International Journal of Geriatric Psychiatry最新文献

{"title":"Loneliness and Suicidality Among Older Korean Adults During the COVID-19 Pandemic: The Mediating Role of Depressive Symptoms","authors":"Jiyoung Lyu","doi":"10.1002/gps.70016","DOIUrl":"10.1002/gps.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, the loneliness of older adults increased. Since loneliness and depressive symptoms may contribute to the development of suicidality, the pathways between loneliness, depressive symptoms, and suicidality should be examined more in depth. Therefore, the purpose of this study was to investigate the relationship between loneliness and suicidality among older Korean adults during the COVID-19 pandemic, and to explore whether it is mediated by depressive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data used for this study was “2020 Chuncheon Elderly Life Survey,” and a total of 1200 adults aged 65 and over were included in the analysis. Suicidality was measured with the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS). Loneliness was measured with the UCLA 3-item Loneliness Scale, and depressive symptoms were measured with the Short form of Geriatric Depression Scale (SGDS). The mediating effect was tested using the PROCESS macro version 4.2 for SPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adjusted for covariates, the indirect effect (path of loneliness to suicidality via depressive symptoms) was statistically significant, but the direct effect of loneliness on suicidality was not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that loneliness is associated with depressive symptoms which in turn explain suicidality among older Korean adults during the COVID-19 pandemic. Further research is required to understand the mechanisms underlying this.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619419","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":"Depression Treatment Trajectories and Associated Social Determinants: A Three-Year Follow-Up Study in 66,540 Older Adults Undergoing First-Time Depression Treatment in Denmark","authors":"Kazi Ishtiak-Ahmed,&nbsp;Christopher Rohde,&nbsp;Ole Köhler-Forsberg,&nbsp;Kaj Sparle Christensen,&nbsp;Christiane Gasse","doi":"10.1002/gps.70006","DOIUrl":"10.1002/gps.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group-based trajectory approach, and explore associated social determinants in older adults undergoing first-time depression treatment during a 3-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This Danish register-based cohort study included all adults aged ≥ 65 who initiated depression treatment by redeeming first-time antidepressant prescriptions (no prescriptions in the last 10 years) between 2006 and 2015. The outcome of interest during the 2-year follow-up was depression treatment, assessed as antidepressant prescriptions redemptions and psychiatric hospital contacts for depression. Latent class growth analyses were applied to model treatment trajectories during 3 years. Multinomial logistic regression analyses were used to analyze adjusted associations between social determinates and trajectory group membership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 66,540 older adults (55.2% females, mean age: 77.3 years), we identified three distinct groups with unique patterns of depression treatment trajectories: ‘brief-treatment’ where individuals stopped depression treatment within 6 months (33.7%); ‘gradual-withdrawal’ (26.5%) where treatment was gradually stopped over 2 years; and ‘persistent-treatment’ where individuals continued depression treatment for the entire 3 years (39.8%). Females, single-person households, and residents of less-urbanized regions were associated with higher odds of membership in the ‘persistent-treatment’ group, while older age, widowhood or separation, and non-Danish ethnicities were associated with lower odds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Three distinct patterns of depression treatment trajectories were identified in older adults, indicating differential clinical courses of depression—potentially influenced by social determinants, including sex, marital status, urban residence, and ethnicity. Early patient stratification and targeted interventions are crucial in depression care for older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563642","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":"ApoE Gene Polymorphism and Clinical, Biochemical, and Sociodemographic Characteristics of Alzheimer's Disease Patients From Northern and Southern Regions of Kazakhstan.","authors":"Gulnaz Zholdasbekova, Aiym Kaiyrlykyzy, Aliya Kassenova, Dinara Alzhanova, Dmitry Klyuev, Sholpan Askarova","doi":"10.1002/gps.70019","DOIUrl":"10.1002/gps.70019","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is the most frequent cause of dementia in seniors and is also one of the critical social issues of modern healthcare. Since AD is considered a multifactorial disease, the significance of particular risk factors in different ethnic populations is constantly reevaluated.