International Journal of Geriatric Psychiatry最新文献

{"title":"Time to Diagnosis in Dementia: A Systematic Review With Meta-Analysis","authors":"Olubunmi Kusoro,&nbsp;Moïse Roche,&nbsp;Rafael Del-Pino-Casado,&nbsp;Phuong Leung,&nbsp;Vasiliki Orgeta","doi":"10.1002/gps.70129","DOIUrl":"https://doi.org/10.1002/gps.70129","url":null,"abstract":"<p>Timely dementia diagnosis is a global priority, reflected in most national and regional policies and plans. Nevertheless, there are currently no robust estimates of the average time to diagnosis (TTD) and factors influencing diagnostic intervals. This article presents the first systematic review of quantitative studies on TTD in dementia and the factors associated with its duration. We systematically searched EMBASE, Psych INFO, MEDLINE, and CINAHL databases for relevant studies published up to December 2024. We defined TTD as the interval between symptom onset (rated by family carers or patients using interviews or medical records) to final diagnosis. Risk of bias was assessed using the Reporting studies on time to diagnosis tool. We included 13 studies reporting data on 30,257 participants, with age at onset ranging between 54 and 93 years. Meta-analysis pooling 10 studies showed that average mean TTD across all types of dementia was 3.5 years [confidence interval (CI): 2.7–4.3; moderate quality evidence]. Analyses of six studies showed that TTD in young onset dementia was 4.1 years (CI: 3.4–4.9; moderate quality evidence). Although the factors influencing TTD were inconsistent, a younger age at onset and having frontotemporal dementia were consistently associated with a longer interval to diagnosis. TTD in dementia remains long, and specific healthcare strategies are urgently needed to improve it. Increasing the evidence base and developing interventions to reduce TTD should be a future research priority. Specialist services are likely to be key in improving TTD in young-onset dementia.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714851","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":"The Moderating Role of Dementia-Related Fear in the Relationship Between Perceived Cognitive Decline and Motivation for Dementia Risk Reduction Behaviors in Community-Dwelling Middle-Aged and Older Adults","authors":"Rose Lin,&nbsp;Sara Laureen Bartels,&nbsp;Ladislav Batalik,&nbsp;Jing Jing Su","doi":"10.1002/gps.70130","DOIUrl":"https://doi.org/10.1002/gps.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing effective policy strategies for dementia risk reduction. This study explores the moderating role of dementia-related fear on the relationship between perceived cognitive decline and engagement in dementia risk reduction behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among 200 Chinese community-dwelling middle-aged and older adults. Hierarchical regression and simple slope analysis were used to assess the moderating effect of dementia-related fear on the relationship between perceived cognitive decline and motivation to engage in dementia risk reduction behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant correlation was found between perceived cognitive decline and increased motivation to engage in dementia risk reduction behaviors (<i>r</i> = 0.44). Dementia-related fear acted as a significant moderator; motivation was positively associated with low to moderate levels of fear, whereas this association diminished and became non-significant at higher levels of fear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that while lower levels of dementia-related fear may be linked to increased motivation for engaging in risk reduction behaviors, elevated levels of fear do not appear to support such engagement. Rather than emphasizing the negative impacts of dementia, public health strategies should empower individuals with actionable messages to engage in dementia risk reduction behaviors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705553","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":"The Cost-Effectiveness of an Intervention to Preserve Independence in People With Dementia (Vs. No Intervention): A Decision-Analytic (Markov) Model Analysis","authors":"Luke Paterson,&nbsp;Rachel A. Elliott,&nbsp;Fofi Constantinidou,&nbsp;Renaud David,&nbsp;Piers Dawes,&nbsp;Eric Frison,&nbsp;Mark Hann,&nbsp;Hannah Hussain,&nbsp;Iracema Leroi,&nbsp;Antonis M. Politis,&nbsp;Chryssoula Thodi,&nbsp;Elizabeth M. Camacho,&nbsp;SENSE-Cog Study Team","doi":"10.1002/gps.70132","DOIUrl":"https://doi.org/10.1002/gps.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Interventions that enable people with dementia to retain some independence in activities of daily living (ADL) may delay transitions into residential care and offset sharp reductions in quality of life (QoL). The aim of this study was to estimate how effective a hypothetical intervention needs to be at preserving independence in home-dwelling people with dementia, to be cost-effective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A decision-analytic model was constructed to compare costs and outcomes of a cohort of people with dementia in the United Kingdom and European Union over a 10-year period. At model entry, the cohort was distributed across low, moderate, or high levels of dependence. The impact of a hypothetical intervention that preserves independence was evaluated by reducing the proportion of people entering the model with moderate and high dependence. The model included costs for the intervention and health and social care resource use. Secondary analysis included estimated costs of informal care. Health benefit was measured as quality-adjusted life-years (QALYs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cost of the intervention was £570/person. At this cost, an intervention that resulted in 7.5% of the sample entering the model in a lower level of dependence (compared with no intervention) was likely to be cost-effective (£8690/QALY). An intervention costing £250/person would only need a 2.5% effect and one costing £1000/person would need to have a 10% effect to be potentially cost-effective. Including informal care costs increased the size of the effect required for the intervention to be cost-effective because more of the care provided at lower levels of dependence is informal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preserving independence in people with dementia may be a cost-effective way to help them live well for longer. Our results provide a guide on costs and required effects for those developing interventions to preserve independence in people with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687867","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":"Criminal Trajectories Across the Dementia Timeline—A Nationwide Finnish Register Study","authors":"Milena Ginters,&nbsp;Tiina Talaslahti,&nbsp;Hannu Kautiainen,&nbsp;Risto Vataja,&nbsp;Anniina Palm,&nbsp;Henrik Elonheimo,&nbsp;Jaana Suvisaari,&nbsp;Nina Lindberg,&nbsp;Hannu Koponen","doi":"10.1002/gps.70131","DOIUrl":"https://doi.org/10.1002/gps.70131","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;The aim of this longitudinal register study was to examine the crime counts, crime incidence and timing of criminal activity in relation to the diagnosis of Alzheimer's disease (AD), frontotemporal dementia (FTD) and Lewy body dementias (LBD). The objective was to analyse the associated risk factors and risk relations among the offender categories.&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;We collected register data from Finnish nationwide registers (Finnish Care Register for Health Care and Finnish National Police Register) between 1998 and 2015. Mortality statistics were collected until the end of 2018 (Statistics Finland). Our study included a total of 92,189 patients, of whom 80,540 had AD, 1059 had FTD, and 10,590 had LBD. We examined the crimes committed by the study population before and after diagnosis. In the follow-up, we primarily focussed on the 4-year period and secondarily on the 10-year period after diagnosis. First, we measured the post-diagnostic crime rates in patients who had committed crimes before diagnosis and in those who had not; we also calculated the incidence rate ratio (IRR) of post-diagnosis crimes in these groups. Second, we calculated the cumulative incidence of first post-diagnoses crimes and investigated the risk of the first post-diagnoses crime by calculating the adjusted subhazard ratio (sHR) in pre-diagnosis offenders and non-offenders.&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;Most of the study population did not exhibit criminal behaviour before or after diagnosis. However, individuals who had engaged in criminal behaviour before diagnosis also showed a higher incidence of criminal activity in the 4-year period after diagnosis compared to patients with no criminal history prior to diagnosis. They also showed a steep increase in the cumulative incidence of the first post-diagnosis crime, particularly in the first 2 years after diagnosis. The age- and sex-adjusted sHR for the occurrence of the first post-diagnosis crime was 4.42 (95% confidence interval: 3.83–5.11) in AD, 4.36 (2.15–8.83) in FTD and 4.87 (3.88–6.12) in LBD in pre-diagnosis offenders versus non-offenders.&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;Individuals with a history of criminal behaviour before diagnosis of a neurocognitive disorder showed higher rates and a higher risk of future criminal activity. The cumulative incidence rose steeply during the first 2 years after diagnosis and after more gradually. Criminal activity closer to the time of diagnosis, especially 1 year prior, was the ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144646899","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":"A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care","authors":"Huong X. T. Nguyen,&nbsp;Zoë Hyde,&nbsp;Kate Smith,&nbsp;Roslyn Malay,&nbsp;Leon Flicker,&nbsp;Rosie Watson,&nbsp;Kylie Radford,&nbsp;Sarah Russell,&nbsp;Rachel Quigley,&nbsp;Betty Sagigi,&nbsp;Edward Strivens,&nbsp;Adrienne Withall,&nbsp;Alison Timbery,&nbsp;Terrence Donovan,&nbsp;Brian Draper,&nbsp;Kim Delbaere,&nbsp;Louise Lavrencic,&nbsp;Robert Cumming,&nbsp;Jo-anne Hughson,&nbsp;Bridgette J. McNamara,&nbsp;Dina LoGiudice","doi":"10.1002/gps.70126","DOIUrl":"https://doi.org/10.1002/gps.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dementia is prevalent within Aboriginal and Torres Strait Islander communities but clients attending primary care often remain undiagnosed. This project aimed to develop a rapid dementia screen for primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Logistic regression was used to identify candidate items from the Kimberley Indigenous Cognitive Assessment (KICA-Cog). The psychometric properties of different scales were assessed using receiver operating characteristic curve analysis and validated in a separate cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four items in the KICA-Cog demonstrated high sensitivity (82.6%), specificity (83.2%) and area under the curve (AUC = 0.90; 95% CI: 0.87–0.94) for dementia at a cut-off point of 7/8 out of 10. This scale has favourable psychometrics (sensitivity 87.5%, specificity 80.9%, AUC = 0.92; 95% CI: 0.85–0.98) when validated in separate cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The proposed prototype tool, ready for community piloting and validation, may be useful in primary care to enable rapid cognitive screening as part of routine health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624498","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":"Barriers and Facilitators to Implementing Cognitive Stimulation and Reminiscence Therapy for Dementia in Care Homes: Systematic Review","authors":"Emily Fisher,&nbsp;Isobel Chick,&nbsp;Jane Fossey,&nbsp;Aimee Spector","doi":"10.1002/gps.70124","DOIUrl":"https://doi.org/10.1002/gps.70124","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;Psychosocial interventions play a vital role in addressing the complex needs of people with dementia in care homes. Cognitive stimulation and reminiscence therapy are recommended by the UK National Institute for Health and Care Excellence to support the cognition, independence, and wellbeing of people with dementia, and crucially, they can be delivered by care home staff or non-specialist interventionists. This review aims to explore factors that influence the implementation of cognitive stimulation and reminiscence therapy for people with dementia delivered by staff in care homes.