<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.0 20040830//EN" "journalpublishing.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="2.0" xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="nlm-ta">JMIR Form Res</journal-id><journal-id journal-id-type="publisher-id">formative</journal-id><journal-id journal-id-type="index">27</journal-id><journal-title>JMIR Formative Research</journal-title><abbrev-journal-title>JMIR Form Res</abbrev-journal-title><issn pub-type="epub">2561-326X</issn><publisher><publisher-name>JMIR Publications</publisher-name><publisher-loc>Toronto, Canada</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">v10i1e76289</article-id><article-id pub-id-type="doi">10.2196/76289</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Paper</subject></subj-group></article-categories><title-group><article-title>Pet Ownership, Depression, Anxiety, Well-Being, and Cognitive Functioning in Older Adults: Cross-Sectional Study</article-title></title-group><contrib-group><contrib contrib-type="author"><name name-style="western"><surname>Saraiva de Albuquerque</surname><given-names>Nath&#x00E1;lia</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Schmitz Klain</surname><given-names>Isabela</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Sigaran Machado</surname><given-names>Luisa</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>de Lara Machado</surname><given-names>Wagner</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>Moret-Tatay</surname><given-names>Carmen</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Quarti Irigaray</surname><given-names>Tatiana</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib></contrib-group><aff id="aff1"><institution>Faculty of Psychology, Pontif&#x00ED;cia Universidade Cat&#x00F3;lica do Rio Grande do Sul</institution><addr-line>Porto Alegre</addr-line><country>Brazil</country></aff><aff id="aff2"><institution>Doctoral School, Catholic University of Valencia San Vicente M&#x00E1;rtir</institution><addr-line>San Agust&#x00ED;n 3, Esc. A, Entresuelo 1</addr-line><addr-line>Valencia</addr-line><country>Spain</country></aff><contrib-group><contrib contrib-type="editor"><name name-style="western"><surname>Mavragani</surname><given-names>Amaryllis</given-names></name></contrib></contrib-group><contrib-group><contrib contrib-type="reviewer"><name name-style="western"><surname>Pritchard</surname><given-names>Michael</given-names></name></contrib></contrib-group><author-notes><corresp>Correspondence to Carmen Moret-Tatay, PhD, Doctoral School, Catholic University of Valencia San Vicente M&#x00E1;rtir, San Agust&#x00ED;n 3, Esc. A, Entresuelo 1, Valencia, 46002, Spain, +3496 363 74 12; <email>mariacarmen.moret@ucv.es</email></corresp></author-notes><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>2</day><month>2</month><year>2026</year></pub-date><volume>10</volume><elocation-id>e76289</elocation-id><history><date date-type="received"><day>20</day><month>04</month><year>2025</year></date><date date-type="rev-recd"><day>17</day><month>11</month><year>2025</year></date><date date-type="accepted"><day>17</day><month>11</month><year>2025</year></date></history><copyright-statement>&#x00A9; Nath&#x00E1;lia Saraiva de Albuquerque, Isabela Schmitz Klain, Luisa Sigaran Machado, Wagner de Lara Machado, Carmen Moret-Tatay, Tatiana Quarti Irigaray. Originally published in JMIR Formative Research (<ext-link ext-link-type="uri" xlink:href="https://formative.jmir.org">https://formative.jmir.org</ext-link>), 2.2.2026. </copyright-statement><copyright-year>2026</copyright-year><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on <ext-link ext-link-type="uri" xlink:href="https://formative.jmir.org">https://formative.jmir.org</ext-link>, as well as this copyright and license information must be included.</p></license><self-uri xlink:type="simple" xlink:href="https://formative.jmir.org/2026/1/e76289"/><abstract><sec><title>Background</title><p>Depression, anxiety, and cognitive decline are prevalent concerns among older adults and can negatively affect their well-being. Pet ownership has been proposed as a potential protective factor, but inconsistencies remain in the current literature.</p></sec><sec><title>Objective</title><p>The study aims to compare symptoms of depression, anxiety, and levels of psychological well-being between older pet owners and non&#x2013;pet owners. Additionally, we compared the cognitive functioning and cognitive reserve between these 2 groups of older individuals.</p></sec><sec sec-type="methods"><title>Methods</title><p>This cross-sectional study included 215 community-dwelling older adults aged &#x2265;59 years (mean 69.13, SD 6.89). Participants completed a sociodemographic questionnaire, the Modified Telephone Interview for Cognitive Status, Cognitive Reserve Index Questionnaire, Mental Health Continuum-Short Form, Geriatric Depression Scale-15, and Geriatric Anxiety Inventory. The data were collected via video calls through WhatsApp and analyzed using the JASP software. Group comparisons (pet owners vs nonowners) were conducted using the Mann-Whitney <italic>U</italic> test, followed by rank-biserial correlation for effect sizes (&#x03B1;=.05).</p></sec><sec sec-type="results"><title>Results</title><p>The sample consisted of 114 (53.0%) older adults pet owners and 101 (46.9%) older adults who did not own pets. Among the pet owners, 77.2% (n=88) were female, and 57.9% (n=66) were married or in common-law marriages. In the non&#x2013;pet owners&#x2019; group, 71.3% (n=72) were female, and 46.5% (n=47) were married or in common-law marriages. Pet owners showed lower depression symptoms (Geriatric Depression Scale-15: mean 2.33 vs 3.00 non-owners; <italic>U</italic>=4714, <italic>P</italic>=.02; <italic>r<sub>b</sub></italic>=&#x2212;0.18, 95% CI &#x2013;0.326 to &#x2013;0.028), indicating a small effect. No significant group differences were observed for anxiety (Geriatric Anxiety Inventory: mean 5.33 vs 4.92, <italic>P</italic>=.52), psychological well-being (Mental Health Continuum-Short Form: mean 68.21 vs 67.46, <italic>P</italic>=.43), cognitive performance (Modified Telephone Interview for Cognitive Status: mean 24.74 vs 24.30, <italic>P</italic>=.60), or cognitive reserve (Cognitive Reserve Index Questionnaire: mean 123.82 vs 123.28, <italic>P</italic>=.95).</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>The pet owner group presents fewer symptoms of depression in comparison to the non&#x2013;pet owner group. Although no differences were observed in anxiety, well-being, cognitive functioning, or cognitive reserve, these findings suggest that pet companionship correlates with better emotional outcomes in later life. Future longitudinal studies are needed to clarify causal pathways and examine whether the frequency and quality of interactions with pets influence these outcomes.</p></sec></abstract><kwd-group><kwd>depression</kwd><kwd>older adults</kwd><kwd>human-animal interaction</kwd><kwd>pets</kwd><kwd>successful aging</kwd></kwd-group></article-meta></front><body><sec id="s1" sec-type="intro"><title>Introduction</title><p>The global population is aging at an increasing rate. According to United Nations projections, the population aged 65 years and older is expected to exceed 2.2 billion by the end of the 2070s, and the number of people aged 80 years or older will surpass the population of infants by the mid-2030s [<xref ref-type="bibr" rid="ref1">1</xref>]. The Brazilian population is following this trend. According to a survey by the Brazilian Institute of Geography and Statistics, life expectancy in Brazil has risen from 71.1 years in 2000 to 76.4 years in 2023 and is projected to reach 83.9 years by 2070. Over the same period, the proportion of older adults aged 60 years or more nearly doubled, increasing from 8.7% (15.2 million individuals) to 15.6% (33.0 million individuals), and approximately 37.8% of Brazil&#x2019;s population is expected to be aged 60 years or older by 2070 [<xref ref-type="bibr" rid="ref2">2</xref>].</p><p>The increase in life expectancy is partly due to improvements in health conditions [<xref ref-type="bibr" rid="ref2">2</xref>]. However, living longer does not always mean living better, as the aging process is associated with a decline in the individual&#x2019;s physical and mental capacity [<xref ref-type="bibr" rid="ref3">3</xref>]. Furthermore, this process brings about a series of changes that can negatively impact the psychological health of older adults [<xref ref-type="bibr" rid="ref4">4</xref>].</p><p>The mental health status of older adults presents considerable challenges. Recent evidence indicates that depression and anxiety are highly prevalent mental health conditions among older adults worldwide [<xref ref-type="bibr" rid="ref5">5</xref>]. In Brazil, a national survey found that 13.2% of the community-dwelling individuals aged 60 years or older reported depressive symptoms [<xref ref-type="bibr" rid="ref6">6</xref>]. Depressive symptoms in older adults are strongly associated with declines in physical health and quality of life [<xref ref-type="bibr" rid="ref7">7</xref>,<xref ref-type="bibr" rid="ref8">8</xref>]. Moreover, late-life depression poses a substantial public health challenge, increasing health care demands and adding to the social and economic burden of aging populations [<xref ref-type="bibr" rid="ref9">9</xref>].</p><p>Regarding anxiety, in a sample of older adults from a city in southern Brazil, the prevalence of anxiety disorders reached 21.9% [<xref ref-type="bibr" rid="ref10">10</xref>]. Anxiety in older adults is often underrecognized, despite its high global prevalence and its associations with comorbidity and cognitive decline [<xref ref-type="bibr" rid="ref5">5</xref>,<xref ref-type="bibr" rid="ref11">11</xref>].</p><p>Cognitive decline is another major challenge associated with aging and has become a growing global public health concern. Recent estimates indicate that approximately 55 million people worldwide are currently living with dementia, and this number is projected to increase to 139 million by 2050 [<xref ref-type="bibr" rid="ref12">12</xref>]. In Brazil, a recent population&#x2212;based study reported a prevalence of 5.8% for dementia and 8.1% for cognitive impairment, with projections suggesting that these figures may increase 5-fold over the next 3 decades [<xref ref-type="bibr" rid="ref13">13</xref>].</p><p>However, not all individuals experience cognitive decline in the same way. Despite similar levels of brain pathology, some older adults maintain relatively preserved cognitive functioning, suggesting that certain factors may protect against or delay the onset of decline. One concept that helps explain these interindividual differences is cognitive reserve, which can be understood as a set of cognitive resources that an individual acquires throughout life, which can help delay declines caused by the process of healthy aging, brain damage from dementia, and slow the progression of neurodegenerative diseases [<xref ref-type="bibr" rid="ref14">14</xref>]. Cognitive reserve has 2 theoretical models, passive and active. The passive model refers to the brain&#x2019;s structural characteristics, providing resilience against healthy brain aging and pathologies [<xref ref-type="bibr" rid="ref15">15</xref>]. The active model, on the other hand, relates to external factors&#x2014;activities performed throughout life that provide cognitive stimulation and lead to the strengthening or creation of new neural networks [<xref ref-type="bibr" rid="ref16">16</xref>].