Data_Sheet_6_Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.docx

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.

研究目的：本研究旨在探讨宗教与灵性（religious and spiritual, RS）实践与老年人心理健康问题的患病率、严重程度及发病率之间的关联。
研究方法：本研究针对纳入60岁及以上老年人的横断面及纵向研究开展系统评价与元分析，采用经过验证的量表及量表相关条目评估RS水平，并通过经过验证的多维度或特异性工具评估心理健康状况。检索时限截至2021年7月31日，检索数据库包括MEDLINE、LILACS、SCOPUS、CINAHL及AgeLine。采用纽卡斯尔-渥太华质量评价量表（Newcastle-Ottawa Quality Assessment Scale, NOS）评估偏倚风险。基于对数比值比（log odds ratio, OR）与Z值计算合并效应量。本研究已在PROSPERO平台完成注册。
研究结果：本研究共纳入102项研究，涉及79918名社区居住、住院及机构养老的老年人。结果显示，较高的RS水平与焦虑及抑郁症状呈负相关，而与生活满意度、生命意义感、社会关系及心理福祉呈正相关。具体而言，具有较高灵性水平、内在宗教虔诚度及宗教归属的人群，其抑郁症状患病率更低。针对纵向分析的结果显示，多数研究支持较高的RS水平与更低的抑郁症状发病率、死亡恐惧及更优的心理健康状况相关。
研究结论：本研究结果表明，RS与老年人心理健康状况显著相关。RS水平较高的人群，其焦虑及抑郁症状患病率更低，同时报告更高的生活满意度与心理福祉、更良好的社会关系及更明确的生命意义感。越来越多的纵向研究数据支持了本研究的多数结论。