Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

ObjectivesThe present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.MethodsWe conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.ResultsOne hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.ConclusionFindings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

Older Adults with Dementia: Association of Prayer with Neuropsychiatric Symptoms, Cognitive Function, and Sleep Disturbances

“…A key component of successful aging, lifestyle factors such as religious and spiritual practices may reduce the risk of cognitive impairment and improve mental and physical health ( Balboni et al 2022 ; Coelho-Junior et al 2022 ; Paillard-Borg et al 2009 ) but more research is needed examining associations with dementia progression using a larger sample size. Most published studies have looked at prayer among adults with advanced illness and dementia caregivers but there is a large gap among persons with dementia.…”

Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China

“…26 The GDS contains 30 items that are answered using a "yes/no" format. The total score ranges from 0 to 30, the individuals are categorized into three groups using the cut-off point: normal (0-9); mild depressives (10)(11)(12)(13)(14)(15)(16)(17)(18)(19); severe depressives (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The GDS has good reliability and validity in Chinese older adults.…”

“…13 A recent systematic review found that individuals with high spirituality had a lower prevalence of depressive symptoms. 14 And it was associated with a reduced incidence risk of depressive symptoms among older adults with heart failure and/or chronic pulmonary disease. 15 In addition, individuals with high level of spirituality also have a significantly increased rate of depression remission over time among the patients with depression.…”

“…High spirituality was associated with lower risk of post‐traumatic stress, fewer symptoms of eating disorders, fewer negative symptoms of schizophrenia, and a lower risk of suicide 13 . A recent systematic review found that individuals with high spirituality had a lower prevalence of depressive symptoms 14 . And it was associated with a reduced incidence risk of depressive symptoms among older adults with heart failure and/or chronic pulmonary disease 15 .…”

Practices of Self-Care in Healthy Old Age: A Field Study

“…Therefore, this model comprises four dimensions: physical, cognitive, social, and spiritual [ 12 ]. Spirituality/religion is related to the personal meaning of life and its relationship to a supreme being, and although it is a complex construct, spirituality seems to be related to healthy aging behaviors, such as self-care [ 13 ]. On the other hand, in recent years, a new approach to healthy aging postulates that personal development in old age is possible [ 14 ].…”