</p><p>The high prevalence of depression, anxiety, and cognitive decline in later life underscores the need to identify protective factors that promote psychological and cognitive health among older adults, and the companionship of an animal could serve as a resource to achieve this goal [<xref ref-type="bibr" rid="ref4">4</xref>]. Pets are becoming increasingly valued in society [<xref ref-type="bibr" rid="ref17">17</xref>], and although pet ownership tends to decline as people age [<xref ref-type="bibr" rid="ref18">18</xref>], it is possible that with the aging population, there will be more older individuals owning a companion animal [<xref ref-type="bibr" rid="ref19">19</xref>]. According to Meier and Maurer [<xref ref-type="bibr" rid="ref18">18</xref>], promoting pet ownership may contribute to enhancing individual well-being in older adults. Companion animals also appear to alleviate psychological symptoms in their owners, as pet ownership has been associated with fewer depressive symptoms, and regular interaction with a dog has been related to lower levels of anxiety [<xref ref-type="bibr" rid="ref20">20</xref>,<xref ref-type="bibr" rid="ref21">21</xref>]. Additionally, evidence suggests that pet ownership contributes to cognitive functioning in older adults and may help slow the rate of decline in executive functioning and episodic memory [<xref ref-type="bibr" rid="ref22">22</xref>,<xref ref-type="bibr" rid="ref23">23</xref>].</p><p>However, other studies do not support these findings. For example, the research by Hansen et al [<xref ref-type="bibr" rid="ref24">24</xref>] found no relationship between pet ownership and psychosocial factors in adults aged 40 years and over, and another study reported no association between pet ownership and depressive symptoms among older adults [<xref ref-type="bibr" rid="ref25">25</xref>]. Moreover, the relationship between pet ownership and better cognitive functioning in older adults is also contested [<xref ref-type="bibr" rid="ref26">26</xref>].</p><p>Considering that symptoms of anxiety and depression are common among older adults [<xref ref-type="bibr" rid="ref5">5</xref>] and that preventing cognitive decline is essential for healthy aging [<xref ref-type="bibr" rid="ref27">27</xref>], it is plausible that pet ownership during this stage of life may contribute to successful aging. However, given the inconsistent findings of previous studies regarding the influence of pets on psychological health and cognition in older adults, further research is warranted. It is also noteworthy that cognitive reserve has been rarely explored in the context of human-animal interaction, underscoring the importance of including this variable in future investigations. Therefore, the aim of this study was to compare symptoms of depression, anxiety, and levels of psychological well-being between older adults who owned pets and those who did not, as well as to examine differences in cognitive functioning and cognitive reserve between these 2 groups.</p></sec><sec id="s2" sec-type="methods"><title>Methods</title><sec id="s2-1"><title>Design</title><p>This is a quantitative cross-sectional observational study.</p></sec><sec id="s2-2"><title>Participants</title><p>A total of 221 individuals were recruited from the general community in Brazil, primarily from the southern region. Recruitment occurred through social media platforms (Facebook and Instagram). In addition, part of the sample was recruited from existing contact lists of older adults who had previously participated in research studies conducted at the Pontifical Catholic University of Rio Grande do Sul. Posts and messages contained standardized text explaining the study objectives, eligibility criteria, and a contact link for interested participants. Individuals who expressed interest were contacted individually via WhatsApp to confirm eligibility before scheduling the interview. The participants were divided into 2 groups: 1 group consisted of participants who owned pets and the other consisted of individuals who did not own pets.</p><p>Eligible participants were community-dwelling older adults aged 59 years or older, who scored more than 14 points on the Modified Telephone Interview for Cognitive Status (TICS-M) [<xref ref-type="bibr" rid="ref28">28</xref>], were literate, and did not have uncorrected hearing problems that could interfere with completing the instruments. All participants provided electronic informed consent before data collection. A total of 6 individuals who did not complete the entire questionnaire were excluded from the study. The final sample consisted of 215 participants.</p></sec><sec id="s2-3"><title>Measures</title><p>The Sociodemographic Questionnaire was used to collect information regarding the sociodemographic characteristics of the sample.</p><p>The TICS-M was employed to assess the cognitive functions of the participants. The original 41-item version (TICS) was developed to identify cognitive decline through a telephone interview [<xref ref-type="bibr" rid="ref29">29</xref>]. In its modified version (TICS-M), 2 items were altered to include a measure to assess late memory [<xref ref-type="bibr" rid="ref30">30</xref>]. This instrument has been translated and validated for the Brazilian population in a sample of elderly stroke survivors, showing a Cronbach &#x03B1; coefficient of 0.93. The Brazilian version of the questionnaire identified 3 domains: working memory, recent and late memory, and orientation [<xref ref-type="bibr" rid="ref28">28</xref>].</p><p>Cognitive Reserve Index Questionnaire (CRIq) was applied to assess the cognitive reserve of the participants. This questionnaire consists of 20 items grouped into 3 subscales (CRIq Education, CRIq WorkingActivity, and CRIq LeisureTime). The total score of the instrument is calculated by adding up the subscores of the 3 subscales. The original version of the CRIq has a Cronbach &#x03B1; coefficient of 0.73 [<xref ref-type="bibr" rid="ref31">31</xref>], and this questionnaire already has a version translated into Brazilian Portuguese [<xref ref-type="bibr" rid="ref32">32</xref>], which was used in this study.</p><p>Mental Health Continuum-Short Form (MHC-SF) was used to assess positive mental health. It consists of 14 items presented in a Likert scale format, ranging from 1 (never) to 6 (every day). The MHC-SF has 3 subscales that assess subjective or emotional well-being, psychological well-being, and social well-being [<xref ref-type="bibr" rid="ref33">33</xref>]. In this study, we applied the translated and validated version of the MHC-SF for the Brazilian population, which shows adequate reliability with a Cronbach &#x03B1; of 0.96 [<xref ref-type="bibr" rid="ref34">34</xref>].</p><p>Geriatric Depression Scale (GDS-15) was used to measure the participants&#x2019; depression symptoms. The GDS is specifically designed for older adults and addresses depression symptoms experienced in the week preceding the questionnaire application. The short version consists of 15 items, with responses classified as &#x201C;yes&#x201D; or &#x201C;no.&#x201D; The total score is calculated by adding up the responses selected by the respondents [<xref ref-type="bibr" rid="ref35">35</xref>]. In this study, we used the translated and validated version for the Brazilian context, which presents adequate reliability coefficients according to the paired Wilcoxon test (<italic>z</italic>=1.60; <italic>P</italic>=.11), Spearman correlation (&#x03C1;=0.86; <italic>P</italic>&#x003C;.001), and weighted kappa (&#x03BA;=0.64) [<xref ref-type="bibr" rid="ref36">36</xref>].</p><p>Geriatric Anxiety Inventory (GAI) was used to assess symptoms of anxiety. This instrument consists of 20 items in which participants indicate whether they agree or disagree with the statements, considering the week before the questionnaire was applied [<xref ref-type="bibr" rid="ref37">37</xref>]. In this study, we used the translated and validated version for the Brazilian population, which has a Cronbach &#x03B1; coefficient of 0.90 and significant test-retest reliability (&#x03C1;=0.85, <italic>P</italic>&#x003C;.001) [<xref ref-type="bibr" rid="ref38">38</xref>].</p></sec><sec id="s2-4"><title>Data Collection</title><p>Data collection was conducted through individual video calls using the WhatsApp messaging app. During each session, participants&#x2019; responses were entered in real time into the Qualtrics platform by the researcher. All data were collected by trained psychology students who received prior instruction and supervision to ensure the standardized administration of the instruments. The data collection period extended from April to September 2023.</p></sec><sec id="s2-5"><title>Ethical Considerations</title><p>The study was approved by the Research Ethics Committee of the Pontifical Catholic University of Rio Grande do Sul (approval number: 65996522.5.0000.5336) and complied with national and institutional ethical standards for research involving human participants, in accordance with Resolution No. 466/2012 of the Brazilian National Health Council and Resolution No. 016/2000 of the Federal Council of Psychology. All participants received an electronic informed consent form outlining the study&#x2019;s objectives, potential risks and benefits, anonymity, and voluntary nature of participation. Only those who agreed to the consent form were included in the study. Participants were assured of the confidentiality of their data and their right to withdraw from the study at any time without any consequences. Data were collected and stored anonymously, and no personally identifying information was retained or linked to participant responses. Participants did not receive financial compensation or any other form of remuneration for their participation.</p></sec><sec id="s2-6"><title>Data Analysis</title><p>The data were analyzed using the JASP software (version 0.18.3.0. JASP Team). Quantitative variables were described using means and standard deviations, while categorical variables were presented in terms of absolute and relative frequency. The normality of the univariate distribution of the variables under investigation was assessed using the Shapiro-Wilk test, adopting a significance level of <italic>P</italic>&#x003C;.05. Since all variables in this study violated the assumption of normality, nonparametric statistical tests were employed. To compare the groups, the Mann-Whitney <italic>U</italic> test was conducted, followed by a rank-biserial correlation (<italic>r<sub>b</sub></italic>) to assess the magnitude of the effect size found.</p></sec></sec><sec id="s3" sec-type="results"><title>Results</title><p>The final sample of this study consisted of 215 participants, with an average age of 69.13 years (SD 6.89), ranging from 59 to 93 years. Among the participants, 160 (74.4%) were female, 188 (86.2%) resided in the state of Rio Grande do Sul, 113 (51.8%) were married or in a common-law marriage, and 80 (37.2%) had higher education. Regarding pet ownership, 114 (53.0%) were pet owners of at least 1 animal, and 101 (46.9%) did not have pets. Among the participants who reported having pets, the majority (n=88, 77.2%) were female, and the most common marital status was married or in a common-law marriage (n=66, 57.9%). Among those who did not have pets, most (n=72, 71.3%) were female, and 47 (46.5%) reported being married or in a common-law marriage. These and other sociodemographic characteristics are presented in <xref ref-type="table" rid="table1">Table 1</xref>.</p><p>Within the group of pet owners, 18 (8.4%) only had cats, 66 (30.7%) only had dogs, and 3 (1.4%) only owned other species of animals. Additionally, 27 (12.5%) individuals reported owning both dogs and cats; 9 (4.2%) owned dogs and other species; 2 (0.9%) had cats and other species; and 4 (1.9%) were owners of dogs, cats, and other species. The most frequently mentioned other animal species were rabbits, turtles, chickens, and monk parakeets.</p><p>Using the Mann-Whitney <italic>U</italic> test, we found significant differences between the groups regarding the total GDS score (<italic>U</italic>=4714, <italic>P</italic>=.02), with a small effect size observed (<italic>r<sub>b</sub></italic>=&#x2212;0.18). No significant differences were found in the other variables. The information is provided in <xref ref-type="table" rid="table2">Table 2</xref>.