Promoting Hope in Older Adults

As evidenced by 15 years of research, hopeful older adults reject negative stereotypes of aging; envision themselves as aging successfully; plan for later life; cope with stressors; apply wisdom; and perceive good physical, mental, and social well-being. Hopeful older adults even live longer than less hopeful older adults. Preliminary research indicates that older adults participating in individual- and small-group interventions can learn and apply strategies to improve hope, goal pursuits, and distress. The larger social and physical environments create barriers to pursuing goals in later life, including ageism and physical barriers. Thus broader social and environmental interventions may provide additional pathways to foster older adults’ hope and goal pursuits, as well as to help younger generations develop more positive views of aging and prepare for successful aging

Knowledge of Depression Among Korean American Older Adults

The present study explored knowledge about depression and the factors that predict that knowledge in a sample of Korean American older adults (N = 675). Compared with other published results, knowledge of depression in the present sample was generally low. The participants provided on average only 42.6% correct answers on the 12-item Depression in Late Life Quiz, and for 9 items, more than 50% of the participants provided incorrect answers. In a multivariate linear regression, acculturation (β = .12, p \u3c .01) and depressive symptoms (β = −.09, p \u3c .05) were significant predictors of knowledge. Individuals with lower levels of acculturation had less knowledge of depression. An interesting finding was that those with higher levels of depressive symptoms exhibited poorer knowledge of depression. The study findings emphasized the need for educational interventions to be provided in order to improve the mental health literacy of Korean American older adults

Knowledge of Depression Among Korean American Older Adults

The present study explored knowledge about depression and the factors that predict that knowledge in a sample of Korean American older adults (N = 675). Compared with other published results, knowledge of depression in the present sample was generally low. The participants provided on average only 42.6% correct answers on the 12-item Depression in Late Life Quiz, and for 9 items, more than 50% of the participants provided incorrect answers. In a multivariate linear regression, acculturation (β = .12, p \u3c .01) and depressive symptoms (β = −.09, p \u3c .05) were significant predictors of knowledge. Individuals with lower levels of acculturation had less knowledge of depression. An interesting finding was that those with higher levels of depressive symptoms exhibited poorer knowledge of depression. The study findings emphasized the need for educational interventions to be provided in order to improve the mental health literacy of Korean American older adults

Predictors of Preventable Nursing Home Hospitalizations: The Role of Mental Disorders and Dementia

Objectives: Nursing home (NH) hospitalizations place an enormous economic burden on an already overtaxed American healthcare system. Hospitalizations for “ambulatory care-sensitive” (ACS) conditions are considered preventable, as these are physical health conditions that can potentially be treated safely in a NH. The authors examined risk factors, including mental disorders and dementia, for hospitalization of Medicaid-enrolled NH residents with ACS conditions during fiscal year 2003–2006. Methods: The authors merged Medicaid claims and enrollment data and Online Survey Certification and Reporting information for 72,251 Medicaid-enrolled NH residents in 647 NHs in Florida. The authors identified at least one ACS hospitalization in 8,382 residents for a total of 10,091 hospital admissions (18.5% of all hospitalizations). The authors used Cox proportional hazard regression to assess time to the first ACS hospitalization. Results: In a fully adjusted model, younger age, non-white race, dementia, and serious mental disorder were associated with greater risk of ACS hospitalization. In addition, residents with a diagnosed mental disorder and no dementia incurred relatively high expenditures for ACS hospitalizations. Among facility characteristics, participants from for-profit facilities, facilities that were not a member of a chain, had more Medicaid recipients, and fewer than 120 beds had greater risk of ACS hospitalizations. Conclusions: Attention to the identified predictors of hospitalization for ACS conditions, which are potentially preventable, could reduce the risk and cost of these hospitalizations among Medicaid-enrolled NH residents. The need to reduce unnecessary hospitalization will become only more urgent as the population ages and healthcare expenses continue to escalate

Six-month longitudinal patterns of mental health treatment utilization by older adults with depressive symptoms

Aims of the study were to describe behavioral health treatment utilization patterns of community-dwelling older adults with depressive symptoms over a six-month period and to identify factors associated with treatment use, guided by a theoretical model emphasizing the dynamic nature of treatment use patterns over time and social context. A total of 144 participants ≥65 years old with depressive symptoms completed an in-person baseline interview and six monthly telephone follow-up interviews. Outcomes at each follow-up included the use of antidepressants or counseling. Covariates included personal and social context variables. Approximately half of the participants (N=70, 48%) received no formal treatment (antidepressant prescription or counseling). Treatment use or nonuse did not change for most participants. More participants with severe symptoms received antidepressants (25%-37%) than did those with milder symptoms (10%-14%), although more participants in the latter group started (milder, 62%,versus severe, 49%) and stopped (milder, 77%, versus severe, 26%) antidepressant treatment at least once. Fewer individuals received counseling overall, with no clear patterns by symptom severity. In multivariate longitudinal analyses, treatment use at follow-up was independently associated with younger age, current major depressive episode, baseline use of antidepressant, intention to begin a new treatment at baseline, and receipt of advice to seek treatment. Over a six-month period, most older adults with depressive symptoms in this study continued their use or nonuse of mental health treatment. Demographic, need, attitudinal, and social variables were related to treatment use over time. Addressing intentions and providing advice may facilitate treatment seekin

Six-Month Longitudinal Patterns of Mental Health Treatment Utilization by Older Adults With Depressive Symptoms

Aims of the study were to describe behavioral health treatment utilization patterns of community-dwelling older adults with depressive symptoms over a six-month period and to identify factors associated with treatment use, guided by a theoretical model emphasizing the dynamic nature of treatment use patterns over time and social context. A total of 144 participants ≥65 years old with depressive symptoms completed an in-person baseline interview and six monthly telephone follow-up interviews. Outcomes at each follow-up included the use of antidepressants or counseling. Covariates included personal and social context variables. Approximately half of the participants (N=70, 48%) received no formal treatment (antidepressant prescription or counseling). Treatment use or nonuse did not change for most participants. More participants with severe symptoms received antidepressants (25%-37%) than did those with milder symptoms (10%-14%), although more participants in the latter group started (milder, 62%,versus severe, 49%) and stopped (milder, 77%, versus severe, 26%) antidepressant treatment at least once. Fewer individuals received counseling overall, with no clear patterns by symptom severity. In multivariate longitudinal analyses, treatment use at follow-up was independently associated with younger age, current major depressive episode, baseline use of antidepressant, intention to begin a new treatment at baseline, and receipt of advice to seek treatment. Over a six-month period, most older adults with depressive symptoms in this study continued their use or nonuse of mental health treatment. Demographic, need, attitudinal, and social variables were related to treatment use over time. Addressing intentions and providing advice may facilitate treatment seekin