Abstract: Violence against older adults is a public health problem often underestimated by healthcare workers and not yet included on the international political agenda. Numerous statistical data confirm its increasing frequency and its effects on morbidity, mortality, and rising healthcare costs. Despite the complexity of this phenomenon, violence against older adults is something that can be contained with concrete actions, public awareness campaigns, and training for healthcare workers, including regarding their reporting obligations. Starting from the international context, the authors analyze how Italy has developed its own regulatory framework that, without compromising the duty of confidentiality, regulates the obligation to report to judicial authorities. Exploring the complex set of laws governing this legal obligation, the recent changes introduced by the Cartabia Reform and its practical implications for healthcare professionals, the authors clarify the meaning of those conceptual categories (fragility, vulnerability, incapacity, and impaired defense) that, in Italy, assume specific relevance in cases of violence against older individuals. Finally, they report a clinical case they observed and formulate a series of final recommendations, implementable at the local level, which the Italian Association of Psychogeriatrics (AIP) will disseminate to the professional community to raise awareness of this complex social emergency.
Abstract: We conducted a retrospective cohort study on patients aged 65+ to evaluate medication prescription patterns following a dementia diagnosis. We matched dementia cases with controls by age, sex, and year and collected data on demographics, medical history, and prescriptions. We used paired t-tests and multivariable regression to analyze medication changes and predictors. Both the dementia and control groups showed increased medication use postdiagnosis. The dementia group had a 13% increase in total medications, with notable rises in psychotropic and antidiabetic drugs. The control group had a 17% increase in total medications, with significant increases in psychotropic and antihypertensive drugs. Age and male sex predicted medication changes. Healthcare professionals should monitor prescribing patterns and optimize medication management in older adults, regardless of dementia status.
Abstract: Limitations in staff resources at memory clinics in Germany can limit their ability to perform diagnostic procedures. Because of demographic changes, an increasing number of people are expected to develop mild cognitive impairment and dementia and thus require effective screening to enable early diagnosis. Telemedicine screening instruments may help identify individuals at risk. We invited N = 30 memory clinic patients to participate in both a telemedicine and an in-person interview. The telephone interview consisted of the German version of a word-retrieval test (Word Finding Test, WoFi 1), the latter a parallel version of the WoFi (WoFi 2), as well as routine diagnostic procedures for assessing neurocognitive impairment. We compared the results of WoFi 1 and 2 with each other and with the results of the neuropsychological cognitive test battery. The analyses included 13 patients diagnosed with Alzheimer’s disease and 13 with mild cognitive impairment; we excluded 4 patients with depressive disorder from the analyses. The scores on WoFi 1 and 2 correlated highly with each other ( ρ = 0.814, p < .001); remote WoFi correlated highly with other verbal word retrieval tests such as semantic (β = 0.760; p < .001), phonemic fluency (β = 0.639; p = .002), and a global cognitive status score (β = 0.591; p = .009). Participants performed better when assessed in person: The mean WoFi score was 87.00 (remotely) and 93.96 (in person). The gold standard for neuropsychological testing is face-to-face interaction between the investigator and the interviewee, but this approach requires significant staff resources and time. The study indicates that a brief, feasible telemedicine screening tool may help identify individuals who could benefit from further cognitive evaluation.
Abstract: Background: Depression has become a widespread mental health concern as millions of older immigrants are living and aging in host countries. This scoping review identified factors associated with depression among immigrants over 65 years old and provided evidence-based recommendations for future research, treatment, and policymaking. Method: We conducted a systematic search across four databases from 2005 to June 2025 and identified 21 studies for an in-depth review. Results: A thematic analysis helped identify several risk and protective factors associated with depression. The risk factors included sociodemographic factors, health-related factors, acculturation challenges, stressful life events, negative emotional traits, loneliness, living alone, and caregiver burden. Protective factors included social relationships, co-residence with children/family, religious participation, physical functioning, technology use, marriage, ethnic identity, and education. Conclusion: Extant studies focused on sociodemographic characteristics, acculturation challenges, health-related factors, and social relations, with limited attention to psychological and behavioral aspects. Future studies should explore internal self-regulation strategies, digital literacy, and social media use in relation to depression. Intervention programs and policies are required to address the mental health needs of older immigrants.
