Safer and more effective programs are required to cope with an increasing number of older people with depression. Hence, we developed the Positive Photo Appreciation (PPA) program. A three-month pilot randomized controlled trial was conducted with healthy Japanese individuals aged 65–84 years, assigned to a PPA group (n = 28) or Photo Correspondence Education (PCE) (control group) (n = 27). We used the Center for Epidemiologic Studies Depression Scale (CES-D) score as the primary outcome measure. Secondary outcome measures, among others, were cognitive function and positive emotion. Data collected at baseline and post-intervention were analyzed using a linear mixed-effect model. Over 80% of the participants in the PPA group completed and were satisfied with the program. Compared with the PCE group, the CES-D score in the PPA group significantly improved (main effect of group: t = −4.30, p < 0.001; interaction effect of group by time: t = 4.39, p < 0.001), with an effect size of d = 1.23. Additionally, a positive significant interaction effect of group by time was found in the Positive and Negative Affect Schedule (t = −2.33, p = 0.024). The PPA program might be promising for mitigating depressive mood in older adults.

Background In Asia, where autonomous decision-making is not well accepted, little is known about whether and how individuals’ preferences are considered when deciding where they receive care. This study examined whether individuals preferring to age in place if confined to bed were less likely to be institutionalized, using longitudinal data of Japanese older adults. Methods We analyzed nationally representative data of 1,290 community-dwelling older adults aged 70 and above. Baseline data were collected in 1999, shortly before the long-term care insurance system was introduced. The outcome was measured as self- or proxy-reported years of institutionalization over seven years. The explanatory variable was whether individuals preferred to age in place if they were confined to bed. Participants were asked about their desired place of care (facility, home, or other) if confined to bed. Covariates were sociodemographic and health-related factors. We used Cox proportional hazards models and calculated hazard ratios (HRs) with 95% confidence intervals (CIs) to evaluate the association of aging-in-place preferences if confined to bed with institutionalization. We applied multiple imputation to deal with missing data. Results Seventy-eight respondents (6.0%) were institutionalized during the follow-up period. Compared to individuals preferring to reside in long-term care facilities if confined to bed (48.7%), those preferring to stay in their homes (39.6%) were less likely to be institutionalized, even after adjusting for relevant covariates (HR = 0.47, 95% CI 0.27–0.79 for model 1 including residential status; HR = 0.45, 95% CI 0.27–0.76 for model 2 including marital status and co-resident children). Conclusions Our findings suggest that individuals’ aging-in-place preferences tend to be considered under the long-term care insurance system. Individuals’ preferences should be shared with families and clinicians when deciding the place of care.

Objectives: Art and cultural activities can benefit mental health. However, there is insufficient evidence on active engagement in art and cultural activities for preventing depressive symptoms among older adults. Therefore, we examined the association of active engagement in art and cultural activities with depressive symptom onset among older adults using 3-year longitudinal data.Methods: This longitudinal study recruited non-institutionalised older adults independent in daily living from the Japan Gerontological Evaluation Study (JAGES) established in 2010, and those without depressive symptoms were followed for three years. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. Active engagement in nine art and cultural activities, including Japanese traditional cultural activities, were evaluated (musical performance, singing, dancing, handicrafts, painting, photography, poetry composition, calligraphy, and tea ceremony/flower arrangement).Results: Ultimately, 37,627 older adults without depressive symptoms at baseline were analysed. The participants' mean age (standard deviation) was 72.6 (5.5) years, and 51.5% were female. During the follow-up period, depressive symptoms occurred in 3844 participants (10.2%). Multivariable logistic regression analysis revealed that active engagement in art and cultural activities was inversely associated with depressive symptom onset (odds ratio = 0.80, 95% confidence interval = 0.73-0.87, p < 0.001). This association was confirmed regardless of age, gender, and socioeconomic status. Among the activities, especially dancing and photography were protective against depressive symptoms. Conclusion:Active engagement in art and cultural activities may contribute to preventing depressive symptoms among older adults. Promoting art and cultural engagement could be important to protect their mental health.

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