&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;Ten electronic databases were searched between 2000 and April 2024. Two reviewers systematically appraised the studies for inclusion using pre-specified criteria and their quality using the Critical Appraisal Skills Programme (CASP) and Mixed Methods Appraisal Tool (MMAT) checklists. Data was analysed thematically using a deductive approach based on the updated Consolidated Framework for Implementation Research (CFIR), and findings were synthesised narratively.&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;Nine studies were included; three focussed on reminiscence therapy, and six on cognitive stimulation. All interventions were delivered in care homes by care home staff. Many studies were excluded because a research team member delivered the intervention. Overall, the quality of the studies was low. Key facilitators to implementation were the availability of standardised manuals or resources, the adaptability of interventions, and staff training and support. Barriers included a lack of staff time and availability and a lack of perceived support from care home management. Most studies collected quantitative outcomes, and a minority collected qualitative information about implementation experiences and perceptions of the intervention. No studies collected qualitative data from people with dementia or their carers.&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;The review highlights the field's reliance on research staff to deliver interventions rather than training and involving care home staff in evaluating interventions. Additionally, there is a lack of qualitative data from people with dementia and their families regarding their views, preferences, and experiences related to participating in psychosocial interventions in care homes. There is a pressing need for high-quality evidence on the implementation of interventions for dementia, which involves collaboration, consultation and ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612018","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":"The Relationship Between Facial Emotion Recognition and Executive Function Varies Depending on the Level of Cognitive Impairment","authors":"Michelle Brandt,&nbsp;Felipe Oliveira,&nbsp;Tatiana Belfort,&nbsp;Marcela Nogueira,&nbsp;Maria Alice Baptista,&nbsp;Isabel Lacerda,&nbsp;Aline Tavares de Lucena,&nbsp;Rogeria Rangel,&nbsp;Marcia Cristina Nascimento Dourado","doi":"10.1002/gps.70127","DOIUrl":"https://doi.org/10.1002/gps.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cognitive domains related to attention and executive functions (a set of cognitive processes that regulate, control, and manage other cognitive abilities) seem to influence the recognition of facial expressions in people with Alzheimer's disease (AD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We examined the relationship between facial expression recognition, global cognition and executive function in people with AD according to their cognitive level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Design</h3>\u0000 \u0000 <p>In a cross-sectional design, we included 130 participants with AD divided into three groups based on their Mini-Mental State Examination (MMSE) scores: MMSE 1 (scores 23–28), MMSE 2 (scores 17–22), and MMSE 3 (scores 11–16). Facial expression recognition ability was analyzed using the Faces Test. Executive function was analyzed using the Trail Making Test (TMT), the Verbal Fluency Test (VFT), the Semantic Fluency Test (SFT), the Digit Span Forward (DSF) and Backward (DSB) tests, and the Clock Drawing Test (CDT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In MMSE 1 group difficulties in divided attention and cognitive flexibility impacted the accuracy of facial expression recognition. In the MMSE 2 group, facial expression recognition was related to impairment in working memory. In the MMSE 3 group, the impact on facial expression recognition was directly related to visuoconstructive abilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We observed that the executive resources involved in each evaluated group differed in terms of facial recognition task performance efficacy. Interventions at stimulating executive and visuoconstructive abilities in people with AD may contribute to better preservation of facial expression recognition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589870","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":"Knowledge and Beliefs About Medical and Non-Medical Interventions to Control Alzheimer’s Disease Among Latinos in New York City","authors":"Evelyn Tran,&nbsp;María Cabán,&nbsp;Alicia Meng,&nbsp;John B. Wetmore,&nbsp;Ruth Ottman,&nbsp;Karolynn Siegel","doi":"10.1002/gps.70128","DOIUrl":"https://doi.org/10.1002/gps.