International Journal of Geriatric Psychiatry最新文献

{"title":"Incidence and Factors Associated With Cognitive Impairment 90 Days After First Ever Ischemic Stroke","authors":"Małgorzata Dec-Ćwiek,&nbsp;Paweł Wrona,&nbsp;Tomasz Homa,&nbsp;Joanna Słowik,&nbsp;Aleksandra Bodzioch,&nbsp;Agnieszka Słowik","doi":"10.1002/gps.70087","DOIUrl":"https://doi.org/10.1002/gps.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Post-stroke cognitive impairment (PSCI) is prevalent among stroke survivors, negatively impacting long-term outcomes. We aimed to assess the prevalence of PSCI and its risk factors in participants from the iBioStroke study (<i>n</i> = 1042), 90 days after their first ischemic stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We prospectively analyzed data from 582 participants, without cognitive problems before stroke based on the structured interview with the patient, a family member or a caregiver, and/or clinical documentation (if available), who completed the Montreal Cognitive Assessment (MoCA) at discharge and 90 days post-stroke. Two MoCA cut-offs were used to define PSCI: a score of ≤ 25 in the first model and ≤ 22 in the second model. Multivariate logistic regression was employed to identify independent risk factors for PSCI based on 30 collected parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the first model, PSCI was identified in 418 (71.8%) participants at day 90. Independent risk factors included older age (OR = 1.05; 95% CI:1.02–1.08), fewer years of education (OR = 0.83; 95% CI: 0.73–0.93), lower MoCA scores at discharge (OR = 0.76; 95% CI: 0.69–0.84), higher anxiety levels (HADS-A) at day 90 (OR = 1.10; 95% CI: 1.01–1.21), and larger stroke volume (OR = 1.01; 95% CI: 1.00–1.01). In the second model, PSCI was observed in 294 (50.5%) participants. Older age (OR = 1.06; 95% CI: 1.03–1.09), fewer years of education (OR = 0.87; 95% CI: 0.78–0.96), lower MoCA scores at discharge (OR = 0.83; 95% CI: 0.77–0.88), and higher depression levels (HADS-D) at day 90 (OR = 1.10; 95% CI: 1.03–1.18) were significant predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on our data, PSCI seems to be a common consequence of stroke. Both irreversible factors, such as age and educational level, stroke volume, and potentially modifiable factors, including post-stroke anxiety or depression and acute cognitive impairment, contribute to PSCI risk. These findings underscore the importance of early cognitive and psychiatric interventions in stroke survivors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877790","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 Mediating Role of Formal Social Engagement in the Relationship Between Oral Health and Depressive Symptoms Among Older Adults in South Korea","authors":"Pildoo Sung,&nbsp;Yanan Zhang,&nbsp;Ji-Young Choi","doi":"10.1002/gps.70085","DOIUrl":"https://doi.org/10.1002/gps.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The reciprocal relationship between oral health and mental health, and the underlying mechanisms remain underexplored. This study examined whether formal social engagement mediates the relationship between oral health and mental health in both directions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-lagged panel models with two-wave mediation were applied to data from 3860 older adults, aged 65 years or above, in the two waves of the Korean Longitudinal Study of Aging conducted in 2018 and 2020. Oral health was measured using the 12-item Geriatric Oral Health Assessment Index, and mental health was assessed with the 10-item Center for Epidemiologic Studies Depression Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis identified a reciprocal relationship between oral health and depressive symptoms, with depressive symptoms exerting a stronger effect on oral health than vice versa. Formal social engagement partially mediated the effect of oral health on depressive symptoms, but not the other way around.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings reaffirm the interplay and interdependence of oral health and mental health among older adults. Comprehensive strategies that integrate social engagement opportunities are imperative for developing interventions targeting older adults with compromised oral health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877833","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":"China's Healthy City Pilot Policy Improves Physical and Mental Health Outcomes for Middle-Aged and Older Adults: A Quasi-Natural Experiment Based on CHARLS","authors":"Zheng Zhang,&nbsp;Huijie Xu,&nbsp;Jiansong Zhou,&nbsp;Xia Cao","doi":"10.1002/gps.70082","DOIUrl":"https://doi.org/10.1002/gps.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rapid urbanization in China has raised significant public health concerns, particularly regarding residents' physical and mental well-being. Effective interventions are urgently needed to address these issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluates the impact of China's Healthy City Pilot Policy (HCPP), introduced in 2016, on improving residents' health outcomes and examines demographic differences and mechanisms driving these effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, a difference-in-differences (DID) approach was employed, along with propensity score matching (PSM-DID), placebo tests, and sensitivity analyses for robust results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The HCPP significantly enhanced residents' health in pilot cities, leading to better