Our study examined the prevalence of childhood and adult ADHD in older adults from clinical and control groups, focusing on impulsivity and psychiatric comorbidities. The sample included 261 participants aged 65 years and older. ADHD diagnoses were established through DSM-5-based structured clinical interviews (SCID-5), supported by standardized self-report measures (ASRS, WURS) and corroborative collateral information from relatives when available (89% of the clinical group), reflecting routine diagnostic practice in older adults. Sociodemographic variables were assessed and compared across groups. Adult ADHD was diagnosed in 9.7% of the clinical group and 1.5% of controls. Probable childhood ADHD (WURS ≥ 36) was identified in 22.5% of clinical participants. Individuals with ADHD had significantly higher attentional impulsivity scores. Within the clinical group, probable childhood ADHD was associated with increased rates of suicide attempts, legal problems, and traffic violations. In multivariable analysis, ADHD diagnosis independently predicted higher impulsivity levels after controlling for age, sex, and education (p = .003). ADHD is associated with clinically relevant impulsivity and behavioral risks in older psychiatric patients, underscoring the importance of considering ADHD in geriatric psychiatric assessments. Routine assessment of attentional impulsivity may improve ADHD recognition in older psychiatric patients.
To evaluate the effects of three months of vitamin D3 supplementation on vitamin D status, motor function, sleep quality, and depressive symptoms in patients with Parkinson's disease and vitamin D insufficiency. In this open-label, single-arm pre - post interventional study, 49 patients with Parkinson's disease received oral vitamin D3 supplementation (7500 IU/day) for three months. Serum 25(OH)D levels and clinical outcomes were assessed at baseline and post-intervention using the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage, Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI). Mean serum 25(OH)D levels increased significantly from 15.91 to 26.45 ng/mL (p < .001). UPDRS total and parts I - III scores improved significantly, while part IV showed no change. PSQI and BDI scores also decreased significantly. However, changes in 25(OH)D levels were not correlated with clinical outcomes, and subgroup analyses showed no differences according to post-intervention vitamin D status. Vitamin D3 supplementation improved biochemical and clinical measures in patients with Parkinson's disease and vitamin D insufficiency. However, the increase in vitamin D levels was not associated with clinical changes. Assessment and correction of vitamin D insufficiency may be considered in Parkinson's disease, but potential clinical benefits should be interpreted cautiously until confirmed by randomized controlled trials.
Frail older adults with coronary heart disease (CHD) face significantly elevated risks of adverse clinical outcomes, including mortality, prolonged hospitalizations, and frequent readmissions. Conventional risk stratification tools, inadequately account for frailty and multimorbidity, limiting their effectiveness in geriatric care. To address this gap, we developed and validated the first machine learning (ML) model that integrates frailty into a multi-outcome risk assessment framework, thereby enhancing clinical decision-making in geriatric cardiology. Utilizing electronic health records from hospitalized frail CHD patients, we developed a multinomial prediction model employing advanced ML techniques, including principal component analysis, gradient boosting, and random forest. The model incorporates explainable artificial intelligence (AI) features to enhance interpretability and a clinical applicability, prioritizing key predictors such as biomarkers and comorbidities. The ML model demonstrated superior predictive performance with receiver operating characteristic curve analysis (area under the curve 0.94, 95% CI: 0.88-1.00) for mortality, 0.72 (95% CI: 0.55-0.87) readmission, and 0.68 (95% CI: 0.57-0.77) prolonged hospital stay, enabling earlier risk identification and personalized intervention strategies. This AI-driven approach represents a significant advancement in geriatric cardiology designed for integration into hospital dashboards, providing real-time patient-centered decision support, optimization of clinical workflow and resource allocation. By advancing digital health solutions and AI driven precision medicine, this model sets a new standard for digital health innovations in aging care.