Abstract: Background: Climate change represents one of the main global threats to public health. The progressive increase in average temperatures and the greater frequency of extreme weather events expose the population to significant physical, psychological, social, and economic risks. The older population appears particularly vulnerable because of the physiological changes and sociocultural conditions associated with the aging process. Aim: This work (1) investigates the main effects of rising temperatures and extreme weather events on the health of older adults; (2) identifies specific risk factors for this age group; (3) identifies prevention and coping strategies that account for the peculiarities of the aging process. Methods: We conducted a systematic review according to the PRISMA criteria, performing a search in the Ebsco PsycINFO, Scopus and MEDLINE PubMed databases from 2007 to March 2024. Results: The content analysis of the articles identified seven areas of interest: (1) the physiological factors affecting mental health, (2) the psychological impact, (3) suicidal behavior, (4) demographic factors, (5) psychosocial factors, (6) protective factors, and (7) psychoeducational programs and coping strategies. Discussion: The results highlight significant effects on physical, mental, and social health, mediated by factors such as social isolation, socioeconomic conditions, and demographic characteristics. Among the studies examined, methodological issues emerge, including the heterogeneity of psychometric instruments, the lack of measurement standardization, and the insufficient integration of subjective and objective data. Intergenerational conflict and climate ageism can hinder the implementation of preventive and adaptation strategies. Conclusion: The study highlights a complex relationship between climate change and the health of older people, highlighting methodological and political gaps in the protection of their rights and needs. In particular, the heterogeneity of research designs and measures across studies limits the comparability and generalizability of their findings, underscoring the need for more standardized approaches in future research.
: As older Americans experience ageism in multiple domains, they tend to have an ongoing need to cope with it. The current study is the first to examine whether attributing ageism to societal rather than dispositional causes can have mental-health advantages. We randomly assigned older individuals to a societal-intervention group (in which ageism was blamed on institutions, such as the anti-aging industry), a dispositional-intervention group (in which ageism was blamed on the inner qualities of the targeters, such as personality), or a neutral-comparison group. Those in the societal intervention showed a 41% greater decline in anxiety than those in the dispositional intervention. In addition, we found that an awareness-raising, blame-shifting, and challenging ageism (ABC) intervention effectively increased positivity of age beliefs and reduced anxiety. The results suggest that identifying the societal sources of ageism that can be targeted by collective action empowers older persons and improves their mental health.
: Objectives: Higher levels of positive emotions relative to negative emotions have been associated with resilience and coping, yet this is rarely explored in the context of caregiving. We examined cross-sectional and longitudinal associations of ratios of positive to negative emotions (affect ratios), coping strategies, and caregiver burden in adult children of older adults living with memory loss over 1 year. Methods: Adult children of parents living with memory loss completed self-report questionnaires about their emotions, coping strategies, and caregiver burden at baseline (N = 150) and at 1-year follow-up (N = 108). We used regression analysis to evaluate the associations between affect ratios, burden, and coping strategy use. We also tested whether the use of coping strategies moderated the association between the affect ratio and caregiver burden. Results: Greater affect ratios were associated with lower caregiver burden both cross-sectionally and longitudinally, even when accounting for individual measures of positive and negative affect. Greater affect ratios were associated with lower use of avoidant coping strategies. The interaction between affect ratio and coping was significantly associated with caregiver burden: Adult children with higher affect ratios and lower use of avoidant coping strategies reported even lower burden. Discussion: The findings highlight the balance between positive and negative emotions as a key indicator of adult children's caregiver burden and a potential intervention target. The interaction between the affect ratio and coping suggests that interventions may be most effective when they also aim to reduce avoidant coping strategies.
: Although previous research suggests a positive shift among older adults with chronic pain, few studies have investigated how this phenomenon occurs in different cultural settings. We compared age-related differences in pain catastrophizing, pain self-efficacy, pain intensity, and pain interference among older, middle-aged, and young adult Japanese and examined age-related differences in patterns of association between pain-related beliefs and pain-related outcomes. Seven hundred and forty participants responded to questionnaires. Analyses of covariance did not show statistically significant age differences in the study variables. The multigroup path analysis showed different patterns in associations of helplessness and rumination subcomponents with pain-related outcomes across age groups. Generally, and contrary to previous research, we did not observe evidence supporting a positive shift of experience in older Japanese adults with chronic pain. The different patterns of associations in the pain-related cognitive model have implications as a guiding framework for pain management in older adults with chronic pain.
: The UN Convention on the Rights of Persons with Disabilities emphasizes supporting individuals with disabilities, including those with dementia, in making self-determined decisions, as cognitive decline often challenges their capacity to consent. This study explored a new approach to supported decision-making by examining whether conducting decision-making conversations in a familiar home setting, rather than a clinical environment, reduces complexity and strengthens consent capacity. We used a randomized AB/BA crossover design to assess the impact of spatial intervention on capacity to consent in N = 28 individuals with suspected or confirmed dementia. We computed linear mixed models for consent capacity facets and secondary endpoints (e.g., task complexity), including baseline covariates. Overall, the participants scored high on consent capacity subscales and showed low anxiety and uncertainty during decision-making. Regression analyses showed no significant differences in capacity to consent depending on location and period. Descriptively, there was a slight increase at the second time point, which was more distinct for participants first assessed at home. Although we found no significant differences, the descriptive results suggest potential learning effects, with the home environment possibly providing supportive conditions. Limitations included a small sample size, challenges faced by physicians unfamiliar with home visits, and ceiling effects.
