[Preventing decline of autonomy through the promotion of mental health: a randomized clinical trial for older adults with disabilities]. / La prévention de la perte d'autonomie par le renforcement de la santé mentale : un essai clinique à répartition aléatoire auprès des personnes âgées avec incapacités.

Among older adults with disabilities, maintaining active aging can often be compromised. However, the literature highlights a positive link between mental health and autonomy on one hand, and self-determined motivation on the other. Therefore, self-determined motivation may be improved by promoting mental health and, in the end, older adults autonomy. In this context, the « pôle bien-être autonomie ¼, a mental health promotion program, has been set up to offer activities adapted to the disabilities and needs of the elderly, hence fostering active aging. The purpose of this longitudinal study is to test the hypothesis that promoting the mental health of disabled older adults would preserve their autonomy through the development of self-determined motivation. The theoretical model was tested using structural equation modelling on data of 170 participants. A RCT was conducted between 2019 and 2021 with the same cohort. Results of the structural equation modelling support the importance of promoting mental health in maintaining active aging. Evaluation of the promotion program indicates a decrease in levels of depression, an increase in the frequency of self-determined activities and in the autonomy of beneficiaries after three months of operation. The discussion focuses on the relevance of a processual analysis of the promotion program and on new directions to maintain autonomy for seniors with disabilities.

Promoting the mental health of elderly people with physical disabilities: a systematic review of available home and facility-based interventions / Promouvoir la santé mentale des personnes âgées avec des incapacités physiques : revue systématique des interventions proposées à domicile et en établissement.

Introduction: Promoting the mental health of vulnerable elderly patients is a public health priority. Context: In many cases, mental health interventions for elderly people are not appropriate for those with multiple physical disabilities. Objectives: This article aims to provide gerontology professionals with an overview of the types of interventions available based on their practice setting (home or long-term care facility) and the characteristics of the people who use them (over 75 years old with physical disabilities). Method: A systematic literature review was conducted using the PsycInfo, PubMed, and Cochrane databases, using data ranging from 2001-2022. All interventions aimed at addressing mental health issues were included, regardless of their research methodology. Results: A total of 18 studies were included in this systematic review. The methodological limitations of these studies had a negative impact on our ability to draw conclusions and generalizations about the results of this review. However, the social and psychological support interventions studied seem to hold much promise. Discussion: The provision of personalized support seems to be an important factor in determining the success of an intervention, whether at home or in a long-stay facility. Conclusion: Further studies are needed to provide evidence of the effectiveness of these interventions.

Introduction: La promotion de la santé mentale des personnes âgées et fragiles est une priorité de santé publique. Contexte: La majorité des interventions ciblant la santé mentale des personnes âgées ne sont pas toujours adaptées à une population qui présente plusieurs incapacités physiques. Objectifs: Cet article souhaite fournir aux professionnels de la gérontologie un aperçu des interventions adaptées à leur lieu d'exercice (domicile ou établissement de longs séjours) et aux caractéristiques de leurs usagers (plus de 75 ans avec des incapacités physiques). Méthode: Un examen systématique de la littérature a été effectué dans les bases de données PsycInfo, PubMed et Cochrane, entre 2001 et 2022. Toutes les interventions ciblant la santé mentale ont été incluses, quelle que soit leur méthodologie de recherche. Résultats: Au total, 18 études ont été retenues pour cette revue systématique. Les limites méthodologiques de ces études viennent impacter négativement les possibilités de conclusion et de généralisation des résultats de la présente revue. Toutefois, les interventions sociales et de soutien psychologique semblent prometteuses. Discussion: Un accompagnement personnalisé semble représenter un facteur important pour garantir le succès d'une intervention à domicile comme en établissement de longs séjours. Conclusion: D'autres études restent nécessaires pour fournir des preuves d'efficacité.

The Lexical Association Technique: A randomized controlled trial with breast cancer patients.

Low self-esteem is a vulnerability factor for depressive disorders, and the prevention of psychological disorders is essential in cancer patients. The enhancement of self-esteem in breast cancer patients may therefore be an appropriate clinical target. Previous studies have shown the efficacy of the Lexical Association Technique to enhance self-esteem in healthy subjects. This study aims to test the clinical efficacy and acceptability of the Lexical Association Technique on the self-esteem of cancer patients. A double-blind randomized controlled trial was conducted on 63 breast cancer patients during their radiotherapy treatment. Global self-esteem measures were taken using the Rosenberg Self-Esteem Scale before and after the Lexical Association Technique and 1 month after its end. The results showed a significant improvement in global self-esteem in patients immediately after performing the Lexical Association Technique compared to an active control group. However, the positive effects did not last 1 month. These results confirm the efficacy and suitability of the Lexical Association Technique for cancer patients. Avenues of research are proposed to extend the effects of the technique and increase its transdiagnostic applicability.

