Social isolation and loneliness are prevalent in older adults and are detrimental to physical and mental health. Social media use has been shown to be effective in maintaining social connections and improving older adults’ psychosocial outcomes. This study aimed to systematically review and synthesize current research on this topic.

Searches were conducted in November 2021 (and updated in October 2023) in PsycINFO, PubMed, and CINAHL. Inclusion criteria: (1) participants ≥ 65 years (mean, median, or minimum age) and (2) reported impact of social media use on psychosocial outcomes (including loneliness, depression, anxiety, social connectedness, wellbeing, life satisfaction, and quality of life). Quality appraisal tools were utilized, and results were synthesized using narrative synthesis.

Sixty-four papers met inclusion criteria, including cross-sectional (n = 38), observational longitudinal (n = 6), interventional (n = 9), mixed-methods (n = 4), and qualitative (n = 7) studies. Participant numbers ranged from 6 to 16,925. While associations between social media use and positive psychosocial outcomes were generally reported in cross-sectional studies, the impact of social media use over time from longitudinal studies was mixed and inconclusive.

While social media use is associated with positive psychosocial outcomes, casual conclusions cannot be drawn. Few longitudinal and randomized controlled trial studies existed, and these reported mixed findings. Large variations in study methodology including participants, measurement of social media use, and outcome measures contributed to the inconsistencies of findings. Addressing this heterogeneity through standardized approaches and more rigorous research may enhance understanding.

Late-life depression (LLD) is common and frequently co-occurs with neurodegenerative diseases of aging. Little is known about how heterogeneity within LLD relates to factors typically associated with neurodegeneration. Varying levels of anxiety are one source of heterogeneity in LLD. We examined associations between anxiety symptom severity and factors associated with neurodegeneration, including regional brain volumes, amyloid beta (Aβ) deposition, white matter disease, cognitive dysfunction, and functional ability in LLD.

Older adults with major depression (N = 121, Ages 65–91) were evaluated for anxiety severity and the following: brain volume (orbitofrontal cortex [OFC], insula), cortical Aβ standardized uptake value ratio (SUVR), white matter hyperintensity (WMH) volume, global cognition, and functional ability. Separate linear regression analyses adjusting for age, sex, and concurrent depression severity were conducted to examine associations between anxiety and each of these factors. A global regression analysis was then conducted to examine the relative associations of these variables with anxiety severity.

Greater anxiety severity was associated with lower OFC volume (β = −68.25, t = −2.18, p = .031) and greater cognitive dysfunction (β = 0.23, t = 2.46, p = .016). Anxiety severity was not associated with insula volume, Aβ SUVR, WMH, or functional ability. When examining the relative associations of cognitive functioning and OFC volume with anxiety in a global model, cognitive dysfunction (β = 0.24, t = 2.62, p = .010), but not OFC volume, remained significantly associated with anxiety.

Among multiple factors typically associated with neurodegeneration, cognitive dysfunction stands out as a key factor associated with anxiety severity in LLD which has implications for cognitive and psychiatric interventions.

To reduce sleep problems in people living with dementia using a multi-component intervention.

Cluster-randomized controlled study with two parallel groups and a follow-up of 16 weeks.

Using external concealed randomization, 24 nursing homes (NH) were allocated either to the intervention group (IG, 12 clusters, 126 participants) or the control group (12 clusters, 116 participants).

Participants were eligible if they had dementia or severe cognitive impairment, at least two sleep problems, and residence of at least two weeks in a NH.

The 16-week intervention consists of six components: (1) assessment of sleep-promoting activities and environmental factors in NHs, (2) implementation of two “sleep nurses,” (3) basic education, (4) advanced education for staff, (5) workshops to develop sleep-promoting concepts, and (6) written information and education materials. The control group (CG) received standard care.

Primary outcome was ≥ two sleep problems after 16 weeks assessed with the Sleep Disorders Inventory (SDI).

