International Journal of Geriatric Psychiatry最新文献

{"title":"Dementia Education and Training for the Multidisciplinary Student Healthcare Workforce: A Systematic Review","authors":"Malvika Muralidhar, Saskia Delray, Claudia Cooper, Sedigheh Zabihi, Sube Banerjee, Clarissa Giebel, Karen Harrison Dening, Yvonne Birks, Charlotte Kenten, Madeleine Walpert","doi":"10.1002/gps.70119","DOIUrl":"https://doi.org/10.1002/gps.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To systematically review research evidence on the effectiveness of dementia education and training for health and social care students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched electronic databases for primary research studies (published between 2015 and 2024), evaluating dementia training for health and social care students. We assessed risk of bias using the Mixed Methods Appraisal Tool, prioritising studies scoring 4+ (higher quality) that reported significant findings on primary outcomes from controlled intervention trials. We reported outcomes using Kirkpatrick's framework. We consulted professional stakeholders in a focus group regarding how findings might inform practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>17/35 included studies were rated 4+ on the MMAT; only one met our criteria for priority evidence. An experiential programme for medical students, ‘Time for Dementia’, which combined skill-learning and reflective sessions with visits to people with dementia, was found to improve Kirkpatrick Level 2 (learning) outcomes, attitudes and knowledge over 2 years of participation; this was supported from findings from qualitative studies. Asynchronous, self-directed learning did not improve learning outcomes, relative to standard training. Though almost all training programmes incorporated lived experience, no patient reported outcomes were used to evaluate the impact of training. Nine focus group attendees agreed that the evidence reflected their experiences that consistent support, combined with skills-based and reflective sessions, optimised student learning from initial patient-focused encounters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Effective interventions increased confidence and enjoyment of dementia care encounters, and increased interest in careers in dementia specialities. Mandating evidence-based dementia skills programmes across specialities could ensure that students learn the skills and competencies required to be part of an effective future workforce and drive important improvements in care quality. Evidence based approaches to enhancing dementia education in training could include experiential learning modules in early years of medical school training and allied health and care professional training, using evidence-based approaches to teach communication skills and other essential dementia care skills within clinical placements, and providing dedicated supervision to support their implementation. Future research could usefully consider patient perspect","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Interactions Between Life Satisfaction and Genetic Predisposition on Risk of Alzheimer's Disease up to 14 Years Later: Findings From the UK Biobank","authors":"Amber John,&nbsp;Roopal Desai,&nbsp;David Bartres-Faz,&nbsp;Dorina Cadar,&nbsp;Darya Gaysina,&nbsp;Aida Suarez Gonzalez,&nbsp;Natalie L. Marchant,&nbsp;Emily Willroth,&nbsp;Marcus Richards,&nbsp;Rob Saunders,&nbsp;Joshua Stott","doi":"10.1002/gps.70120","DOIUrl":"https://doi.org/10.1002/gps.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Previous research investigating associations between life satisfaction and risk of Alzheimer's disease (AD) has been mixed. This association may differ depending on genetic risk for AD. The aim of this study was to test interactions between life satisfaction and genetic predisposition on the future incidence of AD diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were used from 66,668 participants aged 60+ from the UK Biobank. Participants attended an assessment centre at baseline, and data were linked to hospital admissions data and death records up to 14 years later. Cox proportional hazards models were used to test interactions between life satisfaction and a polygenic risk score (PRS) for AD on incident AD diagnosis. Models were also run stratified by genetic risk for AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Models adjusted for age, sex, ethnicity, deprivation, education, and depression showed main effects of both life satisfaction (OR = 0.78, 95% CI = 0.68–0.90, <i>p</i> = 0.001) and the AD PRS (OR = 2.26, 95% CI = 2.12–2.40, <i>p</i> &lt; 0.001) on incident AD. There was a significant interaction between the two (OR = 1.21, 95% CI = 1.09–1.35, <i>p</i> &lt; 0.001). Stratified models showed that life satisfaction was associated with lower incident AD in the low, but not in the high genetic risk group (low: OR = 0.56, 95% CI = 0.42–0.75, <i>p</i> &lt; 0.001; high: OR = 0.88, 95% CI = 0.75–1.04, <i>p</i> = 0.13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results show that genetic risk for AD modified the relationship between life satisfaction and the risk of AD. This suggests that genetic risk may weaken associations between life satisfaction and AD risk. The findings clarify the mixed results of previous research on this topic and may contribute to more tailored approaches to the prevention of AD in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness and Tolerability of Prolonged Intermittent Theta Burst Stimulation in Older Adults With Treatment-Resistant Depression","authors":"Chih-Ming Cheng,&nbsp;Jia-Shyun Jeng,&nbsp;Mu-Hong Chen,&nbsp;Wen-Han Chang,&nbsp;Mu-N Liu,&nbsp;Wei-Chen Lin,&nbsp;Shih-Jen Tsai,&nbsp;Ya-Mei Bai,&nbsp;Tung-Ping Su,&nbsp;Cheng-Ta Li","doi":"10.1002/gps.70111","DOIUrl":"https://doi.org/10.1002/gps.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older treatment-resistant depression (TRD) patients with transportation concerns may struggle to complete 30–36 repetitive transcranial magnetic stimulation (rTMS) sessions. Uninsured rTMS medical costs may be another issue in certain nations. 2-Week prolonged intermittent theta-burst stimulation (iTBS1800) to the left-sided dorsolateral prefrontal cortex (DLPFC) demonstrated similar antidepressant efficacy to standard rTMS or iTBS in adults with TRD. However, no study has yet confirmed the antidepressant effect of iTBS1800 in geriatric TRD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed chart data from May 2018 to September 2022 to identify TRD patients aged ≥ 50 years who received self-pay TMS treatments at a single medical center in Taiwan. All patients had major depressive disorder and had failed at least one prior antidepressant treatment. The Hamilton Depression Rating Scale (HDRS-17) was evaluated before and after TMS stimulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>97 older patients with TRD (mean ± SD, age, 62.81 ± 7.89; 69.1%% female) was identified. Approximately 70% of patients reported anxious depression and prior antidepressant failures (≥ 3). The average number of self-pay TMS sessions was 11.71 ± 3.15) (range:10–30). Patients receiving iTBS1800 demonstrated a greatly higher remission rate than those receiving 10 Hz rTMS (29.5% vs 13.2%, respectively, <i>p</i> = 0.048), particularly in patients with mild and moderate depression. Age was not a clinically significant determinant of remission following TMS therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Left-sided DLPFC iTBS1800 may be a feasible option for treating older patients with TRD due to its favorable effect and shorter treatment period, which may be ideal for patients with transportation, budgetary and vacation restrictions. More study is needed to compare the antidepressant efficacy of iTBS1800 to other TMS protocols in older patients with TRD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Symptoms and White Matter Hyperintensities in Older Cognitively Unimpaired Men Versus Women","authors":"Ioannis Liampas,&nbsp;Daniil Tsirelis,&nbsp;Silvia Demiri,&nbsp;Vasileios Siokas,&nbsp;Antonia Tsika,&nbsp;Elli Zoupa,&nbsp;Polyxeni Stamati,&nbsp;Lambros Messinis,&nbsp;Grigorios Nasios,&nbsp;Efthimios Dardiotis","doi":"10.1002/gps.70107","DOIUrl":"https://doi.org/10.1002/gps.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to examine association patterns of white matter hyperintensities (WMH) with neuropsychiatric symptoms (NPS) in men versus women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a cross-sectional analysis of data acquired from the National Alzheimer's Coordinating Center database. Cognitively unimpaired participants aged ≥ 50 years with data on WMH severity were studied. Using Cardiovascular Health Study scores, WMH were coded as no to mild (score: 0–4), moderate (score: 5–6) or extensive (score: 7–8). NPS were quantified on the Neuropsychiatric Inventory Questionnaire. For the purposes of the main analysis, participants were dichotomized for presence of each NPS (0: absent; 1: present). Adjusted binary logistic regression models estimated the odds of having each of 12 NPS by sex-WMH status. To confirm the validity of our findings, the correlations between NPS severity and WMH burden were also separately explored in men and women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 4617 participants with normal cognition, there were 1502 men and 2685 women with no to mild WMH changes, 102 men and 274 women with moderate WMH changes and 19 men and 35 women with extensive WMH changes. Greater WMH burden (especially extensive changes) was related to increased odds of lability symptoms (agitation, disinhibition, irritability) and apathy in men but not women. Elation and appetite disorders followed the same trend but failed to achieve statistical significance. The exploratory analysis revealed positive correlations between these symptoms' severity with WMH burden in men but not in women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WMH burden was differentially associated with NPS in older men versus women with normal cognition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Depressive Symptoms and Major Depressive Disorder Among the Oldest-Old in India","authors":"Supa Pengpid,&nbsp;Karl Peltzer,&nbsp;André Hajek,&nbsp;Razak M. Gyasi","doi":"10.1002/gps.70112","DOIUrl":"https://doi.org/10.1002/gps.