HAMD scores were significantly reduced in both groups after the eight-week treatment (P < 0.001). There was no significant difference in the BMQ-S scores before and after the treatment (P > 0.050). The medication beliefs of the unremitted inpatients after the treatment were still lower than those of the remitted inpatients (P < 0.001). Logistic-regression analysis showed that low BMQ-S scores at the baseline were an independent risk factor for antidepressant efficacy. Beliefs about medication at baseline may be correlated with the therapeutic efficacy in inpatients with first-diagnosed depression under supervised therapeutic compliance.

PsychoAge and SubjAge: development of deep markers of psychological and subjective age using artificial intelligence

Aging clocks that accurately predict human age based on various biodata types are among the most important recent advances in biogerontology. Since 2016 multiple deep learning solutions have been created to interpret facial photos, omics data, and clinical blood parameters in the context of aging. Some of them have been patented to be used in commercial settings. However, psychological changes occurring throughout the human lifespan have been overlooked in the field of “deep aging clocks”.

In this paper, we present two deep learning predictors trained on social and behavioral data from Midlife in the United States (MIDUS) study: (a) PsychoAge, which predicts chronological age, and (b) SubjAge, which describes personal aging rate perception. Using 50 distinct features from the MIDUS dataset these models have achieved a mean absolute error of 6.7 years for chronological age and 7.3 years for subjective age. We also show that both PsychoAge and SubjAge are predictive of all-cause mortality risk, with SubjAge being a more significant risk factor.

Both clocks contain actionable features that can be modified using social and behavioral interventions, which enables a variety of aging-related psychology experiment designs. The features used in these clocks are interpretable by human experts and may prove to be useful in shifting personal perception of aging towards a mindset that promotes productive and healthy behaviors.