International Journal of Geriatric Psychiatry最新文献

{"title":"Creative Aging: Unraveling the Psychosocial Benefits of Art Among Germany's Oldest Old. Findings From the Nationally Representative Study “Old Age in Germany (D80+)”","authors":"André Hajek,&nbsp;Razak M. Gyasi,&nbsp;Karl Peltzer,&nbsp;Hans-Helmut König,&nbsp;Supa Pengpid","doi":"10.1002/gps.70039","DOIUrl":"10.1002/gps.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is a dearth of studies examining the link between artistic activity and psychosocial outcomes exclusively among the oldest old. Therefore, the purpose of this study was to investigate the association between artistic activity and psychosocial outcomes among individuals aged 80 years and over in Germany.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods/Design</h3>\u0000 \u0000 <p>Data for this analysis were taken from the “Old Age in Germany (D80+)” study, a nationwide sample encompassing both community-dwelling individuals aged 80 and above, as well as those residing in care facilities. The analytic sample included a total of <i>n</i> = 3181 individuals. Established tools were used to quantify the variables of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 25.5% of individuals engaged in artistic activities, with the most popular being singing (9.0%) and making music (7.7%). Most participants engaged in these activities frequently, predominantly at home (84.8%). Regressions showed that overall engagement in the arts was not significantly associated with outcomes, except for reduced loneliness among men. Specific types of arts activities were associated with favorable psychosocial outcomes (e.g., singing and making music were associated with lower loneliness among men, whereas photography/filming was associated with lower loneliness among women). In addition, engaging in artistic activities outside the home was associated with higher life satisfaction among the total sample and women. The frequency of engagement in artistic activities was mainly not associated with psychosocial outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>About one in four individuals aged 80 years and over in Germany is engaged in artistic activities (frequently; mostly at home). Our findings show that engaging in artistic activities may have positive psychosocial benefits (depending on the type and sex-specific), particularly in reducing loneliness and increasing life satisfaction. Artistic engagement, particularly outside the home, may contribute to increased life satisfaction among women. Even rare artistic activities could prove beneficial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948505","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":"Initiation of Psychotropic Drugs in Spouses of Patients With Early-Onset Alzheimer's Disease: A Matched Cohort Study","authors":"Toshiki Fukasawa,&nbsp;Kota Matsumoto,&nbsp;Kotaro Sasaki,&nbsp;Yukako Nakagami,&nbsp;Yuta Goto,&nbsp;Yusuke Sakamoto,&nbsp;Yukihiko Washimi,&nbsp;Sachiko Tanaka-Mizuno,&nbsp;Satomi Yoshida,&nbsp;Kayoko Mizuno,&nbsp;Yuta Kamada,&nbsp;Mika Ishii,&nbsp;Koji Kawakami","doi":"10.1002/gps.70041","DOIUrl":"10.1002/gps.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The diagnosis of early-onset Alzheimer's disease (EOAD) can cause emotional stress not only to the patients themselves but also to their spouses. This study aimed to evaluate the risk of psychiatric disorders in spouses of EOAD patients, using psychotropic drug initiation as a surrogate indicator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort study was conducted using a Japanese claims database, with spouses of EOAD patients (exposed spouses) matched with spouses of non-EOAD individuals (reference spouses) up to a 1:10 ratio. Primary outcome was the initiation of mood disorder drugs, and secondary outcomes were the initiation of drugs for anxiety disorders, sleep disorders, and schizophrenia spectrum disorders. Four study cohorts were created according to each outcome analysis. Multivariable Cox regression models were used to estimate adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for study outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis of mood disorder drugs included 395 exposed spouses and 3711 reference spouses. The proportion of patients excluded from the analysis due to prescription of mood disorder drugs during the baseline period was 4.3% higher among exposed spouses than reference spouses. There was no major difference between groups with respect to mood disorder drug initiation after 1 year (aHR, 2.08 [95% CI, 0.61 to 7.13]). In subgroup analysis of females and dependents, exposed spouses showed a higher rate of initiation (females: aHR, 6.39 [95% CI, 1.24 to 32.80]; dependents: aHR, 6.47 [95% CI, 1.25 to 33.55]). No substantial differences in secondary outcomes were observed in any comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study does not conclusively demonstrate an increase in mood disorder drug initiation among spouses of EOAD patients overall; however, initiation rates may be higher among female or dependent spouses. Our findings also suggest that exposed spouses experience significant psychological stress prior to their partners' EOAD diagnoses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Psychometric Evaluation of the Staff-Reported EOLD-CAD Measure Among Nursing Home Residents With Cognitive Impairment","authors":"John G. Cagle,&nbsp;Timothy E. Stump,&nbsp;Wanzhu Tu,&nbsp;Mary Ersek,&nbsp;Alexander Floyd,&nbsp;Lieve Van den Block,&nbsp;Peiyan Zhang,&nbsp;Todd D. Becker,&nbsp;Kathleen T. Unroe","doi":"10.1002/gps.70037","DOIUrl":"10.1002/gps.70037","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The End-of-Life Dementia—Comfort Assessment in Dying (EOLD-CAD) scale is one of the few outcome instruments designed to capture symptom burden and well-being among nursing home residents with dementia; however, psychometric evaluations of the EOLD-CAD are limited. Although the instrument is often used to assess outcomes prospectively, it was originally developed and tested as a postmortem assessment. The purpose of this study is to evaluate the instrument properties of the EOLD-CAD using staff reports from a large sample of nursing home residents with cognitive impairment prior to death.&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;Using data from the multi-state UPLIFT clinical trial, this study evaluated the psychometric properties of the EOLD-CAD from 168 nursing home staff members reporting outcomes for 611 living residents with moderate to severe cognitive impairment. Staff also reported on resident quality-of-life using two different single item measures. We conducted confirmatory factor analysis (CFA) and assessed construct validity, inter-item reliability, and observer report bias.&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;CFA produced a four-factor solution. All factor loadings were &gt; 0.40, ranging from 0.61–0.95 for Physical Distress, 0.71–0.91 for Dying Symptoms, 0.61–0.78 for Emotional Distress, and 0.89–0.94 for Well-Being. Model indices suggest a good fit to the data with root mean square error of approximation (RMSEA) = 0.053 (95% CI = (0.044, 0.062)), comparative fit index (CFI) = 0.971, and standardized root mean square residual (SRMR) = 0.093, with the SRMR slightly above the conventional threshold of &gt; 0.08. Based on intraclass correlation coefficients (ICC), patterns of observer reports were identified among staff who provided data for multiple residents. ICCs were notably high (&gt; 0.60) for Well-Being items. The EOLD-CAD elicited a Cronbach's alpha of 0.73, and the instrument was negatively correlated with items measuring resident quality of life.&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;We found that when the EOLD-CAD was completed by nursing home staff familiar with the respective residents, observer-based patterns were detectable. Such patterns were adjusted for in our CFA, from we found that the EOLD-CAD exhibited multidimensionality with a four-factor structure capturing: Physical Distress, Emotional Distress, Dying Symptoms, and Well-Being. In addition to the CFA, the EOLD-CAD demonstrated generally valid and reliable psychometric properties in our population of long-stay nursing home residents with moderate to severe cognitive impairment.&lt;/p&gt;","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914496","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":"Risks of Dementia Associated With Anticholinergic Medication Compared to Beta-3 Agonist Among Older Patients With Overactive Bladder in Japan: The LIFE Study","authors":"Yuki Okita,&nbsp;Yoshimitsu Shimomura,&nbsp;Sho Komukai,&nbsp;Ling Zha,&nbsp;Masayo Komatsu,&nbsp;Yasuyoshi Kimura,&nbsp;Yasufumi Gon,&nbsp;Fumiko Murata,&nbsp;Megumi Maeda,&nbsp;Kosuke Kiyohara,&nbsp;Tetsuhisa Kitamura,&nbsp;Haruhisa Fukuda","doi":"10.1002/gps.70036","DOIUrl":"10.1002/gps.