International Journal of Geriatric Psychiatry最新文献

{"title":"Identifying and Addressing Unmet Needs in Dementia: The Role of Care Access and Psychosocial Support","authors":"Annelie Scharf, Bernhard Michalowsky, Anika Rädke, Fabian Kleinke, Stefanie Schade, Moritz Platen, Maresa Buchholz, Michelle Pfaff, Audrey Iskandar, Neeltje van den Berg, Wolfgang Hoffmann","doi":"10.1002/gps.70066","DOIUrl":"https://doi.org/10.1002/gps.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>People with dementia often have various unmet care needs across physical, psychological, environmental, and social domains. There’s a need to explore the association between domains of unmet needs and characteristics of people with dementia. The aim of this paper was to describe the domains of unmet and met needs among community-dwelling people living with dementia, focusing on the home environment, physical, psychological, and social areas, and to identify sociodemographic, clinical, and health-related parameters associated with unmet needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the InDePendent trial’s baseline data of <i>N</i> = 417 people with dementia. The Camberwell Assessment of Needs for the Elderly (CANE) was used to identify needs. Descriptive statistics were used to evaluate the distribution of needs and Logistic and Poisson regression models to detect sociodemographic and clinical factors associated with unmet needs in the four need domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People with dementia were on average 80.6 years old, mostly female (56%) and mildly to moderately cognitively impaired (85%). 98.6% of the participants had at least one need, of which just over a third (36.5%) were rated as met and just under two-thirds (63.5%) as unmet. Lacking a care grade (access to social care) and low education were found to be risk factors for the occurrence of unmet needs in almost all areas. Factors such as increased medication use (OR = 1.10 [95%CI 1.02 to 1.19]) and loneliness (OR = 2.51 [95%CI 1.44 to 4.36]) were associated with a higher likelihood of unmet environmental needs. Similarly, the absence of a caregiver (OR = 2.81 [95%CI 1.03 to 7.64]), lower social support (OR = 1.71 [95%CI 1.02 to 2.84]), and poor physical health (OR = 8.40 [95%CI 3.39 to 20.81]) correlated with unmet physical needs. Participants living alone demonstrated higher levels of unmet physical needs (<i>β</i> = 0.27 [95%CI 0.01 to 0.53]). Depression (OR = 2.13 [95%CI 1.10 to 4.08]), living alone (OR = 1.73 [95%CI 1.04 to 2.86]) and poor physical health (OR = 2.82 [95%CI 1.15 to 6.93]) significantly increased the risk of unmet psychological needs. Social needs are more likely to be unmet in females (OR = 1.88 [95%CI 1.05 to 3.37]). Sensitivity analyses showed the positive effects of regular General Practitioner (GP) visits on the fulfillment of social needs (<i>β</i> = −0.61 [95%CI −1.01 to −0.22]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Access to comprehensive care, for example, throug","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717260","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":"Suicide Among Older People in Spain: The Role of Sex and Urbanicity","authors":"Gabriel Jesús Rodríguez-Rodríguez,&nbsp;Gonzalo Martínez-Alés,&nbsp;Teresa López-Cuadrado","doi":"10.1002/gps.70071","DOIUrl":"https://doi.org/10.1002/gps.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Suicide rates are driven by availability of lethal means, increase with age, and are often higher in rural versus urban areas. This study examines temporal and geographic variations in suicides among elderly with a focus on rural-urban differences in method-specific suicide rates among people aged 65 and older in Spain, a rapidly aging country.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based study including all suicides among people over 65 in Spain between 2010 and 2022. We examined overall and method-specific suicide rates and their temporal and geographical variation, stratifying results by sex and urbanicity level. Time trends were estimated via joinpoint regression. Maps were created to analyze the geographical distribution of suicide rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While 2010–2022 suicide rates in people aged 65 and older remained largely stable overall, they increased by an annual 2.6% for women living in urban areas. The most common suicide methods were hanging for men living in rural and urban areas (68.5% and 47.3%, respectively) and for women living in rural areas (42.1%); for women living in urban areas jumping was the modal suicide method (46.9%). Method-specific trend analyses revealed recent increases in male suicide by poisoning and hanging in rural areas, decreases in male suicide by hanging and increases in male suicide by jumping in urban areas, and increases in female suicide by poisoning and jumping