International Journal of Geriatric Psychiatry最新文献

{"title":"Feeling Younger as an Indicator of Better Overall Intrinsic Capacities in the INSPIRE-T Cohort.","authors":"Antoine Cabrol, Jason Shourick, Nicola Coley, Stéphane Oustric, Sophie Guyonnet, Bruno Vellas, Emile Escourrou, Sandrine Andrieu","doi":"10.1002/gps.70220","DOIUrl":"10.1002/gps.70220","url":null,"abstract":"<p><strong>Objectives: </strong>Existing literature indicates that subjective age-the age an individual feels or perceives themselves to be-is associated with various health outcomes. However, its relationship with global indicators such as intrinsic capacity remains inadequately explored. The primary objective of this study was to investigate the association between subjective age and intrinsic capacities, which encompass mobility, cognition, hearing, vision, mood, and nutrition.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted at baseline, followed by a longitudinal analysis over 8 months, based on the INSPIRE-T project launched in 2019 at a single center in Toulouse, France. The study included individuals aged 50 and above, with 744 participants at baseline, decreasing to 557 for the longitudinal analysis. Bivariate and multivariate logistic regressions were performed for each component of intrinsic capacity and a linear regression was conducted on a global score for impaired intrinsic capacities (0-6).</p><p><strong>Results: </strong>Participants had a mean age of 70.9 years, and 457 (61%) were women. Compared to feeling one's age, feeling younger was significantly associated with less impairment in the intrinsic capacity global score both cross-sectionally (-0.23 [-0.39 to -0.07]) and at 8 months (-0.18 [-0.35 to -0.01]). Feeling older exhibited a non-significant opposite trend. Analysis of each intrinsic capacity domain revealed associations between subjective age and mood, mobility, and hearing.</p><p><strong>Conclusions: </strong>This study demonstrates that feeling younger than one's age is associated with better overall intrinsic capacities at baseline and lesser decline over the monitoring period. Routine assessment of subjective age could help to identify individuals who may benefit from prevention strategies and could promote patient-centered care by providing deeper insights into individuals' perceptions of aging.</p><p><strong>Trial registration: </strong>The INSPIRE-T study has been registered on the site http://clinicaltrials.gov (ID NCT04224038) on October 15, 2019.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 5","pages":"e70220"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771030","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":"Dog Companionship and Loneliness in Community-Dwelling Older Adults: A Multicentre, Cross-Sectional Study.","authors":"Lauriane Segaux, Eric Poitrine, Marguerite Nicodème, Celia Herr, Anne-Julie Vaillant-Ciszewicz, Aline Hurtaud, Nolwenn Bombenger, Marie Boiteux-Chabrier, Emeline Michel, Clémence Maurice, Caroline Gilbert, Florence Canoui-Poitrine, Isabelle Fromantin","doi":"10.1002/gps.70216","DOIUrl":"10.1002/gps.70216","url":null,"abstract":"<p><strong>Objectives: </strong>Loneliness and social isolation are major public health concerns among older adults and are associated with depression, cognitive decline, frailty, and loss of independence. Companion animals (and dogs in particular) might mitigate these adverse outcomes by fostering emotional support, physical activity, and social interactions. The objective of the present study aimed to evaluate the association between dog ownership and loneliness in community-dwelling older adults.</p><p><strong>Methods: </strong>C-KDOG is a multicentre, cross-sectional study conducted between September 2020 and April 2023 at seven investigating centers in France. The participants were aged 75 or over and were living at home. Loneliness was assessed on the 11-item De Jong Gierveld Loneliness Scale. The secondary outcomes included emotional and social loneliness subscores, social isolation (according to the Social Network Index). Associations between dog ownership and loneliness were analyzed using multivariable linear regressions adjusted for sociodemographic, environmental and clinical characteristics.</p><p><strong>Results: </strong>A total of 160 participants were included, of whom 47 were dog owners (mean age: 82 years; females: 116 (73%); living alone: 79 (49%)). The median overall loneliness scores did not differ significantly when comparing dog owners and non-owners. In adjusted models, however, dog ownership was independently associated with lower loneliness. This association was mainly driven by a lower emotional loneliness subscore. Living alone, frailty, depressive symptoms, and sleep problems were independently associated with a greater level of loneliness. Dog ownership was primarily motivated by companionship (81%). Adverse events (such as falls or bites) were rare (5%).