</p><table-wrap id="t1" position="float"><label>Table 1.</label><caption><p>Sociodemographic characteristics of older adults (&#x2265;59 y) participating in a cross-sectional study in Brazil.<sup><xref ref-type="table-fn" rid="table1fn1">a</xref></sup></p></caption><table id="table1" frame="hsides" rules="groups"><thead><tr><td align="left" valign="bottom">Variables</td><td align="left" valign="bottom">Total, n (%)</td><td align="left" valign="bottom">Pet owners, n (%)</td><td align="left" valign="bottom">Non&#x2013;pet owners, n (%)</td></tr></thead><tbody><tr><td align="left" valign="top" colspan="4">Gender</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Women</td><td align="left" valign="top">160 (74.4)</td><td align="left" valign="top">88 (77.2)</td><td align="left" valign="top">72 (71.3)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Male</td><td align="left" valign="top">55 (25.2)</td><td align="left" valign="top">26 (22.8)</td><td align="left" valign="top">29 (28.7)</td></tr><tr><td align="left" valign="top" colspan="4">States of the country</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Goi&#x00E1;s</td><td align="left" valign="top">1 (0.4)</td><td align="left" valign="top">0 (0)</td><td align="left" valign="top">1 (0.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Minas Gerais</td><td align="left" valign="top">6 (2.7)</td><td align="left" valign="top">5 (4.4)</td><td align="left" valign="top">1 (0.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Paran&#x00E1;</td><td align="left" valign="top">3 (1.4)</td><td align="left" valign="top">2 (1.7)</td><td align="left" valign="top">1 (0.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Rio de Janeiro</td><td align="left" valign="top">2 (0.9)</td><td align="left" valign="top">0 (0)</td><td align="left" valign="top">2 (1.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Rio Grande do Sul</td><td align="left" valign="top">188 (86.2)</td><td align="left" valign="top">99 (86.8)</td><td align="left" valign="top">89 (88.1)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Santa Catarina</td><td align="left" valign="top">7 (3.2)</td><td align="left" valign="top">6 (5.2)</td><td align="left" valign="top">1 (0.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>S&#x00E3;o Paulo</td><td align="left" valign="top">8 (3.7)</td><td align="left" valign="top">2 (1.7)</td><td align="left" valign="top">6 (5.9)</td></tr><tr><td align="left" valign="top" colspan="4">Marital status</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Married or common-law marriage</td><td align="left" valign="top">113 (51.8)</td><td align="left" valign="top">66 (57.9)</td><td align="left" valign="top">47 (46.5)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Divorced or separated</td><td align="left" valign="top">39 (17.9)</td><td align="left" valign="top">16 (14.0)</td><td align="left" valign="top">23 (22.8)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Single</td><td align="left" valign="top">25 (11.5)</td><td align="left" valign="top">15 (13.1)</td><td align="left" valign="top">10 (9.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Widow or widower</td><td align="left" valign="top">38 (17.4)</td><td align="left" valign="top">17 (14.9)</td><td align="left" valign="top">21 (20.8)</td></tr><tr><td align="left" valign="top" colspan="4">Education level</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Incomplete primary education (up to 4 y of study)</td><td align="left" valign="top">8 (3.7)</td><td align="left" valign="top">3 (2.6)</td><td align="left" valign="top">5 (5.0)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Incomplete secondary education (less than 11 y of study)</td><td align="left" valign="top">10 (4.7)</td><td align="left" valign="top">5 (4.4)</td><td align="left" valign="top">5 (5.0)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Complete secondary education (up to 11 y of study)</td><td align="left" valign="top">38 (17.7)</td><td align="left" valign="top">21 (18.4)</td><td align="left" valign="top">17 (16.8)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Incomplete higher education</td><td align="left" valign="top">18 (8.4)</td><td align="left" valign="top">9 (7.9)</td><td align="left" valign="top">9 (8.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Complete higher education</td><td align="left" valign="top">80 (37.2)</td><td align="left" valign="top">41 (36.0)</td><td align="left" valign="top">39 (38.6)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Postgraduate (specialization, master&#x2019;s, or doctorate)</td><td align="left" valign="top">61 (28.4)</td><td align="left" valign="top">35 (30.7)</td><td align="left" valign="top">26 (25.7)</td></tr><tr><td align="left" valign="top" colspan="4">Employment status</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Employed</td><td align="left" valign="top">15 (7.0)</td><td align="left" valign="top">9 (7.9)</td><td align="left" valign="top">6 (5.9)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Self-employed</td><td align="left" valign="top">11 (5.1)</td><td align="left" valign="top">10 (8.8)</td><td align="left" valign="top">1 (1.0)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Retired</td><td align="left" valign="top">146 (67.9)</td><td align="left" valign="top">74 (64.9)</td><td align="left" valign="top">72 (71.3)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Retired but still working</td><td align="left" valign="top">40 (18.6)</td><td align="left" valign="top">20 (17.5)</td><td align="left" valign="top">20 (19.8)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Never worked</td><td align="left" valign="top">3 (1.4)</td><td align="left" valign="top">1 (0.9)</td><td align="left" valign="top">2 (2.0)</td></tr><tr><td align="left" valign="top" colspan="4">Medication use</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Yes</td><td align="left" valign="top">175 (80.3)</td><td align="left" valign="top">89 (78.1)</td><td align="left" valign="top">86 (85.1)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>No</td><td align="left" valign="top">40 (18.3)</td><td align="left" valign="top">25 (21.9)</td><td align="left" valign="top">15 (14.8)</td></tr></tbody></table><table-wrap-foot><fn id="table1fn1"><p><sup>a</sup>Data were collected through online interviews conducted via WhatsApp video calls between April and September 2023. The table presents the total sample and subgroup distributions for pet owners and nonowners.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t2" position="float"><label>Table 2.</label><caption><p>Differences in depression, anxiety, well-being, and cognitive measures between pet owners and nonowners in a cross-sectional study with older adults from Brazil.<sup><xref ref-type="table-fn" rid="table2fn1">a</xref></sup></p></caption><table id="table2" frame="hsides" rules="groups"><thead><tr><td align="left" valign="bottom">Variable</td><td align="left" valign="bottom">Pet owners (mean)</td><td align="left" valign="bottom">Non&#x2013;pet owners (mean)</td><td align="left" valign="bottom"><italic>U</italic></td><td align="left" valign="bottom"><italic>P</italic> value</td><td align="left" valign="bottom">Effect size</td><td align="left" valign="bottom">SE effect size</td><td align="left" valign="bottom" colspan="2">95% CI for rank-biserial correlation</td></tr><tr><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom"/><td align="left" valign="bottom">Lower</td><td align="left" valign="bottom">Upper</td></tr></thead><tbody><tr><td align="left" valign="top">Orientation TICS-M<sup><xref ref-type="table-fn" rid="table2fn2">b</xref></sup></td><td align="left" valign="top">6.737</td><td align="left" valign="top">6.752</td><td align="left" valign="top">5651</td><td align="left" valign="top">.75</td><td align="left" valign="top">&#x2212;0.018</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.172</td><td align="left" valign="top">0.136</td></tr><tr><td align="left" valign="top">Recall TICS-M</td><td align="left" valign="top">4.912</td><td align="left" valign="top">4.653</td><td align="left" valign="top">6195</td><td align="left" valign="top">.32</td><td align="left" valign="top">0.076</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.079</td><td align="left" valign="top">0.227</td></tr><tr><td align="left" valign="top">Attention TICS-M</td><td align="left" valign="top">4.307</td><td align="left" valign="top">4.495</td><td align="left" valign="top">5462</td><td align="left" valign="top">.48</td><td align="left" valign="top">&#x2212;0.051</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.203</td><td align="left" valign="top">0.103</td></tr><tr><td align="left" valign="top">Memory TICS-M</td><td align="left" valign="top">4.807</td><td align="left" valign="top">4.772</td><td align="left" valign="top">5897</td><td align="left" valign="top">.65</td><td align="left" valign="top">0.024</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.130</td><td align="left" valign="top">0.177</td></tr><tr><td align="left" valign="top">Language TICS-M</td><td align="left" valign="top">0.851</td><td align="left" valign="top">0.772</td><td align="left" valign="top">6209</td><td align="left" valign="top">.14</td><td align="left" valign="top">0.079</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.076</td><td align="left" valign="top">0.230</td></tr><tr><td align="left" valign="top">Delayed Recall TICS-M</td><td align="left" valign="top">3.123</td><td align="left" valign="top">2.851</td><td align="left" valign="top">6171</td><td align="left" valign="top">.36</td><td align="left" valign="top">0.072</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.083</td><td align="left" valign="top">0.223</td></tr><tr><td align="left" valign="top">Total TICS-M</td><td align="left" valign="top">24.737</td><td align="left" valign="top">24.297</td><td align="left" valign="top">5996</td><td align="left" valign="top">.598</td><td align="left" valign="top">0.042</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.113</td><td align="left" valign="top">0.194</td></tr><tr><td align="left" valign="top">CRI-Education</td><td align="left" valign="top">126.658</td><td align="left" valign="top">130.059</td><td align="left" valign="top">5265</td><td align="left" valign="top">.28</td><td align="left" valign="top">&#x2212;0.085</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.236</td><td align="left" valign="top">0.069</td></tr><tr><td align="left" valign="top">CRI-WorkingActivity</td><td align="left" valign="top">116.711</td><td align="left" valign="top">116.772</td><td align="left" valign="top">5623</td><td align="left" valign="top">.77</td><td align="left" valign="top">&#x2212;0.023</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.176</td><td align="left" valign="top">0.131</td></tr><tr><td align="left" valign="top">CRI-LeisureTime</td><td align="left" valign="top">110.605</td><td align="left" valign="top">106.030</td><td align="left" valign="top">6272</td><td align="left" valign="top">.26</td><td align="left" valign="top">0.090</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.065</td><td align="left" valign="top">0.240</td></tr><tr><td align="left" valign="top">Total CRIq<sup><xref ref-type="table-fn" rid="table2fn3">c</xref></sup></td><td align="left" valign="top">123.816</td><td align="left" valign="top">123.277</td><td align="left" valign="top">5784</td><td align="left" valign="top">.95</td><td align="left" valign="top">0.005</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.149</td><td align="left" valign="top">0.158</td></tr><tr><td align="left" valign="top">EWB<sup><xref ref-type="table-fn" rid="table2fn4">d</xref></sup> MHC-SF<sup><xref ref-type="table-fn" rid="table2fn5">e</xref></sup></td><td align="left" valign="top">15.842</td><td align="left" valign="top">15.426</td><td align="left" valign="top">6306</td><td align="left" valign="top">.22</td><td align="left" valign="top">0.095</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.059</td><td