{"title":"Written in Fate: Nepali Older Adults' Understanding of Suicide.","authors":"Pralhad Adhikari, Taneile Kitchingman, Clifford Lewis, Suzanne McLaren","doi":"10.1080/07317115.2025.2541765","DOIUrl":"10.1080/07317115.2025.2541765","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore Nepali older adults' understanding of suicide and its solutions.</p><p><strong>Methods: </strong>Focus groups were conducted to understand culturally appropriate ways to start conversations about suicide with Nepali older adults. Informed by the focus group findings, 24 interviews were then conducted with older adults in rural and urban areas.</p><p><strong>Results: </strong>Thematic analysis resulted in three key themes: 1) meanings of suicide (damnation, fate, unnatural death, dishonor), 2) causes of suicide (lack of social support, limited resources, declining functioning, impaired cognition, mental pain, bad deeds), and 3) solutions (family/friends support, governmental/community role).</p><p><strong>Conclusions: </strong>Cultural beliefs have shaped the perception of suicide among Nepali older adults. Their belief in fate can be a barrier to preventing suicide. However, their belief that suicide results in bad afterlife consequences can be exploited to potentially prevent it. Moreover, older adults thought that suicide prevention involves roles for family, community, and government.</p><p><strong>Clinical implications: </strong>Interventions designed to increase mental health literacy and to capitalize on the practice of mindfulness associated with local religions may help to prevent suicide among Nepali older adults. Moreover, community resources should be available to assess the risks of suicide and offer support to vulnerable older adults.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"529-541"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-09-04DOI: 10.1080/07317115.2025.2548431
Beau Nieuwenhuijs, Nico De Witte, Ellen Gorus
{"title":"Assessment of suicidal ideation and behavior in community-dwelling older adults: a systematic review.","authors":"Beau Nieuwenhuijs, Nico De Witte, Ellen Gorus","doi":"10.1080/07317115.2025.2548431","DOIUrl":"10.1080/07317115.2025.2548431","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review aims to provide a comprehensive overview of the available instruments to detect suicidal ideation and behavior in community-dwelling older adults. We further aim to evaluate the instruments' psychometric properties, diagnostic accuracy, and practical utility.</p><p><strong>Methods: </strong>A systematic review of PubMed, PsycINFO, Sociological Abstracts, and Web of Science databases was carried out. Risk of bias was evaluated with the COSMIN risk of bias checklist or the QUADAS 2 tool.</p><p><strong>Results: </strong>22 studies detailing 22 instruments were found. Instruments either assessed suicidality directly or indirectly, through the assessment of depression or known risk factors. Psychometric evaluation showed that the validity was better in the original instruments rather than shortened instruments. Evidence for reliability was not always sufficient. All instruments had good diagnostic accuracy. Most instruments were suitable for primary care settings, but their use is context dependent.</p><p><strong>Conclusions: </strong>A variety of instruments are used. Additional research is required for validation and practical use.</p><p><strong>Clinical implications: </strong>Valid instruments assessing suicidality, depression, or risk factors can be used to detect suicide risk in community-dwelling older adults.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"510-528"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-10-13DOI: 10.1080/07317115.2025.2570180
Tobias Becker, Meinolf Peters, Simon Forstmeier
{"title":"Personality Functioning Measured with the OPD-Structure Questionnaire in Older Adults With and Without Depression: The Mediating Role of the Attitude Toward Own Aging.","authors":"Tobias Becker, Meinolf Peters, Simon Forstmeier","doi":"10.1080/07317115.2025.2570180","DOIUrl":"10.1080/07317115.2025.2570180","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the prevalence of difficulties in personality functioning (PF) in older adults with depression and to explore the mediating role of the attitude toward own aging (ATOA).</p><p><strong>Methods: </strong>To examine differences in the level of PF between healthy older adults (<i>n</i> = 42) and older inpatients with depression (<i>n</i> = 36), the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQ) was employed. Moreover, in the total sample of older adults (<i>N</i> = 78), we examined whether the relationship between the level of PF and depression is mediated by the ATOA.