Twenty-two clusters (IG = 10, CG = 12) with 191 participants completed the study. At baseline, 90% of people living with dementia in the IG and 93% in the CG had at least two sleep problems. After 16 weeks, rates were 59.3% (IG) vs 83.8% (CG), respectively, a difference of −24.5% (95% CI, −46.3% – −2.7%; cluster-adjusted odds ratio 0.281; 95% CI 0.087–0.909). Secondary outcomes showed a significant difference only for SDI scores after eight and 16 weeks.

The MoNoPol-Sleep intervention reduced sleep problems of people living with dementia in NH compared to standard care.

To assess differences in psychosocial and mental health outcomes between older lesbian and bisexual women compared to heterosexual women.

Cross sectional study.

The study was carried out in the California Teachers Study, a prospective cohort study.

Self-identified heterosexual (n = 35,846), lesbian (n = 710), and bisexual (n = 253) women 50 years of age and older were enrolled.

Validated questionnaires were used to measure social connection, overall happiness, and depression. Logistic regression modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) comparing lesbian and bisexual women separately to heterosexual women in relation to psychosocial and mental health outcomes.

After controlling for age and marital status, older bisexual women were significantly more likely to report lack of companionship (OR = 2.00; 95% CI, 1.30–3.12) and feeling left out (OR = 2.33; 95% CI, 1.36–3.97) compared to older heterosexual women. The odds of reporting feeling isolated from others was significantly higher in lesbian (OR = 1.56; 95% CI, 1.06–2.30) and bisexual women (OR = 2.30; 95% CI, 1.37–3.87) than in heterosexual women. The OR (95% CI) for reporting not being very happy overall was 1.96 (CI, 1.09–3.52) in bisexual women and 1.40 (0.92–2.14) in lesbian women compared to heterosexual women. The likelihood of reporting diagnosed depression was significantly higher in lesbian women (OR = 1.65; 95% CI, 1.38–1.97) and bisexual women (OR = 2.21; 95% CI, 1.67–2.93) compared to heterosexual women.

Inclusion of lesbian and bisexual women in aging research is essential to understand their unique mental and other health needs, including those specific to bisexual women.

Geriatric depression (GD) is associated with cognitive impairment and brain atrophy. Tai-Chi-Chih (TCC) is a promising adjunct treatment to antidepressants. We previously found beneficial effects of TCC on resting state connectivity in GD. We now tested the effect of TCC on gray matter volume (GMV) change and the association between baseline GMV and clinical outcome.

Forty-nine participants with GD (>=60 y) underwent antidepressant treatment (38 women).

Participants completed 3 months of TCC (N = 26) or health and wellness education control (HEW; N = 23).

Depression and anxiety symptoms and MRI scans were acquired at baseline and 3-month follow-up. General linear models (GLMs) tested group-by-time interactions on clinical scores. Freesurfer 6.0 was used to process T1-weighted images and to perform voxel-wise whole-brain GLMs of group on symmetrized percent GMV change, and on the baseline GMV and symptom change association, controlling for baseline symptom severity. Age and sex served as covariates in all models.

There were no group differences in baseline demographics or clinical scores, symptom change from baseline to follow-up, or treatment-related GMV change. However, whole-brain analysis revealed that lower baseline GMV in several clusters in the TCC, but not the HEW group, was associated with larger improvements in anxiety. This was similar for right precuneus GMV and depressive symptoms.

While we observed no effect on GMV due to the interventions, baseline regional GMV predicted symptom improvements with TCC but not HEW. Longer trials are needed to investigate the long-term effects of TCC on clinical symptoms and neuroplasticity.

The association between sleep quality and cognition is widely established, but the role of aging in this relationship is largely unknown.

To examine how age impacts the sleep–cognition relationship and determine whether there are sensitive ranges when the relationship between sleep and cognition is modified. This investigation could help identify individuals at risk for sleep-related cognitive impairment.

Sample included 711 individuals (ages 36.00–89.83, 59.66 ± 14.91, 55.7 % female) from the Human Connectome Project-Aging (HCP-A).