in urban areas. We identified and mapped remarkable geographic variation in overall and sex-specific suicide rates across Spain's regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results, highlighting recent increases in female suicides in urban areas and in specific method-specific male suicides both in rural and urban areas, and demonstrating geographical variation across regions, should help guide targeted suicide prevention efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690007","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":"Exploring Socio-Economic Differences and Developer Medical Involvement of Dementia-Related English Version Mobile Health Applications","authors":"Tzu Han Chen,&nbsp;Wei-Fen Ma","doi":"10.1002/gps.70064","DOIUrl":"10.1002/gps.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The rise of mobile health interventions offers significant potential to improve the well-being of the aging global population, particularly individuals at an increased risk of dementia. To fully leverage this potential, it is crucial to evaluate the mobile health applications across different demographic and socio-economic landscapes. This study investigated the relationship between a country's development status and the quality of dementia-focused mobile health applications, as well as the influence of developers' medical expertise on app quality and perceived impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational design study utilized the uMARS tool to evaluate the objective and subjective quality of dementia-related mobile health applications. Objective quality was assessed across engagement, functionality, aesthetics, and information domains, while subjective quality included user recommendations, anticipated usage, and perceived impact. A stratified random sampling method selected 17 apps for evaluation, and inter-reviewer reliability was confirmed (Kendall's <i>W</i> = 0.143, <i>p</i> = 0.045). Data analysis involved descriptive statistics, independent sample <i>t</i>-tests, and Pearson's correlation coefficients, with statistical significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 51 dementia-related mobile health app analyzed, only one was developed in a low-income country. Additionally, this study found a linear correlation between the perceived impact of a mobile health app for dementia and the medical background of the development team, with a Pearson correlation coefficient of <i>t</i> = 3.708 (<i>p</i> &lt; 0.001). Engagement was highly correlated with subjective quality (Pearson correlation coefficient <i>r</i> = 0.955, <i>p</i> &lt; 0.001), and there was a strong correlation between the information provided by the apps and the perceived impact (Pearson correlation coefficient <i>r</i> = 0.884, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The adoption of mobile health apps must be prioritized to assist individuals with dementia and their caregivers in low income countries. Future apps should focus on improving engagement and involving medical experts in development to increase credibility and utilization across socioeconomic levels and healthcare systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673770","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":"Changes in the Disease Burden of Depressive Disorders Among Middle-Aged and Older Adults (Aged 45–89) in China Over 30 years: Insights From the Global Burden of Disease Study 2021","authors":"Yu Xiao,&nbsp;Ting-ting Chen,&nbsp;Zhou Zhang,&nbsp;Liang Liu,&nbsp;Na Du","doi":"10.1002/gps.70069","DOIUrl":"https://doi.org/10.1002/gps.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In China, depressive disorder (DD) among middle-aged and older adults is a significant public health concern. This research utilized the latest Global Burden of Disease Study (GBD) database to evaluate the evolving disease burden of DD in this demographic over the past 3 decades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on the incidence and disability-adjusted life years (DALY) of DD among people aged 45–89 in China between 1992 and 2021 were collected from the GBD 2021. The age-period-cohort (APC) model was applied to determine the effects of age, period, and cohort on the incidence and DALY rates of DD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>(1) Over the last 30 years, there was a 6.49% increase in the overall age-standardized incidence rate (ASIR) and a 3.99% increase in age-standardized DALY rates (ASDR) for DD among middle-aged and older adults in China, with females consistently exhibiting higher ASIR and ASDR than males. In 2020, COVID-19 significantly increased the ASIR and ASDR of DD in the population, especially in females. (2) The APC analysis revealed an annual net drift of 0.38% in incidence and 0.17% in DALY rate. For both genders, local drifts of incidence were negative for the 45–54 