Impact of an overweight body representation in virtual reality on locomotion in a motor imagery task.

Virtual reality immersion enables a person to embody avatars that strongly deviate from his/her biological body. Interestingly, the person's expectations about the embodied avatar lead to congruous behavior, phenomenon referred to as the Proteus effect. The objective of the present study was to investigate, in virtual reality, the relationship between body-shape representation and expected physical abilities in a locomotor imagery task, in the context of overweight avatar embodiment. Given the negative stereotypes concerning overweight people's physical abilities, we expected overweight avatar embodiment to have a negative impact on performance in the locomotor imagery task. Thirty-five healthy-weight participants, with a body mass index between 16.5 and 30 at the time of the experiment or in the past, embodied both a healthy-weight avatar and an overweight avatar on two different experimental sessions while performing the imagery task (walking four different distances on two different slopes). In accordance with our hypothesis, participants took longer to perform the locomotor imagery task when embodying an overweight avatar than when embodying a healthy-weight one (the "avatar effect")-especially so when the distance to be covered was long. We conclude that, as has already been reported for people with anorexia nervosa, considering one's own body to be fatter than it really is leads to congruent weight-related behavior.

How Should Self-Esteem Be Considered in Cancer Patients?

Numerous studies showed that cancer significantly increases the risk of developing depressive and anxious symptoms. It has been shown that self-esteem is an important psychological resource and is associated with many health behaviors. Furthermore, the vulnerability model of low self-esteem, which has received strong empirical support, highlights that low self-esteem is a real risk factor in the development of depressive disorders. This article aims at providing an overview of the involvement of self-esteem in the psychological adjustment to cancer. After briefly reviewing the literature, we suggest that its implication in the development of depressive disorders and its association with coping strategies and social support in cancer patients justify the consideration of self-esteem in oncology psychological care, especially in young adult patients and those with significant physical impairment following treatment.

Personnes âgées à domicile avec limitations fonctionnelles : étude préliminaire d'une intervention centrée sur le bien-être et l'autonomie.

In the context of demographic aging, preventing autonomy loss is a major issue. Adapting care systems to help keep seniors at home is a daily challenge. "La Mutualité Française", a national mutual insurance company, has implemented in one of its healthcare services an innovative program to strengthen well-being: "The Well-Being Autonomy Pole." This program comprises five Prevention and Support Care components and hypothesizes that strengthening the well-being of elderly people already suffering from physical limitations would prevent their autonomy decline. The originality of this program is its focus on elderly people who have rarely been studied in terms of preventing autonomy loss, given their existing functional limitations. A first evaluation was carried out over three months to verify the methodological feasibility of an impact assessment and to provide preliminary results on the effectiveness of the program. Key findings suggest improved levels of self-esteem, physical well-being, psychological autonomy and decreased anxiety. Methodological limitations of this first feasibility assessment and perspectives for future research are discussed.

The impact of embodying an "elderly" body avatar on motor imagery.

When an individual embodies an avatar, the latter's characteristics or stereotype can change the individual's behavior and attitudes; this is known as the Proteus effect. Here, we looked at whether the embodiment of an avatar resembling an elderly adult (seen from a first-person perspective and facing a virtual mirror) changed mentally represented physical activity in a motor imagery task performed by young adult participants (N = 52). To ensure that the impact of embodiment of an elderly avatar on the motor imagery task was not influenced by a potentially confounded stereotype assimilation effect (due to the mere presence of an avatar), a "young" avatar and an "elderly" avatar were always present together in the virtual environment-even though only one (the self-avatar) was embodied at a given time. We found that it took longer for the participants to perform the motor imagery task with the elderly self-avatar than with the young self-avatar. The more negative the participant's beliefs about motor activity in the elderly, the greater the observed effect of the avatar on motor imagery performance. We conclude that knowledge about the characteristics of an embodied avatar can modify the subject's level of mentally represented physical activity.

Distinct effects of cognitive versus somatic anxiety on cognitive performance in old age: the role of working memory capacity.

Objective: The adverse effects of anxiety on cognition are widely recognized. According to Attentional Control Theory, worry (i.e. facet of cognitive anxiety) is the component that is responsible for these effects, and working memory capacity (WMC) plays an important role in regulating them. Despite the increasing importance of this problem with aging, little is known about how these mechanisms interact in old age. In this study, we explored the distinct contributions of the somatic and cognitive components of anxiety to neuropsychological performance, and the potential moderating role of WMC.Method: We administered cognitive tasks testing processing speed, cognitive flexibility and working memory to 605 older adults, who also underwent depression and test anxiety assessments (data from VLV study).Results: Multiple regression analyses showed that cognitive (but not somatic) aspects of anxiety affected cognitive flexibility. The effect of cognitive anxiety on processing speed was moderated by WMC: the anxiety-performance association was lower for participants with greater WMC.Conclusion: Results confirmed the specific role of worry in the anxiety-performance relationship in old age and supported the hypothesis that working memory resources regulates its deleterious effect on cognition. The absence of a moderation effect in the more costly switching task may reflect a limitation of resources with aging.