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Anticholinergic drugs can cause cognitive impairment. The risk of dementia associated with anticholinergics compared to beta-3 agonists (mirabegron and vibegron) has not been extensively investigated in the super-aging society of Japan. This study evaluated the association between the dementia risk and anticholinergics compared to beta-3 agonists in older adults with overactive bladder in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study had 1,493,202 participants from the Longevity Improvement &amp; Fair Evidence Study, which includes claim data in Japan from 2014 to 2022. The participants included 13,448 anticholinergic drug users and 24,669 beta-3 agonist users diagnosed with overactive bladder and aged ≥ 65 years. The Cox proportional hazards regression model was used to calculate hazard ratios and 95% confidence intervals being adjusted for confounding variables to evaluate the impact of anticholinergic drugs compared to beta-3 agonists prescribed at index date to patients with overactive bladder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the beta-3 agonist and anticholinergic drug users, the mean (standard deviation) age was 78.9 (6.7) and 78.8 (7.0) years, and the percentage of men was 47.2% and 39.7%, respectively. In the beta-3 agonist group, 2130 participants were newly diagnosed with dementia during the 51,605 person-years of follow-up from the index date, whereas in the anticholinergic drug group, 1826 participants were diagnosed during the 34,929 person-years of follow-up. In the Cox proportional hazard regression model, there was an increased risk of dementia in the anticholinergic drug group compared to the beta-3 agonist group (adjusted hazard ratio [aHR] = 1.22; 95% confidence interval [CI], 1.15–1.30). The increased risk remained identical when Inverse Probability Weighting (IPW) model was used for the analysis (aHR = 1.19; 95% CI, 1.11–1.28).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to beta-3 agonists, anticholinergic drugs are associated with an increased risk of dementia in older adults with overactive bladder, in Japan. These findings suggest that beta-3 agonists may have a lower risk of dementia than anticholinergics and have potential to be a good alternative opinion for older people with OAB, which warrants further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914483","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":"Inequalities in the Quality and Safety of Post-Diagnostic Primary Care for People With Dementia: A Scoping Review","authors":"Charlotte Morris,&nbsp;Roukia Techache,&nbsp;Katie Davies,&nbsp;Tom Blakeman,&nbsp;Evangelos Kontopantelis,&nbsp;Darren M. Ashcroft,&nbsp;Dame Louise Robinson","doi":"10.1002/gps.70035","DOIUrl":"10.1002/gps.70035","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;International guidelines make recommendations for the delivery of safe, high-quality primary care for people with dementia including prescribing, personalised care planning and regular holistic reviews. It is unclear how the quality and safety of this healthcare varies with socio-economic factors.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review aimed to understand the depth and breadth of existing evidence exploring socio-economic variation in the quality and safety of primary care for people with dementia.&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;Prescribing and care planning indicators of high-quality, safe primary care were defined from guidance. Composite and proxy markers of socio-economic status (SES) were defined. EMBASE, MEDLINE, PsychInfo, The Cochrane Database of Systematic Reviews, worldcat.org and clinicaltrial.gov databases were searched. Studies in English, on human participants from 2006 onwards were eligible. Narrative synthesis was conducted. Studies explored how one or more selected indicators (anti-dementia medication and anti-psychotic prescribing, potentially inappropriate prescribing (PIP), medication review, dementia review or care planning) varied with a recognised marker of SES in people with dementia.&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;Searches identified 1980 studies after removing duplicates. 385 full texts were reviewed, with 53 eligible for inclusion (51 quantitative, 2 reviews). Most identified studies explored prescribing processes (50 quantitative, 2 reviews), with 2 exploring annual review.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;There was evidence of substantial disparity in quality and safety indicators in studies exploring prescribing; 20/29 (69%) of studies exploring anti-dementia medication prescribing found those with markers of lower SES were significantly less likely to receive these. 16/28 studies exploring PIP/Anti-psychotics found significant disparities in safe prescribing for those with markers of lower SES. Neither study exploring annual reviews found any significant differences across SES.