age group and positive for the 55–89 age group; DALY rates showed negative local drifts for the 45–59 age group and positive for the 60–89 age group. (3) Incidence and DALY rates increased with age, displaying a trend of initial decline followed by an increase in period effects, but a trend of initial increase followed by a decrease in cohort effects. Moreover, the impacts of age, period, and cohort exhibited gender differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings provide a comprehensive and in-depth perspective for studying the changing trends of DD’s burden in China and for identifying targeted prevention and treatment policies for DD from different aspects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632671","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":"Determining the Psychometric Properties of the Turkish Version of the Positive Caregiving Experience Scale in Dementia","authors":"Mükerrem Kabataş Yıldız,&nbsp;Ayşe Çal","doi":"10.1002/gps.70063","DOIUrl":"https://doi.org/10.1002/gps.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Caring for individuals with dementia presents significant challenges for caregivers. However, positive experiences such as personal growth and emotional satisfaction play a vital role in fostering resilience and improving caregiving outcomes. This study highlights the need for a culturally relevant tool to assess these positive feelings, focusing on the adaptation and validation of the Dementia Caregiver Positive Feeling Scale for Turkish caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to carry out the Turkish validity and reliability study of the 21-item Dementia Caregiver Positive Feeling Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This methodological study was conducted between February and December 2023 with 200 caregivers of dementia patients receiving treatment at the education and research hospital in Samsun, Türkiye. Data were collected using an individual information form and the 21-item Dementia Caregiver Positive Feeling Scale. Data analysis was performed using SPSS 22.0 and Amos 22.0 software. Cronbach's alpha reliability coefficient was calculated, and exploratory factor analysis and confirmatory factor analysis were conducted to test the construct validity of the scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of caregivers was 45.18 ± 12.02 (min = 18, max = 78), and 78.0% were female. The average caregiving duration was 4.07 ± 3.00 (1–18) years. The total Cronbach's alpha value of the scale is 0.80. Exploratory factor analysis revealed a KMO coefficient of 0.756 and a Bartlett's test result of <i>χ</i>² = 960.382, <i>p</i> &lt; 0.001. Factor loadings ranged from 0.32 to 0.61 and the total variance explained was 47.232. Confirmatory factor analysis supported the scale's 20-item, four-factor structure, with fit indices indicating an acceptable model fit: RMSEA 0.07, GFI 0.85, AGFI 0.80, CFI 0.77 and <i>χ</i>2/sd 2.15 (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Dementia Caregiver Positive Feeling Scale has been determined to be a valid and reliable instrument for the Turkish community. It serves as a valuable tool that can be used in research evaluating the positive experiences of caregivers of dementia patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622336","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":"Dementia in Turkey–Physician's Perspectives on Facilitating and Challenging Aspects in the Diagnostic Process","authors":"Till Neugebauer,&nbsp;Patrick Brzoska,&nbsp;Hilal Özcebe,&nbsp;Yüce Yilmaz-Aslan","doi":"10.1002/gps.70068","DOIUrl":"https://doi.org/10.1002/gps.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Facilitating and challenging aspects of a non-linear diagnostic process of dementia were explored in interviews with physicians from outpatient clinics of a major hospital in Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with 15 physicians between March and April 2023. Purposive sampling was used to identify clinics that perform dementia diagnostics, including neurology, geriatrics, and psychiatry outpatient clinics. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Facilitating and challenging aspects were perceived on three levels: (1) diagnostic procedures and methods, which focus on the assessment of dementia and the aspects that arise in the process; (2) communication, which describes the verbal and nonverbal relationships between health care professionals, patients, and their caregivers, as well as their communication styles; (3) care environment, which describes the various environmental influences on patients, both on a sociocultural and institutional level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diagnostic process for dementia involves several interrelated aspects, making a flexible, holistic approach essential. In this study, the social and cultural