International Journal of Geriatric Psychiatry最新文献

{"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}

{"title":"Effectiveness of Interventions to Support Carers of People With Dementia in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis","authors":"Frank Chen,&nbsp;Zhiwei Hu,&nbsp;Quan Li,&nbsp;Xuan Zheng,&nbsp;Meizhi Li,&nbsp;Maximilian Salcher-Konrad,&nbsp;Adelina Comas-Herrera,&nbsp;Martin Knapp,&nbsp;Cheng Shi,&nbsp;The STRiDE consortium","doi":"10.1002/gps.70054","DOIUrl":"https://doi.org/10.1002/gps.70054","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;Family and other carers of people with dementia can potentially benefit from training and support to reduce the negative impacts of caregiving and prevent harm to care recipients. While interventions for carers in low- and middle-income countries (LMICs) are emerging, their effectiveness is not well understood. Through a systematic review and meta-analysis, the objective was to evaluate the effectiveness of interventions to support carers of people with dementia in improving the well-being of carers and their care recipients in LMICs.&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;This review, registered with PROSPERO (CRD42018106206), built on a systematic mapping of dementia interventions in LMICs under the Strengthening Responses to Dementia (STRiDE) project. It analysed evidence on interventions to support carers in these regions. Title and abstract screening, full-text review, data extraction and risk of bias assessment were each conducted by two reviewers independently, with disagreements resolved through group discussion. Pairwise meta-analyses were conducted, with robustness tested via leave-one-out analysis. Heterogeneity was explored using subgroup analysis, meta-regression and MetaForest. Medline, Embase, Global Health and PsycINFO (via Ovid) and CINAHL (via EBSCO) databases were searched. We included randomised control trials focused on carer well-being in LMICs, 2008–2022. Primary outcomes were perceived burden and depression; other health-related quantitative outcomes were collected.&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;From 5228 records, 48 studies in English and Chinese were identified as eligible, reporting on 67 carer outcomes and 36 care recipient outcomes. Forty-one studies were at high risk of bias. Meta-analysis revealed statistically significant medium-to-large intervention effects on three key carer outcomes—perceived burden, depression, and anxiety—and on four major outcomes for people with dementia—neuropsychiatric symptoms, cognitive function, quality of life (QoL), and activities of daily living (ADL). These effects were larger than those typically observed in previous studies in high-income countries (HICs).&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;This review provides a comparative overview and summarises the characteristics of published interventions to support carers in LMICs. It reveals medium-to-large beneficial effects of the interventions on several key outcomes for carers and care recipients in LMICs. Future research employing more rigorous methodologies i","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513555","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":"Non-Pharmacological Interventions for People With Dementia Who Live Alone: A Systematic Review","authors":"Sarah Polack,&nbsp;Georgia Bell,&nbsp;Barbora Silarova,&nbsp;Molly Hebditch,&nbsp;Alison Tingle,&nbsp;Andrew Sommerlad,&nbsp;Elena Portacolone,&nbsp;Kath Sykes,&nbsp;Naji Tabet","doi":"10.1002/gps.70059","DOIUrl":"https://doi.org/10.1002/gps.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Approximately one third of people with dementia live on their own and they face an increased risk of unmet needs and loneliness. This systematic review aimed to identify and describe non-pharmacological interventions that have been evaluated for people with dementia living alone and to examine the effectiveness of these interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, six databases were systematically searched: MEDLINE, Embase, CINAHL, PsycINFO, Social Care online, and ClinicalTrials.gov. Studies that reported on the impact or experience of an intervention for people with dementia living alone in the community (not long-term care) and that had been published since 2000 were included in the review. No restrictions were applied in terms of study design or outcome measures. Study risk of bias was assessed, and a narrative approach was used to synthesize findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies of 13 different interventions were included, grouped into five intervention categories: home-based dementia case/care management (<i>n</i> = 4), technology (<i>n</i> = 3), social (<i>n</i> = 3), cognitive (<i>n</i> = 2) and psychological (<i>n</i> = 1). There was one randomized controlled trial (RCT), and two economic evaluations that used data from RCTs. Most other studies were small-scale, and only two were evaluated to have low risk of bias. Most studies reported positive or mixed findings in terms of the intervention's impact on the person with dementia or aspects of feasibility. However, studies were heterogeneous in terms of intervention, study design, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review of a limited body of research highlights the potential for interventions to support people with dementia who live alone. It also identifies key evidence gaps and the need for more robust and comparable research to better understand what works, why, for who, and how. Involving people with dementia who live alone in the design, implementation, and evaluation of these interventions will be crucial to ensure that their needs and preferences are met.