</p><p><strong>Conclusions: </strong>Dog ownership was associated with a lower level of emotional loneliness among community-dwelling older adults, independently of living alone frailty and depression. Companion dogs might contribute to emotional well-being in older adults. However, longitudinal studies are needed to confirm causality.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 5","pages":"e70216"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814811","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":"Sad Mood in Late-Life Depression Correlates With Reduced Thickness in Orbitofrontal Cortex.","authors":"Julia C Loureiro, Bruce Martins, Leandro da C L Valiengo, Bianca S Pinto, Bruna B Teixeira, Luara C Tort, Leonardo A Santosa, Rafael G Benatti, Maira M P Lessa, Jessica F Silva, Cristiane S Miranda, Henriette B Cardeal, André R Brunoni, Orestes V Forlenza","doi":"10.1002/gps.70218","DOIUrl":"https://doi.org/10.1002/gps.70218","url":null,"abstract":"<p><strong>Introduction: </strong>Late-life depression (LLD) is a heterogeneous psychiatric condition characterized by a wide range of psychopathological symptoms and associated with functional and structural abnormalities in brain networks implicated in mood and cognitive regulation. This cross-sectional study investigated the relationship between specific depressive symptom dimensions and cortical brain measures, as assessed by magnetic resonance imaging, in a sample of 87 community-dwelling older adults with depression.</p><p><strong>Results: </strong>Significant associations were identified between the severity of sad mood and reduced cortical volume in the right medial orbitofrontal cortex (OFC) (p [FDR] = 0.047), as well as reduced cortical thickness in the left OFC (p [FDR] = 0.008), left ventrolateral prefrontal cortex (VLPFC) (p [FDR] = 0.02), and right dorsolateral prefrontal cortex (DLPFC) (p [FDR] = 0.054). Apathy/lassitude was also significantly associated with reduced thickness in the left OFC (p [FDR] = 0.016) and left VLPFC (p [FDR] = 0.046). Moreover, overall depression severity correlated with reduced thickness in the right middle temporal cortex (MTC) (p [FDR] = 0.035).</p><p><strong>Discussion: </strong>Our results suggest that feelings of low mood and lassitude in LLD are linked to structural changes in brain regions involved in emotion regulation, motivational drive, self-referential thinking, executive control, and decision-making. The findings contribute to the understanding of the neurobiological underpinnings of LLD and support the hypothesis that symptom-specific disruptions within mood and cognitive processing circuits are integral to its pathophysiology.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 5","pages":"e70218"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770971","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":"Bipolar Disorder Hospitalization in Older Adults: A Nationwide Retrospective Study.","authors":"Daniela Soberano, Ana Rita Ferreira, Alberto Freitas, Lia Fernandes, Manuel Gonçalves-Pinho","doi":"10.1002/gps.70217","DOIUrl":"10.1002/gps.70217","url":null,"abstract":"<p><strong>Background: </strong>Bipolar disorder (BD) in older adults is linked to significant medical comorbidities and hospitalization burden, yet nationwide data remain scarce. This study aims to compare younger versus older BD hospitalization trends, patient characteristics, and the impact of comorbidities on hospitalization outcomes in Portugal (2008-2015).</p><p><strong>Methods: </strong>A retrospective observational study was conducted using a Portuguese administrative database, selecting hospitalization episodes of patients aged ≥ 60 years with a primary BD diagnosis. Variables analyzed included demographics, psychiatric comorbidities, Charlson Comorbidity Index (CCI), length of stay (LoS), in-hospital mortality, hospital charges, and readmissions.</p><p><strong>Results: </strong>From a total of 21,793 BD hospitalizations, there were 4801 (22.0%) BD-related hospitalizations in the older age group, and the annual hospitalization rate was 23.4 per 100,000 inhabitants. The median admission age was 66.0 years, and 67.7% were female. BD type I with a manic episode (32.9%) was the most frequent subtype, and 85.5% of admissions were emergent. The median LoS was 18.0 days, significantly longer than in younger adults (p < 0.001). Readmission occurred in 52.4% of cases, with in-hospital mortality at 0.7%. Comorbidities were present in 23.0% of hospitalizations, with diabetes (13.1%) and dementia (3.2%) being most prevalent.