context of the patients and the involvement of the family emerged as crucial elements. By integrating these aspects, along with a mix of informal and formal communication between healthcare providers and families, the diagnostic process can become more patient-centered and effective. To further improve outcomes, raising awareness and providing education about dementia could reduce stigma and encourage earlier recognition and better management of the condition during the diagnostic process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622335","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":"Norms of Hong Kong Brief Cognitive Test and the Utility for Screening Cognitive Impairment Among Chinese Older Adults","authors":"Yaonan Zheng,&nbsp;Jiahui Zhu,&nbsp;Nan Li,&nbsp;Minyue Pei,&nbsp;Helen F. K. Chiu,&nbsp;Shuping Tan,&nbsp;Xijin Wang,&nbsp;Yan Xia,&nbsp;Chengbing Huang,&nbsp;Yong Zeng,&nbsp;Sha Liu,&nbsp;Yi Li,&nbsp;Shaohong Zou,&nbsp;Yanchi Zhang,&nbsp;Shaohua Hu,&nbsp;Luoyi Xu,&nbsp;Yanhui Cai,&nbsp;Daxing Wu,&nbsp;Hui Zeng,&nbsp;Guoqing Jiang,&nbsp;Chuan Shi,&nbsp;Huali Wang,&nbsp;Xin Yu","doi":"10.1002/gps.70056","DOIUrl":"https://doi.org/10.1002/gps.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To establish the norms of the Hong Kong Brief Cognitive Test (HKBC) among Chinese older adults and to examine its utility for differentiating neurocognitive disorders from cognitively normal controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two thousand three hundred twelve participants aged 40 years and above were recruited from six regions of China as the norm construction sample. 93 normal participants and 246 cognitive impairment patients were included for diagnostic test of HKBC. Based on the multinomial regression model, which analyzed the relationship between HKBC score and demographic information, the norm of HKBC score and converted T score (HKBC-T) were constructed. The ROC curve of HKBC-T was depicted to calculate the optimal cutoff value of screening cognitive impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed that HKBC score was negatively correlated with age (SE = −5.48, <i>p</i> &lt; 0.001) and positive correlation with education (SE = 1.53, <i>p</i> &lt; 0.001), with no significant association with gender and living area. The AUC value of HKBC-T is 0.85 in distinguishing cognitive impairment and normal older adults. The optimal cutoff value was 45.79 points, achieving a sensitivity of 91.4% and a specificity of 66.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age and education must be adjusted when creating the HKBC norms. The HKBC-T is promising in detecting cognitive impairment at the population level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622479","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":"Economic Implications of Off-Road Cycle Lanes to Increase Physical Activity and Reduce Sex and Gender Differences in the Risk of Dementia","authors":"Magdalena Walbaum,&nbsp;Elisa Aguzzoli,&nbsp;Laura Castro-Aldrete,&nbsp;Eva Cyhlarova,&nbsp;Antonella Santuccione Chadha,&nbsp;Martin Knapp","doi":"10.1002/gps.70067","DOIUrl":"https://doi.org/10.1002/gps.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dementia represents one of the greatest global health challenges. There are known risk factors that might prevent or delay nearly 50% of the different types of dementia. There are substantial differences in risk factors and progression of dementia between women and men, including engagement in regular physical activity. The study aimed to quantify the impact of increasing women's participation in physical activity with off-road cycles and its effect on dementia incidence, relative to men and the associated health and social care costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our study employed a population model with secondary data analysis approach to investigate the potential economic effect of implementing off-cycle lanes in the UK. Data were drawn from published evidence on lifetime risk of dementia relative to physical activity in men and women for the UK population, levels of physical activity in the UK, evidence on the effectiveness of off-road cycle lanes in increasing the level of physical activity in men and women, lifetime costs of dementia in the UK. Two scenarios were compared, assuming an increase from the baseline levels of cycling of 40.3% and 114% for women and by 36.4% and 77% for men, respectively. Sensitivity analysis was conducted to account for variations in key variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Current dementia related lifetime costs were estimated at £1090.1 billion, and total lifetime costs £3326.1 billion. Under Scenario 1, dementia related lifetime costs decreased by £4.7 billion, and total lifetime costs by £0.11 billion. In Scenario 2, dementia related lifetime costs decreased by £7.0 billion, and