align="left" valign="top">0.246</td></tr><tr><td align="left" valign="top">SWB<sup><xref ref-type="table-fn" rid="table2fn6">f</xref></sup> MHC-SF</td><td align="left" valign="top">31.553</td><td align="left" valign="top">31.139</td><td align="left" valign="top">5917</td><td align="left" valign="top">.73</td><td align="left" valign="top">0.028</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.144</td><td align="left" valign="top">0.164</td></tr><tr><td align="left" valign="top">PWB<sup><xref ref-type="table-fn" rid="table2fn7">g</xref></sup> MHC-SF</td><td align="left" valign="top">20.816</td><td align="left" valign="top">20.891</td><td align="left" valign="top">5817</td><td align="left" valign="top">.896</td><td align="left" valign="top">0.010</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.127</td><td align="left" valign="top">0.181</td></tr><tr><td align="left" valign="top">Total MHC-SF</td><td align="left" valign="top">68.211</td><td align="left" valign="top">67.455</td><td align="left" valign="top">6113</td><td align="left" valign="top">.43</td><td align="left" valign="top">0.062</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.093</td><td align="left" valign="top">0.214</td></tr><tr><td align="left" valign="top">Total GAI<sup><xref ref-type="table-fn" rid="table2fn8">h</xref></sup></td><td align="left" valign="top">5.325</td><td align="left" valign="top">4.921</td><td align="left" valign="top">6048</td><td align="left" valign="top">.52</td><td align="left" valign="top">0.051</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.104</td><td align="left" valign="top">0.203</td></tr><tr><td align="left" valign="top">Total GDS<sup><xref ref-type="table-fn" rid="table2fn9">i</xref></sup></td><td align="left" valign="top">2.333</td><td align="left" valign="top">3.000</td><td align="left" valign="top">4714</td><td align="left" valign="top">.02</td><td align="left" valign="top">&#x2212;0.181</td><td align="left" valign="top">0.079</td><td align="left" valign="top">&#x2212;0.326</td><td align="left" valign="top">&#x2212;0.028</td></tr></tbody></table><table-wrap-foot><fn id="table2fn1"><p><sup>a</sup>Statistical comparisons were conducted using the Mann&#x2013;Whitney <italic>U</italic> test, with effect sizes reported as rank-biserial correlations (&#x03B1;=.05).</p></fn><fn id="table2fn2"><p><sup>b</sup>TICS-M: Modified Telephone Interview for Cognitive Status.</p></fn><fn id="table2fn3"><p><sup>c</sup>CRIq: Cognitive Reserve Index Questionnaire.</p></fn><fn id="table2fn4"><p><sup>d</sup>EWB: emotional well-being.</p></fn><fn id="table2fn5"><p><sup>e</sup>MHC-SF: Mental Health Continuum-Short Form.</p></fn><fn id="table2fn6"><p><sup>f</sup>SWB: social well-being.</p></fn><fn id="table2fn7"><p><sup>g</sup>PWB: psychological well-being.</p></fn><fn id="table2fn8"><p><sup>h</sup>GAI: Geriatric Anxiety Inventory.</p></fn><fn id="table2fn9"><p><sup>i</sup>GDS: Geriatric Depression Scale.</p></fn></table-wrap-foot></table-wrap></sec><sec id="s4" sec-type="discussion"><title>Discussion</title><sec id="s4-1"><title>Principal Findings</title><p>This study aimed to compare symptoms of depression, anxiety, and levels of psychological and cognitive well-being between older individuals who owned pets and those who did not. The results showed that pet owners presented fewer symptoms of depression compared to non&#x2013;pet owners, whereas no significant differences were observed for anxiety, cognitive functioning, or cognitive reserve.</p><p>The observed association between pet ownership and lower depressive symptoms aligns with previous findings, suggesting that companion animals can mitigate depression symptoms among older individuals who had experienced loss, such as a divorce or the death of a spouse [<xref ref-type="bibr" rid="ref21">21</xref>]. Furthermore, in another study, older individuals who frequently engaged in activities with their pets reported lower levels of depression symptoms, regardless of factors such as age, gender, and education. However, this effect was not observed when considering only the presence of a pet [<xref ref-type="bibr" rid="ref39">39</xref>].</p><p>Friedmann et al [<xref ref-type="bibr" rid="ref19">19</xref>] proposed the biopsychosocial model as a framework to explain how companion animals may help minimize depressive symptoms in their owners. According to this perspective, pet ownership can influence health through the interaction of biological, psychological, and social factors. The presence of an animal may enhance the social dimension by providing companionship and emotional support, which can improve the psychological state through social support or other mechanisms, such as reducing depression, stress, and anxiety, and ultimately promote positive health outcomes in older adults [<xref ref-type="bibr" rid="ref19">19</xref>].</p><p>However, not all studies have found the same association. Sharpley et al [<xref ref-type="bibr" rid="ref40">40</xref>], in a longitudinal study, reported that older individuals with more symptoms of depression were more likely to own a dog. However, in this study, pet ownership was not associated with changes in symptoms of depression over time [<xref ref-type="bibr" rid="ref40">40</xref>]. Similar results were observed in the study by Mueller et al [<xref ref-type="bibr" rid="ref41">41</xref>], where pet ownership was associated with a higher likelihood of having experienced symptoms of depression over the course of life. In contrast, no relationship was found between current depression and pet ownership [<xref ref-type="bibr" rid="ref41">41</xref>].</p><p>In another investigation, cat owners exhibited more symptoms of depression in comparison to dog owners or older individuals without pets [<xref ref-type="bibr" rid="ref42">42</xref>]. These results were corroborated by other studies that also found no evidence of an association between having a pet and symptoms of depression in the older population [<xref ref-type="bibr" rid="ref19">19</xref>,<xref ref-type="bibr" rid="ref24">24</xref>,<xref ref-type="bibr" rid="ref43">43</xref>,<xref ref-type="bibr" rid="ref44">44</xref>].</p><p>One possible explanation for these inconsistencies is that while some older individuals may benefit from living with pets, for others, the responsibility of caring for an animal could be detrimental [<xref ref-type="bibr" rid="ref24">24</xref>]. This may be due to the stress caused by the commitment or difficulties in meeting the pet&#x2019;s needs [<xref ref-type="bibr" rid="ref42">42</xref>]. The responsibility of taking care of a pet might interfere with the individual&#x2019;s freedom, limiting outings and travel. Financial concerns, such as the costs of food and veterinary care, may also cause worries for some pet owners [<xref ref-type="bibr" rid="ref45">45</xref>,<xref ref-type="bibr" rid="ref46">46</xref>].</p><p>As for anxiety symptoms, no significant differences were found between the groups. This result also shows contradictory findings across studies. While some research has not observed differences in anxiety symptoms when comparing older individuals with and without pets [<xref ref-type="bibr" rid="ref19">19</xref>,<xref ref-type="bibr" rid="ref47">47</xref>], the results from Bolstad et al [<xref ref-type="bibr" rid="ref48">48</xref>] suggest that having a pet during old age is associated with lower anxiety symptoms. Additionally, the systematic review conducted by Hughes et al [<xref ref-type="bibr" rid="ref49">49</xref>] concluded that interaction with companion animals can alleviate anxiety symptoms in older individuals. Moreover, a study that evaluated mental health outcomes in older individuals with dogs concluded that the frequency of contact with a dog might be associated with lower anxiety levels [<xref ref-type="bibr" rid="ref20">20</xref>].</p><p>Regarding psychological well-being, the results of this study did not indicate significant differences between the groups. This finding is consistent with previous studies that also found no differences when comparing the psychological well-being of older individuals with and without pets [<xref ref-type="bibr" rid="ref19">19</xref>,<xref ref-type="bibr" rid="ref47">47</xref>]. However, the study by Hui Gan et al [<xref ref-type="bibr" rid="ref46">46</xref>] does not support these findings, highlighting the positive effect of pets on the well-being of older individuals. Furthermore, recent research suggests that owning a dog may be effective in enhancing the psychological well-being of socially isolated older individuals. However, the authors of the study highlight that this effect was not observed among cat owners [<xref ref-type="bibr" rid="ref50">50</xref>].</p><p>As observed by Bennett et al [<xref ref-type="bibr" rid="ref47">47</xref>], merely owning a pet may not be associated with substantial differences in the well-being of older individuals, a point also noted by studies investigating other psychological measures, such as anxiety and depression symptoms [<xref ref-type="bibr" rid="ref39">39</xref>,<xref ref-type="bibr" rid="ref47">47</xref>]. This observation may help explain the inconsistencies in the scientific literature that evaluated human-animal interactions [<xref ref-type="bibr" rid="ref47">47</xref>]. Recent research conducted with adults supports this hypothesis, indicating that interactions with animals may have a protective effect against negative feelings. These studies show that tactile interactions and activities like playing with, caring for, and training the animal are associated with greater well-being among pet owners [<xref ref-type="bibr" rid="ref51">51</xref>-<xref ref-type="bibr" rid="ref53">53</xref>]. Thus, it may be more important to consider the frequency of contact with the pet rather than merely evaluating the presence of a pet [<xref ref-type="bibr" rid="ref47">47</xref>].</p><p>Additionally, comparing these studies is challenging due to their methodological differences, such as the use of different instruments to assess the same constructs and the heterogeneity of their samples. It is also important to consider that mental health is influenced by various factors, and pet ownership is just 1 aspect. Therefore, it is crucial to investigate other elements that also affect mental health [<xref ref-type="bibr" rid="ref54">54</xref>]. In this study, these sources of variability were minimized by employing validated assessment instruments and standardized procedures for data collection, as well as by including a relatively homogeneous sample in terms of education and cognitive level.</p><p>When assessing the cognitive level and cognitive reserve of the participants, no significant differences were found between the groups. An earlier study also found no association between cognitive function and pet ownership [<xref ref-type="bibr" rid="ref26">26</xref>]. However, other studies reveal that older individuals who own pets exhibit better cognitive function compared to those who do not [<xref ref-type="bibr" rid="ref22">22</xref>,<xref ref-type="bibr" rid="ref23">23</xref>,<xref ref-type="bibr" rid="ref43">43</xref>]. Furthermore, the study by McDonough et al [<xref ref-type="bibr" rid="ref55">55</xref>], conducted with participants up to 74 years old, indicated that pet ownership was associated with higher levels of cognition and larger brain structures, especially among dog owners. Thus, we can infer from these studies that pet ownership may also be associated with a higher level of cognitive reserve.</p><p>The inconsistencies observed in these research results may be due to the different methods used to assess cognition. Additionally, evidence suggests that long-term pet ownership (more than 5 y) is what might provide cognitive benefits for older individuals [<xref ref-type="bibr" rid="ref56">56</xref>]. Since the time spent with the pet was not included in the analyses of this study, and some studies did not mention whether this variable was evaluated [<xref ref-type="bibr" rid="ref43">43</xref>,<xref ref-type="bibr" rid="ref43">43</xref>], this may be an alternative explanation for the discrepancies found between the results.