JMIR Publications

ABSTRACT

Background:

Demoralization negatively affects quality of life, especially in people with mental disorders.

Objective:

This study aims to assess demoralization in a cohort of community-dwelling older adults, to identify groups of individuals who share similar characteristics in terms of mental health conditions and severity of demoralization domains, and to investigate the different characteristics across these groups.

Methods:

Subjects were enrolled in three centers within the cross-sectional MentDis_ICF65+ study and were assessed with the Demoralization Scale and the Composite International Diagnostic Interview at baseline. A cluster analysis was performed using the partitioning around medoids (PAM) algorithm with Gower’s distance to classify individuals based on demoralization severity and diagnosis of mental health disorders, allocating individuals to a distinct number of patterns by investigating individuals’ similarities across these variables.

Results:

Three clusters were identified: the “low psychopathology” cluster with very few mental health diagnoses, the “affective” cluster characterized by affective disorders (100% of subjects), the “anxiety” cluster, characterized by anxiety disorders (100% of subjects). Men were prevalent in the “low psychopathology” cluster (n=635, 59.1%, P<0.01), women in the “affective” cluster (N=133, 72.3%, P<0.01) and “anxiety” cluster (N= 79, 71.8%, P<0.01). The “affective” cluster had the highest mean scores for disheartenment (17.1, SD=6.7, P<0.01), dysphoria (12.1, SD=3.5, P<0.01), and loss of meaning (11.8, SD=4.9, P<0.01) but the lowest for sense of failure (17.4, SD=3.2, P<0.01).

Conclusions:

The identification of different clusters of demoralization and mental health disorders in community-dwelling elderly and sex-based differences highlights the need for tailored mental health interventions in this vulnerable population