Explore the vast range of titles available.

Beackground Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrant further investigation. Methods We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N  = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18–25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55–64 OR 1.02, 65–74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.

According to recent surveys, dementia worry (DW) is a widespread phenomenon in mid-life and old age, at least in Western populations. DW has been shown to be only loosely related to sociodemographic factors. Unfortunately, the concept of DW has found only very little conceptual and empirical attention in previous research. In this conceptual review, we take (mostly) a psychological approach to DW. First, we define DW as an emotional response to the perceived threat of developing dementia. We then conceptualise DW as a hybrid, combining elements of ageing anxiety and health anxiety. On the population level, we argue that the high prevalence of DW may be reflective of the increasing awareness of dementia in times of increasing ‘‘dementia encounters’, widespread misperceptions of risks and consequences of dementia and a perceived lack of coping resources. Finally, we propose that DW may affect a range of important behaviours, such as how people interpret evidence of their own or others’ age-related cognitive changes, how they interact with people with dementia, how they anticipate and plan for their future, how they engage in screening and prevention behaviours and how they exploit healthcare resources. We conclude with suggestions for future research, including a further in-depth investigation of psychological and micro-/macrosocial factors associated with DW.

In times of demographic change, psychotherapists tend to stay longer in their jobs. Against the background of two contradictory age stereotypes (wise/generous versus senile/outdated old person), this analogue study investigates young adults’ preference for old over young psychotherapists, depending on presenting problem. In a within-subjects design, therapy-motivated young female participants ( N  = 79) received two kinds of hypothetical presenting problems, ‘universal problems’ (addressing fundamental questions of life virulent across the adult life span) and ‘young problems’ (life events that are developmentally close to and specific for young adulthood in today’s world). For each presenting problem, participants were presented with two naturalistic photographs of an old (55 + years) and a young (< 35 years) female psychotherapist; in a two-alternative forced choice decision task, participants were then asked to decide whom of the two psychotherapists they would prefer. Participants had neither an overall preference for old nor for young psychotherapists. As expected, we found a preference for old psychotherapists in case of ‘universal problems’ (friend’s death, natural disaster, quarreling with one’s past). In turn, a preference for young psychotherapists was observed in case of ‘young problems’ (cyberbullying, paternalizing parents, lovesickness). Effect size was medium-to-large. Organizations that provide services to younger people may want to inquire about a patient’s preference about age of a therapist prior to treatment. As catering to patient’s preferences for therapy has been shown to lead to better engagement and therapy outcomes, health care providers should try to meet the patient’s needs.

Background There is a need to improve psychotherapeutic approaches to treatment for vulnerable older adults with depression in terms of both clinical practice and health care supply. Against this background, PSY-CARE is testing the feasibility and effectiveness of outpatient psychotherapy for home-living older adults in need of care with depression in Berlin, Germany, and neighboring suburban areas. Methods In a two-arm single-center pragmatic randomized controlled trial (RCT), manual-guided outpatient psychotherapy will be compared to brief psychosocial counseling. The study population will be compromised of older adults with clinically significant depressive symptoms who have a long-term care grade, as assessed by the German compulsory state nursing care insurance. In the intervention group, individual cognitive-behavioral psychotherapy tailored to the specific needs of this population will be offered by residential psychotherapists as part of the regular healthcare service. In the active control group, participants will receive individual psychosocial telephone counselling and a self-help guide. The planned sample size is N  = 130 ( n  = 65 participants per group). The reduction of depressive symptoms (primary outcome) as well as the maintaining of activities of daily living, quality of life, and functioning will be assessed with questionnaires provided at baseline, after the end of the intervention and after three months. Feasibility and process evaluation will be conducted qualitatively based on documentation and interviews with psychotherapists, gatekeepers and the participants. Discussion PSY-CARE investigates the potentials and limitations of providing outpatient psychotherapeutic treatment meeting the demands of vulnerable home-living older adults with depression under the real conditions of the health care system. The study will provide practical implications to improve access to and quality of outpatient psychotherapy for this poorly supplied population. Trial registration The trial is registered at ISRCTN55646265 ; February 15, 2019.

Background Depression is highly prevalent in nursing home residents living with moderate to severe dementia. However, assessing depressive symptoms in residents with dementia can be challenging and may vary by rater perspective. We aimed to investigate the concordance of, and factors associated with self- and informant-rated depressive symptoms in nursing home residents with dementia. Methods Cross-sectional data was collected from N  = 162 nursing home residents with dementia (age: 53–100; 74% women). Self-ratings were assessed with the Geriatric Depression Scale, while the depression and anxiety items of the Neuropsychiatric Inventory were used for informant-ratings. Cohen’s Kappa was calculated to determine the concordance of both measures and of each with antidepressant medication. Multivariate associations with sociodemographic variables, self- and informant-rated quality of life, dementia stage, neuropsychiatric symptoms, functional status and antidepressant medication were analysed with linear mixed models and generalized estimating equations. Results Concordance between self- and single item informant-rated depressive symptoms was minimal (Cohen’s Kappa = .22, p  = .02). No concordance was found for self-reported depressive symptoms and the combined informant-rated depression-anxiety score. Self-reported depression was negatively associated with self-rated quality of life (β = -.32; 95%CI: -.45 to -.19, p  < .001), informant-rated quality of life (β = -.25; 95%CI: -.43 to -.07, p  = .005) and functional status (β = -.16; 95%CI: -.32 to -.01, p  = .04), whilst single item informant-rated depression revealed negative associations with informant-rated quality of life (β = -.32; 95%CI: -.52 to -.13, p  = .001) and dementia stage (β = -.31; 95%CI: -.52 to -.10, p  = .004). The combined informant-rated depression-anxiety score showed negative associations with self-rated quality of life (β = -.12; 95%CI: -.22 to -.03, p  = .01) and dementia stage (β = -.37; 95%CI: -.67 to -.07, p  = .02) and a positive association with neuropsychiatric symptoms (β = .30; 95%CI: .10 to .51, p  = .004). No concordance was found with antidepressant medication. Conclusions In line with our expectations, low agreement and unique association patterns were found for both measures. These findings indicate that both instruments address different aspects of depression und underline the need for comprehensive approaches when it comes to detecting signs of clinically relevant depressive symptoms in dementia. Trial registration The trial was registered with the ISRCTN registry (Trial registration number: ISRCTN98947160 ).