The association between sleep quality (Pittsburgh Sleep Quality Index, PSQI) and cognition (Crystallized Cognition Composite and Fluid Cognition Composite from the NIH Toolbox, the Trail Making Test, TMT, and the Rey Auditory Verbal Learning Test, RAVLT) was measured using linear regression models, with sex, race, use of sleep medication, hypertension, and years of education as covariates. The interaction between sleep and age on cognition was tested using the moderation analysis, with age as both continuous linear and nonlinear (quadratic) terms.

There was a significant interaction term between the PSQI and nonlinear age term (age2) on TMT-B (p = 0.02) and NIH Toolbox crystallized cognition (p = 0.02), indicating that poor sleep quality was associated with worse performance on these measures (sensitive age ranges 50–75 years for TMT-B and 66–70 years for crystallized cognition).

The sleep–cognition relationship may be modified by age. Individuals in the middle age to early older adulthood age band may be most vulnerable to sleep-related cognitive impairment.

We examined the association between perceived discrimination and the risk of cognitive impairment with no dementia (CIND) and Alzheimer’s disease and related dementias (ADRD) while considering the potential effects of nativity status.

A prospective analysis of discrimination and nativity status with dementia and cognitive impairment was conducted among Latinx adults aged 51 years and older who participated in the Health and Retirement Study.

A national representative sample.

A sample of 1,175 Latinx adults aged 51 years and older.

Demographics, cognitive functioning, perceived discrimination, and nativity status (US-born vs. non-US born) were assessed. Traditional survival analysis methods (Fine and gray models) were used to account for the semi-competing risk of death with up to 10 years of follow-up.

According to our results, neither everyday discrimination nor nativity status on their own had a statistically significant association with CIND/ADRD; however, non-US-born Latinx adults who reported no discrimination had a 42% lower risk of CIND/ADRD (SHR = 0.58 [0.41, 0.83], p = .003) than US-born adults.

These results highlight the need for healthcare providers to assess for discrimination and provide support and resources for those experiencing discrimination. It also highlights the need for better policies that address discrimination and reduce health disparities.

To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia.

Three longitudinal cohort studies.

Participants recruited from the electoral roll, Australian Twins Registry, and community advertisements.

Older adults (aged 65–106) without dementia from the Sydney Memory and Ageing Study (n = 1037; median age 78), Older Australian Twins Study (n = 361; median age 68), and Sydney Centenarian Study (n = 217; median age 97).

Frequency of super-aging was assessed using nine super-aging definitions based on performance on neuropsychological testing. Levels of agreement between definitions were calculated, and associations between super-aging status for each definition and functioning (Bayer ADL score), structural brain imaging measures, and incident dementia were explored.

Frequency of super-aging varied between 2.9 and 43.4 percent with more stringent definitions associated with lower frequency. Agreement between different criteria varied from poor (K = 0.04, AC1 = .24) to very good (K = 0.83, AC1 = .91) with better agreement between definitions using similar tests and cutoffs. Super-aging was associated with better functional performance (4.7–11%) and lower rates of incident dementia (hazard ratios 0.08–0.48) for most definitions. Super-aging status was associated with a lower burden of white matter hyperintensities (3.8–33.2%) for all definitions.

The frequency of super-aging is strongly affected by the demographic and neuropsychological testing parameters used. Greater consistency in defining super-aging would enable better characterization of this exceptional minority.

The aim of this systematic review is to examine the cognitive impact of psychotropic medications including benzodiazepines, antidepressants, mood stabilizers, antipsychotics, or a combination of these drugs on older adults.

Systematic review.

We searched Medline, PsycINFO, and Embase through the Ovid platform, CINAHL through EBSCO, and Web of Science.

Randomized control trials (RCTs) and cohort studies that used a validated scale to measure cognition with a follow-up period of at least six months were included.

The primary outcome of interest was cognitive change associated with psychotropic medication use.

