The effect of social support on the emotional well-being of people with amyotrophic lateral sclerosis: Exploring the mediating role of spirituality.

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that, so far, is considered always fatal. Treatments mainly consist in increasing survival and aim to improve the quality of life of people with ALS (pwALS). Social support and spirituality have been shown to play a key role in pwALS' quality of life. Our study explored it in depth by investigating the underlying mechanisms linking social support, spirituality, and emotional well-being. METHODS: Thirty-six pwALS underwent a battery of tests evaluating emotional well-being (emotional well-being scale of the 40-item Amyotrophic Lateral Sclerosis Assessment Questionnaire), social support (6-item Social Support Questionnaire), and spiritual well-being (12-item Functional Assessment of Chronic Illness Therapy - Spiritual well-being). Our recruitment was web-based through the FILSLAN and the ARSLA websites as well as through Facebook® advertisements (ALS groups). Data were analyzed by Pearson correlation analysis and Process macro was used in an SPSS program to analyze the mediator variable effect. RESULTS: Availability of social support, spiritual well-being, and 2 of its dimensions, i.e., meaning and peace, were positively correlated with emotional well-being. The mediational analyses showed that spiritual well-being, meaning, and peace act as mediators in the association between availability of social support and good emotional well-being. SIGNIFICANCE OF RESULTS: Availability of social support and spirituality are essential for the emotional well-being of pwALS. Spirituality as a mediator between availability of social support and emotional well-being appears as real novel finding which could be explored further. Spiritual well-being, meaning, and peace appear as coping resources for pwALS. We provide practical guidance for professionals working with pwALS.

Profiles of well-being in French older adults and associations with successful aging and personality: findings from the SHARE project.

Maintaining the well-being of the older adults is a primary concern in gerontology. This study determined different profiles of well-being (WB) and compared the profiles in terms of successful aging (SA), personality, and sociodemographic variables. The study sample consisted of 856 adults aged 65-98 years. WB was taken into account in an eudemonic and hedonic approach. SA was measured by assessing the three distinct components of Rowe and Kahn's model (Successful aging. Gerontol 37(4):433-440. 10.1093/geront/37.4.433, 1997), personality by the Big Five Inventory, and sociodemographic variables. Latent class analyses (LCA) determined the number of WB profiles, and ANOVAs and Chi2 tests to compare them. The LCA revealed three WB profiles: Profile 1 (9.35%, n = 80), Profile 2 (37.38%, n = 320), and Profile 3 (53.27%, n = 456) in which participants reported lower, intermediate, and higher WB scores. Our results confirm that a high level of WB (Profile 3) can be linked to the components of SA and socio-demographic characteristics (age, marital status, level of education, income). This raises questions about the injunctions concerning healthy aging that older people integrate. It's also interesting to note that the intermediate profile (profile 2) can be either close to the "lower WB" profile (Profile 1) in terms of openness, conscientiousness, and agreeableness or to the "higher WB" profile (Profile 3) in terms of extraversion. However the three profiles do not have the same level of neuroticism. These results also showed the importance of adapting the support offered to older people according to their health status and/or individual characteristics.

Implementation of equine-assisted intervention for older adults with Alzheimer's disease residing in a nursing home: Brakes and levers.

OBJECTIVE: Although research on equine-assisted intervention (EAI) for older adults is beginning to be published, no scientific study has examined the various elements that can limit or facilitate the implementation of EAI with older adults suffering from Alzheimer's disease (AD) residing in nursing homes. The aim of this study was to identify the possible brakes and levers of implementing EAI with AD patients. A focus on professional affiliation was conducted. METHOD: The survey was posted online on 2 February 2021 via the Sphinx software. As this study was aimed at gerontology professionals working in nursing homes, they were contacted through various specialized social networks. A total of 663 people answered the survey. RESULTS: The results indicate that for 45% of the participants, the main brake to implementing EAI is related to the institutional burden. As for the levers, 29% of the people indicated that it would mainly be beneficial due to the cognitive stimulation that EAI would provide. People who were not familiar with EAI reported more brakes to its implementation. Finally, it was observed that the caregivers were those who put forward the most levers for the implementation of EAI with AD patients living in nursing homes. CONCLUSION: Thus, this study allows us to understand some of the reasons why nursing homes are reluctant to set up EAI. Communication on this subject is currently a lever to be developed. IMPLICATIONS FOR PRACTICE: By highlighting the brakes and levers on the implementation of EAIs, we are able to identify suitable guidelines for developing this type of intervention in nursing homes, which could be used as a complement to nursing care to help Alzheimer's patients overcome physical or psychological health problems.