self-rated health, lower medical expenses, higher life satisfaction, and reduced depression. These benefits were most pronounced among the elderly, women, less-educated individuals, and residents of rural and central-western regions. Key mechanisms included increased physical exercise, social activities, and improved air quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The HCPP positively impacts urban health, especially for vulnerable groups, highlighting the urgent need to integrate health considerations into urban planning and providing valuable insights for future policy development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875499","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":"Simplified Screening for Depression in Acutely Hospitalized Geriatric Patients: Comparison of the Two-Item Whooley Questions With the Geriatric Depression Scale-15","authors":"Johannes Trabert,&nbsp;Elena Bauer,&nbsp;Rejane Golbach,&nbsp;Katrin Jekel,&nbsp;Christina Wunner,&nbsp;Katrin Singler,&nbsp;Sandra Schütze","doi":"10.1002/gps.70083","DOIUrl":"https://doi.org/10.1002/gps.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the study is to investigate sensitivity and specificity of the two-item Whooley questions compared to the 15-item Geriatric Depression Scale (GDS-15) for the detection of depressive symptoms in acutely hospitalized geriatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were prospectively recruited. Two-item Whooley questions and GDS-15 were performed within 24 h of admission, the GDS-15 being part of the routine geriatric assessment. Montgomery-Asberg Depression Rating Scale (MADRS) served as gold standard in the form of a structured interview which was performed within 48 h of admission. In addition, all patients were examined for independence (Barthel Index), cognition (mini-mental status examination), vision and hearing (finger rub test) and multimorbidity (Charlson Comorbidity Index).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>248 patients were recruited. Median (Q1/3) age was 83 (/3 79/86) years, 157 patients (63%) were female. Whooley questions had a sensitivity of 0.95 (95% CI: 0.81–0.99) and specificity of 0.49 (95% CI: 0.43–0.56) identifying moderate depressive symptoms (MADRS ≥ 20 points) with a negative predictive value (NPV) of 0.99. This is compared to a sensitivity of 0.57 (95% CI: 0.37–0.75) and specificity of 0.62 (95% CI: 0.56–0.68) using GDS-15 to identify moderate depressive symptoms. Both functional impairment and cognitive deficits had an impact on the result of GDS-15, but did not influence the result of Whooley questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to the GDS-15, the two-item Whooley questions are more accurate to screen for symptoms of depression in acutely hospitalized geriatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861514","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 Impact of Behavioral and Psychological Symptoms of Dementia on Mental Health, Sleep Quality, and Caregiver’s Burden","authors":"I-Wen Chen,&nbsp;Jia-Ying Sung,&nbsp;Wei-Han Wang","doi":"10.1002/gps.70080","DOIUrl":"https://doi.org/10.1002/gps.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psychological Symptoms of Dementia (BPSD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 280 dementia patients (130 with BPSD, 150 without) and their caregivers were included. Patients with Clinical Dementia Rating scores from 0.5 to 2 were assessed. Caregivers’ psychological symptoms, sleep quality, and burden were evaluated using the Symptom Checklist-90-Revised, Pittsburgh Sleep Quality Index, and Caregiver Burden Inventory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Caregivers of patients with BPSD reported significantly greater psychological distress, burden, and poorer sleep quality than those caring for patients without BPSD. Their distress spanned multiple symptom dimensions, including depression and anxiety. Somatization and phobic anxiety were also more pronounced in caregivers of mild and moderate dementia with BPSD. Among caregivers of patients with BPSD, those of individuals with moderate dementia experienced the highest distress, burden, and poorest sleep quality compared to those with very mild dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BPSD is a major contributor to greater caregiver distress, sleep disturbances, and burden, regardless of dementia severity, or duration alone. These findings highlight the need for targeted interventions to manage BPSD, which may help alleviate caregiver psychological distress and improve sleep quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857169","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":"Delirium in Elderly Hospitalized Patients: Analyzing Clinical and Social Determinants in a Colombian Retrospective Cohort","authors":"Alejandra Ospina-Lehmann,&nbsp;María Camila Castañeda-Gómez,&nbsp;Eduardo José Pabón-Martínez,&nbsp;Juan Pablo Vigoya-Aponte,&nbsp;Santiago Orozco-Castro,&nbsp;Diego Andrés Chavarro-Carvajal,&nbsp;Carlos Alberto Cano-Gutiérrez","doi":"10.1002/gps.70079","DOIUrl":"https://doi.org/10.1002/gps.