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497120","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":"What Works Well for People With Dementia and Their Supporters From South Asian, African and Caribbean Communities in the UK: A Narrative Synthesis Systematic Review and Expert Consultations","authors":"Orii McDermott,&nbsp;Thea Sobers,&nbsp;Naaheed Mukadam,&nbsp;Abigail Rebecca Lee,&nbsp;Martin Orrell","doi":"10.1002/gps.70047","DOIUrl":"https://doi.org/10.1002/gps.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This review aims to synthesise the evidence regarding the use and provision of dementia services and support for people with dementia and/or supporters from South Asian, African or Caribbean backgrounds living in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative synthesis systematic review of the original research articles published up to April 2024 was conducted. A lay summary of the initial review findings was evaluated by experts-by-experience (<i>n</i> = 15) for scrutiny and to enable further discussions, to produce key recommendations for further developing dementia services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 18 studies (16 qualitative and 2 mixed methods studies) met the full inclusion criteria and were included in the review. The review findings and experts-by-experience consultations highlighted that: (1) dementia is not openly discussed or disclosed within many diverse ethnic communities. This can lead to family carers and people with dementia feeling isolated and unsupported. (2) Mainstream dementia support services and hospitals often do not meet diverse communities' cultural and religious needs, and (3) home-based care supported by external care agencies can be helpful but ensuring consistency of care staff in their culturally appropriate care can be extremely difficult to ensure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Encouraging South Asian, African and Caribbean communities to increase their dementia knowledge is important. However, mainstream dementia support services also need to incorporate their cultural and religious essentials into care packages to encourage their help seeking behaviours and tackle dementia stigma. Collaborative service developments between the diverse communities, Health and Social Care providers and policy makers are essential to ensure equitable and culturally appropriate dementia care for diverse community members in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497112","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":"Functional Connectivity Changes Associated With Depression in Dementia With Lewy Bodies","authors":"Manon Querry,&nbsp;Anne Botzung,&nbsp;Marion Sourty,&nbsp;Elena Chabran,&nbsp;Léa Sanna,&nbsp;Paulo Loureiro de Sousa,&nbsp;Benjamin Cretin,&nbsp;Catherine Demuynck,&nbsp;Candice Muller,&nbsp;Alix Ravier,&nbsp;Benoît Schorr,&nbsp;Nathalie Philippi,&nbsp;Frédéric Blanc","doi":"10.1002/gps.70058","DOIUrl":"https://doi.org/10.1002/gps.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Depressive symptoms are frequent in the early stages of dementia with Lewy bodies (DLB), and more than half of DLB patients would have a history of depression. Our study sought to investigate the functional connectivity (FC) changes associated with depressive symptoms in prodromal to mild DLB patients compared with controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MRI data were collected from 66 DLB patients and 18 controls. Depression was evaluated with the Mini International Neuropsychiatric Interview. Resting-state FC (rsFC) was investigated with the CONN toolbox using a seed-based approach and both regression and comparison analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Correlations were found between the depression scores and the rsFC between fronto-temporal and primary visual areas in DLB patients (<i>p</i> &lt; 0.05, FDR corrected). Depressed DLB patients also showed decreased rsFC within the salience network (SN), increased rsFC between the default mode network (DMN) and the language network (LN) and decreased rsFC between the cerebellar network (CN) and the fronto-parietal network (FPN) compared to non-depressed DLB patients (<i>p</i> &lt; 0.05, uncorrected). Comparison analyses between antidepressant-treated and non-treated DLB patients highlighted FC changes in treated patients involving the SN, the DMN, the FPN and the dorsal attentional network (<i>p</i> &lt; 0.05, uncorrected).