Unrepresented adults - incapacitated individuals lacking surrogates and documented treatment preferences - pose profound clinical and ethical care challenging. This qualitative descriptive study explored hospital staff's encounters with unrepresented adults, their characteristics, and life-sustaining treatment decision-making for this population in South Korea. We conducted semi-structured interviews with 48 hospital staff including physicians, nurses, and social workers across South Korea who provided care for unrepresented adults. Data were analyzed using directed content analysis. Participants frequently encountered these adults, typically socioeconomically vulnerable middle-aged or older men exhibiting complex care needs, requiring prolonged hospitalization. The life-sustaining treatment decision-making involved physician-led decision-making, consultation with other professionals, alternative consent strategies, and constrained withdrawal and selective withholding of such treatment. Staff navigated these ethically complex decisions by weighing patients' recoverability, presumed life values, and the ethical principle of justice in resource allocation. Crucially, participants experienced significant clinical distress constrained by the lack of legal frameworks and standardized clinical guidelines. Ad-hoc life-sustaining treatment decision-making for unrepresented adults places an immense ethical burden on healthcare providers. Safeguarding this vulnerable population and alleviating provider distress urgently requires robust legal frameworks, standardized clinical guidelines, and institutional multidisciplinary ethics support.
BACKGROUND: Hypertension is associated with an increased risk of cognitive impairment, yet brief and practical screening tools suitable for routine clinical settings remain needed. This study evaluated diagnostic accuracy of the Clock Drawing Test (CDT) for identifying screen-positive cognitive impairment in hypertensive adults aged ≥ 50 years. METHODS: We conducted a cross-sectional study among 365 patients with essential hypertension attending neurology and family medicine outpatient clinics of a secondary-care hospital in Turkey. CDT was administered by two trained family physicians using a standardized instruction and scored using two methods: CDT-1 (0–4 points) and CDT-2 (dichotomous normal/abnormal; scored as 1/0). The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were administered by a gerontologist blinded to CDT results; CDT, MoCA, and MMSE were scored independently by neurologists blinded to each other’s scores and to other cognitive test results. Screen-positive cognitive impairment was operationally defined as MoCA ≤ 21 (primary reference) and low global cognitive performance as MMSE < 24 (secondary reference). Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analyses, including the area under the ROC curve (AUC), sensitivity, and specificity at clinically feasible CDT cut-offs. RESULTS: The mean age was 63.7 ± 7.9 years; 53.5% were male. The prevalence of screen-positive cognitive impairment was 49.9% by MoCA ≤ 21 (182/365) and 33.2% by MMSE < 24 (121/365). CDT-1 demonstrated good discrimination against MoCA ≤ 21 (AUC 0.830; 95% confidence interval [CI] 0.787–0.873) and MMSE < 24 (AUC 0.834; 95% CI 0.787–0.881). For MoCA ≤ 21, sensitivity/specificity were 62.1%/91.3% at CDT-1 ≤ 2 and 83.0%/65.6% at CDT-1 ≤ 3. For MMSE < 24, sensitivity/specificity were 74.4%/84.0% at CDT-1 ≤ 2 and 88.4%/56.1% at CDT-1 ≤ 3. CONCLUSIONS: In hypertensive adults aged ≥ 50 years, CDT-1 showed good overall discrimination and a clear sensitivity–specificity trade-off depending on the cut-off, supporting its use as a rapid pre-screening/triage tool to identify individuals who may warrant more comprehensive cognitive assessment.
The contextual elements of financial decision-making contributed to the creation of a financial exploitation vulnerability scale. This study was a cross-validation study of earlier findings that financial exploitation vulnerability is significantly related to subjective cognitive decline (SCD), a self-rating of cognitive decline. This study used a website designed for older adults to fill out the financial exploitation vulnerability survey anonymously. In this cross-validation sample, 1,436 adults aged 60 and older completed the survey. Correlational and multiple regression analyses were used to test the study's hypotheses. Chi-square, correlation and regression analyses were used to investigate correlates of financial vulnerability. Higher financial vulnerability scores were related to SCD, less education, older age, and for persons of color. We collapsed the self-reported racial groups that were Black (6%), Asian (3%), Latino (2.5%), and other self-reported races into one group due to the low representation of these groups in the sample. Regression analyses accounted for 20% of the overall variance for financial exploitation vulnerability scores, and SCD was the strongest predictor. The findings support the validity of the Financial Exploitation Vulnerability measure and its use as a clinical risk assessment tool. Assessment of SCD is increasingly important. Utilizing measures of financial exploitation risk in clinical settings allows for earlier detection of exploitation vulnerability in persons with SCD, and earlier intervention to help prevent financial exploitation.