Limitations in staff resources at memory clinics in Germany can limit their ability to perform diagnostic procedures. Because of demographic changes, an increasing number of people are expected to develop mild cognitive impairment and dementia and thus require effective screening to enable early diagnosis. Telemedicine screening instruments may help identify individuals at risk. We invited N = 30 memory clinic patients to participate in both a telemedicine and an in-person interview. The telephone interview consisted of the German version of a word-retrieval test (Word Finding Test, WoFi 1), the latter a parallel version of the WoFi (WoFi 2), as well as routine diagnostic procedures for assessing neurocognitive impairment. We compared the results of WoFi 1 and 2 with each other and with the results of the neuropsychological cognitive test battery. The analyses included 13 patients diagnosed with Alzheimer's disease and 13 with mild cognitive impairment; we excluded 4 patients with depressive disorder from the analyses. The scores on WoFi 1 and 2 correlated highly with each other (rho = 0.814, p < .001); remote WoFi correlated highly with other verbal word retrieval tests such as semantic (beta = 0.760; p < .001), phonemic fluency (beta = 0.639; p = .002), and a global cognitive status score (beta = 0.591; p = .009). Participants performed better when assessed in person: The mean WoFi score was 87.00 (remotely) and 93.96 (in person). The gold standard for neuropsychological testing is face-to-face interaction between the investigator and the interviewee, but this approach requires significant staff resources and time. The study indicates that a brief, feasible telemedicine screening tool may help identify individuals who could benefit from further cognitive evaluation.
: Both people with dementia and their caregivers show a decrease in quality of life and well-being. The Alzheimer Caf & eacute; (AC) is a psychosocial intervention supporting both people with dementia and their caregivers. This pilot study aims to (1) create a network of Alzheimer's associations operating in different Italian regions; (2) assess the project's feasibility; and (3) evaluate the impact of AC participation on (a) the quality of life of people with mild cognitive impairment (MCI) or dementia and (b) the caregivers' depressive symptoms and burden. We conducted a multicenter pilot study involving a network of Alzheimer's associations. People with MCI or dementia (referred to as "participants") and their caregivers participated in weekly AC meetings that included psychosocial, cognitive, physical, and educational activities. We enrolled a total of 168 participants and 161 caregivers through a network of 16 AC across eight Italian regions. We measured the outcomes at baseline and at 6 and 12 months. The primary outcome was the change in the participants' quality of life. Secondary outcomes included changes in caregiver burden, depressive symptoms, and psychological stress. We used generalized linear models to analyze the changes in test scores over time. At follow-up, the participants' neuropsychiatric symptoms had significantly improved, and their overall quality of life remained stable. Among the caregivers, distress related to the participants' neuropsychiatric symptoms significantly declined, and burden remained moderate. The AC appears to reduce participants' neuropsychiatric symptoms and has a beneficial impact on caregivers' distress, suggesting its potential as a valuable psychosocial support model.
: Being exposed to or connected to nature has significant advantages for health, well-being, and daily life in old age (Grave et al., 2023), yet little is known about the deeper meaning that nature holds in very old age (80+). We used a sequential two-component design to explore this. In the qualitative exploration, interview analysis (N = 7, age 81-95) revealed seven themes in the narratives of very old adults regarding the meaning of nature, including well-being and meaning in life, appreciation of nature, philosophical and spiritual considerations of nature, nature as a source of inspiration, the role of nature in structuring daily life, reflections on nature's influence across the lifespan, and the importance of environmental protection. In a follow-up extensive representative survey (N = 1,863, age 80-102), nature connectedness was assessed with two pragmatic single-item indicators (perceived importance and frequency of nature-connectedness). The quantitative analysis confirmed the relationships between nature and the key themes identified in qualitative exploration, highlighting care for nature and the environment (eco-generativity) as the most important construct predicted by nature-connectedness. These findings indicate the enduring personal and societal relevance of nature in very old age, suggesting that fostering a connection to nature may support both individual and planetary well-being.