Motivation as a Mediator of the Relation Between Cognitive Reserve and Cognitive Performance.

OBJECTIVES: Interindividual differences in cognitive aging may be explained by differences in cognitive reserve (CR) that are built up across the life span. A plausible but underresearched mechanism for these differences is that CR helps compensating cognitive decline by enhancing motivation to cope with challenging cognitive situations. Theories of motivation on cognition suggest that perceived capacity and intrinsic motivation may be key mediators in this respect. METHOD: In 506 older adults, we assessed CR proxies (education, occupation, leisure activities), motivation (perceived capacity, intrinsic motivation), and a global measure of cognitive functioning. RESULTS: Perceived capacity, but not intrinsic motivation, significantly mediated the relation between CR and cognitive performance. DISCUSSION: Complementary with neurobiological and cognitive processes, our results suggest a more comprehensive view of the role of motivational aspects built up across the life span in determining differences in cognitive performance in old age.

Emotional decoding abilities in Alzheimer's disease: a meta-analysis.

Studies on emotional processing in Alzheimer's disease (AD) have reported abnormalities in emotional decoding. However, it remains unclear whether the impairment depends on a general cognitive decline that characterizes these patients or is an independent deficit. We conducted a comprehensive meta-analysis of existing studies that compared AD patients with age-matched healthy older adults (HOA) on measures of emotional decoding abilities. Our first goal was to quantify the magnitude of the AD patients' deficit. The second goal was to identify variables that may modulate the deficit, including emotional task design and participants' characteristics. The random-effects model analysis on 212 effect sizes indicated that AD patients showed significant impairment in emotional decoding abilities. This deficit is consistent regardless of the emotional task, stimuli, type of emotion considered, or disease severity. After we controlled for cognitive status, the emotional performance in AD patients was still poorer than that in HOA. The effect size of emotional performance was significantly lower when the cognitive status was considered than when it was not. Thus, our results suggest that impaired emotion processing in AD patients cannot be solely explained by the cognitive deficit. These findings provide evidence that progressive neuropathological changes characterizing the disease could affect emotional processing, which may suggest that clinicians should be sensitive to the emergence of impairments in emotional decoding. Further research that addresses the limitations of existing studies is needed to draw conclusions about methodological issues and the impact of the AD patient's depression symptoms on emotional decoding.

Evaluating short-term and working memory in older adults: French normative data.

Short-term and working memory (WM) capacities are subject to change with ageing, both in normal older adults and in patients with degenerative or non-degenerative neurological disease. Few normative data are available for comparisons of short-term and WM capacities in the verbal, spatial and visual domains. To provide researchers and clinicians with a set of standardised tasks that assess short-term and WM using verbal and visuospatial materials, and to present normative data for that set of tasks. The present study compiled normative French data for three short-term memory tasks (verbal, visual and spatial simple span tasks) and two WM tasks (verbal and spatial complex span tasks) obtained from 445 healthy older adults aged between 55 and 85 years. Our data reveal main effects of age, education level and gender on older adults' short-term and WM performances. Equation-based normalisation can therefore be used to take these factors into account. The results provide a set of cut-off scores for five standardised tasks that can be used to determine the presence of short-term or WM impairment in older adults.

Are memory self-efficacy and memory performance related? A meta-analysis.

The association between memory self-efficacy (MSE) and memory performance is highly documented in the literature. However, previous studies have produced inconsistent results, and there is no consensus on the existence of a significant link between these two variables. In order to evaluate whether or not the effect size of the MSE-memory performance relationship in healthy adults is significant and to test several theory-driven moderators, we conducted a meta-analysis of published and unpublished studies. A random-effects model analysis of data from 107 relevant studies (673 effect sizes) indicated a low but significant weighted mean correlation between MSE and memory performance, r = .15, 95% CI [.13, .17]. In addition, the mean effect size was significantly moderated by the way MSE was assessed. Memory performance was more strongly related to concurrent MSE (perceived current ability to perform a given task) than it was to global MSE (perceived usual memory ability in general). Furthermore, we found marginally larger MSE-memory performance correlations when the memory situations used to assess MSE involved familiar stimuli. No effect of the method used to assess global MSE or domain MSE (memory rating vs. performance predictions) was found. The results also show that the resource demands of the memory tasks have a moderator effect, as the MSE-performance correlation is larger with free-recall and cued-recall tasks than it is with recognition tasks. Limitations (generalization issues, moderators not considered) and implications for future research are discussed.