This study examined the effects of an age-adapted mindfulness-based cognitive therapy (MBCT) program on depression, anxiety, stress, mindfulness, and sleep quality among older adults. A quasi-experimental pretest - posttest design with intervention and control groups was used. Sixty-two community-dwelling adults aged 60 years and older completed the study. The intervention group participated in an eight-week, age-adapted, group-based MBCT program, while the control group received no psychological intervention. Outcomes were assessed using validated self-report measures. Within-group changes were analyzed using paired samples t-tests, and between-group differences were examined using analysis of covariance (ANCOVA) controlling for baseline scores. Effect sizes were calculated using Cohen's dz for within-group comparisons and Cohen's d for between-group differences. The intervention group showed significant improvements in mindfulness, sleep quality, depression, and stress symptoms compared to the control group, while anxiety scores showed improvement trends. ANCOVA confirmed these gains after adjusting for baseline differences. Large effect sizes suggest clinically meaningful effects. Age-adapted MBCT appears to be a feasible and clinically meaningful non-pharmacological intervention for older adults. Group-based, age-adapted mindfulness interventions may serve as a valuable component of geriatric mental health services and can be successfully integrated into community-based programs.
Although eating disorders (ED) are often associated with adolescence and young adulthood, they extend across the lifespan. This scoping review maps the literature on ED in midlife and older adulthood (≥40 years), focusing on prevalence, clinical characteristics, age of onset, and consequences within a biopsychosocial framework. A scoping review was conducted in accordance with PRISMA-ScR guidelines. A systematic literature search was performed up to August 2025. Peer-reviewed research and review articles published in English or Turkish were included; studies focusing exclusively on children or adolescents were excluded. Twenty-nine publications were included. ED in midlife and older adulthood were prevalent and heterogeneous, encompassing both newly emerging and longstanding presentations. Prevalence estimates were comparable to those in younger populations, and cases were frequently associated with substantial medical and psychiatric comorbidity. Underrecognition, diagnostic challenges, and limited age-specific treatment approaches were consistently reported. ED in later life represent a significant yet underrecognized clinical concern with elevated morbidity and mortality risk, underscoring the need for improved diagnostic awareness and age-sensitive research. Clinicians should consider ED in midlife and older adults and adopt multidisciplinary, biopsychosocial approaches that account for age-related medical complexity and psychosocial context.
To identify multidimensional risk factors associated with poor sleep quality and to develop and temporally validate a machine learning-based model for predicting the 2-year risk of poor sleep quality among community-dwelling older adults in China. Data were drawn from the China Health and Retirement Longitudinal Study (2011-2018). Participants aged ≥ 60 years with good baseline sleep were included. Missing data were imputed using a random forest-based iterative method, and key predictors were selected using LASSO regression. Multiple machine learning algorithms were trained with cross-validation and evaluated using discrimination, calibration, and clinical utility metrics, with SHAP used for model interpretation. Among 3,471 participants, 23.2% developed poor sleep quality. Fifteen predictors across demographic, biological, psychological, and social-behavioral domains were identified. LightGBM performed slightly better overall (AUC = 0.641). The model demonstrated acceptable predictive performance and potential utility for early identification and targeted intervention. Poor sleep quality in older adults reflects the combined contributions of demographic, biological, psychological, and social factors, underscoring the need for multidimensional assessment framework in clinical and community settings. Identifying cumulative risk across emotional, physical, and social domains may facilitate earlier detection of high-risk individuals and more targeted prevention and intervention strategies.
The oldest-old (aged 85 and older) with hypertension face unique challenges in maintaining consistent medication refill patterns, yet their impact on mortality remains unclear. This study examines refill patterns as a marker of health vulnerability and mortality risk in Medicare beneficiaries to inform clinical interventions. We conducted a retrospective cohort study of 1,205,032 U.S. Medicare beneficiaries aged 85 and older with hypertension, using claims data from 2006 to 2021. Refill patterns for antihypertensive medications, including dihydropyridine calcium channel blockers (dCCBs), were assessed using 30-day gaps in prescription claims, modeled as a time-varying exposure. Secondary analyses evaluated statins and proton pump inhibitors (PPIs). Cox proportional hazards models estimated adjusted hazard ratios (aHRs) for all-cause mortality, with sensitivity analyses using a 60-day gap threshold. Among 1,205,032 individuals (median age 86; 69.6% women), consistent refill patterns were associated with reduced all-cause mortality across medication classes. Adherence to dCCBs was associated with a 65% lower-mortality risk (aHR 0.35, 95% CI 0.34-0.35) in fully adjusted models. Statins (aHR 0.40, 95% CI 0.38-0.41) and PPIs (aHR 0.45, 95% CI 0.42-0.47) showed comparable associations. Sensitivity and subgroup analyses (aged ≥95) confirmed these findings, although associations likely reflect underlying health status and end-of-life care decisions. In Medicare beneficiaries aged 85 and older, consistent medication refill patterns were associated with lower mortality, likely reflecting health resilience. Refill data may identify at-risk individuals for timely clinical interventions.