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings revealed that depressive symptoms would especially be associated with rsFC changes between fronto-temporal and primary visual areas in DLB patients. Such alterations could contribute to difficulties in regulating emotions, processing biases towards negative stimuli, and self-focused ruminations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study is part of the cohort study AlphaLewyMA (https://clinicaltrials.gov/ct2/show/NCT01876459)</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497114","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":"Correction to Pre-Stroke and Early Post-Stroke Apathy Is Associated With Increased Risk of Dementia 3 Months After Stroke","authors":"","doi":"10.1002/gps.70062","DOIUrl":"https://doi.org/10.1002/gps.70062","url":null,"abstract":"<p>Lopatkiewicz AM, Slowik A, Dziedzic T. Pre-stroke and early post-stroke apathy is associated with increased risk of dementia 3 months after stroke. <i>Int J Geriatr Psychiatry</i>. 2023 Dec;38(12):e6043.</p><p>In the Table 1, information that scores of NPI-apathy, AES-C, NPI-depression and PHQ-9 are shown as <i>n</i> (%) is incorrect. These scores are expressed as mean (standard deviation).</p><p>We apologize for this error.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497113","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":"Attitudes and Preferences Towards Screening for Dementia From the Perspectives of Healthcare Professionals: An Updated Systematic Review","authors":"Ríona Mc Ardle,&nbsp;Abigail Dsouza,&nbsp;Alexander Hagan,&nbsp;Amani Al-Oraibi,&nbsp;Matilda Hanjari,&nbsp;Blossom C. M. Stephan,&nbsp;Carol Brayne,&nbsp;Louise Lafortune,&nbsp;Manpreet Bains,&nbsp;Nadeem Qureshi,&nbsp;Louise Robinson","doi":"10.1002/gps.70057","DOIUrl":"https://doi.org/10.1002/gps.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Approximately 55 million people are living with dementia globally. Global policies have suggested that screening for dementia in asymptomatic populations may support risk-reduction approaches to stem the rising numbers of people with the condition. A previous systematic review of literature up to 2012 indicated that healthcare professionals negatively view dementia screening; however, the research and clinical landscape has made significant advances in the last decade. Therefore, the aim of this systematic review is to re-examine the attitudes and preferences of healthcare professionals since 2012 regarding primary and community care-based dementia screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review was pre-registered on PROSPERO (CRD42024531455) and followed PRISMA guidelines. Key terms relevant to the aim were input into six databases, and articles between 2012 and 2024 were considered. Titles, abstracts and full texts were independently screened by two reviewers. Articles were eligible for inclusion if peer-reviewed, written in English, considered primary or community care-based dementia screening and included healthcare perspectives from either quantitative or qualitative methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 18,732 identified titles, 19 articles were included in this review. Seventeen studies presented perspectives from primary care practitioners. Key findings suggest that healthcare professionals have mixed views regarding their willingness to conduct dementia screening, although limited studies suggest an interest in engaging in dementia risk reduction. Common influences on perspectives included knowledge, skills and training; resource provision; access to a dedicated screening service and referral pathways; and stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that healthcare professionals' perspectives and resource are not aligned with international policies promoting dementia screening. When considering implementing evidence-based dementia screening in the future, a dedicated screening service is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455797","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":"Mapping the Numbers of Dementia in Brazil: A Delphi Consensus Study","authors":"Márlon Juliano Romero Aliberti,&nbsp;Claudia Kimie Suemoto,&nbsp;Jerson Laks,&nbsp;Paulo Caramelli,&nbsp;Sonia Maria Dozzi Brucki,&nbsp;Nicolas Farina,&nbsp;Daniel Apolinario,&nbsp;Einstein Francisco Camargos,&nbsp;Eleonora d'Orsi,&nbsp;Gilberto Sousa Alves,&nbsp;Karolina Gouveia César-Freitas,&nbsp;Luís Fernando Rangel,&nbsp;Márcia Lorena Fagundes Chaves,&nbsp;Marcos Antonio Lopes,&nbsp;Marcus Vinicius Della Coletta,&nbsp;Matheus Ghossain Barbosa,&nbsp;Norberto Anizio Ferreira Frota,&nbsp;Ricardo Nitrini,&nbsp;Cleusa Pinheiro Ferri","doi":"10.1002/gps.70055","DOIUrl":"https://doi.org/10.1002/gps.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>As the global dementia crisis intensifies, especially in low-and middle-income countries (LMICs), there is a pressing need for comprehensive prevalence data across diverse regions, including Brazil, where studies have been predominantly limited to affluent urban centers. This study aimed to conduct an expert consensus to determine the prevalence of all-cause dementia in Brazil, considering various age groups, sexes, and geographical areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi consensus process with clinical and academic experts from across Brazil was conducted to provide dementia prevalence estimates in people aged ≥ 60 years living throughout Brazil for 2019. Each round consisted of answering structured questionnaires that incorporated information from the literature. A priori criteria