total lifetime costs by £1.9 billion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Off-road cycle lanes, especially for women, this type of structural and lifestyle intervention has the potential to bring health and economic benefits. Increased physical activity not only provides numerous health benefits, but also contributes to preventing the onset and lifetime costs of dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595238","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":"Brain Signatures of Very Early Cognitive Decline in Asymptomatic Middle-Aged Offspring of People With Alzheimer's Disease","authors":"Nadia Ramsingh,&nbsp;Hung-Mo Lin,&nbsp;Yuxia Ouyang,&nbsp;Ramit Ravona-Springer,&nbsp;Abigail Livny,&nbsp;Laili Soleimani,&nbsp;Barbara B. Bendlin,&nbsp;Adar Matatov,&nbsp;Tal Niv,&nbsp;Tamar Shamir,&nbsp;Ithamar Ganmore,&nbsp;Anthony Heymann,&nbsp;Mary Sano,&nbsp;Joseph Azuri,&nbsp;Michal Schnaider Beeri","doi":"10.1002/gps.70060","DOIUrl":"https://doi.org/10.1002/gps.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the relationship of subtle preclinical cognitive changes with white matter microstructure and cortical volume in middle-aged adults at high AD risk due to a parental history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 278) were AD patients' offspring from the Israel Registry for Alzheimer's Prevention study. Cognitively unimpaired-decliners (CU-D) were based on a linear regression model. In a subsample with MRI (<i>n</i> = 220), we examined relationships of CU-D with white matter (WM) microstructure (fractional anisotropy [FA] and mean diffusivity [MD]) and cortical volume in brain regions commonly affected in AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CU-D participants had lower FA in the superior longitudinal fasciculus (SLF) (<i>p</i> = &lt; 0.001) and higher MD in the SLF (<i>p</i> = &lt; 0.001), and cingulum adjacent to the corpus callosum (<i>p</i> = &lt; 0.001) and genu (<i>p</i> = 0.006) compared to cognitively unimpaired-stable (CU-S) participants. The groups did not differ in cortical brain volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CU-D participants had poorer WM microstructure in brain tracts affected early in AD. Early interventions can target individuals that fit the CU-D criteria.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143564826","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":"Changes in Loneliness, Social Isolation, and Social Support: A Gender-Disaggregated Analysis of Their Associations With Dementia and Cognitive Decline in Older Adults","authors":"Htet Lin Htun,&nbsp;Achamyeleh Birhanu Teshale,&nbsp;Haoxiong Sun,&nbsp;Joanne Ryan,&nbsp;Alice J. Owen,&nbsp;Robyn L. Woods,&nbsp;Raj C. Shah,&nbsp;Trevor T.-J. Chong,&nbsp;Rosanne Freak-Poli","doi":"10.1002/gps.70065","DOIUrl":"https://doi.org/10.1002/gps.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Limited evidence exists on the gender-specific impact of changes in loneliness, social isolation, and social support on dementia risk. We examined these changes and their relationships with dementia and cognitive decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from over 12,000 community-dwelling Australians aged 70+ years without significant cognitive impairment at enrolment were analysed. Loneliness, social isolation, and social support were self-reported at baseline and ∼2 years later (social isolation and social support) or ∼3 years later (loneliness), classified as never, transient, incident, or persistent. Dementia diagnosis followed <i>DSM-IV</i> criteria, adjudicated by an expert panel. Gender-disaggregated Cox proportional hazards regressions were conducted, adjusting for age and other dementia risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, participants were aged 70–95 years (mean: 75.2 ± 4.3), with 54% being women. Overall, 81.1% of men and 71.7% of women reported never feeling lonely at baseline, while transient, incident, and persistent loneliness were experienced by 4.9%, 8.4%, and 5.5% of men and 8.5%, 11.6%, and 8.3% of women, respectively. Over a median 8-year follow-up, incident loneliness in men (HR: 1.52, 95% CI: 1.08–2.13) and persistent loneliness in women (HR: 2.14, 95% CI: 1.55–2.97) were associated with a greater dementia risk, compared to those who were never lonely. No increased risk was observed for transient loneliness. Despite the remarkably low prevalence of social isolation and poor social support in this initially healthy cohort, both were associated with cognitive decline (secondary outcome) but not with dementia risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Persistent loneliness in people aged 70+, especially in women, was associated with a higher risk of dementia and cognitive decline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554322","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}