Self-perceptions of aging (SPA) predict behavioral health outcomes in later life, yet whether positive and negative attitudes arise from distinct psychosocial pathways remain unclear. This study examined correlates of positive and negative SPA among diverse older adults. Community-dwelling adults aged 65 and older (N = 150; 30.7% born outside the United States) completed assessments of psychological, social, religious, health, and sociodemographic factors. Post-LASSO variable selection identified correlates of positive and negative Attitudes Toward Own Aging (ATOA) dimensions from 25 candidate variables. Positive and negative SPA reflected distinct yet related pathways. Purpose in life was most strongly associated with both dimensions. Positive SPA was uniquely associated with greater life satisfaction, higher self-esteem, and more frequent social contact. Negative SPA was uniquely associated with greater perceived constraints, less diverse social networks, and greater multimorbidity. Religious affiliation was associated with more positive SPA, whereas higher religiosity was associated with less positive and greater negative SPA. Nativity and race/ethnicity were not significantly associated with either dimension. Models explained 51.7% (R2 = .517) and 42.4% (R2 = .424) of variance, respectively (both ps < .001). Findings support distinct psychosocial pathways underlying SPA, with implications for targeted behavioral health interventions in later life. Assessing positive and negative self-perceptions of aging separately may support more targeted clinical decision-making. Interventions may be strengthened by addressing both psychological resources and perceived constraints. Purpose in life may serve as a cross-cutting focus for assessment and intervention.
Extant research on hoarding has largely taken place in urban settings, preventing generalizations to rural communities. Thus, our objective was to provide a profile of late life rural hoarding. We used data from a survey distributed at community presentations (N = 97) and data from baseline assessments administered as part of larger treatment outcome studies for geriatric hoarding (N = 55). On the community sample, 33% of participants scored above the clinical cutoff on a brief screening measure. Of the older adults diagnosed with hoarding disorder, 65% lived with at least one other person and 49% were married, a strong contrast to urban samples. Participants who lived alone had higher levels of clutter than those who lived with at least one other person, but did not report higher levels of subjective hoarding symptoms. While rurality might lead to lower clutter levels in primary rooms in the home, it does not affect the overall volume of clutter that has accumulated, nor the subjectively experienced level of distress. Our rural sample differed substantially from urban samples on characteristics that should be considered by clinicians when forming their case conceptualization for late life hoarding patients.
There are to date only a few culturally appropriate evidence-based psychoeducational interventions to support Hispanic dementia caregivers. The program Cuidando Juntos has recently been shown to be a culturally appropriate adaptation of one such programs. The current paper presents a follow-up quantitative assessment of (a) user-reactions to the Cuidando Juntos program and (b) the preliminary efficacy of the Cuidando Juntos to improve caregiver subjective health and well-being (SHWB). A one-arm clinical trial was conducted, with a pre-post data collection methodology. User-reactions were assessed via a set of 24 items assessing four domains: (a) helpfulness of program, (b) strategy utilization, (c) skill utilization, and (d) website usefulness. Caregiver SHWB was operationalized as perceived general health, caregiving self-efficacy, depression, stress, and caregiving burden. Caregivers (N = 31) were mostly female (98%), White (77%), of Mexican origin (71%). Most user-reactions were quite positive, with most participants rating all aspects as quite or very positive. Analysis of SHWB indicated significant improvement from pre- to post-intervention, on average, on all 5 measures. Effect sizes ranged from small (d = 0.33; general health) to medium (d = 0.59 to 0.77; depression, stress and burden) to large (d = 1.17; self-efficacy). Results indicate the program generates positive user-reactions, and participation in the program can yield a small to large positive impact on caregivers' self-reported health and well-being. Further examination of the key psychological factors impacting dementia caregivers SHWB is encouraged. NCT06394388, Unique Protocol ID: 24-0291-01.