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Few studies have assessed the prevalence and correlates of major depressive disorder (MDD) and depressive symptoms among the oldest-old (≥ 80 years) in low- and middle-income countries. Using national data from India, the study's objective was to determine the prevalence of MDD and depressive symptoms, as well as the characteristics that are related to them, among people aged 80 and beyond.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the nationally representative cross-sectional 2017-2018 Longitudinal Aging Study in India (LASI) were analyzed. The analytical sample consisted of 3163 community-dwelling people aged 80 and older (proxy interviews were excluded). MDD and depressive symptoms were evaluated using established measures. Multiple logistic regressions were used (with demographic, health, and social-related explanatory factors).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of depressive symptoms was 34.8% and MDD 10.3%. Regressions found that higher food insecurity (Adjusted Odds Ratio-AOR: 1.22, 95% Confidence Interval-CI: 1.03–1.44), lower subjective economic status (AOR: 0.90, 95% CI: 0.82–0.98), lower self-rated health status (AOR: 0.78, 95% CI: 0.66–0.93), lower life satisfaction (AOR: 0.66, 95% CI: 0.56–0.78), higher functional disability (AOR: 1.18, 95% CI: 1.06–1.32), physical inactivity (AOR: 1.57, 95% CI: 1.09–2.28), and higher perceived discrimination (AOR: 1.49, 95% CI: 1.35–1.64) increased the odds of depressive symptoms, and higher food insecurity (AOR: 1.31, CI: 1.02–1.68), lower self-rated health status (AOR: 0.65, 95% CI: 0.50–0.85), higher functional disability (AOR: 1.23, 95% CI: 1.08–1.40), and higher perceived discrimination (AOR: 1.23, 95% CI: 1.06–1.42) increased the odds of MDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Depression was prevalent among the oldest-old in India. Appropriate intervention strategies should be applied to prevent MMD among the oldest-old in India.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autism, Diagnostics, and Dementia: A Consensus Report From the 2nd International Summit on Intellectual Disabilities and Dementia","authors":"Matthew P. Janicki,&nbsp;Philip McCallion,&nbsp;Nancy Jokinen,&nbsp;Frode Kibsgaard Larsen,&nbsp;Kathyrn P. Service,&nbsp;Dawna T. Mughal,&nbsp;Karen Watchman,&nbsp;Tiziano Gomiero,&nbsp;Seth M. Keller","doi":"10.1002/gps.70110","DOIUrl":"https://doi.org/10.1002/gps.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The second International Summit on Intellectual Disability and Dementia, held in 2023, highlighted the unique challenges of diagnosing dementia in older autistic adults, particularly those with intellectual disabilities, due to the complex interplay of cognitive, communicative, and behavioral factors. This article addresses key diagnostic issues and post-diagnostic considerations for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A consensus report was developed by the Summit's Autism/Dementia Working Group through background reviews, expert discussions at the Summit, and iterative draft revisions, incorporating feedback from internal and external stakeholders. Key issues were extracted from the report and abridged for this manuscript.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Diagnostic challenges stem from overlapping symptoms of co-occurring neurodevelopmental and psychiatric conditions, rendering standard dementia tools insufficient. Comprehensive evaluations tailored to autism-related traits, sensory sensitivities, and alternative communication methods are essential. Building diagnostic capacity among clinicians and fostering multidisciplinary collaboration are critical. Longitudinal assessments, initiated before dementia symptoms appear, facilitate early detection of subtle changes. Emerging biomarkers and neuroimaging techniques show promise and should be incorporated where feasible. Accommodations, such as virtual assessments in familiar settings, can enhance diagnostic accuracy by reducing anxiety. Creating transition processes from diagnostics to post-diagnostic supports will aid in mitigating challenges and enhance life quality when dementia is a factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Research and clinician education are urgently needed to improve diagnostic approaches and streamline the transition from diagnosis to tailored post-diagnostic support. An integrated framework of comprehensive efforts is vital for our better understanding of age-associated neuropathological diagnostics and enabling long-term well-being of older autistic adults with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Stimulation Therapy—Spain (CST-ES): Cultural Adaptation Process and Pilot Study","authors":"Enrique Pérez-Sáez,&nbsp;Elisa Aguirre Sánchez,&nbsp;Mireia Tofiño García,&nbsp;Teresa Rodríguez del Rey,&nbsp;Beatriz Peláez Hernández","doi":"10.1002/gps.70109","DOIUrl":"https://doi.org/10.1002/gps.