</p><p>However, the lack of significant differences between the groups regarding cognitive level and cognitive reserve reinforces the finding that indicates fewer depression symptoms among pet owners. Considering the relationship between depression symptoms and cognitive decline in older individuals [<xref ref-type="bibr" rid="ref57">57</xref>,<xref ref-type="bibr" rid="ref58">58</xref>], the absence of differences in cognitive levels and cognitive reserve suggests that variations in depression symptoms between groups cannot be attributed to differences in cognitive function. Instead, it is more likely a direct result of the influence of pet ownership. Thus, pet ownership may act as a protective factor against depression symptoms in the older population.</p></sec><sec id="s4-2"><title>Limitations and Future Directions</title><p>These findings should be interpreted with caution due to several limitations. First, the cross-sectional design precludes causal inferences. Second, the data were based on self-reported measures, which may be subject to response bias. Additionally, the study did not assess the duration or nature of pet ownership, factors that could influence psychological outcomes. Moreover, the sample was primarily composed of highly educated older adults with preserved cognitive functioning from southern Brazil, which may limit the generalizability of the results to other populations.</p><p>Future studies should investigate the activities performed with pets to gain a better understanding of how pet ownership can influence the psychological health of older individuals. Additionally, future studies must explore this association with larger samples and use a longitudinal design to examine the effect of pet ownership on depressive symptoms over time.</p></sec><sec id="s4-3"><title>Conclusions</title><p>Despite the mentioned limitations, the results of this study are relevant, as they compared groups with similar cognitive characteristics, suggesting that the differences found may be attributed to the presence of pets. Therefore, the present findings indicate that pet ownership may be associated with fewer depressive symptoms in older adults, although no significant effects were observed on cognitive reserve, cognitive functioning, anxiety, or psychological well-being. These findings highlight the potential role of companion animals as a source of emotional support in later life. Moreover, these findings have practical implications, as encouraging community initiatives that foster human-animal interaction, such as volunteer programs in shelters or animal-assisted physical activities, may help mitigate depressive symptoms in older adults while also promoting animal welfare.</p></sec></sec></body><back><ack><p>The authors declare the use of generative artificial intelligence (GenAI) in the research and writing process. According to the GAIDeT taxonomy (2025), proofreading and editing and translation were delegated to Geriatric Anxiety Inventory (GAI) tools under full human supervision. The GenAI tool used was ChatGPT-5. Responsibility for the final manuscript lies entirely with the authors. GenAI tools are not listed as authors and do not bear responsibility for the final outcomes.</p></ack><notes><sec><title>Funding</title><p>This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil.</p></sec><sec><title>Data Availability</title><p>The datasets generated or analyzed during this study are not publicly available due to participant confidentiality but are available from the corresponding author on reasonable request.</p></sec></notes><fn-group><fn fn-type="con"><p>NSdA and TQI contributed to the conceptualization and methodology of the study. NSdA and ISK were responsible for data collection. WdLM performed the formal analysis and contributed to writing the original draft, together with NSdA and ISK. NSdA, TQI, and CM-T contributed to the writing&#x2014;review and editing of the manuscript. TQI and CM-T provided supervision throughout the project. All authors have read and approved the final version of the manuscript. NSdA is the co-corresponding author of this study and can be reached via email at nathalia.albuquerque@edu.pucrs.br.</p></fn><fn fn-type="other"><label>Disclosure of Delegation to Generative AI</label><p>The authors declare the use of generative AI in the research and writing process. According to the GAIDeT taxonomy (2025), the following tasks were delegated to GAI tools under full human supervision:</p><p>- Proofreading and editing</p><p>- Translation</p><p>The GAI tool used was: ChatGPT-5.</p><p>Responsibility for the final manuscript lies entirely with the authors.</p><p>GAI tools are not listed as authors and do not bear responsibility for the final outcomes.</p><p>Declaration submitted by: Collective responsibility</p></fn><fn fn-type="conflict"><p>None declared.</p></fn></fn-group><glossary><title>Abbreviations</title><def-list><def-item><term id="abb1">CRIq</term><def><p>Cognitive Reserve Index Questionnaire</p></def></def-item><def-item><term id="abb2">GAI</term><def><p>Geriatric Anxiety Inventory</p></def></def-item><def-item><term id="abb3">MHC-SF</term><def><p>Mental Health Continuum-Short Form</p></def></def-item><def-item><term id="abb4">TICS-M</term><def><p>Modified Telephone Interview for Cognitive Status</p></def></def-item></def-list></glossary><ref-list><title>References</title><ref id="ref1"><label>1</label><nlm-citation citation-type="web"><article-title>World population prospects 2024: summary of results</article-title><source>United Nations Department for Economic and Social Affairs</source><year>2025</year><access-date>2025-11-01</access-date><comment><ext-link ext-link-type="uri" xlink:href="https://population.un.org/wpp/assets/Files/WPP2024_Summary-of-Results.pdf">https://population.un.org/wpp/assets/Files/WPP2024_Summary-of-Results.pdf</ext-link></comment></nlm-citation></ref><ref id="ref2"><label>2</label><nlm-citation citation-type="web"><article-title>Popula&#x00E7;&#x00E3;o do pa&#x00ED;s vai parar de crescer em 2041</article-title><source>Agencia de Noticias</source><year>2024</year><access-date>2025-11-01</access-date><comment><ext-link ext-link-type="uri" xlink:href="https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/41056-populacao-do-pais-vai-parar-de-crescer-em-2041">https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/41056-populacao-do-pais-vai-parar-de-crescer-em-2041</ext-link></comment></nlm-citation></ref><ref id="ref3"><label>3</label><nlm-citation citation-type="web"><article-title>Ageing and health</article-title><source>World Health Organisation</source><year>2021</year><access-date>2024-04-16</access-date><comment><ext-link ext-link-type="uri" xlink:href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">https://www.who.int/news-room/fact-sheets/detail/ageing-and-health</ext-link></comment></nlm-citation></ref><ref id="ref4"><label>4</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Mueller</surname><given-names>MK</given-names> </name><name name-style="western"><surname>Curl</surname><given-names>AL</given-names> </name></person-group><article-title>Human&#x2013;animal interaction and older adults: an overview</article-title><source>Front Psychol</source><year>2017</year><volume>8</volume><fpage>1416</fpage><pub-id pub-id-type="doi">10.3389/fpsyg.2017.01416</pub-id><pub-id pub-id-type="medline">28878713</pub-id></nlm-citation></ref><ref id="ref5"><label>5</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Jalali</surname><given-names>A</given-names> </name><name name-style="western"><surname>Ziapour</surname><given-names>A</given-names> </name><name name-style="western"><surname>Karimi</surname><given-names>Z</given-names> </name><etal/></person-group><article-title>Global prevalence of depression, anxiety, and stress in the elderly population: a systematic review and meta-analysis</article-title><source>BMC Geriatr</source><year>2024</year><month>10</month><day>4</day><volume>24</volume><issue>1</issue><fpage>809</fpage><pub-id pub-id-type="doi">10.1186/s12877-024-05311-8</pub-id><pub-id pub-id-type="medline">39367305</pub-id></nlm-citation></ref><ref id="ref6"><label>6</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Sguerri</surname><given-names>V dos S</given-names> </name><name name-style="western"><surname>Castro-Costa</surname><given-names>&#x00C9; de</given-names> </name><name name-style="western"><surname>Loyola Filho</surname><given-names>A de</given-names> </name></person-group><article-title>Sintomas depressivos na popula&#x00E7;&#x00E3;o idosa brasileira: um estudo baseado na pesquisa nacional de sa&#x00FA;de-2019</article-title><source>Ci&#x00EA;nc sa&#x00FA;de coletiva</source><year>2025</year><volume>30</volume><issue>7</issue><fpage>e00362024</fpage><pub-id pub-id-type="doi">10.1590/1413-81232025307.00362024</pub-id></nlm-citation></ref><ref id="ref7"><label>7</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Ito</surname><given-names>NT</given-names> </name><name name-style="western"><surname>Oliveira</surname><given-names>D</given-names> </name><name name-style="western"><surname>Rodrigues</surname><given-names>FMS</given-names> </name><name name-style="western"><surname>Castro-Costa</surname><given-names>E</given-names> </name><name name-style="western"><surname>Lima-Costa</surname><given-names>MF</given-names> </name><name name-style="western"><surname>Ferri</surname><given-names>CP</given-names> </name></person-group><article-title>Depressive symptoms and self-rated health among Brazilian older adults: baseline data from the ELSI-Brazil study</article-title><source>Braz J Psychiatry</source><year>2024</year><volume>46</volume><fpage>e20233331</fpage><pub-id pub-id-type="doi">10.47626/1516-4446-2023-3331</pub-id><pub-id pub-id-type="medline">37995196</pub-id></nlm-citation></ref><ref id="ref8"><label>8</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Liegert</surname><given-names>P</given-names> </name><name name-style="western"><surname>Pabst</surname><given-names>A</given-names> </name><name name-style="western"><surname>Conrad</surname><given-names>I</given-names> </name><etal/></person-group><article-title>The effect of depressive symptoms on quality of life and its different facets in the oldest age population: evidence from the AgeQualiDe prospective cohort study</article-title><source>Qual Life Res</source><year>2024</year><month>02</month><volume>33</volume><issue>2</issue><fpage>387</fpage><lpage>398</lpage><pub-id pub-id-type="doi">10.1007/s11136-023-03526-7</pub-id><pub-id pub-id-type="medline">37897642</pub-id></nlm-citation></ref><ref id="ref9"><label>9</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Luppa</surname><given-names>M</given-names> </name><name name-style="western"><surname>Sikorski</surname><given-names>C</given-names> </name><name name-style="western"><surname>Motzek</surname><given-names>T</given-names> </name><name name-style="western"><surname>Konnopka</surname><given-names>A</given-names> </name><name name-style="western"><surname>K&#x00F6;nig</surname><given-names>HH</given-names> </name><name name-style="western"><surname>Riedel-Heller</surname><given-names>SG</given-names> </name></person-group><article-title>Health service utilization and costs of depressive symptoms in late life&#x2014;a systematic review</article-title><source>Curr Pharm Des</source><year>2012</year><volume>18</volume><issue>36</issue><fpage>5936</fpage><lpage>5957</lpage><pub-id pub-id-type="doi">10.2174/138161212803523572</pub-id><pub-id pub-id-type="medline">22681171</pub-id></nlm-citation></ref><ref id="ref10"><label>10</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bellora</surname><given-names>RM</given-names> </name><name name-style="western"><surname>Sgnaolin</surname><given-names>V</given-names> </name><name name-style="western"><surname>Engroff</surname><given-names>P</given-names> </name><name