</p><p><strong>Results: </strong>Compared with healthy older adults, older inpatients with depression reported significantly greater structural deficits in PF, notably in the subdomains of self-perception, self-regulation, and attachment to internal objects. The mediation analysis demonstrated that the relationship between PF and depression was partially mediated by the ATOA.</p><p><strong>Conclusions: </strong>Depression is closely associated with impairments in PF even in older individuals. These impairments may be partially mediated by a negative ATOA, which in turn exacerbates depressive symptoms.</p><p><strong>Clinical implications: </strong>It seems useful to assess PF in older inpatients with depression and to accompany this with an exploration of the patient's ATOA.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"628-642"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychometric Validation and Cross-Cultural Adaptation of the Duke Anxiety-Depression Scale (DUKE-AD) in Persian-Speaking Older Adults.","authors":"Mehri Seyedjavadi, Parvin Sarbakhsh, Asghar Mohammadpoorasl, Abdolreza Shaghaghi","doi":"10.1080/07317115.2025.2579844","DOIUrl":"10.1080/07317115.2025.2579844","url":null,"abstract":"<p><strong>Objectives: </strong>Sub-threshold cases of depression and anxiety disorders in older adults are often undetected and undertreated. The 7-item Duke Anxiety-Depression Scale (DUKE-AD) assesses mental distress; this study evaluated the psychometric validity and cross-cultural applicability of its Persian version (DUKE-AD-PERSIAN).</p><p><strong>Methods: </strong>A cross-sectional study among 500 older adults assessed for content and face validity as measured by 20 experts, and estimated content validity ratio (CVR) and item-level content validity index (I-CVI). Exploratory and Confirmatory Factor Analyses (EFA, CFA) examined the factor structure.</p><p><strong>Results: </strong>Participants had a mean age of 70.62 ± 7.42 years and mean anxiety-depression score of 25.05 ± 22.39. The implemented EFA and CFA's outputs (CMIN = 29.933, DF = 11, <i>p</i>value = 0.002, CMIN/DF = 2.721, RMSEA = 0.05 (95% CI: 0.034, 0.084), PNFI = 0.511, PCFI = 0.515, TLI = 0.969, IFI = 0/984, CFI = 0.984) supported unidimensionality of the scale. The estimated reliability and stability coefficients (Cronbach's α = 0.98, ICC = 0.97) were acceptable.</p><p><strong>Conclusions: </strong>Findings supported the reliability and validity of the Persian DUKE-AD as a brief self-report measure for assessing anxiety and depression in older adults.</p><p><strong>Clinical implications: </strong>The Persian DUKE-AD enables efficient screening of anxiety and depression symptoms among older adults, facilitating early intervention in primary care and community health settings.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"582-595"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-12-29DOI: 10.1080/07317115.2025.2606696
Dahee Kim, Ladda Thiamwong, Yingru Li, Jethro Raphael M Suarez, Rui Xie, Yan Wang, Victoria Loerzel
{"title":"Modified Fall Risk Appraisal Matrix and Mental Health in Community-Dwelling Older Adults.","authors":"Dahee Kim, Ladda Thiamwong, Yingru Li, Jethro Raphael M Suarez, Rui Xie, Yan Wang, Victoria Loerzel","doi":"10.1080/07317115.2025.2606696","DOIUrl":"10.1080/07317115.2025.2606696","url":null,"abstract":"<p><strong>Objectives: </strong>The fall risk appraisal (FRA) matrix provides multidimensional approaches to detecting falls in late adulthood. This study investigated a modified FRA (mFRA) matrix based on self-assessed fall risk (SFR) and fear of falling (FOF). We also compared the mental health and characteristics of the four mFRA groups: Rational (low SFR and low FOF), Irrational (low SFR and high FOF), Incongruent (high SFR and low FOF), and Congruent (high SFR and high FOF).</p><p><strong>Methods: </strong>This study used data from 181 older adults (MeanAge = 74.58, SDAge = 7.13) in Central Florida. SFR was measured using the CDC Stopping Elderly Accidents, Deaths, and Injuries fall checklist. FOF was measured using the Short Fall Efficacy Scale-International. Descriptive and group comparison analyses were performed using SPSS.</p><p><strong>Results: </strong>The participants were categorized: Rational (<i>n</i> = 80, 44.2%), Irrational (<i>n</i> = 12, 6.6%), Incongruent (<i>n</i> = 26, 14.4%), and Congruent (<i>n</i> = 63, 34.8%). Rational showed better mental health, fewer falls, and higher health literacy. In contrast, Congruent reported worse mental health, more falls, and lower health literacy.</p><p><strong>Conclusions: </strong>Findings provided empirical evidence to design fall prevention and interventions that consider older adults' experiential and psychological fall risks.</p><p><strong>Clinical implications: </strong>Fall risks of older adults may be measured and comprehended as a multidimensional concept.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"643-651"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-04-08DOI: 10.1080/07317115.2025.2488953