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the validity and acceptability of an adapted version of Cognitive Stimulation Therapy (CST) for the Spanish population and culturally adapt the original UK manuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The process followed the Formative Method for Adapting Psychotherapy (FMAP). Two focus groups were conducted with healthcare professionals specialized in the care of people with dementia, a pilot study with a small sample size (<i>n</i> = 6), and individual interviews with participants, family caregivers, and group facilitators. The study was conducted at the <i>National Reference Center for Alzheimer's and Dementia Care</i> (CREA), a specialized dementia care center in Spain. The participants included eight healthcare professionals for the focus groups, six persons with dementia from CREA outpatient programs for the pilot study, their family caregivers, and two group facilitators. Assessments for the pilot study included the Mini-Mental State Examination (MMSE), Cambridge Cognitive Assessment Revised (CAMCOG-R), Geriatric Depression Scale (GDS-15), Quality of Life in Alzheimer's Disease Scale (QoL-AD), Barthel Index (BI), and the Lawton and Brody Scale for Instrumental Activities of Daily Living (IADL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The adapted CST principles and structure were deemed suitable for the Spanish context, with necessary linguistic and cultural adjustments. The pilot study reported no implementation issues, with positive feedback from participants, caregivers, and facilitators, alongside significant cognitive and quality of life improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The culturally adapted <i>Cognitive Stimulation Therapy—Spain</i> (CST-ES) is a valid and appropriate intervention for the Spanish population, providing a valuable addition to non-pharmacological therapies for dementia in Spain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms Before and During the COVID-19 Pandemic in Veteran Nursing Home Residents","authors":"Madeline B. Benz,&nbsp;James L. Rudolph,&nbsp;Frank DeVone,&nbsp;Thomas A. Bayer,&nbsp;Alexander Garbin,&nbsp;Mriganka Singh,&nbsp;Stefan Gravenstein,&nbsp;Scotte Hartronft,&nbsp;Rhonda Toms,&nbsp;Brandon A. Gaudiano,&nbsp;Jane Metrik,&nbsp;Julia Browne","doi":"10.1002/gps.70108","DOIUrl":"https://doi.org/10.1002/gps.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Infection control measures in the Department of Veterans Affairs Community Living Centers (CLCs), analogous to nursing homes, during the COVID-19 pandemic may have impacted residents' mental health. The purpose of this study was to examine changes in depressive symptoms before and during the COVID-19 pandemic in CLC residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional national cohort study evaluated depressive symptoms in Veteran CLC residents from geographically diverse CLCs across four 9-month periods of the COVID-19 pandemic: pre (before COVID-19), early (before vaccine), mid (before booster), and late (after booster). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9), a standardized depression assessment, which is a required measure in the Minimum Data Set (MDS). We computed change in PHQ-9 scores from the initial to the last PHQ-9 assessment for each pandemic period. We also performed a focused analysis of residents with a past year depression diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall sample comprised 47,755 Veteran CLC residents, 43% percent (<i>n</i> = 20,554) of whom had a depression diagnosis. The overall cohort mean PHQ-9 scores were similar across pandemic periods (pre = 2.64, early = 2.48, mid = 2.61, late = 2.45). There was intra-resident decline in PHQ-9 during each period which was statistically, but not clinically significant (pre = −0.54, early = −0.47, mid = −0.55, late = −0.49). Residents with a depression diagnosis followed a similar pattern for scores and decline in the periods compared with the full sample. PHQ-9 average scores indicated minimal depression even among those with a depression diagnosis, limiting ability to detect changes over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For CLC residents during the COVID-19 pandemic, PHQ-9 scores were not meaningfully different between time periods. Characteristics of the study (e.g., sample/setting) or of older adults generally (e.g., resilience) may explain the low rates of depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Frailty Predict Cognitive and Functional Deficits After Nine Years?","authors":"Beatriz Raz Franco de Santana,&nbsp;Daniela de Assumpção,&nbsp;Flávia Silva Arbex Borim,&nbsp;Ivan Aprahamian,&nbsp;Ligiana Pires Corona,&nbsp;Samila Sathler Tavares Batistoni,&nbsp;Deusivania Vieira da Silva Falcão,&nbsp;Meire Cachioni,&nbsp;Ruth Caldeira de Melo,&nbsp;Anita Liberalesso Neri,&nbsp;Monica Sanches Yassuda","doi":"10.1002/gps.70104","DOIUrl":"https://doi.org/10.1002/gps.