</p><p><strong>Method: </strong>The study group consisted of 181 patients with AD, and the control group included 244 healthy seniors comparable in sex and age to the dementia group. Our study compared clinical data, blood biochemical parameters, various sociodemographic characteristics, and ApoE gene polymorphism in patients diagnosed with AD from Kazakhstan's north (Astana city) and south (Almaty city) regions.</p><p><strong>Results: </strong>In our cohort, significant dementia-associated variables included smoking, clinically significant depression, dyslipidemia, impaired glucose metabolism, insulin resistance, and liver dysfunction. Notably, AD patients had higher HDL levels, lower ALT levels, and higher total bilirubin and AST/ALT ratios. The ApoE ɛ4 genotype, a well-known AD risk factor, was more prevalent in the northern AD group. Additionally, participants from Astana city had a higher incidence of strokes, potentially linked to elevated LDL levels, while Almaty city residents exhibited a higher prevalence of clinically severe depression.</p><p><strong>Discussion: </strong>These findings underscore the importance of considering bio-geographic and environmental factors in AD research. The study's outcomes may aid in further research and the development of personalized approaches for managing and treating AD in distinct geographical regions.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":"e70019"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681788","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":"Real-World Use of Trazodone in Older Persons in Long Term Care Setting: A Retrospective Study","authors":"Alessandra Coin,&nbsp;Alba Malara,&nbsp;Marianna Noale,&nbsp;Caterina Trevisan,&nbsp;Maria Devita,&nbsp;Angela Marie Abbatecola,&nbsp;Pietro Gareri,&nbsp;Stefania Del Signore,&nbsp;Giuseppe Bellelli,&nbsp;Stefano Fumagalli,&nbsp;Fabio Monzani,&nbsp;Enrico Mossello,&nbsp;Stefano Volpato,&nbsp;Gianluca Zia,&nbsp;Raffaele Antonelli Incalzi,&nbsp;the GeroCovid Observational Working Group","doi":"10.1002/gps.70009","DOIUrl":"10.1002/gps.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trazodone, an antidepressant drug is also largely used in several medical contexts. Insomnia, behavioral disorders, and anxiety may be underlying symptoms for prescribing trazodone. This cross-sectional study aims to identify reasons for trazodone prescription, assess the efficacy, as well as identify any related side effects in older persons living in long term care facilities (LTCFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Older adults aged ≥ 60 years, at risk of or affected with Covid-19 and enrolled in the GeroCovid Observational study from LTCFs, and using trazodone were included. A structured questionnaire was administered to treating physicians regarding reasons for trazodone prescription, discontinuation, possible adverse events and benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-seven out 74 LTCFs participating in both the GeroCovid and GeroCovid Vax studies completed the questionnaire regarding trazodone use. Of the 427 participants included in this study analysis, we found that 43% had diagnoses of dementia and depression, 33% had dementia, no behavioral and psychological symptoms of dementia (BPSD) and no depression, 14% had dementia with BPSD and no depression, and &lt; 11% had only depression. The main reasons for trazodone prescription included agitation, insomnia, depression and anxiety. Trazodone use was reported as partially or totally effective in more than 90% of participants using the drug. Falls were the most frequent adverse event (30% of participants).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data suggest that trazodone behaves as an eclectic antidepressant that, in the clinical practice, may also be used for BPSD and insomnia, especially in older people with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557815","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":"Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study","authors":"Matthias Hoben,&nbsp;Shovana Shrestha,&nbsp;Hana Dampf,&nbsp;David B. Hogan,&nbsp;Kimberlyn McGrail,&nbsp;Jennifer Knopp-Sihota,&nbsp;Colleen J. Maxwell","doi":"10.1002/gps.70005","DOIUrl":"10.1002/gps.