Depression and anxiety disorders have a substantial impact on the quality of life, the functioning and mortality of older adults with Parkinson’s disease (PD). The purpose of this systematic review was to examine the factors associated with the prevalence of depression and anxiety disorders among individuals with PD aged 60 years and older. Following a literature search in PubMed, PsycINFO, CINAHL, and EMBASE, 5 articles met the inclusion criteria (adults aged 60 years and older, individuals with PD, and with depression and anxiety disorders, and English-language peer reviewed articles) and were included in this review. These studies were conducted in the U.S (n=3), in Italy (n=1) and the U.K (n=1). Findings indicated that autonomic symptoms, motor fluctuations, severity and frequency of symptoms, staging of the disease, and PD onset and duration were associated with the prevalence of depression and anxiety disorders among older adults suffering from PD. Despite the limited number of studies included in the review, depression and anxiety disorders are often unrecognized and untreated and the comorbidity greatly exacerbates PD symptoms. The identification of factors associated with the development of depression and anxiety disorders could help in designing preventive interventions that would decrease the risk and burden of depression and anxiety disorders among older adults with PD.

Suicide prevention should include limiting access to large quantities of prescription medications and firearms for those at risk of suicide. More effective mental health/substance abuse treatment and chronic illness management support are also needed.

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Background Poor self-management of heart failure (HF) has contributed to poor health outcomes. Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors to trigger progress, rewards, content, and positive feedback in a digital game to motivate real-time behaviors. Objectives To assess the usability of an SCDG prototype over a week of game-playing among 10 older adults with HF in their homes. Methods During initial play, participants' SCDG experiences were observed in their homes using a checklist based on the seven-item Serious Game User Evaluator (SeGUE) instrument. After a week of game-playing, participants completed a survey guided by the Intrinsic Motivation Inventory, to provide their perceptions of the SCDG's usability. Qualitative analysis via semistructured interview-derived themes on experiences playing the SCDG, perceptions regarding engaging with the SCDG, and any usability issues encountered. Results Ten HF participants (50% women and 50% White) played the SCDG for an average of 6 out of 7 days. Nine found the SCDG to be interesting, satisfying, and easy to play. The average step count over a week was 4,117 steps (range: 967–9,892). Average adherence with weight monitoring was 5.9 days in a week. Qualitative analysis yielded outcomes regarding attitudes toward SCDG, and barriers and facilitators that influenced participants' engagement with the SCDG. Conclusion To the best of the authors' knowledge, this usability and feasibility study is the first to report an SCDG designed to improve HF self-management behaviors of older adults in their homes. Future research should consider several issues, such as user profiles, prior game-playing experiences, and network conditions most suitable for connected health interventions for older adults living in the community.