name-style="western"><surname>Dannebrock</surname><given-names>LG</given-names> </name><name name-style="western"><surname>Diefenthaeler</surname><given-names>EC</given-names> </name><name name-style="western"><surname>Neto</surname><given-names>AC</given-names> </name></person-group><article-title>Transtornos de ansiedade em idosos: preval&#x00EA;ncia, perfil e fatores associados em um ambulat&#x00F3;rio de psiquiatria geri&#x00E1;trica de porto alegre, brasil [Article in Portuguese]</article-title><source>Pan Am J Aging Res</source><year>2021</year><volume>9</volume><fpage>e40528</fpage><pub-id pub-id-type="doi">10.15448/2357-9641.2021.1.40528</pub-id></nlm-citation></ref><ref id="ref11"><label>11</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Wolitzky-Taylor</surname><given-names>KB</given-names> </name><name name-style="western"><surname>Castriotta</surname><given-names>N</given-names> </name><name name-style="western"><surname>Lenze</surname><given-names>EJ</given-names> </name><name name-style="western"><surname>Stanley</surname><given-names>MA</given-names> </name><name name-style="western"><surname>Craske</surname><given-names>MG</given-names> </name></person-group><article-title>Anxiety disorders in older adults: a comprehensive review</article-title><source>Depress Anxiety</source><year>2010</year><month>02</month><volume>27</volume><issue>2</issue><fpage>190</fpage><lpage>211</lpage><pub-id pub-id-type="doi">10.1002/da.20653</pub-id><pub-id pub-id-type="medline">20099273</pub-id></nlm-citation></ref><ref id="ref12"><label>12</label><nlm-citation citation-type="report"><article-title>Global status report on the public health response to dementia</article-title><year>2021</year><access-date>2025-12-16</access-date><publisher-name>World Health Organization</publisher-name><comment><ext-link ext-link-type="uri" xlink:href="https://iris.who.int/server/api/core/bitstreams/9e8aab50-ca34-45e0-9fb0-26e675746f65/content">https://iris.who.int/server/api/core/bitstreams/9e8aab50-ca34-45e0-9fb0-26e675746f65/content</ext-link></comment></nlm-citation></ref><ref id="ref13"><label>13</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bertola</surname><given-names>L</given-names> </name><name name-style="western"><surname>Suemoto</surname><given-names>CK</given-names> </name><name name-style="western"><surname>Aliberti</surname><given-names>MJR</given-names> </name><etal/></person-group><article-title>Prevalence of dementia and cognitive impairment no dementia in a large and diverse nationally representative sample: the ELSI-Brazil study</article-title><source>J Gerontol A Biol Sci Med Sci</source><year>2023</year><month>06</month><day>1</day><volume>78</volume><issue>6</issue><fpage>1060</fpage><lpage>1068</lpage><pub-id pub-id-type="doi">10.1093/gerona/glad025</pub-id><pub-id pub-id-type="medline">36682021</pub-id></nlm-citation></ref><ref id="ref14"><label>14</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Stern</surname><given-names>Y</given-names> </name><name name-style="western"><surname>Arenaza-Urquijo</surname><given-names>EM</given-names> </name><name name-style="western"><surname>Bartr&#x00E9;s-Faz</surname><given-names>D</given-names> </name><etal/></person-group><article-title>Whitepaper: defining and investigating cognitive reserve, brain reserve, and brain maintenance</article-title><source>Alzheimers Dement</source><year>2020</year><month>09</month><volume>16</volume><issue>9</issue><fpage>1305</fpage><lpage>1311</lpage><pub-id pub-id-type="doi">10.1016/j.jalz.2018.07.219</pub-id><pub-id pub-id-type="medline">30222945</pub-id></nlm-citation></ref><ref id="ref15"><label>15</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Stern</surname><given-names>Y</given-names> </name></person-group><article-title>An approach to studying the neural correlates of reserve</article-title><source>Brain Imaging Behav</source><year>2017</year><month>04</month><volume>11</volume><issue>2</issue><fpage>410</fpage><lpage>416</lpage><pub-id pub-id-type="doi">10.1007/s11682-016-9566-x</pub-id><pub-id pub-id-type="medline">27450378</pub-id></nlm-citation></ref><ref id="ref16"><label>16</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Stern</surname><given-names>Y</given-names> </name></person-group><article-title>Cognitive reserve in ageing and Alzheimer&#x2019;s disease</article-title><source>Lancet Neurol</source><year>2012</year><month>11</month><volume>11</volume><issue>11</issue><fpage>1006</fpage><lpage>1012</lpage><pub-id pub-id-type="doi">10.1016/S1474-4422(12)70191-6</pub-id><pub-id pub-id-type="medline">23079557</pub-id></nlm-citation></ref><ref id="ref17"><label>17</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Irvine</surname><given-names>L</given-names> </name><name name-style="western"><surname>Cilia</surname><given-names>L</given-names> </name></person-group><article-title>More&#x2010;than&#x2010;human families: pets, people, and practices in multispecies households</article-title><source>Sociol Compass</source><year>2017</year><month>02</month><volume>11</volume><issue>2</issue><fpage>e12455</fpage><pub-id pub-id-type="doi">10.1111/soc4.12455</pub-id></nlm-citation></ref><ref id="ref18"><label>18</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Meier</surname><given-names>C</given-names> </name><name name-style="western"><surname>Maurer</surname><given-names>J</given-names> </name></person-group><article-title>Buddy or burden? Patterns, perceptions, and experiences of pet ownership among older adults in Switzerland</article-title><source>Eur J Ageing</source><year>2022</year><month>12</month><volume>19</volume><issue>4</issue><fpage>1201</fpage><lpage>1212</lpage><pub-id pub-id-type="doi">10.1007/s10433-022-00696-0</pub-id><pub-id pub-id-type="medline">36506656</pub-id></nlm-citation></ref><ref id="ref19"><label>19</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Friedmann</surname><given-names>E</given-names> </name><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Simonsick</surname><given-names>EM</given-names> </name><etal/></person-group><article-title>Pet ownership patterns and successful aging outcomes in community dwelling older adults</article-title><source>Front Vet Sci</source><year>2020</year><volume>7</volume><fpage>293</fpage><pub-id pub-id-type="doi">10.3389/fvets.2020.00293</pub-id><pub-id pub-id-type="medline">32671105</pub-id></nlm-citation></ref><ref id="ref20"><label>20</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Maurice</surname><given-names>C</given-names> </name><name name-style="western"><surname>Engels</surname><given-names>C</given-names> </name><name name-style="western"><surname>Canou&#x00EF;-Poitrine</surname><given-names>F</given-names> </name><name name-style="western"><surname>Lemogne</surname><given-names>C</given-names> </name><name name-style="western"><surname>Fromantin</surname><given-names>I</given-names> </name><name name-style="western"><surname>Poitrine</surname><given-names>E</given-names> </name></person-group><article-title>Dog ownership and mental health among community-dwelling older adults: a systematic review</article-title><source>Int J Geriatr Psychiatry</source><year>2022</year><month>11</month><volume>37</volume><issue>11</issue><pub-id pub-id-type="doi">10.1002/gps.5815</pub-id><pub-id pub-id-type="medline">36184824</pub-id></nlm-citation></ref><ref id="ref21"><label>21</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Carr</surname><given-names>DC</given-names> </name><name name-style="western"><surname>Taylor</surname><given-names>MG</given-names> </name><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Sachs-Ericsson</surname><given-names>N</given-names> </name></person-group><article-title>Psychological health benefits of companion animals following a social loss</article-title><source>Gerontologist</source><year>2020</year><month>04</month><day>2</day><volume>60</volume><issue>3</issue><fpage>428</fpage><lpage>438</lpage><pub-id pub-id-type="doi">10.1093/geront/gnz109</pub-id><pub-id pub-id-type="medline">31504497</pub-id></nlm-citation></ref><ref id="ref22"><label>22</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Friedmann</surname><given-names>E</given-names> </name><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Simonsick</surname><given-names>EM</given-names> </name><etal/></person-group><article-title>Pet ownership and maintenance of cognitive function in community-residing older adults: evidence from the Baltimore Longitudinal Study of Aging (BLSA)</article-title><source>Sci Rep</source><year>2023</year><month>09</month><day>7</day><volume>13</volume><issue>1</issue><fpage>14738</fpage><pub-id pub-id-type="doi">10.1038/s41598-023-41813-y</pub-id><pub-id pub-id-type="medline">37679499</pub-id></nlm-citation></ref><ref id="ref23"><label>23</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Rostekova</surname><given-names>A</given-names> </name><name name-style="western"><surname>Lampraki</surname><given-names>C</given-names> </name><name name-style="western"><surname>Maurer</surname><given-names>J</given-names> </name><name name-style="western"><surname>Meier</surname><given-names>C</given-names> </name><name name-style="western"><surname>Wieczorek</surname><given-names>M</given-names> </name><name name-style="western"><surname>Ihle</surname><given-names>A</given-names> </name></person-group><article-title>Longitudinal relationships between pet ownership and cognitive functioning in later adulthood across pet types and individuals&#x2019; ages</article-title><source>Sci Rep</source><year>2025</year><month>05</month><day>30</day><volume>15</volume><issue>1</issue><fpage>19066</fpage><pub-id pub-id-type="doi">10.1038/s41598-025-03727-9</pub-id><pub-id pub-id-type="medline">40447721</pub-id></nlm-citation></ref><ref id="ref24"><label>24</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hansen</surname><given-names>PR</given-names> </name><name name-style="western"><surname>K&#x00F6;nig</surname><given-names>HH</given-names> </name><name name-style="western"><surname>Hajek</surname><given-names>A</given-names> </name></person-group><article-title>Pet ownership and psychosocial factors in adults aged 40 years and over: results of a large nationally representative longitudinal survey</article-title><source>Societies (Basel)</source><year>2024</year><volume>14</volume><issue>8</issue><fpage>132</fpage><pub-id pub-id-type="doi">10.3390/soc14080132</pub-id></nlm-citation></ref><ref id="ref25"><label>25</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Albright</surname><given-names>AE</given-names> </name><name name-style="western"><surname>Cui</surname><given-names>R</given-names> </name><name name-style="western"><surname>Allen</surname><given-names>RS</given-names> </name></person-group><article-title>Pet ownership and mental and physical health in older White and Black males and females</article-title><source>Int J Environ Res Public Health</source><year>2022</year><month>05</month><day>6</day><volume>19</volume><issue>9</issue><fpage>5655</fpage><pub-id pub-id-type="doi">10.3390/ijerph19095655</pub-id><pub-id pub-id-type="medline">35565050</pub-id></nlm-citation></ref><ref id="ref26"><label>26</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Branson</surname><given-names>SM</given-names> </name><name name-style="western"><surname>Boss</surname><given-names>L</given-names> </name><name name-style="western"><surname>Padhye</surname><given-names>NS</given-names> </name><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Tr&#x00F6;tscher</surname><given-names>TT</given-names> </name></person-group><article-title>Biopsychosocial factors and cognitive function in cat ownership and attachment in community-dwelling older adults</article-title><source>Anthrozo&#x00F6;s</source><year>2019</year><month>03</month><day>4</day><volume>32</volume><issue>2</issue><fpage>267</fpage><lpage>282</lpage><pub-id pub-id-type="doi">10.1080/08927936.2019.1569908</pub-id></nlm-citation></ref><ref