</p><p><strong>Limitations: </strong>The study relies on secondary administrative data, subject to coding inaccuracies, and its retrospective design limits causal inferences.</p><p><strong>Conclusions: </strong>BD hospitalizations in older adults carry a high medical burden, with comorbidities impacting outcomes. Early screening, multidisciplinary care, and targeted interventions are crucial to improving management and reducing hospitalizations. Further research is needed to explore long-term outcomes and outpatient care strategies.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 5","pages":"e70217"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771041","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":"Mortality of People With Alzheimer's Disease and Psychiatric Morbidity: A Nationwide Finnish Cohort Study","authors":"Aleksi Alastalo,&nbsp;Marianne Haapea,&nbsp;Tanja Nordström,&nbsp;Anna-Maija Tolppanen,&nbsp;Jouko Miettunen,&nbsp;Miika Nietola,&nbsp;Sirpa Hartikainen,&nbsp;Erika Jääskeläinen","doi":"10.1002/gps.70210","DOIUrl":"10.1002/gps.70210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Psychiatric comorbidities are common in Alzheimer's disease (AD), and they have a negative impact on quality of life, but their impact on mortality remains unclear. This study examined mortality among persons with AD and psychiatric morbidity compared to persons with AD without psychiatric morbidity. This is the first study to analyze Alzheimer's disease mortality based on the timing of earlier psychiatric morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized the nationwide register-based MEDALZ cohort, including 70,718 Finnish individuals diagnosed with AD between 2005 and 2011. Individuals were categorized into four groups based on the occurrence of their hospital-treated psychiatric diagnosis before the diagnosis of AD. Mortality was assessed over an 8-year follow-up. Chi-square test was used to compare the differences between the four groups in terms of causes of death and annual cumulative mortality. We determined cumulative mortality curves and hazard ratios, stratified by age, gender, cardiovascular disease, and the year of AD diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the 8-year follow-up, 70.4% of the AD cohort had died. Persons with earlier psychiatric morbidity had an AD diagnosis 1.4–4.3 years earlier and died 1.4–4.1 years younger. Mortality risk was slightly higher among those with psychiatric morbidity compared to those without (adjusted HRs 1.03–1.41), with the effect decreasing over the years of follow-up. Mortality risk was not affected by the timing of psychiatric morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Psychiatric comorbidity is associated with earlier AD onset and reduced lifespan; however, post-diagnosis survival appears to be largely determined by AD progression itself.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645163","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":"N-Acetylcysteine and Dementia Risk in Elderly Patients.","authors":"Mingyang Sun, Zhongyuan Lu, Wan-Ming Chen, Shuang Lv, Ningning Fu, Yitian Yang, Yangyang Wang, Mengrong Miao, Szu-Yuan Wu, Jiaqiang Zhang","doi":"10.1002/gps.70212","DOIUrl":"10.1002/gps.70212","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between N-acetylcysteine (NAC) use and dementia risk in elderly individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD).</p><p><strong>Methods: </strong>Utilizing Taiwan's National Health Insurance Research Database (NHIRD), we conducted a population-based cohort study of 105,144 elderly COPD patients to investigate the association between NAC use and dementia risk. Propensity score matching (PSM) ensured balanced covariates between NAC users and nonusers. Cox regression analysis and Poisson Regression analysis were employed to assess dementia risk, considering NAC dosage, treatment duration, and comorbidities. Competing risk analysis and Kaplan-Meier method were used to account for mortality risk and estimate dementia incidence, respectively.</p><p><strong>Results: </strong>Elderly NAC users demonstrated a significant association with a lower dementia risk (adjusted hazard ratio [aHR]: 0.76, 95% confidence interval [CI]: 0.74-0.78). Higher daily NAC intake was associated with a dose-dependent decline in dementia risk, with optimal benefits observed at an average daily dose of 1.61 defined daily doses (DDD). Stratification by cumulative defined daily doses (cDDD) of NAC revealed a consistent dose-response relationship, with progressively diminished dementia risk across quartiles of cDDD. Notably, NAC use was associated with a lower risk of Alzheimer's dementia (aHR: 0.68, 95% CI: 0.66-0.70) compared to non-NAC antimucolytic users.