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify the variables at baseline, including physical frailty, that might predict cognitive and functional deficits in a 9-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This investigation included participants from the FIBRA study in Campinas city and Ermelino Matarazzo, subdistrict of São Paulo city, with complete data collected at baseline and follow-up for the variables sex, age, education, frailty phenotype, number of chronic diseases, and tobacco and alcohol use. Of the initial 1284 participants at baseline, 98 that exhibited cognitive impairment were excluded. At follow-up, 451 participants were located and reinterviewed and 85 scored below the cut-off on the Mini-Mental State Exam (MMSE), of which 45 also presented functional deficit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The follow-up subsample comprised predominantly participants that were female (68.1%), aged 65–74 years (71.6%), and had low education (0–4 years of education, 75.6%). At baseline, 35.5% were non-frail, 57.0% pre-frail and 7.5% frail, whereas at follow-up, 29.4% were non-frail, 62.3% pre-frail and 8.3% frail. Logistic regression showed that age and education but not frailty at baseline were associated with cognitive and functional deficits at follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher age and lower education at baseline were predictors of cognitive and functional deficits after 9 years, whereas frailty was not. Further longitudinal studies should be conducted to elucidate the factors predicting cognitive and functional decline in low-and middle-income countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Treatment-Resistant Depression With and Without Parkinsonism in the Elderly From a Psychiatric Perspective by 99mTc-TRODAT-1 SPECT Imaging","authors":"Tung-Ping Su,&nbsp;Chiu-Jung Huang,&nbsp;Wei-Chung Mao,&nbsp;Yu-Hsien Chiu,&nbsp;Ren-Shyan Liu,&nbsp;Li-Fen Chen","doi":"10.1002/gps.70102","DOIUrl":"https://doi.org/10.1002/gps.70102","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Late-life depression often overlaps with neurodegenerative diseases leading to diagnostic and treatment challenges for neuropsychiatrists. This study aimed to differentiate elderly treatment-resistant depression (TRD) comorbid with parkinsonism from elderly TRD without Parkinsonism as well as elderly healthy controls using striatum dopamine transporter (DAT) imaging by &lt;sup&gt;99m&lt;/sup&gt;Tc TRODAT-1 SPECT.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three groups were enrolled, including patients with TRD, patients with TRD comorbid with parkinsonism, and healthy controls. To obtain the DAT availability, the specific uptake ratios of the bilateral striatum were evaluated. Linear regression analyses were performed to evaluate the relationship between age and DAT level in the subregions of the striatum. Machine learning was applied to categorize the three groups with 10-fold cross-validation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study enrolled 32 patients with TRD (&lt;span&gt;&lt;/span&gt;&lt;math&gt;\u0000 &lt;semantics&gt;\u0000 &lt;mrow&gt;\u0000 &lt;mn&gt;66.15&lt;/mn&gt;\u0000 &lt;mo&gt;±&lt;/mo&gt;\u0000 &lt;mn&gt;6.82&lt;/mn&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;annotation&gt; $66.15pm 6.82$&lt;/annotation&gt;\u0000 &lt;/semantics&gt;&lt;/math&gt;), 36 TRD patients with parkinsonism (&lt;span&gt;&lt;/span&gt;&lt;math&gt;\u0000 &lt;semantics&gt;\u0000 &lt;mrow&gt;\u0000 &lt;mn&gt;70.27&lt;/mn&gt;\u0000 &lt;mo&gt;±&lt;/mo&gt;\u0000 &lt;mn&gt;5.63&lt;/mn&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;annotation&gt; $70.27pm 5.63$&lt;/annotation&gt;\u0000 &lt;/semantics&gt;&lt;/math&gt;), and 74 healthy elderly (&lt;span&gt;&lt;/span&gt;&lt;math&gt;\u0000 &lt;semantics&gt;\u0000 &lt;mrow&gt;\u0000 &lt;mn&gt;66.95&lt;/mn&gt;\u0000 &lt;mo&gt;±&lt;/mo&gt;\u0000 &lt;mn&gt;10.59&lt;/mn&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;annotation&gt; $66.95pm 10.59$&lt;/annotation&gt;\u0000 &lt;/semantics&gt;&lt;/math&gt;). A normative DAT concentration by age was established, providing a reference for clinical use. DAT levels differed among groups (all pairwise &lt;i&gt;p&lt;/i&gt; &lt; 0.01), with healthy controls exhibiting the highest levels, followed by patients with TRD, and then TRD patients with parkinsonism. Further, the Fine k-NN classifier emerged as the top performer to achieve 85.7% accuracy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Besides clinical assessment, dopaminergic as","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}