id="ref27"><label>27</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Kim</surname><given-names>SH</given-names> </name><name name-style="western"><surname>Park</surname><given-names>S</given-names> </name></person-group><article-title>A meta-analysis of the correlates of successful aging in older adults</article-title><source>Res Aging</source><year>2017</year><month>06</month><volume>39</volume><issue>5</issue><fpage>657</fpage><lpage>677</lpage><pub-id pub-id-type="doi">10.1177/0164027516656040</pub-id><pub-id pub-id-type="medline">27334287</pub-id></nlm-citation></ref><ref id="ref28"><label>28</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Baccaro</surname><given-names>A</given-names> </name><name name-style="western"><surname>Segre</surname><given-names>A</given-names> </name><name name-style="western"><surname>Wang</surname><given-names>YP</given-names> </name><etal/></person-group><article-title>Validation of the Brazilian-Portuguese version of the modified telephone interview for cognitive status among stroke patients</article-title><source>Geriatr Gerontol Int</source><year>2015</year><month>09</month><volume>15</volume><issue>9</issue><fpage>1118</fpage><lpage>1126</lpage><pub-id pub-id-type="doi">10.1111/ggi.12409</pub-id><pub-id pub-id-type="medline">25407304</pub-id></nlm-citation></ref><ref id="ref29"><label>29</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Brandt</surname><given-names>J</given-names> </name><name name-style="western"><surname>Spencer</surname><given-names>M</given-names> </name><name name-style="western"><surname>Folstein</surname><given-names>M</given-names> </name></person-group><article-title>The telephone interview for cognitive status</article-title><source>Neuropsychiatry Neuropsychol Behav Neurol</source><year>1988</year><volume>1</volume><fpage>111</fpage><lpage>117</lpage></nlm-citation></ref><ref id="ref30"><label>30</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Seo</surname><given-names>EH</given-names> </name><name name-style="western"><surname>Lee</surname><given-names>DY</given-names> </name><name name-style="western"><surname>Kim</surname><given-names>SG</given-names> </name><etal/></person-group><article-title>Validity of the telephone interview for cognitive status (TICS) and modified TICS (TICSm) for mild cognitive imparment (MCI) and dementia screening</article-title><source>Arch Gerontol Geriatr</source><year>2011</year><volume>52</volume><issue>1</issue><fpage>e26</fpage><lpage>30</lpage><pub-id pub-id-type="doi">10.1016/j.archger.2010.04.008</pub-id><pub-id pub-id-type="medline">20471701</pub-id></nlm-citation></ref><ref id="ref31"><label>31</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Nucci</surname><given-names>M</given-names> </name><name name-style="western"><surname>Mapelli</surname><given-names>D</given-names> </name><name name-style="western"><surname>Mondini</surname><given-names>S</given-names> </name></person-group><article-title>Cognitive reserve index questionnaire (CRIq): a new instrument for measuring cognitive reserve</article-title><source>Aging Clin Exp Res</source><year>2012</year><month>06</month><volume>24</volume><issue>3</issue><fpage>218</fpage><lpage>226</lpage><pub-id pub-id-type="doi">10.3275/7800</pub-id><pub-id pub-id-type="medline">21691143</pub-id></nlm-citation></ref><ref id="ref32"><label>32</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Teixeira</surname><given-names>AR</given-names> </name><name name-style="western"><surname>Pereira</surname><given-names>LD</given-names> </name></person-group><article-title>Tradu&#x00E7;&#x00E3;o, valida&#x00E7;&#x00E3;o cultural e sem&#x00E2;ntica do cognitive reserve index questionnaire (CRIq) para o portugu&#x00EA;s brasileiro</article-title><source>Estud interdiscip envelhec</source><year>2022</year><volume>27</volume><issue>1</issue><fpage>109</fpage><lpage>132</lpage><pub-id pub-id-type="doi">10.22456/2316-2171.107662</pub-id></nlm-citation></ref><ref id="ref33"><label>33</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Keyes</surname><given-names>CLM</given-names> </name></person-group><article-title>The subjective well-being of America&#x2019;s youth: toward a comprehensive assessment</article-title><source>Adolesc Fam Health</source><year>2006</year><volume>4</volume><fpage>3</fpage><lpage>11</lpage></nlm-citation></ref><ref id="ref34"><label>34</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Machado</surname><given-names>WL</given-names> </name><name name-style="western"><surname>Bandeira</surname><given-names>DR</given-names> </name></person-group><article-title>Positive mental health scale: validation of the mental health continuum-short form</article-title><source>Psico-USF</source><year>2015</year><volume>20</volume><fpage>259</fpage><lpage>274</lpage><pub-id pub-id-type="doi">10.1590/1413-82712015200207</pub-id></nlm-citation></ref><ref id="ref35"><label>35</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Yesavage</surname><given-names>JA</given-names> </name><name name-style="western"><surname>Brink</surname><given-names>TL</given-names> </name><name name-style="western"><surname>Rose</surname><given-names>TL</given-names> </name><etal/></person-group><article-title>Development and validation of a geriatric depression screening scale: a preliminary report</article-title><source>J Psychiatr Res</source><year>1982</year><volume>17</volume><issue>1</issue><fpage>37</fpage><lpage>49</lpage><pub-id pub-id-type="doi">10.1016/0022-3956(82)90033-4</pub-id><pub-id pub-id-type="medline">7183759</pub-id></nlm-citation></ref><ref id="ref36"><label>36</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Almeida</surname><given-names>OP</given-names> </name><name name-style="western"><surname>Almeida</surname><given-names>SA</given-names> </name></person-group><article-title>Confiabilidade da vers&#x00E3;o brasileira da Escala de Depress&#x00E3;o em Geriatria (GDS) vers&#x00E3;o reduzida</article-title><source>Arq Neuro-Psiquiatr</source><year>1999</year><month>06</month><volume>57</volume><issue>2B</issue><fpage>421</fpage><lpage>426</lpage><pub-id pub-id-type="doi">10.1590/S0004-282X1999000300013</pub-id></nlm-citation></ref><ref id="ref37"><label>37</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Pachana</surname><given-names>NA</given-names> </name><name name-style="western"><surname>Byrne</surname><given-names>GJ</given-names> </name><name name-style="western"><surname>Siddle</surname><given-names>H</given-names> </name><name name-style="western"><surname>Koloski</surname><given-names>N</given-names> </name><name name-style="western"><surname>Harley</surname><given-names>E</given-names> </name><name name-style="western"><surname>Arnold</surname><given-names>E</given-names> </name></person-group><article-title>Development and validation of the geriatric anxiety inventory</article-title><source>Int Psychogeriatr</source><year>2007</year><month>02</month><volume>19</volume><issue>1</issue><fpage>103</fpage><lpage>114</lpage><pub-id pub-id-type="doi">10.1017/S1041610206003504</pub-id><pub-id pub-id-type="medline">16805925</pub-id></nlm-citation></ref><ref id="ref38"><label>38</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Massena</surname><given-names>PN</given-names> </name><name name-style="western"><surname>de Ara&#x00FA;jo</surname><given-names>NB</given-names> </name><name name-style="western"><surname>Pachana</surname><given-names>N</given-names> </name><name name-style="western"><surname>Laks</surname><given-names>J</given-names> </name><name name-style="western"><surname>de P&#x00E1;dua</surname><given-names>AC</given-names> </name></person-group><article-title>Validation of the Brazilian Portuguese version of geriatric anxiety inventory&#x2013;GAI-BR</article-title><source>Int Psychogeriatr</source><year>2015</year><month>07</month><volume>27</volume><issue>7</issue><fpage>1113</fpage><lpage>1119</lpage><pub-id pub-id-type="doi">10.1017/S1041610214001021</pub-id><pub-id pub-id-type="medline">24946782</pub-id></nlm-citation></ref><ref id="ref39"><label>39</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Cheung</surname><given-names>CK</given-names> </name><name name-style="western"><surname>Kam</surname><given-names>PK</given-names> </name></person-group><article-title>Conditions for pets to prevent depression in older adults</article-title><source>Aging Ment Health</source><year>2018</year><month>12</month><volume>22</volume><issue>12</issue><fpage>1627</fpage><lpage>1633</lpage><pub-id pub-id-type="doi">10.1080/13607863.2017.1385723</pub-id><pub-id pub-id-type="medline">28976782</pub-id></nlm-citation></ref><ref id="ref40"><label>40</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Sharpley</surname><given-names>C</given-names> </name><name name-style="western"><surname>Veronese</surname><given-names>N</given-names> </name><name name-style="western"><surname>Smith</surname><given-names>L</given-names> </name><etal/></person-group><article-title>Pet ownership and symptoms of depression: a prospective study of older adults</article-title><source>J Affect Disord</source><year>2020</year><month>03</month><day>1</day><volume>264</volume><fpage>35</fpage><lpage>39</lpage><pub-id pub-id-type="doi">10.1016/j.jad.2019.11.134</pub-id><pub-id pub-id-type="medline">31846900</pub-id></nlm-citation></ref><ref id="ref41"><label>41</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Mueller</surname><given-names>MK</given-names> </name><name name-style="western"><surname>Gee</surname><given-names>NR</given-names> </name><name name-style="western"><surname>Bures</surname><given-names>RM</given-names> </name></person-group><article-title>Human-animal interaction as a social determinant of health: descriptive findings from the health and retirement study</article-title><source>BMC Public Health</source><year>2018</year><month>03</month><day>9</day><volume>18</volume><issue>1</issue><fpage>305</fpage><pub-id pub-id-type="doi">10.1186/s12889-018-5188-0</pub-id><pub-id pub-id-type="medline">29519232</pub-id></nlm-citation></ref><ref id="ref42"><label>42</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Enmarker</surname><given-names>I</given-names> </name><name name-style="western"><surname>Hellz&#x00E9;n</surname><given-names>O</given-names> </name><name name-style="western"><surname>Ekker</surname><given-names>K</given-names> </name><name name-style="western"><surname>Berg</surname><given-names>AGT</given-names> </name></person-group><article-title>Depression in older cat and dog owners: the Nord-Tr&#x00F8;ndelag Health Study (HUNT)-3</article-title><source>Aging Ment Health</source><year>2015</year><volume>19</volume><issue>4</issue><fpage>347</fpage><lpage>352</lpage><pub-id pub-id-type="doi">10.1080/13607863.2014.933310</pub-id><pub-id pub-id-type="medline">24990174</pub-id></nlm-citation></ref><ref id="ref43"><label>43</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Branson</surname><given-names>S</given-names> </name><name name-style="western"><surname>Boss</surname><given-names>L</given-names> </name><name name-style="western"><surname>Cron</surname><given-names>S</given-names> </name><name name-style="western"><surname>Kang</surname><given-names>DH</given-names> </name></person-group><article-title>Examining differences between homebound older adult pet owners and non-pet owners in depression, systemic inflammation, and executive function</article-title><source>Anthrozo&#x00F6;s</source><year>2016</year><month>05</month><day>3</day><volume>29</volume><issue>2</issue><fpage>323</fpage><lpage>334</lpage><pub-id pub-id-type="doi">10.1080/08927936.2016.1152764</pub-id></nlm-citation></ref><ref id="ref44"><label>44</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Batty</surname><given-names>GD</given-names> </name><name name-style="western"><surname>Zaninotto</surname><given-names>P</given-names> </name><name name-style="western"><surname>Watt</surname><given-names>RG</given-names> </name><name