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Latinos experience significant health disparities for Alzheimer's disease (AD) with an increased likelihood in developing the disease relative to non-Latino Whites. Our study sought to examine Latinos' beliefs about controlling the symptoms and progression of AD to identify gaps in community knowledge and improve understanding of culturally based perceptions of health and illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted in-depth, semi-structured interviews in English or Spanish with 216 Latinos aged 40–60 years (average age 53 years) living in the neighborhoods of northern Manhattan. We asked them whether they believed there were interventions that could help control AD. The data was analyzed using content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most participants viewed medications as important in the management of AD, though they had limited specific knowledge about existing medications for AD. Some participants thought herbal and nutritional supplements could have some benefits. Many believed activities for mental stimulation could help enhance cognitive functioning. A few suggested that a healthy diet and exercise could help slow the progression of AD. Some participants believed that emotional wellness and degree of support influenced AD progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Limited knowledge of available medications and evidence-based non-medical approaches to control AD may adversely impact help-seeking behavior and use of effective management strategies among those with AD. Future interventions should strive to expand knowledge about ways to effectively manage and treat AD in Latino communities.</p>\u0000 \u0000 <p><b>Trial Registration:</b> The ClinicalTrials.gov ID is NCT04471779. The date registered was July 15, 2020</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581822","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":"Cost of Psychiatric Inpatient Treatment for Dementia in Switzerland: A Case-Level Analysis of Billing Data","authors":"Elena Bleibtreu,&nbsp;Florian Riese","doi":"10.1002/gps.70122","DOIUrl":"https://doi.org/10.1002/gps.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to investigate the cost of care for patients with a primary diagnosis of dementia in Swiss hospitals under the new TARPSY reimbursement system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a dataset of the Swiss hospital reimbursement system TARPSY from 2016 to 2019, including all relevant remuneration variables at the patient level, to investigate hospital costs. Costs were analyzed by geographic location and hospital type. Homogeneity coefficients were used to analyze case cost homogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 7090 cases in the TARPSY database who were treated in Swiss hospitals under the primary diagnosis of dementia from 2016 to 2019. Of these, 6747 cases were included in our analysis. The total case costs and daily costs increased from 2016 to 2019, whereas the length of stay decreased. The average total case cost in 2019 was CHF 34,917 (<i>σ</i> = 32,926), corresponding to a daily cost of CHF 946 (<i>σ</i> = 373.44). Patients were treated for an average of 39.7 (<i>σ</i> = 32.40) days. In 2019, the total costs billed according to TARPSY for 57,939 days of hospital care for dementia as the primary diagnosis were CHF 51.3 million. The case costs differed by region and hospital type. Overall, cost homogeneity for total case cost as a proxy for the quality of the cost calculation was “satisfactory, sufficient” and did not show a clear trend towards improvement during the introduction of TARPSY.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our analysis provides reliable, case-level cost data for dementia hospital treatment in Switzerland. The total cost of dementia treatment in psychiatric hospitals appears to be much lower than previous estimates had indicated. When correcting for changes in accounting practices, total case costs only increased modestly from 2016 to 2019.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558301","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":"An International Validation of the Stigma Impact Scale With People With Dementia","authors":"Jem Bhatt,&nbsp;Sara Evans-Lacko,&nbsp;Katrina Scior,&nbsp;Rob Saunders","doi":"10.1002/gps.70123","DOIUrl":"https://doi.org/10.1002/gps.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A robust psychometric instrument is imperative to measure the devastating impact of self-stigma in dementia to adequately inform policy and practice. Our objective was to evaluate the psychometric properties of the Stigma Impact Scale in a global sample of people with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were analysed from the World Alzheimer Report including 710 participants in 42 countries who completed the SIS. Detailed psychometric analyses of the SIS included estimating reliability, convergent validity with the Warwick-Edinburgh mental Well-being Scale (WEMWBS) and the Dementia Quality of Life instrument (DQoL), the factor structure of the measure (through both exploratory and confirmatory factor analysis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The SIS and its subscales had ‘good’ to ‘excellent’ internal consistency (Cronbach's Alpha: 0.883–0.943). However, convergent validity correlations were not in the predicted direction; no significant correlations were noted between the SIS and the WEMWBS and DQoL. Factor analysis suggested marginal improvements in global fit indices for the observed model compared to the theoretical model, though none met the thresholds for acceptable fit. The final proposed model had three factors: rejection and secrecy, loneliness and belonging and perceived social isolation. Most SIS items were strongly endorsed by participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The SIS is the most robustly tested instrument measuring self-stigma in dementia. The SIS has good to excellent reliability and relevance to the target population, however future work is required to improve the factor structure of the scale. Further the results of the validity testing pose a number of theoretical and empirical questions for future research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550883","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}