A total of 7551 articles were identified from the primary electronic literature search across the five databases after eliminating duplicates. Based on full-text analysis, 27 articles (two RCTs, 25 cohorts) met the inclusion criteria. Of these, nine each examined the impact of benzodiazepines and antidepressants, five examined psychotropic combinations, three on antipsychotic drugs, and one on the effects of mood stabilizers.

This is the first systematic review to examine the cognitive impact of multiple psychotropic drug classes in older adults over an extended follow-up period (six months or more) using robust sample sizes, drug-free control groups, and validated cognitive instruments. We found evidence to indicate cognitive decline with the cumulative use of benzodiazepines and the use of antidepressants, especially those with anticholinergic properties among older adults without cognitive impairment at baseline. Further, the use of antipsychotics and psychotropic combinations is also associated with cognitive decline in older adults.

We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced among Holocaust survivors (HS), especially those with high-level posttraumatic stress disorder (PTSD) symptoms.

Self-report questionnaires completed online via Qualtrics.

An online-based survey conducted in Israel.

A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. HS (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939 and 1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5).

Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates.

Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups.

Findings suggest that the experience of FE may be particularly impactful among survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.

A number of studies have compared Alzheimer’s disease (AD), the commonest form of dementia, based on their age of onset, i.e. before the age of 65 years (early-onset AD, EO-AD) to those developing after 65 years of age (late-onset AD, LO-AD), but the differences are not clear. We performed a systematic review and meta-analysis to compare clinical characteristics between EO-AD and LO-AD.

Medline, Embase, PsycINFO, and CINAHL databases were systematically searched for studies comparing time to diagnosis, cognitive scores, annual cognitive decline, activities of daily living (ADLs), neuropsychiatric symptoms (NPS), quality of life (QoL), and survival time for EO-AD and LO-AD patients.

Forty-two studies were included (EO-AD participants n = 5,544; LO-AD participants n = 16,042). An inverse variance method with random effects models was used to calculate overall effect estimates for each outcome. People with EO-AD had significantly poorer baseline cognitive performance and faster cognitive decline but longer survival times than people with LO-AD. There was no evidence that EO-AD patients differ from people with LO-AD in terms of symptom onset to diagnosis time, ADLs, and NPS. There were insufficient data to estimate overall effects of differences in QoL in EO-AD compared to LO-AD.

Our findings suggest that EO-AD differs from LO-AD in baseline cognition, cognitive decline, and survival time but otherwise has similar clinical characteristics to LO-AD. Larger studies using standardized questionnaires focusing on the clinical presentations are needed to better understand the impact of age of onset in AD.

This study aims to systematically review the literature on using electroconvulsive therapy (ECT) in patients with dementia/major NCD (Neuro cognitive disorder) presenting with behavioral symptoms.

We conducted a PRISMA-guided systematic review of the literature. We searched five major databases, including PubMed, Medline, Embase, Cochrane, and registry (ClinicalTrials.gov), collaborating with “ECT” and “dementia/major NCD” as our search terms.

Out of 445 published papers and four clinical trials, only 43 papers and three clinical trials met the criteria. There were 22 case reports, 14 case series, 4 retrospective chart reviews, 1 retrospective case–control study, 1 randomized controlled trial, and 2 ongoing trials. We evaluated existing evidence for using ECT in dementia/major NCD patients with depressive symptoms, agitation and aggression, psychotic symptoms, catatonia, Lewy body dementia/major NCD, manic symptoms, and a combination of these symptoms.

The studies were conducted in the in-patient setting.

Seven hundred and ninety total patients over the age of 60 years were added.

All reviewed studies reported symptomatic benefits in treating behavioral symptoms in individuals with dementia/major NCD. While transient confusion, short-term memory loss, and cognitive impairment were common side effects, most studies found no serious side effects from ECT use.

Current evidence from a systematic review of 46 studies indicates that ECT benefits specific individuals with dementia/major NCD and behavioral symptoms, but sometimes adverse events may limit its use in these vulnerable individuals.