Effects of equine-assisted interventions on older adults' health: A systematic review.

Objective: Equine-assisted interventions (EAI) can improve a variety of health problems in older adults and thus promote their well-being. This systematic review aimed to synthesize studies on EAI to understand better their effects on the health of older adults. Method: A systematic search guided by the PRISMA 2020 approach was performed on specific databases: Medline (PubMed), EMBASE, PsycINFO, and Cochrane Library. Peer-reviewed articles published in the English language from inception to June 2022 were retrieved. Methodological quality was established using the modified version of the Downs and Black checklist. Results: A total of 244 studies were retrieved, and 13 eligible studies were finally included. Three health domains were investigated: physical (balance, gait, and muscular strength), psychological (quality of life and cognitive assessment), and physiological (hormonal measures, cerebral and muscular activity). Among the eight studies investigating the physical dimension, four studies highlighted a positive effect of EAI on balance, four for gait, and three for strength. Regarding the three studies investigating the psychological dimension, two studies showed a positive effect of EAI on quality of life. Lastly, the four studies investigating the physiological dimensions all demonstrated a positive effect of EAI on hormonal measures and cerebral and muscular activity. Conclusion: Nevertheless, this systematic review provides promising findings regarding the positive effects of EAI on physical, psychological, and physiological health in older adults. Research on EAI should therefore be pursued rigorously to promote this non-pharmacological intervention in an older adult population.

Associations Between Frailty and Inflammation, Physical, and Psycho-Social Health in Older Adults: A Systematic Review.

Frailty is a complex geriatric syndrome with multifactorial associated mechanisms that need to be examined more deeply to help reverse the adverse health-related outcomes. Specific inflammatory and physical health markers have been associated with the onset of frailty, but the associations between these factors and psycho-social health outcomes seem less studied. This systematic review aimed to identify, in the same study design, the potential associations between frailty and markers of inflammation, and physical or psycho-social health. A literature search was performed from inception until March 2021 using Medline, Psycinfo, and EMBASE. Three raters evaluated the articles and selected 22 studies, using inclusion and exclusion criteria (n = 17,373; 91.6% from community-dwelling samples). Regarding biomarkers, 95% of the included studies showed significant links between inflammation [especially the higher levels of C-reactive protein (CRP) and interleukin-6 (IL-6)], and frailty status. Approximately 86% of the included studies showed strong links between physical health decline (such as lower levels of hemoglobin, presence of comorbidities, or lower physical performance), and frailty status. At most, 13 studies among the 22 included ones evaluated psycho-social variables and mixed results were observed regarding the relationships with frailty. Results are discussed in terms of questioning the medical perception of global health, centering mostly on the physical dimension. Therefore, the development of future research studies involving a more exhaustive view of frailty and global (bio-psycho-social) health is strongly encouraged.

Bridging the Gap between Research and the Community: Implementing Physical and Cognitive Interventions to Improve Spontaneous Walking Speed in Older Adults.

The application of interventions to enhance mobility in ecological settings remain understudied. This study was developed to evaluate the feasibility of training methods in a community centre and to evaluate their impact on mobility outcomes. Fifty-four participants were randomized to one of three 12-week training programs (three times/week): aerobic (AE), gross motor abilities (GMA) or cognitive (COG). Feasibility was evaluated by calculating adherence, feedback from participants and long-term participation. The impact of these interventions on mobility was assessed by comparing pre- and post-program on Timed-up-and-go (TUG) and spontaneous walking speed (SWS) performances. Results showed relatively high rates of adherence (85.1%) and long-term participation (66.7%), along with favorable feedbacks. SWS significantly improved in COG (0.10 ± 0.11 m.s-1; p = 0.004) and AE (0.06 ± 0.11 m.s-1; p = 0.017) groups, and TUG performance was maintained in all groups. Results of this feasibility study demonstrated successful implementation of physical and cognitive training programs, encouraging the development of real-world applications.

Prevalence of malnutrition risk among older French adults with culinary dependence.