Abigail J Laine, Kamila S White, Ann M Steffen
{"title":"The Later Life Depression Knowledge Questionnaire (LLD-KQ): Development and Initial Validation.","authors":"Abigail J Laine, Kamila S White, Ann M Steffen","doi":"10.1080/07317115.2025.2488953","DOIUrl":"10.1080/07317115.2025.2488953","url":null,"abstract":"<p><strong>Objectives: </strong>Later life depression is an important mental health concern requiring knowledge and skill competencies for behavioral health providers. This study developed and evaluated the initial validity of the Later Life Depression Knowledge Questionnaire (LLD-KQ) as a measure of clinical knowledge of later life depression.</p><p><strong>Methods: </strong>Domain identification, item generation, and content validity were first explored with five geropsychologists. Initially drafted questions were pre-tested with 10 additional geropsychologists. A pool of prospective survey items was administered to licensed masters-level social workers (<i>n</i> = 300) for individual item examination, confirmatory factor analyses testing 1- and 3-factor models, and initial estimates of reliability and validity.</p><p><strong>Results: </strong>From the pool of items pertaining to three identified domains (i.e. psychopathology, assessment/diagnosis, and treatment), 25 items were retained for the final LLD-KQ. The three-factor CFA model did not demonstrate adequacy above that of the single factor CFA model. The results provide initial support for internal consistency and construct validity.</p><p><strong>Conclusions: </strong>Initial psychometric support for the LLD-KQ was observed while further research on scale dimensionality is warranted.</p><p><strong>Clinical implications: </strong>The LLD-KQ may advance research on behavioral health providers' knowledge of later life depression to evaluate the current state of specialized knowledge in mental health and aging.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"605-616"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association Between Cognitive Impairment, Functional Decline and Frailty in Older Adults with Affective Disorders: Insights into Geriatric vulnerability.","authors":"Ariane Madruga Monteiro, Marcela Leão Petersen, Giovana Fagundes Kaminski, Isabella Tamiozo Rodrigues, Mariana Santos Olivieri, Raissa Luise Gonçalves, Gabriel Meda Rezende, Luiza Alvarenga Schulman, Marcus Kiiti Borges","doi":"10.1080/07317115.2025.2589774","DOIUrl":"10.1080/07317115.2025.2589774","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between affective disorders and frailty in older adults remains underexplored, despite their impact on quality of life and healthcare costs. This study aimed to investigate the relationship between affective symptoms, cognitive impairment, functional decline and frailty.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 153 patients aged ≥60 years from two Psychogeriatric outpatient clinics. Standardized tools were used, including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), Pfeffer Questionnaire and Katz Index (to assess functional decline), Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI), and a clinical-sociodemographic questionnaire. Spearman correlations and Poisson regression were performed.</p><p><strong>Results: </strong>Frailty prevalence was 62.1, and significant associations were found between frailty and depressive symptoms on GDS-15 (OR = 6.74), cognitive impairment on VFT (OR = 2.80), CDT (OR = 4.33), MMSE (OR = 4.88) and functional disability on Pfeffer (OR = 14.95). Multivariate analysis identified polypharmacy (OR = 1.64), depressive symptoms (OR = 1.97), cognitive impairment in VFT (OR = 1.30), and functional disability in Pfeffer (OR = 1.96) as independent predictors of frailty.</p><p><strong>Conclusions: </strong>These findings reinforce the association between affective disorders, cognitive impairment, functional decline and frailty in older adults.</p><p><strong>Clinical implications: </strong>The use of integrated tools can help identify patients at greater risk of frailty, guiding multidisciplinary interventions in geriatric mental health.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"744-756"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-05-25DOI: 10.1080/07317115.2025.2505581