Subjective technology adaptivity, as a motivational resource related to technology use, has become an important predictor of the technology use among older people. Given intensifying population aging and rising digital health management demands among older Chinese with chronic diseases, this study aimed to translate the Subjective Technology Adaptivity Inventory (STAI) into Chinese and explore its psychometric properties among older adults with chronic diseases. A two-phase adaptation and validation study was conducted. 635 older patients with chronic diseases were recruited to assess the psychometric properties of the Chinese version of the STAI. Besides item analysis, this study evaluated the inventory's content validity, structural validity, convergent validity, discriminant validity, criterion-related validity, known-groups validity, internal consistency, split-half reliability and test-retest reliability. The Chinese version of the STAI had satisfactory structural validity with a stable three-factor structure in the exploratory factor analysis and good fit indices in the confirmatory factor analysis, and good content validity, convergent validity, discriminant validity, criterion-related validity and known-groups validity. The Cronbach's α coefficient of 0.932, split-half reliability of 0.883, and test-retest reliability of 0.809 were excellent. The Chinese version of the STAI had good validity and reliability among older patients with chronic diseases. In clinical practice, this instrument can help healthcare professionals identify individuals with low subjective technology adaptivity, who may require additional support when using digital devices. Providing simple guidance and opportunities for repeated practice can improve their engagement with healthcare technology in routine self-management.
To examine whether a brief, fully online caregiver-targeted multicomponent psychological intervention improves self-reported quality of life (QoL) in people with Alzheimer's disease (AD). In this randomized controlled trial, 56 people with AD and their informal caregivers were assigned to an intervention (n = 28) or usual-care control group (n = 28). Caregivers in the intervention group completed an 8-week online program combining psychoeducation and mindfulness. Outcomes were assessed at baseline and post-intervention by blinded assessors. The primary outcome was QoL assessed with the QoL-AD. Group-by-time effects were analyzed using linear mixed-effects models. Compared with controls, people with AD in the intervention group showed greater improvement in QoL-AD (p < .001). Neuropsychiatric symptoms worsened in the control group but remained stable in the intervention group (group × time p = .039). No significant effects were observed for cognitive performance. A brief caregiver-targeted online intervention was associated with improved QoL and stabilization of neuropsychiatric symptoms in people with AD. Trial registration: ClinicalTrials.gov, NCT04280861 (registered 17 February 2020).
Patient engagement is central in managing chronic conditions. Engagement may be particularly challenging for older adults with their age-related changes. However, the concept and strategies for promoting patient engagement among older adults remain underdeveloped. We conducted a scoping review to understand the current state of knowledge about older adults' engagement in managing their chronic conditions. Following Arksey and O'Malley's framework, we searched and reviewed studies focused on older adults' engagement in managing chronic conditions using three databases (PubMed, SCOPUS, and CINAHL). Data were extracted using a standardized form and summarized descriptively. From 6,780 records, 65 articles met the criteria, including 34 observational, 18 qualitative, and 13 experimental studies. Patient activation, participation, and engagement were commonly used terms, but they were used interchangeably and rarely defined. Key factors influencing patient engagement included patient attributes (e.g., age, health literacy), clinician attributes, and healthcare system characteristics. Outcomes were assessed through clinical measures (e.g., blood pressure, hemoglobin A1c), patient-reported outcomes, and self-management behaviors. Although experimental studies reported positive outcomes, the generalizability of findings was limited due to the heterogeneity of interventions and outcome measures without a clear theoretical framework. Engagement of older adults in their chronic care is inconsistently defined and measured across the literature. Measures without theoretical frameworks make it difficult to translate the findings and build evidence. A systematic approach is needed to build an evidence base to understand and develop interventions to improve older adult engagement in their care.
Respite care provides temporary relief to family caregivers yet remains underused, and the factors shaping its utilization among Veteran caregivers are not well understood. This evaluation examined caregiver‑ and Veteran‑specific characteristics associated with respite care use within the Department of Veterans Affairs (VA) Caregiver Support Program's Program of General Caregiver Support Services (PGCSS). We analyzed survey and administrative data from 1,727 caregivers of Veterans enrolled in PGCSS who completed baseline surveys between 2018 and 2021. Caregivers were predominantly female (96%) with a mean age of 62 years; Veterans averaged 70 years. Respite use within 2 years of survey completion was identified through linked VA data. Guided by Andersen's Healthcare Utilization Model, 34 caregiver and Veteran variables were evaluated with random forest models to identify characteristics that most strongly differentiated respite users from non‑users. Respite care was used by 23.5% of caregivers. Use was more common among older caregivers and Veterans (predisposing factors), among caregivers reporting greater burden, depression, or financial strain and Veterans with higher frailty, functional limitation, or dementia (need factors), and among caregivers perceiving stronger communication and collaboration with the clinical team (enabling factors). Model performance was strong (testing accuracy = 0.79 with all variables; 0.77 with the top 15), and results remained consistent in a sensitivity analysis limited to caregivers of Veterans who survived the 2‑year follow‑up period. Both caregiving intensity and care‑recipient complexity characterize respite use even within a system of broad service availability. Findings provide a foundation for future hypothesis‑driven studies and inform efforts to align respite programs more closely with caregiver-Veteran needs.