OBJECTIVE: The term 'culinary dependence' denotes a situation in which someone delegates all or part of their daily meal-related activities to a third party. The present study aimed to explore nutritional risk among older people (≥65 years) with culinary dependence. METHOD: The first survey included 559 people either living at home without help, with help unrelated to food activities, with help related to food activities or living in nursing home. The second survey included 319 people with food help provided by a caregiver, by meals-on-wheels or by a nursing home. Nutritional status was assessed with the Mini-Nutritional Assessment. Sociological background and wellness variables (health, cognitive and mental status) were collected. RESULTS: The first survey found a strong association between culinary dependence and nutritional risk. About half of the people who delegated their food-related activities were malnourished or at risk of malnutrition compared with only 4% for people with no help and 12% for people with help unrelated to food activity. According to the second survey, this prevalence varied slightly depending on who the tasks were delegated to (46% for those who had the support of a caregiver; 60% for those who used a meals-on-wheels service; 69% for those living in nursing home). According to multivariate analyses, dependence categories, depressive symptoms and cognitive status were identified as independent determinants of malnutrition. CONCLUSION: Without inferring a causal relationship between dependence and malnutrition, there is a strong need for care structures to take into account the issue of malnutrition when developing services targeting older people.

Validation of the Revised Collett-Lester Fear of Death Scale in a French Population.

Death and dying are processes that every human being encounters in his or her lifetime and perhaps the greatest loss an individual can suffer. In this sense, fear of death is regarded as a risk and maintaining factor of psychopathology. As such, effective and efficient measurement of this construct becomes a priority. While the Revised Collett-Lester Fear Of Death Scale (CL-FODS) is a brief, commonly used assessment, such a tool is lacking in French clinical practice. The present study aimed to adapt the revised CL-FODS in a general French sample and to determine its psychometric properties, namely its factorial structure, concurrent and convergent validity, and internal consistency. A sample of 590 participants responded to the French revised CL-FODS, as well as three instruments assessing death anxiety (DAS), neuroticism and spirituality (FACIT-Sp), to examine the internal consistency, validity and factorial structure of the scale. Both exploratory and confirmatory factor analysis confirmed a four-factor model: (1) One's Own Death," (2) The Death of Others, (3) The Dying of Others, and (4) One's Own Dying. Five items did not load on these four factors, suggesting that the revised CL-FODS might require further psychometric refinement. The revised CL-FODS showed good internal consistency. The scale was found to be significantly associated with the Death Anxiety Scale. When the appropriate psychometric characteristics are taken into account, this scale can be used in clinical and research settings to assess death concerns in French society.

Food perception, lifestyle, nutritional and health status in the older people: Typologies and factors associated with aging well.

The aging process is associated with physiological, sensory, psychological, and sociological changes likely to have an impact on food intake and the nutritional status. The present study aimed to explore the heterogeneity of the French older population (>65 years old) using a multidisciplinary approach. More specifically, the study aimed to highlight different typologies (i.e. clusters of individuals with similar characteristics) within the older population. We conducted face-to-face interviews and tests with 559 French older people, recruited from different categories of dependency (at home without help, at home with help, in nursing homes). Clustering analysis highlighted seven clusters. Clusters 1-3 contained 'young' older people (<80) with a good nutritional status; these clusters differed according to food preferences, the desire to have a healthy diet, or interest in food. Clusters 4-7 mainly contained 'old' older people (80+), with an increase in the nutritional risk from cluster 4 to cluster 7. Two of these clusters grouped healthy and active people with a good level of appetite, while the two other clusters were associated with a clear decline in nutritional status, with people suffering from eating difficulties or depression. The results raise the need to develop targeted interventions to tackle malnutrition and implement health promotion strategies among the seniors.

Brakes and levers to implement an animal-assisted intervention in nursing homes: Preliminary study.

BACKGROUND: Increasing numbers of scientific studies have dealt with the benefits of animal assisted intervention programs (AAI). Although many positive effects have been identified, there are still few AAI programs in nursing homes. To date, no study has investigated special the difficulties in implementing such a program. The aim of this study was to explore the representations of this type of program among caregivers. METHODS: This qualitative study was conducted between January and June 2019. Psychologists conducted 11 interviews with people working in nursing homes. The sample was based on different professions and on the fact that participants had already been involved in an IAA program. RESULTS: The results were organized according to two main themes: brakes and levers. The results show that the brakes were raised quickly before the implementation of the project, but once the project had been implemented, the perceived beneficial effects multiplied and all those interviewed mentioned the benefits of animals. More than half of the caregivers interviewed mentioned animals as a lever, facilitating contact with elderly people suffering from dementia. Setting up a project upstream enhanced the success of this type of program. CONCLUSION: The benefits perceived by the people interviewed are consistent with the scientific literature. The obstacles mentioned for implementing this type of program can be reduced by a rigorous and well-thought-out project.

The impact of street clothes among caregivers on residents with dementia in special care units: The STRECLO study.

