| dc.description.abstract | Systematic Review Abstract Objective: Due to the changing demographics within society, more people are getting older than ever before. The effectiveness of psychological interventions for older adults needs to be better understood. Depression and anxiety are two of the most common mental health difficulties that older adults experience. Although the evidence base indicates that Cognitive Behavioural Therapy (CBT) is effective for late-life depression/anxiety, it is important to explore other approaches to provide older adults with greater choice in their treatment. This review seeks to explore whether third-wave approaches are efficacious in reducing depression and/or anxiety symptoms in older adults. Methods: Guided by PRISMA-P, a systematic review was completed, with relevant articles identified using PsycINFO, Medline, Ageline, Psychology and Behavioural Sciences Collection, and Scopus. Quality of included articles was assessed using the Randomised Control Trial of Psychotherapy Quality Rating Scale. Results: A total of eight articles met criteria for inclusion, reporting on Acceptance and Commitment Therapy (ACT), mindfulness-based therapies, and Dialectical Behavioural Therapy (DBT). Overall, it appears that third-wave approaches are efficacious in reducing depression and/or anxiety symptoms in older adults, when compared to control conditions, in addition to two studies showing similar levels of symptom reduction when compared to CBT. Conclusions: Third wave approaches appear to be acceptable approaches for later-life depression and anxiety. More research needs to substantiate these findings, comparing against active therapies, whilst further exploring how efficacious these approaches are in the oldest-old. Empirical Paper Abstract Objectives: People are living longer than ever before, meaning the experiences and challenges of older adults need to be further explored. Older adults have a relationship to their own ageing experience which can influence their feelings, thoughts, and behaviours. Evidence indicates that negative attitudes towards ageing are associated with poor physical and psychological outcomes and that poorer health is associated with lower quality of life (QOL) and health-related quality of life (HRQOL). Thus, research should further investigate the relationship between ageing attitudes, health status, and HRQOL. Methods: A secondary data analysis (N=5144) of a cross-sectional international database explored the relationship between the attitudes to ageing questionnaire (AAQ), subjective health status, and HRQOL, in addition to exploring the contribution of depression status to this. Missing data was managed using multiple imputation. Data was analysed using logistic regression, independent t-tests, and mediation analyses. Results: Jointly, AAQ domains, HRQOL, and depression status correctly predict health status in 79% of cases. Those who consider themselves healthy have a statistically different AAQ profile (lower Psychosocial Loss scores, and higher Physical Change and Psychological Growth scores). Mediation analyses indicate statistically significant partial mediations between health status and HRQOL, with and without covariates including age, gender, depression, and recruitment centre. Effect sizes indicate very small magnitudes for the Psychological Growth domain, and when all covariates were included all domain effect sizes were small. Conclusions: This study provides further support for the relationship between ageing attitudes, health status, and HRQOL, suggesting that positive attitudes are associated with better subjective health. Clinical implications are presented, both for clinicians working with older adults and on a broader societal level, alongside areas for future research. | en_GB |
