Background: Entering old age is associated with various physical and psychological disabilities. Therefore, the aim of this study is to determine the effect of mindfulness-based stress reduction program on emotion regulation and sleep problems in depressed elderly. Methods: This study was a clinical trial conducted on 60 elderly individuals with depression using purposive sampling. These elderly were referred by geriatricians and were included in the study based on the inclusion criteria. The participants were randomly assigned to two groups: the Mindfulness-Based Stress Reduction (MBSR) group and the control group. Both groups completed the Geriatric Depression Scale (GDS), the Gratz and Roemer Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index before and after the intervention. The MBSR sessions were held for the experimental group in 8 sessions of 90 min each, once a week. Finally, all the data were analyzed using SPSS software version 26 through descriptive and analytical statistics such as mean and standard deviation, t-tests and mixed analysis of covariance (ANCOVA) with repeated measures. Results: The results showed that the MBSR intervention led to a significant reduction in depression symptoms (p < 0.001) and improvement in emotion regulation and sleep quality (p < 0.001) among the elderly participants with depression in the intervention group. Discussion: The results of this study showed that MBSR can be effective in reducing depression levels, improving emotion regulation, and sleep quality among depressed elderly individuals compared to the control group. Caregivers and psychotherapists of nursing homes can use care programs such as MBSR program to improve the physical and mental condition of the elderly. Trial registration: First Registration: 13/01/2022, Registration Number: IRCT20211118053099N1, Access: https://www.irct.ir/trial/61207.

Background: Dementia as a major cognitive neurological disorder is defined as impairment in one or more cognitive territories compared with the former level of performance. This disorder disrupts patient's independence, and the patient would need others aid in order of doing daily and complex activities. The aim of this study was to evaluate the efficacy of Rosa damascena extract in the improvement of cognitive function in patients with dementia. Methods: This study is a randomized double-blind, placebo-controlled clinical trial on 40 patients older than 55 years with dementia referred to Specialized Elderly Patients Clinic in 2015–2016. Patients were divided randomly into two groups (control and intervention). The intervention group used donepezil and R. damascena capsules, and in control group, placebo capsule instead of R. damascena added on donepezil. Four test was filled three times at the study initiation, after month one and also after month three: Mini–Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination Revised (ACE-R) were used for cognition evaluation, for depression assessment, Geriatric Depression Scale was administered, and checklist of memory and behavioral disorders were filled. Results: The results showed add-on donepezil and R. damascena versus placebo improved cognitive impairment based on MMSE with P = 0.002, ACE-R with total P = 0.001, depression (P = 0.012), behavioral disorders (P < 0.001), and daily activity (P < 0.001). Conclusions: The R. damascena extract affected cognitive impairment of dementia patients significantly and also have significant effects on improving depression and behavioral problems.

Background: The rate of dementia is increasing rapidly. With the recognized high rate of illiteracy among geriatric patients, preparing an appropriate device for special screening among the low-educated elderly seems to be necessary. The aim of this study is to prepare and assess the psychometric properties of the Persian version of the Kimberley Indigenous Cognitive Assessment (KICA) in Iranian adults, in 2012. Materials and Methods: One hundred and eighty elders participated in this psychometric study. Ninety patients with dementia according to the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition, Text Revision (DSM-IV-TR) criteria, who had been admitted to Geriatrics and Neurology in some of the private clinics in Esfahan, Iran, in 2012, were selected. The rest of the participants were normal persons with the same demographic characteristics as the dementia group, who were selected from the patients' acquaintances and from the Retired Personnel Organization. The statistical tools were the KICA scale, Mini-Mental State Examination (MMSE), and Modified Mini-Mental State Examination (3MSE). Results: The best clinical cutoff point of the test was 31, with a sensitivity of 92% and specificity of 88%. The Cronbach's alpha coefficient of KICA was 0.93. Among the KICA's subscales, the maximum Cronbach's alpha coefficient belonged to Praxis (α = 0.933) and the minimum one belonged to Delayed Recall (α = 0.927). The correlation coefficients of the KICA score with MMSE and 3MSE were 0.58 and 0.57, respectively. Conclusion: The KICA test has been seen to be a reliable and valid tool to assess cognitive impairment in the aged people of Iran. The KICA test can be used as a cognitive assessment test for distinguishing patients with dementia, especially illiterate ones from other healthy people in Iran.