: Change is an inherent part of aging, often understood in terms of whether it is primarily determined by biological factors (i.e., genetic inheritance) or shaped by human experiences and adaptability. Essentialist beliefs about aging have been shown to play a crucial role in shaping developmental outcomes and have been previously assessed using multi-item scales. This paper introduces a single-item visual analog scale for assessing these (non)essentialist beliefs about aging ([N]EBA-SIS). Three studies (N1 = 320, 18 - 82 years, N2 = 164, 54 - 75 years, and N3 = 98, 67 - 96 years) provide converging evidence for the validity (convergent, discriminant, and test-retest) of the (N)EBA-SIS across various contexts and populations (healthy adults, geriatric patients). Results demonstrate that the (N)EBA-SIS has strong reliability and validity, including robust test-retest reliability over a 4-month period.
Abstract: Physical activity is crucial for preventing and treating age-related impairments and mental health conditions in older adults. Structured exercise programs help counteract sedentary behavior and improve well-being. This synthesis reviews clinical guidelines and evidence on exercise interventions in geriatric psychiatry. We propose the “Geriatric Psychiatry in Motion” pathway, emphasizing (a) multiprofessional responsibility, (b) comprehensive geriatric assessment, (c) goal-setting, (d) interdisciplinary interventions, and (e) structured evaluation with transsectoral care. Research and technological advancements support the development of personalized interventions for aging and physical activity. To optimize patient outcomes, we advocate for integrating physical activity as a core treatment in geriatric psychiatry and encourage collaboration among healthcare professionals, researchers, and policymakers for sustainable implementation.
: Loneliness and depression are common in older people, but there are very few studies on geriatric inpatients. Our study examines the incidence of loneliness and depression in a clinical sample. It identifies predictors of loneliness and compares two screening instruments for the assessment of depression. We included a total of 174 patients from an acute geriatric clinic in the study (age MW 83.9 years; 64.9% female). In addition to investigating the experience of loneliness by asking a question about the experience of loneliness as part of the admission, we recorded the presence of depression using two screening procedures. We also examined the group differences between lonely and depressed patients and possible predictors of loneliness. 26.4% of patients felt lonely and were significantly younger and more depressed than nonlonely patients. Significant predictors of loneliness were the living situation (living alone) and depression. The Whooley two-question test proved to be an economical alternative to the GDS-15. Patients at risk could be identified well with screening procedures and, if necessary, interventions could be provided.
: Background: Previous studies have established a strong link between maladaptive interpersonal patterns (MIPs) and depression. This study explored the specificity of this association in older patients. Methods: We conducted a cross-sectional study in which we administered the MIP Q-Sort to older inpatients with depression (n = 36) and healthy older adults (n = 42). We also compared the older sample with previously published data from a middle-aged inpatient sample with depression (n = 69). Results: Compared with the healthy control sample, older inpatients with depression presented a significantly greater extent of MIP and experienced themselves as more submissive and others as more dominant. Compared with previously published data from a middle-aged inpatient sample, older inpatients perceived their own interpersonal behavior as less problematic. Conclusions: Similar specific MIPs are evident in older and middle-aged patients with depression. We discuss the finding that older patients perceive their interpersonal behavior as less problematic as a self-protective mechanism that should be considered in psychotherapy with older patients.
Views on aging (VoA) have been comprehensively examined in the health context, whereas little is known about how VoA vary between age groups. Two representative surveys (WIdO survey: N = 3,000, 18-39 years; German Ageing Survey: N = 4,349, 40-85 years) used the same five scales to measure VoA. We found a tipping point between feeling older than one's chronological age and feeling younger at age 24.6. Gain-related perceptions of aging were high in all age groups, and loss-based perceptions increased with advancing age. Only after the age of 77 did participants count themselves in the group of "old people." These findings underscore the importance of conceptualizing VoA as a lifespan construct and extend earlier studies with either younger or older adults.
The pernicious effects of discrimination and ageism are experienced across multiple life domains in older adulthood. However, work is needed to identify potential mechanisms that may underlie these associations. The current study examined associations between forms of discrimination and different subtypes of self-efficacy beliefs among older adults ( N = 250, M age = 65.5 years). We surveyed participants regarding ageist discrimination, internalized ageism, and everyday discrimination as well as general self-efficacy and five forms of domain-specific self-efficacy. Our findings demonstrated significant negative associations between all forms of discrimination and self-efficacy beliefs. Associations were stronger between ageism and memory self-efficacy than to the other constructs assessed. These findings advance the literature by underscoring the nuanced connections between discrimination and self-efficacy in older adulthood.
Abstract: Current research findings on interventions based on the Mindfulness-Based Stress Reduction concept indicate various applications and positive effects. Positive effects are found in both longer and shorter mindfulness training sessions. Based on a narrative review, we review the positive effects regarding stress reduction, mindfulness, and emotional well-being among older adults. Because of the rather small body of research on older adults and at the same time the high relevance of the application, the authors call for increased research activities in this area.