The Self-Care of Chronic Illness Inventory (SC-CII) is a theoretically grounded instrument comprising three scales measuring self-care maintenance, monitoring and management behaviors in adults with chronic illnesses. Although its validity and reliability have been demonstrated in cross-sectional studies, the stability of its psychometric properties over time has not been examined. This study aimed to test the longitudinal measurement equivalence of the three SC-CII Scales. Longitudinal measurement equivalence was assessed over a 12-month period using a Confirmatory Factor Analysis (CFA) approach. Patients aged 65 or older with multiple chronic conditions (MCCs) were enrolled. Four increasingly restrictive level of invariance were tested: configural, metric, scalar and strict invariance at the first and second-order level. Participants (N = 630) had a mean age of 77 years, were mostly female. For the Self-Care Maintenance scale, full metric invariance and partial scalar and strict invariance were achieved at both first- and second-order levels. For the Self-Care Monitoring scale, full metric and scalar invariance, and partial strict invariance were established. For the Self-Care Management scale, full metric, full scalar (first-order), partial scalar (second-order) and partial strict (first- and second-order) were achieved. The SC-CII proved to be longitudinally stable, confirming its suitability for repeated assessments of self-care. The SC-CII can be confidently used by nurses to monitor self-care behaviors and evaluate changes during the disease trajectory, supporting the development of tailored interventions. This study demonstrated the SCCII's temporal equivalence, strengthening its use in clinical and research settings.
As populations age, extending healthy life expectancy and reducing morbidity are priorities. Cognitive frailty, the co-occurrence of cognitive impairment and physical frailty without dementia, may offer a window for prevention. However, there is limited evidence on how cognitive frailty is understood, which may undermine recognition and risk reduction. This study provides new insights into how cognitive frailty is conceptualised across public and professional contexts, by exploring perceptions, causes and risk factors of cognitive frailty to inform public health and clinical practice. We conducted 22 semi-structured interviews with members of the public and healthcare professionals. Interviews examined perceived definitions, symptoms and risk factors. Data were analysed using reflexive thematic analysis. Three analytic domains were identified: conceptualisations, manifestations and risk factors. Participants often conflated cognitive frailty with cognitive impairment or described it as an early stage of dementia. The physical frailty aspect was under-recognised, particularly among public participants. When presented with the international definition, many reframed cognitive frailty as a transitional and potentially preventable state. Healthcare professionals articulated broader symptom profiles and more integrated risk frameworks, whereas the public emphasised observable physical change. Across both groups, mood changes, social withdrawal and unhealthy lifestyle were viewed as central risks, though their interplay was described with varying detail. Inconsistent understanding of cognitive frailty may hinder early recognition and prevention. Clearer operational definitions, supportive policy and targeted education are needed to strengthen detection, risk reduction and intervention strategies that protect independence in later life.
We aim to synthesize interventions for older adults that report positive effects on meaning in life (MiL). This systematic review, conducted in accordance with the PRISMA 2020 guidelines, synthesized findings from 22 studies examining interventions targeting MiL in adults aged 60 years and older. Study quality was appraised using the Critical Appraisal Skills Program (CASP) tools. Most studies used heterogeneous, quasi-experimental designs and assessed MiL as a secondary outcome; interventions commonly relied on life review, narrative, and dialogical approaches, often delivered in group formats, with outcomes shaped by cultural context, health status, and the therapeutic relationship. Overall, the strength of evidence was moderate and limited by study design and variability in outcome definitions. Future research should prioritize more precise conceptualization of MiL, improved methodological rigor, and culturally sensitive approaches to enhance the applicability of findings across diverse older adult populations. The findings indicate that clinical interventions may engage MiL across multiple dimensions, that their impact varies by individual and contextual factors in older adults, and that validated MiL measures should be used to assess change.