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia, between June 2019 and June 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analytical study. Data were extracted from the hospital's electronic medical records. The primary outcome was delirium upon admission. Exposure variables included clinical (e.g., malnutrition, dementia, oropharyngeal dysphagia) and social factors (e.g., living alone, social networks). Associations between delirium and exposure variables were assessed using a multivariate logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The studied cohort comprised 4601 patients, mean age of 83.93 years and 56.26% were women. The prevalence of delirium upon admission was 22.39%. Key factors associated with delirium included older age (OR 1.04, 95% CI 1.01–1.06), malnutrition (OR 2.42, 95% CI 1.93–2.79), dementia (OR 2.57, 95% CI 2.02–3.38), functional impairment (OR 2.50, 95% CI 1.74–3.59), and oropharyngeal dysphagia (OR 1.49, 95% CI 1.08–1.99). Social determinants such as female sex, limited social networks, living alone, and enrollment in the subsidized health regime were not significantly associated with delirium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delirium upon admission is highly prevalent among elderly inpatients and is associated with clinical factors, particularly malnutrition, dementia, and oropharyngeal dysphagia. Although no significant associations were found between social determinants of health (SDH) and delirium in this cohort, further research in diverse healthcare settings is needed to better understand the broader impact of SDH on delirium risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852901","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":"Social Frailty and Social Isolation in the Context of Dementia: A Simultaneous Concept Analysis","authors":"Ziyue Wang,&nbsp;Dympna Casey,&nbsp;Duygu Sezgin","doi":"10.1002/gps.70074","DOIUrl":"https://doi.org/10.1002/gps.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Early management of risk factors related to social health such as social frailty and social isolation could modify the progression of dementia and reduce its impact on people with dementia. However, due to overlapping definitions and interchangeable use of measurement tools, the precise distinction between these two concepts is unclear. This simultaneous concept analysis aimed to examine the definitions and interrelationships between the concepts of social frailty and social isolation within the context of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The simultaneous concept analysis method developed by Haase et al. was employed. A literature search was conducted across six databases (Ovid Medline, CINAHL, PsycINFO, Scopus, Embase and Cochrane Library) to retrieve original research, review and theoretical papers, published in English. Data from the literature was synthesised and analysed thematically following Braun and Clarke's six steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The attributes of concepts of social frailty and social isolation overlap, including being alone and having limited or less social activities, engagements or interactions. The specific attributes of social frailty are financial difficulties and less talk while social isolation is distinctly marked by a lack of social networks or social relationships. Socio-economic welfare is a specific antecedent of social frailty, while decreased access to social resources and lower social well-being are distinctive consequences of social isolation. Cognitive decline and dementia are distinctive antecedents of social isolation; however, they also exist as shared consequences of both social frailty and social isolation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This simultaneous concept analysis clarified the similarities and differences between social frailty and social isolation in the context of dementia. A clearer understanding of the interrelationships between social frailty and social isolation and distinct and overlapping characteristics of them will support strategies to comprehensively address social health issues experienced by people with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849309","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 Cross Sectional and Longitudinal Assessment of Neuropsychiatric Symptoms and Brain Functional Connectivity in Patients With Mild Cognitive Impairment, Cerebrovascular Disease and Parkinson Disease","authors":"Neda Rashidi-Ranjbar,&nbsp;Nathan W. Churchill,&nbsp;Sandra E. Black,&nbsp;Sanjeev Kumar,&nbsp;Maria C. Tartaglia,&nbsp;Morris Freedman,&nbsp;Anthony Lang,&nbsp;Joel Ramirez,&nbsp;Gustavo Saposnik,&nbsp;Paula M. McLaughlin,&nbsp;Sean Symons,&nbsp;Bruce G. Pollock,&nbsp;Tarek K. Rajji,&nbsp;Michael Borrie,&nbsp;Mario Masellis,&nbsp;Stephen H. Pasternak,&nbsp;Andrew Frank,&nbsp;Dallas Seitz,&nbsp;Zahinoor Ismail,&nbsp;David F. Tang-Wai,&nbsp;Christopher J. M. Scott,&nbsp;Dar Dowlatshahi,&nbsp;Ayman Hassan,&nbsp;David G. Munoz,&nbsp;Luis Fornazzari,&nbsp;Corinne E. Fischer,&nbsp;Tom A. Schweizer","doi":"10.1002/gps.70075","DOIUrl":"https://doi.org/10.1002/gps.70075","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mild Behavioral Impairment (MBI) is characterized by later-life emergent and persistent neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a potential precursor to various forms of dementia. This study explores the association between NPS and functional connectivity (FC) of the default mode network (DMN), executive control network (ECN), and salience network (SN) across three cohorts: mild cognitive impairment due to AD (MCI), cerebrovascular disease (CVD), and Parkinson's disease (PD). Additionally, the effect of CNS medication on NPS-FC associations was explored.