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Resident pain has been a common quality challenge in congregate care for older adults, and organizational context may explain variations in resident pain beyond resident-level factors. Most studies have focused on nursing homes (NHs), largely neglecting assisted living (AL). AL residents are at similar risk for pain as NH resident, but with AL providing fewer services and staffing resources. Our objective was to examine whether organizational context in AL was associated with resident pain during the first two waves of the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This repeated cross-sectional study linked AL home surveys, collected in COVID-19 waves 1 (March–June 2020) and 2 (October 2020–February 2021) from a key contact, to administrative Resident Assessment Instrument-Home Care (RAI-HC) records in these homes. Surveys assessed preparedness for COVID-19 outbreaks, availability of a registered nurse or nurse practitioner, direct care staff shortages, decreased staff morale, COVID-19 outbreaks, confinement of residents to their rooms, supporting video calls with physicians, facilitating caregiver involvement. The dependent variable (moderate daily pain or pain of a severe intensity) and resident covariates came from the RAI-HC. Using general estimating equations, adjusted for repeated resident assessments and covariates, we assessed whether AL organizational context was associated with resident pain during the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 985 residents in 41 facilities (wave 1), and 1134 residents in 42 facilities (wave 2). Pain prevalence [95% confidence interval] decreased non-significantly from 20.6% [18.6%–23.2%] (March–June 2019) to 19.1% [16.9%–21.6%] (October 2020–February 2021). Better preparedness (odds ratio = 1.383 [1.025–1.866]), confinement of residents to their rooms (OR = 1.616 [1.212–2.155]), availability of a nurse practitioner (OR = 0.761 [0.591–0.981]), and staff shortages (OR = 0.684 [0.527–0.888]) were associated with resident pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AL organizational context factors were associated with resident pain. Policy and management interventions can and must address such factors, providing potentially powerful levers for improving AL resident quality of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545358","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":"Impact of Neuropsychological Assessment on Subjective Memory Complaints in Patients With Mild Cognitive Impairment","authors":"Ricardo Anjos,&nbsp;Nuno Madruga,&nbsp;Sandra Cardoso,&nbsp;Ben Schmand,&nbsp;Manuela Guerreiro,&nbsp;Alexandre de Mendonça,&nbsp;Filipa Ribeiro","doi":"10.1002/gps.70007","DOIUrl":"10.1002/gps.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with Alzheimer's disease (AD), namely at an initial stage like amnestic cognitive impairment (aMCI), typically present with memory complaints. They also have difficulties regarding self-knowledge about their cognitive deficits. In clinical practice, a formal neuropsychological assessment is often done. The present study aimed to understand whether patients with aMCI retain the ability to monitor the success or failure in their performance during the neuropsychological assessment and adjust the report of memory complaints accordingly, as compared to healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were patients with aMCI and healthy controls who were questioned about their own memory abilities using the Subjective Memory Complaints (SMC) scale, applied before and after the neuropsychological assessment protocol. A repeated measures General Linear Model was performed to analyze changes in SMC (within-subjects effects) after the neuropsychological assessment, in patients with aMCI and healthy controls (between-subjects effects).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty volunteers, 40 patients with aMCI and 40 healthy controls, participated in the study. Patients with aMCI showed lower MMSE scores, more depressive symptoms, and deficits in memory and learning, language and executive domains. Patients with aMCI had higher SMC scores [9.4(3.6)] than healthy controls [4.4(2.3)] before the neuropsychological assessment. A statistically significant interaction was found between the SMC and the diagnostic group, meaning that healthy controls decreased SMC [3.4(1.9)] after the neuropsychological assessment, whereas patients with aMCI kept high levels of SMC [9.6(3.9)]. In patients with aMCI, an inverse correlation between logical memory and the change in SMC was found, so that patients with lower scores in the logical memory test tended to increase their memory complaints after the assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both patients with aMCI and healthy controls can monitor and update the impression about their memory abilities following a formal neuropsychological assessment. Patients with aMCI maintain a high SMC level, which is inversely associated with their memory performance. In practical terms, SMC should be measured consistently at a