Emilee M Ertle, Darby M Simon, Benjamin T Mast
{"title":"Patient Values Influence Clinician Judgment of Medical Decision-Making Capacity.","authors":"Emilee M Ertle, Darby M Simon, Benjamin T Mast","doi":"10.1080/07317115.2025.2505581","DOIUrl":"10.1080/07317115.2025.2505581","url":null,"abstract":"<p><strong>Objectives: </strong>Medical decision-making capacity assessments commonly focus on patient communication, understanding, appreciation, and reasoning, with less emphasis on patient values or preferences that could influence their medical decision. The current study investigates the role of patient values in capacity assessments.</p><p><strong>Methods: </strong>One hundred and ten clinicians with experience conducting medical decision-making capacity assessments completed an online survey. Participants read two vignettes about a patient with questionable capacity and were asked to determine whether the patient had capacity. For the second vignette, participants were randomly assigned to read a vignette which contained information about the patient's longstanding values or a vignette without this information.</p><p><strong>Results: </strong>When information about the patient's values and preferences was included in the vignette, participants were significantly more likely to determine the patient had capacity to make a medical decision. Other significant contributors to a clinician's judgment included experience conducting medical decision-making capacity assessments in a VA hospital and whether the clinician prioritized the patient's autonomy or their health and safety.</p><p><strong>Conclusions: </strong>A patient's values and preferences provide important context which significantly influences clinician judgment of capacity.</p><p><strong>Clinical implications: </strong>Clinicians should regularly assess a patient's values and preferences when conducting capacity assessments, as this may promote patient autonomy.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"669-680"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2025-11-01DOI: 10.1080/07317115.2025.2581762
Nava Mironi, Gali H Weissberger, Yoav S Bergman
{"title":"Objective and Subjective Visual Difficulties and Financial Exploitation in Older Adults.","authors":"Nava Mironi, Gali H Weissberger, Yoav S Bergman","doi":"10.1080/07317115.2025.2581762","DOIUrl":"10.1080/07317115.2025.2581762","url":null,"abstract":"<p><strong>Objectives: </strong>Financial exploitation (FE) is associated with negative social and health consequences. This study examined the relationship between objective/subjective vision abilities and FE vulnerability among older adults.</p><p><strong>Methods: </strong>97 community-dwelling older adults aged 60 and over completed self-report questionnaires assessing subjective vision difficulties, FE vulnerability, and history of FE experiences. Additionally, participants underwent objective vision assessments (distance, near and contrast sensitivity) conducted by a certified gerontological optometrist.</p><p><strong>Results: </strong>Multiple linear regression and logistic regression models showed that self-reported vision difficulties were associated with FE vulnerability (<i>β</i> = .355, <i>p</i> < .001) and self-reported FE experiences (OR = 7.866, <i>p</i> = .005), while objective vision measures were not.</p><p><strong>Conclusions: </strong>Self-perceived vision difficulties are more strongly linked to FE than objective measures. Subjective vision may reflect a cognitive averaging of vision ability not fully captured in well-controlled environments characteristic of objective assessments.</p><p><strong>Clinical implications: </strong>These findings advance our understanding of FE risk factors by highlighting the importance of subjective vision abilities, and suggest practical approaches for identifying and supporting at-risk older adults through patient-reported visual assessments.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"692-703"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical GerontologistPub Date : 2026-05-01Epub Date: 2026-05-04DOI: 10.1080/07317115.2026.2651991
Jennifer Moye
{"title":"Considerations for Assessing Mental Health and Cognitive Function in Older Adults.","authors":"Jennifer Moye","doi":"10.1080/07317115.2026.2651991","DOIUrl":"https://doi.org/10.1080/07317115.2026.2651991","url":null,"abstract":"","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":"49 3","pages":"507-509"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}