AIMS AND OBJECTIVES: To examine the impact of caregivers' street clothes on people living in special care units (SCUs). We hypothesised that caregivers wearing street clothes would improve residents' relationships with other residents and caregivers and, as a consequence, would improve their quality of life. BACKGROUND: Environmental factors have been recognised as important elements in the care of people with dementia. Among these factors, the importance of the caregivers' appearance and more particularly their street clothes has been raised. DESIGN: The Street Clothes study (STRECLO) was designed as a multicentre crossover observational study. METHOD: This study was conducted in two volunteer nursing homes. It involved videotaping residents (N = 24) over a 6-month period: caregivers wore uniform and then street clothes for two consecutive three-month periods. Three outcome measures were observed as follows: (a) behaviours of residents, (b) contents of conversations and (c) proximal interactions between residents and caregivers. The STROBE checklist was used to ensure quality reporting during this observational study. RESULTS: When caregivers wore street clothes, we observed the following: (a) greater solicitation and less anxiety in residents, (b) content of conversations between residents and caregivers included more personal and less health information, and (c) more proximal interaction between caregivers and residents. CONCLUSION: To our knowledge, this is the first study which investigated the long-term effects on residents of SCU caregivers wearing street clothes. Our study demonstrated the potential benefit of not wearing uniform on the quality of life of institutionalised people with dementia. RELEVANCE TO CLINICAL PRACTICE: Given the budgetary constraints faced by nursing homes, wearing street clothes for caregivers could be readily applied to clinical practice and represents a promising way to increase the quality of life of dementia residents and their families.

Intergenerational programs: What can school-age children and older people expect from them? A systematic review.

Over the past 40 years, there has been a growing trend for intergenerational initiatives worldwide. Intergenerational programs (IGPs) aim to facilitate cooperation and exchange among different age groups. While most studies highlight the benefits for each generation, the programs and study designs vary widely. We conducted a systematic review of the scientific literature between 2005 and 2015 to: (1) characterize and define the IGPs studied and (2) identify the benefits for school-age children and older people aged 60 years or over. First, 53 articles with defined keywords were collected from online databases. Then, using inclusion and exclusion criteria, 11 articles were selected. These were classified according to methodological quality and were analyzed one by one. The content of the programs varied: three involved artistic activities, three educational activities, one health, three open-ended activities, and one was organized around a citizen's project. Concerning the benefits of IGPs for children and older adults, some studies highlighted significant differences in positive attitudes, behaviors, confidence, and competence for the children, and significant differences in mental and physical health, and quality of life for older adults. However, it should be noted that those benefits are not systematic. Our findings are discussed in the light of the meaningfulness of the activities and the role of IGPs, organization of the program, and participants' knowledge of the other generation. Future studies may wish to consider searching for additional variables to further refine our understanding of the benefits for participants.

Spirituality, social support, and flexibility among older adults: a five-year longitudinal study.

ABSTRACTObjectives:The objectives of the study were to examine the trajectory of spirituality among older adults, to investigate the roles of gender and religion on the developmental trajectory of spirituality, and to explore whether the linear growth of spirituality accelerated or decelerated at time points at which the participants reported high scores of social support and flexibility. DESIGN: A five-year longitudinal study. SETTING: The research used data from a longitudinal study, which follows a non-institutionalized older adults cohort of residents from France. The data used in this paper were collected at three time points (T1: 2007; T2: 2009; T3: 2012). PARTICIPANTS: A total of 567 participants were included in the analysis (59.44% female; Mage = 75.90, SD = 5.12). MEASUREMENTS: Multilevel growth curve analysis was used measuring spirituality, satisfaction with social support, and flexibility. RESULTS: The results indicated the following: (1) stability of spirituality over time, (2) older women reported higher levels of spirituality than older men, and those who had a religion reported higher scores of spirituality than their counterparts who had no religion (these effects were strong and clinically meaningful), (3) older adults who reported higher levels of social support and flexibility also reported higher levels of spirituality, and (4) the slope of spirituality seemed to accelerate at time points at which participants also had higher levels of social support and flexibility (these effects were rather small but of theoretical interest). CONCLUSION: The results of the present study help to improve the understanding of the potential benefit of encouraging the spiritual aspects of life.

Longitudinal Patterns of Stability and Change in Tenacious Goal Pursuit and Flexible Goal Adjustment among Older People over a 9-Year Period.