Background: Dementia is a syndrome that reduces the cognitive and functional abilities of the brain increasing the need for care. The caregivers of these patients are mostly their family members. The great care burden causes devastating effects on the health of family caregivers and the grief experienced by these family caregivers is considerable. This study was conducted to investigate the effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia. Method: The present study was a randomized controlled clinical trial in which 70 family caregivers of people suffering from dementia were sampled through the block method and they were divided into experimental and control groups. The data collection tools included demographic information questionnaire and grief inventory that was completed before, a week and a month after the implementation of the compassion-based program in five sessions virtually by sending offline content to the experimental group. The obtained data were analyzed by SPSS 22 software using the repeated measures analysis of variance. Results: The mean comparison of scores of the grief experienced in the experimental group between pretest and posttest and follow-up, unlike the control group, showed a significant difference (p < 0.001). The mean scores of the experimental and the control groups were significantly different in terms of experiencing mourning and all of its fields (p < 0.001). The mean comparison of post-test and follow-up showed that the effect of a compassion-based program at the follow-up stage has been mitigated. Conclusions: According to the study results, the compassion-based program reduced the grief experienced by the family caregivers of people suffering from dementia. Nevertheless, the effect of a compassion-based program has been reduced over time. This program can be a good guide for providing society-oriented services to the health team. Trial registration: This study is registered by Iranian Registry of Clinical Trials with decree code:IRCT20190712044181N4 on 02/06/2020.

Marital discordance is known to be associated with morbidity and mortality in chronically ill patients, but its correlates have yet to be fully addressed in renal recipients. The aim of this study was to assess marital relationship and its correlation with patients' morbidity after kidney transplantation. Ninety-three married Iranian kidney recipients who had undergone kidney transplantation in Baqiyatallah Hospital, Tehran, Iran, were assessed for marital adjustment with the Revised Dyadic Adjustment Scale (RDAS). The patients' quality of life (Short From-36), anxiety and depression (Hospital Anxiety and Depression Scale), and sexual relationship (Relationship and Sexuality Scale) were also evaluated. Eighty-seven subjects (93.5%) completed our study. The mean (SD) of RDAS was 52.9 (9.7). RDAS score showed a significant correlation with anxiety symptoms, frequency of intercourse and quality of life (p < 0.05). Also, RDAS score was poorer in recipients with low education level, low family income and positive history of graft rejection (p < 0.05). RDAS score was not significantly associated with gender, occupation, age at transplantation time, transplant-to-rejection time interval, source of graft, cause and duration of end-stage renal disease and depression (p > 0.05). Transplantation medical teams should refer patients to psychologists and/or psychiatrists for marital satisfaction consultation before kidney transplantation. This is of great significance especially in those with older ages, lower levels of education and lower income. Marital discord may also be considered as a cause or an effect of an unsatisfactory sexual relationship, higher anxiety or lower quality of life after kidney transplantation.

Family psycho-education is one of the most effective interventions for preventing relapse in patients with schizophrenia. We evaluated the efficacy of a needs-assessment–based educational program in comparison with a current program (textbook based) in the treatment of schizophrenia. Patients with schizophrenia and their families (N = 60) were allocated to needs-assessment–based education (treatment) and textbook-based (control) programs; both included 10 sessions of education within about 6 months. Symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) prior to intervention and every 3 months for a total of 18 months. A 25% decrease or increase in total PANSS score was considered as response or relapse, respectively. Forty-two cases completed the study. The total PANSS score was significantly decreased in both groups with more reduction in the treatment group. Positive and negative scale scores were reduced in the treatment group, but not significantly in the control group. Response rate was higher in the treatment group and relapse rate was lower (15% vs. 27.2%, P = 0.279). In logistic regression analysis, needs-assessment–based psycho-education was associated with more treatment response. Needs-assessment–based psycho-education is more effective than textbook-based education for treating schizophrenia. We recommend psychiatric care centers to conduct needs-assessment and develop their own program for family psycho-education.