&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;Participants were recruited from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). NPS were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). We used dual regression to generate subject-specific whole-brain FC maps of the DMN, ECN, and SN. Using permutation testing we examined the association between NPS scores and FC maps at baseline (&lt;i&gt;n&lt;/i&gt; = 349) and over a 2-year period (&lt;i&gt;n&lt;/i&gt; = 225), controlling for age, sex, and years of education. A post-hoc linear model was used to assess the effect of CNS medication on each significant NPI-FC association within each group.&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;In the MCI group (&lt;i&gt;n&lt;/i&gt; = 73), baseline disturbed nighttime behavior was positively correlated with functional connectivity (FC) between the anterior sensorimotor network. Longitudinally (&lt;i&gt;n&lt;/i&gt; = 46), appetite changes were positively associated with FC between the anterior SN and fusiform gyrus. Disinhibition and apathy correlated with FC between the posterior SN and DMN. In the CVD group (&lt;i&gt;n&lt;/i&gt; = 144), baseline anxiety was negatively associated with FC within the DMN and between the right ECN and DMN in the left hippocampus. Longitudinally (&lt;i&gt;n&lt;/i&gt; = 99), agitation/aggression changes were negatively associated with FC between the right ECN and left anterior cerebellum. Irritability, the most common symptom in both MCI and CVD, did not have identifiable neural correlates, possibly due to its complexity or analysis limitations. In the PD group (&lt;i&gt;n&lt;/i&gt; = 132), baseline disturbed nighttime behavior was positively associated with FC between the right ECN and DMN in the precuneus and left ECN and fusiform gyrus. Longitudinally (&lt;i&gt;n&lt;/i&gt; = 80), changes in nighttime behavior correlated with FC between the left ECN and DMN in the precuneus. CNS medications had no effect on NPI-FC associations in the MCI group. In the CVD group, the absence of CNS medications was linked to decreased right ECN FC. In the PD group, Parkinson's ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846003","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":"Feasibility of Telephone-Based Cognitive Assessments and Healthcare Utilization in US Medicare-Enrolled Older Adults Following Emergency Department Discharge","authors":"Walter D. Dawson,&nbsp;Natasha Spoden,&nbsp;Sarah Gothard,&nbsp;Nora Mattek,&nbsp;Jeffrey Kaye,&nbsp;Kirsten Wright","doi":"10.1002/gps.70078","DOIUrl":"https://doi.org/10.1002/gps.70078","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Wider screening and assessment for Alzheimer's disease and other related dementias (ADRD) may increase access to supportive care, improve allocation of medical care, and foster the use of interventions that prevent or delay disease progression. Yet, the effect of diagnostic timing on clinical and utilization outcomes is poorly understood. Community-based settings such as a hospital emergency department (ED) may be an underrecognized opportunity to assess cognition and impacts on individuals and health systems. This study assessed the feasibility of recruiting older adults for telephone-based trials following presentation to the ED and administering telephone based cognitive assessments over the phone in this population.&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;Medicare-enrolled individuals 65+ years of age (&lt;i&gt;n&lt;/i&gt; = 160) presenting to the Oregon Health &amp; Science University Emergency Department (Portland, Oregon) between May 2022 and February 2023 were recruited by telephone. Participants were administered the Telephone Interview for Cognitive Status (TICS) Assessment and the Patient Reported Outcomes Measurement Information System (PROMIS) Cognitive Measure Questions on Mental Clarity via telephone 1–12 weeks post-discharge to evaluate cognition. Electronic medical records (EMR) were reviewed for medical care utilization including primary care provider (PCP) visits, hospital admissions, and ED visits for the 3 years prior to ED presentation.&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;Twenty-six percent of eligible ED users contacted elected for study enrollment. The TICS Assessment score had a significant relationship with the three evaluated health care utilization measures (ED, PCP visits, or hospitalizations); the PROMIS Assessment had significant but weak correlations to ED and PCP visits.&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;Older adults 65+ years presenting to the ED are amenable to enroll in telephone-based cognition-focused trials and cognitive assessments can be carried out over the telephone in this population. The PROMIS Assessment may be a better cognition assessment tool when evaluating for cognition and care utilization in this population. In addition to the limits of the screening tools used in this study, a lack of a representative sample is a limitation of the study design. Future studies could use other validated cognitive assessment tools and utilize a study design with a recruitment strategy focused on obtaining a representative sample of older ED patients.&lt;/p&gt;\u0000 ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840833","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":"Primary Care Provider Perspectives on Depression Management in Older Adults With Multimorbidity","authors":"Irina Mindlis,&nbsp;Dimitris Kiosses,&nbsp;M. Carrington Reid","doi":"10.1002/gps.70073","DOIUrl":"https://doi.org/10.1002/gps.70073","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840780","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}