</p><p><strong>Conclusions: </strong>NAC use is associated with a dose-dependent reduction in dementia risk among elderly COPD patients, particularly for Alzheimer's dementia. Our findings underscore the potential of NAC as a potential protective factor against dementia in this vulnerable population, warranting further investigation and consideration in clinical practice.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":"e70212"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698336","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":"Development and Cross-Sectional Validation of the Quality of Life and Function Five-Domain Scale (QFS-5) in Dementia-Free Community-Dwelling Older Adults.","authors":"Zahinoor Ismail, Ibadat Warring, Dylan X Guan, Pierre Chue, Andrea Bardell, Clive Ballard, Byron Creese, Anne Corbett, Ellie Pickering, Pamela Roach, Eric E Smith","doi":"10.1002/gps.70215","DOIUrl":"https://doi.org/10.1002/gps.70215","url":null,"abstract":"<p><strong>Introduction: </strong>Quality of life (QoL) captures objective life conditions, subjective wellbeing, and personal aspirations. Interest is growing in ability-based, patient-centered instruments, not confounded by health outcomes. The Quality of Life and Function Five Domain Scale (QFS-5) uses a multi-dimensional approach to measure QoL emphasizing abilities and life engagement. We describe the development and validation of the QFS-5 in a large sample of community-dwelling older adults.</p><p><strong>Methods: </strong>The validation sample comprised 1610 participants aged ≥ 50 from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN-PROTECT). Internal consistency was assessed using Cronbach's alpha and item-total correlations. Confirmatory factor analysis (CFA) evaluated domain structure. Criterion validity was tested through Pearson's correlation with the EuroQol-5D (EQ-5D). Convergent and discriminant validity were evaluated from associations with cognitive, mental health, and functional measures. Floor and ceiling effects were investigated.</p><p><strong>Results: </strong>The QFS-5 demonstrated excellent internal consistency (α = 0.92); CFA supported the proposed domain structure with strong item loadings. Criterion validity was confirmed with correlation of -0.61 against the EQ-5D; higher symptom burden on related scales were associated with lower QFS-5 scores. Floor effects were minimal, while modest ceiling effects were observed in some domains. No significant floor or ceiling effects were found in participants with frailty.</p><p><strong>Conclusion: </strong>Validity and reliability are established for this ability-based QoL scale, within a sample of mostly cognitively unimpaired, community-dwelling older adults. The QFS-5 aligns with EQ-5D, demonstrating potential clinical and research utility to measure relevant patient-reported QoL outcomes.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":"e70215"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770996","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":"Resilience Shields and Grit Intensifies Subjective Cognitive Decline in Middle-To-Older Aged Black Americans.","authors":"Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L Jackson, Candidus Nwakasi, Darlingtina K Esiaka","doi":"10.1002/gps.70214","DOIUrl":"10.1002/gps.70214","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.</p><p><strong>Methods: </strong>The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to explore if the associations differed by sex.</p><p><strong>Results: </strong>Analysis showed that grit (β = 0.386, p < 0.001) was positively associated with SCD, but the effect size was larger in Black men (β = 0.527, p < 0.001) than women (β = 0.285, p < 0.001). Also, resilience (β = -0.220, p < 0.001) was negatively associated with SCD and the effect size was larger in Black men (β = -0.266, p < 0.001) than women (β = -0.187, p < 0.01).</p><p><strong>Conclusion: </strong>Our findings suggest that while higher levels of resilience may be a protective factor against SCD, higher grit may be associated with greater likelihood of SCD. Future studies should assess whether these associations persist when using objective measures of cognitive decline and further examine these factors as potential targets for cognitive health interventions.