particular moment in time, preferably preceding the objective neuropsychological assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545359","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":"A Systematic Review on the Evidence of Misdiagnosis in Dementia and Its Impact on Accessing Dementia Care","authors":"Clarissa Giebel,&nbsp;Wagner Silva-Ribeiro,&nbsp;James Watson,&nbsp;Anna Volkmer,&nbsp;Ilaria Chirico,&nbsp;Ana Diaz,&nbsp;Bronte Heath,&nbsp;Kerry Hanna,&nbsp;Catherine Talbot","doi":"10.1002/gps.6158","DOIUrl":"10.1002/gps.6158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Whilst there is a drive to increase diagnosis rates in dementia, there is a lack of attention on getting a correct and timely subtype diagnosis. For people with a rarer subtype of dementia, getting the correct diagnosis, and subsequent care, might be more difficult than for people aged 65+ presenting with the more common symptoms of Alzheimer's disease dementia. Thus, the aim of this mixed-method systematic review was to synthesise the evidence base on misdiagnosis of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Misdiagnosis in dementia was defined as either receiving an initial incorrect dementia subtype diagnosis or receiving an incorrect non-dementia diagnosis. Post-mortem assessments of subtype diagnosis were excluded. Nine databases were searched in June 2023, with screening of titles and abstracts and consequent full texts completed independently by two researchers. Findings were synthesised using narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty studies were included. Studies were categorised into four themes: (i) Factors associated with delayed diagnosis or misdiagnosis; (ii) Difficulties related to the diagnostic process; (iii) Economic consequences of misdiagnosis; and (iv) Experiences of delayed diagnosis or help-seeking. People with Lewy Body dementia or behavioural variant fronto-temporal dementia were found to experience longer diagnosis times and often incorrect initial diagnoses. Whilst evidence is limited regarding the economic impacts, evidence from the US points towards increased economic costs of misdiagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is an urgent need to investigate the rates and emotional and economic impacts of misdiagnosis on people with dementia, their carers, and the health and social care system. Advancing the evidence base is crucial to reduce misdiagnosis and inform clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499959","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":"Health Profile Transitions and the Association With Cognitive Impairment in Older Nursing Home Residents With Suicidal Ideation","authors":"Yiyang Yuan,&nbsp;Adrita Barooah,&nbsp;Kate L. Lapane,&nbsp;Deborah Mack,&nbsp;Anthony J. Rothschild,&nbsp;Christine M. Ulbricht","doi":"10.1002/gps.70003","DOIUrl":"10.1002/gps.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In older U.S. nursing home residents with suicidal ideation (SI), limited studies have longitudinally investigated their health changes as related to cognitive function. This study aimed to identify the health profiles and the transitions between profiles at admission and 90-days and examine the associations with cognitive impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using Minimum Data Set 3.0 (2011–15), we identified 10,079 older residents without severe cognitive impairment who reported SI on Patient Health Questionnaire-9. Health profile indicators included at-admission and 90-day post-admission depressive symptoms, frailty, and pain frequency and intensity. Using latent transition analysis, we identified distinct health profiles, examined the transitions between profiles over time, and estimated their associations with cognitive impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One third of residents continued to report SI at 90 days. The five health profiles identified at admission were distinctive with varying levels of frailty, depressive symptoms, and pain, from the most severe Profile 1 characterized by frailty, all depressive symptoms, and horrible or frequent pain, to the least severe Profile 5 characterized by pre-frailty, depressed mood, and no pain. The 90-day profiles were mostly consistent. Most residents remained in a similar profile over time. Relative to residents with intact cognition/mild cognitive impairment, those with moderate impairment were less likely to belong to profiles characterized by more depressive symptoms and pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Residents with SI had heterogeneous health profiles, which varied by cognitive impairment levels, but showed minimal changes despite being in a medically supervised setting. Findings highlighted the critical need for adequate recognition and management of SI in nursing homes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499961","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":"Characteristics of and Risk Factors for Depressive Symptoms Preceding Dementia: A Study of 82-Year-Old Men From the Uppsala Longitudinal Study of Adult Men","authors":"Angelica Kallström,&nbsp;Vilmantas Giedraitis,&nbsp;Kristin Franzon,&nbsp;Malin Löwenmark,&nbsp;Lena Kilander,&nbsp;Gustaf Boström","doi":"10.1002/gps.70000","DOIUrl":"10.1002/gps.