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We found evidence of disparity in the quality and safety of post-diagnostic primary care for people with dementia based on SES, particularly for a range of prescribing indicators. Further work exploring inequalities in care planning and reviews for people with dementia is needed to understand","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mini-Cog: A Community Screening Tool for Dementia in Indonesia","authors":"Yuda Turana,&nbsp;Nicolas Farina,&nbsp;Imelda Theresia,&nbsp;Tara Puspitarini Sani,&nbsp;Ika Suswanti,&nbsp;Fasihah Irfani Fitri,&nbsp;Emiliano Albanese,&nbsp;Adelina Comas-Herrera,&nbsp;Martin Knapp,&nbsp;Sube Banerjee","doi":"10.1002/gps.70033","DOIUrl":"10.1002/gps.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early detection of dementia enables more effective planning and can enable access to treatment and support. The Mini-Cog is a widely used screening instrument in Indonesia; however, this instrument has never undergone a translation and cultural adaptation process. Currently, there is no data on how accurate the tool is against diagnostic criteria, particularly in low-education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Embedded within the community-based dementia prevalence study was the Strengthening Responses to Dementia in Developing Countries (STRiDE) project; older adults (aged ≥ 65 years) were randomly recruited from sites in Jakarta and North Sumatra, Indonesia. All participants were asked to complete the Mini-Cog and the 10/66 short dementia diagnostic schedule. The accuracy of three Mini-Cog algorithms (Mini-Cog1, Mini-Cog2, and Mini-Cog3) were compared against and the 10/66 short dementia diagnostic schedule. Additional analysis explored its performance accuracy at different educational levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Mini-Cog test performance assessment was conducted on 2098 older adults</p>\u0000 \u0000 <p>The area under the curve (AUC) of Mini-Cog1, Mini-Cog2, and Mini-Cog3 receiver operator characteristic (ROC) curves were 0.66, 0.62, and 0.64, respectively. All algorithms demonstrated high sensitivity (Sv) but low specificity (Sp). (Mini-Cog1: Sv 83.2%; Sp 49.2%, Mini-Cog2: Sv 87.1%; Sp 37.8% and Mini-Cog3: Sv 72.5%; Sp 56%). All algorithms showed no affected by education. Only 59.1% of people without dementia could do the CDT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The high sensitivity of the Mini-Cog1 algorithm lends itself to screening purposes. Given that the specificity is still low, and less than 60% of patients without dementia can complete the CDT. Further research is needed, as is the development of screening instruments with high accuracy values in low- and middle-income countries, particularly in Indonesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835636","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":"Assessment of Dementia in Minority Ethnic Groups in Europe: A 14-Year Follow-Up Survey","authors":"T. Rune Nielsen,&nbsp;Alexandre de Mendonça,&nbsp;Lutz Frölich,&nbsp;Sebastiaan Engelborghs,&nbsp;Dianne Gove,&nbsp;Daphné Lamirel,&nbsp;Clara Calia,&nbsp;Gunhild Waldemar","doi":"10.1002/gps.70034","DOIUrl":"10.1002/gps.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is no European consensus on good clinical practice for timely diagnosis and culturally appropriate care of people with dementia from minority ethnic groups. Despite significant advances in culture-sensitive dementia diagnostics, little is known about how this has been implemented in clinical practice. The aims of this follow-up survey were to explore current practices for assessing dementia in patients from minority ethnic groups in Europe and to determine whether barriers in access to specialized dementia services have changed during the last 14 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was conducted in the European Alzheimer's Disease Consortium (EADC) in June 2023. The survey utilized questionnaires from a previous EADC survey from 2009 and focused on different points in the clinical assessment of dementia in patients from minority ethnic groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three centers from 15 countries participated in the survey, of which 21 were the same as in the 2009 survey. Patients from minority ethnic groups were seen on a regular basis in 91% of these centers, which was a significant increase compared to 2009 (69%, <i>p</i> = 0.04). Despite perceived clinical expertise increasing, implemented strategies for bypassing cultural and linguistic barriers were sparse and communication problems and lack of adequate assessment tools continued to be the main perceived barriers in diagnostic assessment of dementia in minority ethnic groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients from minority ethnic groups are increasingly being referred for diagnostic assessment of dementia in Europe. Despite some improvements, diagnostic challenges generally remained the same