name-style="western"><surname>Bell</surname><given-names>S</given-names> </name></person-group><article-title>Associations of pet ownership with biomarkers of ageing: population based cohort study</article-title><source>BMJ</source><year>2017</year><month>12</month><day>13</day><volume>359</volume><fpage>j5558</fpage><pub-id pub-id-type="doi">10.1136/bmj.j5558</pub-id><pub-id pub-id-type="medline">29237607</pub-id></nlm-citation></ref><ref id="ref45"><label>45</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Applebaum</surname><given-names>JW</given-names> </name><name name-style="western"><surname>Ellison</surname><given-names>C</given-names> </name><name name-style="western"><surname>Struckmeyer</surname><given-names>L</given-names> </name><name name-style="western"><surname>Zsembik</surname><given-names>BA</given-names> </name><name name-style="western"><surname>McDonald</surname><given-names>SE</given-names> </name></person-group><article-title>The impact of pets on everyday life for older adults during the COVID-19 pandemic</article-title><source>Front Public Health</source><year>2021</year><volume>9</volume><fpage>652610</fpage><pub-id pub-id-type="doi">10.3389/fpubh.2021.652610</pub-id><pub-id pub-id-type="medline">33898382</pub-id></nlm-citation></ref><ref id="ref46"><label>46</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hui Gan</surname><given-names>GZ</given-names> </name><name name-style="western"><surname>Hill</surname><given-names>AM</given-names> </name><name name-style="western"><surname>Yeung</surname><given-names>P</given-names> </name><name name-style="western"><surname>Keesing</surname><given-names>S</given-names> </name><name name-style="western"><surname>Netto</surname><given-names>JA</given-names> </name></person-group><article-title>Pet ownership and its influence on mental health in older adults</article-title><source>Aging Ment Health</source><year>2020</year><month>10</month><volume>24</volume><issue>10</issue><fpage>1605</fpage><lpage>1612</lpage><pub-id pub-id-type="doi">10.1080/13607863.2019.1633620</pub-id><pub-id pub-id-type="medline">31242754</pub-id></nlm-citation></ref><ref id="ref47"><label>47</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bennett</surname><given-names>PC</given-names> </name><name name-style="western"><surname>Trigg</surname><given-names>JL</given-names> </name><name name-style="western"><surname>Godber</surname><given-names>T</given-names> </name><name name-style="western"><surname>Brown</surname><given-names>C</given-names> </name></person-group><article-title>An experience sampling approach to investigating associations between pet presence and indicators of psychological wellbeing and mood in older Australians</article-title><source>Anthrozo&#x00F6;s</source><year>2015</year><month>09</month><day>2</day><volume>28</volume><issue>3</issue><fpage>403</fpage><lpage>420</lpage><pub-id pub-id-type="doi">10.1080/08927936.2015.1052266</pub-id></nlm-citation></ref><ref id="ref48"><label>48</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bolstad</surname><given-names>CJ</given-names> </name><name name-style="western"><surname>Porter</surname><given-names>B</given-names> </name><name name-style="western"><surname>Brown</surname><given-names>CJ</given-names> </name><name name-style="western"><surname>Kennedy</surname><given-names>RE</given-names> </name><name name-style="western"><surname>Nadorff</surname><given-names>MR</given-names> </name></person-group><article-title>The relation between pet ownership, anxiety, and depressive symptoms in late life: propensity score matched analyses</article-title><source>Anthrozoos</source><year>2021</year><volume>34</volume><issue>5</issue><fpage>671</fpage><lpage>684</lpage><pub-id pub-id-type="doi">10.1080/08927936.2021.1926707</pub-id><pub-id pub-id-type="medline">34776606</pub-id></nlm-citation></ref><ref id="ref49"><label>49</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hughes</surname><given-names>MJ</given-names> </name><name name-style="western"><surname>Verreynne</surname><given-names>ML</given-names> </name><name name-style="western"><surname>Harpur</surname><given-names>P</given-names> </name><name name-style="western"><surname>Pachana</surname><given-names>NA</given-names> </name></person-group><article-title>Companion animals and health in older populations: a systematic review</article-title><source>Clin Gerontol</source><year>2020</year><volume>43</volume><issue>4</issue><fpage>365</fpage><lpage>377</lpage><pub-id pub-id-type="doi">10.1080/07317115.2019.1650863</pub-id><pub-id pub-id-type="medline">31423915</pub-id></nlm-citation></ref><ref id="ref50"><label>50</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Ikeuchi</surname><given-names>T</given-names> </name><name name-style="western"><surname>Taniguchi</surname><given-names>Y</given-names> </name><name name-style="western"><surname>Abe</surname><given-names>T</given-names> </name><etal/></person-group><article-title>Association between experience of pet ownership and psychological health among socially isolated and non-isolated older adults</article-title><source>Animals (Basel)</source><year>2021</year><month>02</month><day>24</day><volume>11</volume><issue>3</issue><fpage>595</fpage><pub-id pub-id-type="doi">10.3390/ani11030595</pub-id><pub-id pub-id-type="medline">33668283</pub-id></nlm-citation></ref><ref id="ref51"><label>51</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Ravenscroft</surname><given-names>SJ</given-names> </name><name name-style="western"><surname>Barcelos</surname><given-names>AM</given-names> </name><name name-style="western"><surname>Mills</surname><given-names>DS</given-names> </name></person-group><article-title>Cat-human related activities associated with human well-being</article-title><source>Hum Anim Interact Bull</source><year>2021</year><pub-id pub-id-type="doi">10.1079/hai.2021.0006</pub-id></nlm-citation></ref><ref id="ref52"><label>52</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Barcelos</surname><given-names>AM</given-names> </name><name name-style="western"><surname>Kargas</surname><given-names>N</given-names> </name><name name-style="western"><surname>Maltby</surname><given-names>J</given-names> </name><name name-style="western"><surname>Hall</surname><given-names>S</given-names> </name><name name-style="western"><surname>Mills</surname><given-names>DS</given-names> </name></person-group><article-title>A framework for understanding how activities associated with dog ownership relate to human well-being</article-title><source>Sci Rep</source><year>2020</year><month>07</month><day>9</day><volume>10</volume><issue>1</issue><fpage>11363</fpage><pub-id pub-id-type="doi">10.1038/s41598-020-68446-9</pub-id><pub-id pub-id-type="medline">32647301</pub-id></nlm-citation></ref><ref id="ref53"><label>53</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Barcelos</surname><given-names>AM</given-names> </name><name name-style="western"><surname>Kargas</surname><given-names>N</given-names> </name><name name-style="western"><surname>Maltby</surname><given-names>J</given-names> </name><name name-style="western"><surname>Hall</surname><given-names>S</given-names> </name><name name-style="western"><surname>Assheton</surname><given-names>P</given-names> </name><name name-style="western"><surname>Mills</surname><given-names>DS</given-names> </name></person-group><article-title>Theoretical foundations to the impact of dog-related activities on human hedonic well-being, life satisfaction and eudaimonic well-being</article-title><source>Int J Environ Res Public Health</source><year>2021</year><month>11</month><day>25</day><volume>18</volume><issue>23</issue><fpage>12382</fpage><pub-id pub-id-type="doi">10.3390/ijerph182312382</pub-id><pub-id pub-id-type="medline">34886109</pub-id></nlm-citation></ref><ref id="ref54"><label>54</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Scoresby</surname><given-names>KJ</given-names> </name><name name-style="western"><surname>Strand</surname><given-names>EB</given-names> </name><name name-style="western"><surname>Ng</surname><given-names>Z</given-names> </name><etal/></person-group><article-title>Pet ownership and quality of life: a systematic review of the literature</article-title><source>Vet Sci</source><year>2021</year><month>12</month><day>16</day><volume>8</volume><issue>12</issue><fpage>332</fpage><pub-id pub-id-type="doi">10.3390/vetsci8120332</pub-id><pub-id pub-id-type="medline">34941859</pub-id></nlm-citation></ref><ref id="ref55"><label>55</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>McDonough</surname><given-names>IM</given-names> </name><name name-style="western"><surname>Erwin</surname><given-names>HB</given-names> </name><name name-style="western"><surname>Sin</surname><given-names>NL</given-names> </name><name name-style="western"><surname>Allen</surname><given-names>RS</given-names> </name></person-group><article-title>Pet ownership is associated with greater cognitive and brain health in a cross-sectional sample across the adult lifespan</article-title><source>Front Aging Neurosci</source><year>2022</year><volume>14</volume><fpage>953889</fpage><pub-id pub-id-type="doi">10.3389/fnagi.2022.953889</pub-id><pub-id pub-id-type="medline">36337704</pub-id></nlm-citation></ref><ref id="ref56"><label>56</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Applebaum</surname><given-names>JW</given-names> </name><name name-style="western"><surname>Shieu</surname><given-names>MM</given-names> </name><name name-style="western"><surname>McDonald</surname><given-names>SE</given-names> </name><name name-style="western"><surname>Dunietz</surname><given-names>GL</given-names> </name><name name-style="western"><surname>Braley</surname><given-names>TJ</given-names> </name></person-group><article-title>The impact of sustained ownership of a pet on cognitive health: a population-based study</article-title><source>J Aging Health</source><year>2023</year><month>03</month><volume>35</volume><issue>3-4</issue><fpage>230</fpage><lpage>241</lpage><pub-id pub-id-type="doi">10.1177/08982643221122641</pub-id><pub-id pub-id-type="medline">36006805</pub-id></nlm-citation></ref><ref id="ref57"><label>57</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Aajami</surname><given-names>Z</given-names> </name><name name-style="western"><surname>Kazazi</surname><given-names>L</given-names> </name><name name-style="western"><surname>Toroski</surname><given-names>M</given-names> </name><name name-style="western"><surname>Bahrami</surname><given-names>M</given-names> </name><name name-style="western"><surname>Borhaninejad</surname><given-names>V</given-names> </name></person-group><article-title>Relationship between depression and cognitive impairment among elderly: a cross-sectional study</article-title><source>J Caring Sci</source><year>2020</year><month>08</month><volume>9</volume><issue>3</issue><fpage>148</fpage><lpage>153</lpage><pub-id pub-id-type="doi">10.34172/jcs.2020.022</pub-id><pub-id pub-id-type="medline">32963983</pub-id></nlm-citation></ref><ref id="ref58"><label>58</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Conde-Sala</surname><given-names>JL</given-names> </name><name name-style="western"><surname>Garre-Olmo</surname><given-names>J</given-names> </name><name name-style="western"><surname>Calv&#x00F3;-Perxas</surname><given-names>L</given-names> </name><name name-style="western"><surname>Turr&#x00F3;-Garriga</surname><given-names>O</given-names> </name><name name-style="western"><surname>Vilalta-Franch</surname><given-names>J</given-names> </name></person-group><article-title>Course of depressive symptoms and associated factors in people aged 65+ in Europe: a two-year follow-up</article-title><source>J Affect Disord</source><year>2019</year><month>02</month><day>15</day><volume>245</volume><fpage>440</fpage><lpage>450</lpage><pub-id pub-id-type="doi">10.1016/j.jad.2018.10.358</pub-id><pub-id pub-id-type="medline">30428444</pub-id></nlm-citation></ref></ref-list></back></article>