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Depression and dementia are known to be associated. The identification of characteristics distinguishing depression prodromal to dementia from other depressive symptoms would be of value for early identification of dementia. The study of risk factors for depressive symptoms prodromal to dementia could improve preventive care and provide clues to the causes of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Dementia-free 82-year-old participants were stratified into groups that did (<i>n</i> = 126) and did not (<i>n</i> = 378) subsequently develop dementia. Examinations took place from 2003 to 2005 and follow-up ended 1 January 2015. Their baseline characteristics and depressive symptoms, measured using the 15-item Geriatric Depression Scale (GDS-15), were compared. Multivariate regression analyses were performed for the two groups separately, with the total GDS-15 score as the dependent variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The groups did not differ significantly in answers to any of the GDS-15 questions, or mean ± SD score, which was 2.4 ± 2.5 among those who developed dementia and 2.1 ± 2.3 among those who did not. (<i>p = 0.33</i>). Stroke before the age of 82 years and the inability to use stairs had significant impacts on the GDS-15 scores in both groups. For those who did not develop dementia, age, dependence in activities of daily living, and cancer also had significant impacts. Cancer had opposite associations with depressive symptoms in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No difference was found in depressive symptoms preceding and not preceding dementia using the GDS-15. The results suggest that risk factors for depressive symptoms may differ depending on whether they precede dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499960","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":"Suspected Pseudobulbar Affect in Neurodegenerative Disease","authors":"Maureen K. O’Connor,&nbsp;Brandon Frank,&nbsp;Renée DeCaro,&nbsp;Ana Vives-Rodriguez,&nbsp;Landon Hurley,&nbsp;Katherine W. Turk,&nbsp;Andrew E. Budson","doi":"10.1002/gps.70002","DOIUrl":"10.1002/gps.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between suspected pseudobulbar affect (PBA), clinical diagnosis, cognitive testing, and self-reported mood in older adults presenting for evaluation of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients presenting to an outpatient memory disorders clinic (<i>N</i> = 311).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used traditional and novel network modeling approaches to examine associations between neuropsychological (NP) tests, patient and clinician rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) among patients with suspected AD (<i>n</i> = 133) and other neurocognitive diagnosis (<i>n</i> = 178). We then examined differences in test performance between patients with and without suspected PBA (CNS-LS cut-off of ≥ 13), while accounting for demographic and psychiatric covariates with propensity score matching. Group differences were assessed with Bayesian models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of suspected PBA in AD was slightly less than half (44.4%) and at a similar rate in other dementias (e.g., 46.9% in CVD and 45.5% in LBD). In network models, the CNS-LS was associated with higher anxiety and better word list recall. After accounting for covariates, AD patients with suspected PBA performed better on word list recall <i>β</i>_<i>M</i> = 0.40, 95% CI [0.15, 0.66], and committed fewer false positive errors on recognition <i>β</i>_<i>M</i> = −1.51, 95% CI [−2.34, −0.59] than AD patients without suspected PBA. There were no differences in patients with any other diagnostic impression, nor group differences on other NP measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with suspected PBA and AD diagnosis had better memory recall and recognition than those without suspected PBA, suggesting that impaired emotional regulation may be an early sign of AD in patients with less prominent memory decline. Better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification, education, and initiation of treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464688","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}