Using the dual-process model of assimilative-tenacity (TGP) and accommodative-flexibility (FGA), the study aims to identify trajectories of TGP and FGA over five time points within a 9-year period, explore the relationships between the trajectories of TGP and FGA, and explore if participants from distinct TGP and FGA trajectories differed in indicators of well-being and depression. Latent class growth analysis was used in a five-wave longitudinal design among an older population of 747 participants over 65 years. Results highlight (1) emergence of four trajectories for flexibility (low and increasing, moderate and increasing, moderately high and stable, and high and stable trajectories) and three trajectories for tenacity (low and stable, moderate and stable, and high and decreasing trajectories), (2) that older people belonging to particular trajectories of FGA are not more likely to belong to particular trajectories of TGP, and (3) that participants from the high and decreasing TGP and high or moderately high and stable FGA trajectories were characterized by high score of perceived health, satisfaction with life, and self-esteem and low score of depression moods. These results highlight that the heterogeneity in longitudinal TGP and FGA scores throughout the life span needs to be accounted for in future research.

Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp12) on French Old People.

The study aimed to develop a French version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being short version (FACIT-Sp12), in order to provide a self-reported measure for French people in the field of gerontology. The study involving 63 nursing home residents was conducted to evaluate the construct validity, reliability, and convergence validity of the FACIT-Sp12. A confirmatory factor analysis corroborated a three-factor model (Meaning, Peace and Faith) with modifications for two items, also valid among people with cognitive impairment. Subscales showed good internal consistency and are correlated with quality of life and depression. In conclusion, the validated French version is an suitable instrument to study the maintenance and promotion of quality of life in the elderly.

The Geriatric Depression Scale: does it measure depressive mood, depressive affect, or both?

OBJECTIVE: Self-report measures of depression are highly important tools used in research and in various healthcare settings for the diagnosis of different levels of depression. The Geriatric Depression Scale (GDS) is the first and the most popular scale used to screen for late-life depression. It is endorsed by the Royal College of Physicians and the British Geriatric Society (1992). The purpose of the present research was to investigate whether scores on the GDS15 capture depressive mood (i.e. trait depression), depressive affect (i.e. short-term depressive state), or both. METHODS: For this purpose, a trait-state model (stable trait, autoregressive trait, and state model) was applied to GDS15 scores obtained at four time points over a 6-year period among a sample of community-dwelling older persons (N = 753). This model allows decomposing the GDS15 scores into three different variance components: stable trait variance, autoregressive trait variance, and state variance. RESULTS: Our findings revealed a general pattern of a major proportion of stable trait (69%) and autoregressive trait (22%) variance and a very smaller amount of state variance (9%) in the GDS scores across 6 years. Age and gender (i.e. being female) were shown to be positively linked to more stable trait variance. CONCLUSIONS: Depression, as assessed with the GDS15 , should be regarded as a relatively stable and enduring trait construct, reflecting a stable core of a person's depressivity. The negligible amount of state elements in the variation of the GDS15 scores provides evidence that changing the context will not be enough to cause significant changes in depressive symptoms. Copyright © 2016 John Wiley & Sons, Ltd.

Tenacious goal pursuit and flexible goal adjustment in older people over 5 years: a latent profile transition analysis.

BACKGROUND: previous research has shown that tendencies to tenaciously pursue goals (TGP) and flexibly adapt goals (FGA) relate to well-being of older people. OBJECTIVES: this study aimed to identify subpopulations of elderly people with different coping profiles, describe change in participants' profiles over time and determine the influence of coping profiles on well-being over a 5-year period. METHODS: latent profile transition analysis (LPTA) was used in a three-wave longitudinal data collection measuring flexibility, tenacity, depression, self-rated health and life satisfaction among an elderly population over 65 years old. RESULTS: three coping profiles were identified. Profile 1 was characterised by participants with high flexibility and tenacity scores, Profile 2 with moderate flexibility and low tenacity scores and Profile 3 with low flexibility and moderate tenacity scores. Results indicate stability of these profiles over time, with Profile 1 being the most adaptive in terms of ageing well. CONCLUSION: high flexibility and tenacity in older people is a stable coping profile that is associated with successful ageing.

Relationships between nutritional status, depression and pleasure of eating in aging men and women.

Nutritional health is an essential component of quality of life among older adults. The aim of this study was to identify the predictors of nutritional status in order to identify both common and sex specific predictive pathways in an aging population. A questionnaire was administered to 464 people living at home aged 65 years and above. Part of the questionnaire contained questions about nutritional status (MNA), depression (GDS), pleasure of eating and demographic characteristics. Structural equation modeling was used to examine relationships between the variables. For both sexes, results indicate that depression and pleasure of eating are related to nutritional status. In addition, different pathways were found between men and women. In particular, while pleasure of eating is affected by depression among aging women this is not the case for men. The implications of the findings for nutrition communication are discussed.