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":"e70214"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716639","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":"Inequities in Dementia Diagnosis: Evidence From the ELSI-Brazil Study.","authors":"Andrew Christopher Claro Miguel, Lucas Martins-Teixeira, Carolina Godoy, Gustavo Melo de Andrade Lima, Maria Fernanda Lima-Costa, Matheus Ghossain Barbosa, Cleusa Pinheiro Ferri","doi":"10.1002/gps.70219","DOIUrl":"https://doi.org/10.1002/gps.70219","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the national proportion of undiagnosed dementia cases in Brazil, examine its distribution across Brazilian regions sociodemographic subgroups, and identify factors associated with receiving a diagnosis.</p><p><strong>Methods: </strong>We conducted a cross-sectional, population-based analysis using baseline data (2015-2016) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative survey of community-dwelling adults. Dementia was identified through an established algorithm incorporating cognitive testing and functional impairment, combined with self-reported medical diagnosis of Alzheimer's disease. Underdiagnosis was defined as meeting dementia criteria without a prior medical diagnosis. Sociodemographic, clinical, cognitive, and functional variables were assessed. Survey-weighted logistic regression models estimated factors associated with underdiagnosis.</p><p><strong>Results: </strong>Among 5249 participants aged ≥ 60 years, 392 met criteria for dementia. Overall, 83.1% (95% CI: 76.5-88.1) had no previous diagnosis. Underdiagnosis was more frequent in poorer regions (90.2%) than in richer regions (76.0%), and higher among illiterate individuals (93.9%). In fully adjusted models, older age (OR = 0.91; 95% CI: 0.85-0.97), more years of education (OR = 0.86; 95% CI: 0.76-0.96), a higher number of chronic conditions (OR = 0.72; 95% CI: 0.54-0.97), and better memory performance (OR = 0.68; 95% CI: 0.56-0.84) were associated with a lower likelihood of underdiagnosis, while living alone was associated with a higher likelihood of underdiagnosis (OR = 3.65 [1.05-12.6]).</p><p><strong>Conclusions: </strong>About four in five older Brazilians meeting dementia criteria had no prior clinical diagnosis, with marked sociodemographic and regional disparities. Both individual factors-such as age, education, and multimorbidity-and structural inequities across regions influenced diagnostic likelihood. Strengthening early-detection strategies, improved health professional training, and regionally tailored approaches may improve recognition of dementia in Brazil's public health system.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":"e70219"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770980","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":"Ten Years of Actor and Cross-Partner Influence on Cognitive Function: Between- and Within-Couple Analysis","authors":"Zehao Zhang,&nbsp;Jeong Jin Yu,&nbsp;Xuyan Meng","doi":"10.1002/gps.70208","DOIUrl":"10.1002/gps.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although cognitive interdependence among spouses is recognized, there remains a paucity of research that disentangles these reciprocal associations at the between- and within-couple levels, particularly within non-Western populations. This study addresses these gaps by examining longitudinal dyadic interactions in cognitive functioning among middle-aged and older Chinese couples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Five-wave data collected over a decade were derived from the China Health and Retirement Longitudinal Study (CHARLS), encompassing 6089 heterosexual couples. At baseline, the mean age was 54.99 years (SD = 9.51) for husbands and 52.83 years (SD = 9.13) for wives. Cross-Lagged Panel Model (CLPM) and Random Intercept (RI)-CLPM were utilized to distinguish between between-couple and within-couple mutual effects. Age and education level were investigated as potential moderators of these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The between-couple findings revealed significant mutual effects among couples. Conversely, evidence for within-couple cognitive contagion was limited. Neither age nor education level moderated these reciprocal effects. Lower-educated wives tended to exhibit greater stability in cognitive functioning than their higher-educated counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The between-couple findings support the similarity-attraction theory and highlight gender-specific role transitions that influence cognitive aging, while the absence of within-couple cognitive concordance may be due to the length of assessment intervals or individual differences. These findings emphasize the need for future research with more frequent assessments and better control of trait-like characteristics to clarify these dynamics and support targeted cognitive health interventions for middle-aged and older couples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573900","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}