were used to ascertain the point in which consensus was achieved for &gt; 70% of the 15 prevalence estimates—for (1) total, (2) women and men, and (3) the five Brazilian macro-regions. The current and projected dementia cases in Brazil were calculated based on age and sex population distributions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen experts, with a mean professional experience of 25 ± 10 years, reached a consensus in the fourth round. Experts agreed with a mean all-cause dementia prevalence of 8.5% among Brazilians aged ≥ 60 years, which comprised 2.46 million people in 2019 in this age. They reported higher dementia rates in women (9.1%) than men (7.7%); the highest total prevalence was in those over 80 where it exceeds 20%. Regional variations were also noted, with lower prevalence in the South (7.3%) and higher in the North (8.9%) and Northeast (10.1%). Projections estimate that considering Brazil’s rapidly aging population, dementia cases will rise to 8.89 million by 2060.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This Delphi study estimated that dementia already affects roughly 1 in 12 older Brazilians aged 60 and above, with slightly higher prevalence in women and significant geographical variations. These results underscore the urgency for targeted public health strategies in Brazil and offer a framework for similar challenges in other LMICs, especially given that dementia cases are projected to increase by approximately 3.6 times in 4 decades.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397064","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 Incidence and Prevalence of Dementia Among Ontario Adults With and Without Intellectual and Developmental Disabilities","authors":"Prachi Patel,&nbsp;Winnie Sun,&nbsp;Andrea Mataruga,&nbsp;Kinwah Fung,&nbsp;Robert Balogh","doi":"10.1002/gps.70050","DOIUrl":"https://doi.org/10.1002/gps.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There are more than 66,000 Ontario adults living with intellectual and developmental disabilities (IDD). While the risk of dementia is well established among those with Down Syndrome (DS), there is limited research in persons with IDD excluding DS (Non-DS IDD). This study aimed to compare the incidence and prevalence of dementia in Ontario adults with and without IDD over time and by demographic information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Administrative data were used to calculate and compare the annual age- and sex-adjusted cumulative incidence and period prevalence of dementia from fiscal years 2011/12 to 2020/21 in three cohorts: (1) Non-DS IDD, (2) DS, and (3) No IDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to persons without IDD, cumulative incidence of dementia was on average 4.27 and 5.33 times higher in persons with Non-DS IDD and DS respectively and period prevalence of dementia was on average 4.87 and 5.93 times higher in persons with Non-DS IDD and DS respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Given the increased rates of dementia within the IDD population, it is imperative that early dementia screening take place, appropriate health and social services are implemented and more actions are taken to delay the onset of dementia, while considering the needs of this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396907","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":"Cost-Effectiveness of the Tailored Activity Programme for Person With Dementia-Caregiver Dyads: A Markov Model","authors":"Brenda Gannon,&nbsp;Vinh Vo,&nbsp;Laura N. Gitlin,&nbsp;Sally Bennett","doi":"10.1002/gps.70049","DOIUrl":"https://doi.org/10.1002/gps.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Tailored Activity Programme (TAP) is a home-based programme with compelling outcomes for reducing behavioural and psychological symptoms of dementia and functional decline. We conducted a cost-utility analysis of TAP compared to usual care, for the person with dementia and their caregiver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a Markov Model, from the healthcare sector perspective. Using parameters from the dementia care literature. Base-case and probabilistic sensitivity analyses were applied to handle uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Given the growing need for cost-effective dementia care, understanding the cost-effectiveness of TAP is crucial for health service design and its implementation into healthcare settings. Our study shows that TAP is cost-effective for both males and females with dementia and their caregivers. The most favourable cost-effectiveness acceptability curves were found in men and women with dementia, aged 50 to 70, with lower costs and higher QALYs compared to those over 80. The probability of TAP being cost-effective rises with public higher willingness-to-pay thresholds, especially for people with dementia in the age group of 50–70.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate TAP is highly cost-effective for individuals living with dementia compared to usual home care, which provides evidence for policy makers towards their decisions on resource allocation and for implementing TAP in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380164","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}