Views on ageing (VoA) have special relevance for the ageing process by influencing health, well-being, and longevity. Although VoA form early in life, so far, most research has concentrated on how VoA affect later middle-aged and older adults. In this theoretical article, we argue that a lifespan approach is needed in order to more fully understand the origins of VoA, how they change over ontogenetic time, and how they shape development across the full breadth of the lifespan. We begin by explicitly linking VoA to fundamental principles of lifespan development. We review existing theories of VoA and discuss their respective contributions and limitations. We then outline a lifespan approach to VoA that integrates existing theories and addresses some of their limitations. We elaborate on three core propositions of a lifespan approach to VoA: (1) VoA develop as the result of a dynamic, ongoing, and complex interaction between biological-evolutionary, psychological, and social-contextual factors; however, the relative importance of different sources changes across the lifespan; (2) VoA impact development across the whole lifespan; however, different outcomes, mechanisms, and time frames need to be considered in order to describe and understand their effects; and (3) VoA are multidimensional, multidirectional, and multifunctional throughout life, but their complexity, meaning, and adaptivity change across the lifespan. We conclude with recommendations for future lifespan research on VoA.

“Dementia worry” (DW; i.e., concern about developing dementia) is highly prevalent in the general population. However, research on the characteristics associated with lower and higher levels of DW is still limited. Based on previous empirical and conceptual work, we examined the extent to which DW was related to a comprehensive range of objective and subjective characteristics (sociodemographics, contact with people with dementia, physical health-related risk factors, well-being/psychological distress, aging self-perceptions, social-cognitive health beliefs about dementia). A convenience sample of N  = 219 German adults 40 + years ( M  = 65.50 years, SD = 11.34; 40–94 years) reporting no dementia or cognitive impairment diagnosis completed questionnaires. We improved upon previous research by using a ten-item scale to measure DW. We used bivariate correlations and multivariate regression to examine the extent to which DW was related to the potential concomitants. 41.1% of the participants indicated DW. Together, the predictor variables explained 53.3% of the variance in DW. DW was related to psychological distress, perceived memory change, aging anxiety, and personal risk perception in both the bivariate and multivariate analyses. There was a quadratic (reverse U shape) relationship between age and DW. Physical health-related risk factors were not related to DW. Our findings suggest that DW represents a hybrid of psychological distress, aging self-perceptions, and a specific type of health concern. Healthcare practitioners should consider a person’s psychological characteristics when deciding how to intervene when someone indicates moderate or high DW.

Although a large body of research has demonstrated the predictive power of subjective ageing for several decisive developmental outcomes, there remains some controversy about whether subjective ageing truly represents a unique construct. Thus, information about the convergent and discriminant validity of different approaches to measuring subjective ageing is still critically needed. Using data from the 2014 wave of the German Ageing Survey, we examined how three established subjective ageing measures (subjective age, global attitude toward own ageing, multidimensional ageing-related cognitions) were inter-related as well as distinct from general dispositions (optimism, self-efficacy) and well-being (negative affect, depressive symptoms, self-rated health). Using correlational and multivariate regression analysis, we found that the three subjective ageing measures were significantly inter-related ( r  = |.09| to |.30|), and that each measure was distinct from general dispositions and well-being. The overlap with dispositional and well-being measures was lowest for subjective age and highest for global attitudes towards own ageing. The correlation between global attitudes towards own ageing and optimism was particularly striking. Despite the high convergent validity of the different dimensions of ageing cognitions, we nevertheless observed stronger associations between specific dimensions of ageing cognitions with negative affect and self-rated health. We conclude that researchers should be aware of the multidimensional nature of subjective ageing. Furthermore, subjective age appears to be a highly aggregated construct and future work is needed to clarify its correlates and reference points.

The Covid-19 pandemic, with its adverse implications for older adults, has generated unprecedented public interest in issues around age and ageing globally. We systematically investigated the responses of national gerontological and geriatric societies (NGGS) to emerging challenges during the first wave of the pandemic. Framed within traditional research topics in gerontology, the aim was to identify the spectrum of focal points and positions directed towards governments, policy makers, researchers and society. A comprehensive, two-phased data collection strategy generated N  = 22 position statements of NGGS affiliated to the International Association of Gerontology and Geriatrics. Using Ayalon et al. (J Gerontol Ser B, 2020. https://doi.org/10.1093/geronb/gbaa066 ) thematic categorisation of gerontological research, we applied quantitative and qualitative content analysis to analyse “calls for action” within the statements. The content of NGGS’ position statements show a high level of agreement on the salient topics during the first wave of the pandemic and reveal shared values such as equality, diversity and inclusion of older adults and the discipline of gerontology to be an applied one with relevance to policy and practice. The results can support future interdisciplinary research in gerontology post Covid-19 based on a vision to contribute to a society of all ages.

The article “Views on ageing: a lifespan perspective”, written by Anna E. Kornadt, Eva-Marie Kessler, Susanne Wurm, Catherine E. Bowen, Martina Gabrian and Verena Klusmann., was originally published electronically on the publisher’s internet portal on 11 October 2020 without open access.