as in 2009 and there is a continuous need to implement effective cross-cultural communication and assessment practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812385","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":"Establishing Gold Standard Assessment for Young Onset Dementia: A Modified E-Delphi Consensus Survey Based in Australia","authors":"Josyane Lau,&nbsp;Monica Cations,&nbsp;Mary O'Malley,&nbsp;Vasileios Stamou,&nbsp;Jan R. Oyebode,&nbsp;Jacqueline H. Parkes,&nbsp;Janet Carter,&nbsp;Samantha M. Loi","doi":"10.1002/gps.70028","DOIUrl":"10.1002/gps.70028","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;A modified e-Delphi was used to explore subject-expert consensus to create a minimum &amp; gold standard assessment for young-onset dementia (YOD) for clinicians based in Australia.&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;A list of 72 statements adapted from an international study, O'Malley et al. 2020, was included in an online survey that was distributed to clinical experts in the field. Respondents were asked to rate statements on a Likert scale of 1–7 (ranging from ‘1’ being ‘not at all important’ to ‘7’ being ‘absolutely essential’). The mean and standard deviation (SD) were calculated for each statement. Full consensus, designated as ‘minimum standard’ was defined as 100% of respondents rating statement(s) as ‘absolutely essential’ (7) or ‘very important’ (6), while high consensus, designated as ‘gold standard’ was defined as 80% (16 out of 20) of respondents rating statement(s) as either ‘absolutely essential’ or ‘very important’ in the assessment for YOD. The statements that had overall mean scores below 6 did not reach consensus.&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;Full consensus was achieved on 13 statements (‘minimum standard’), 80% consensus was reached on 37 statements (‘gold standard’), and no consensus was reached on 35 statements. Most clinicians agreed that the diagnosis of YOD is largely based on history, with less emphasis placed on aspects of the examination and investigations conducted. History of first-degree family members with YOD and any past psychiatric symptoms were reported to be potential triggers for a YOD diagnosis. There was agreement that the routine dementia blood screen and baseline structural imaging should be a part of the diagnostic assessment criteria of YOD. Comparisons were made between the results of this Australian-based study to the original international study, which found that 55/72 statements (76%) were similarly rated.&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;Based on the results of this modified e-Delphi study, full and high consensus was reached on 37 statements which were comparable to results in an international study. This suggests that in general, clinicians in Australia have agreement with international experts about what is important for the assessment and diagnosis of YOD. Because the statements used in the international study were used in this Australian study, consideration of what issues may be specific to the Australian context such as YOD in Aboriginal Australians and rurality may have not been ascertained. In spite of this, these results may be useful to aid clinicians in their assessment for YOD but cons","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800684","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 Dual Group-Based 11-Year Trajectory Analysis of Cognitive Impairment and Transport Restriction for Community-Dwelling Older Adults","authors":"Yong Yang,&nbsp;Yu Jiang,&nbsp;Ming Wen,&nbsp;Li Wang","doi":"10.1002/gps.70032","DOIUrl":"10.1002/gps.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the trajectories of cognitive impairment and transport restriction over time and the interrelation between these trajectories among older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Group-based trajectory modeling was used on the longitudinal National Health and Aging Trends Study (NHATS) over 11 years from 2011 to 2021, among 5753 participants, stratified by age in 2011 to three groups of 65–74 years, 75–84 years, and 85 years and above.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For transport restrictions, these trajectory groups were: (1) a majority with no restrictions, (2) low and increasing or stable, and (3) moderate or high and decreasing. The overall pattern was largely consistent across the three age groups, with the older group showing a higher predicted likelihood of transport restrictions compared to the younger group. For each of the three age groups, there were two cognitive impairment trajectories including (1) low and (2) increasing cognitive impairment. The proportions of increasing cognitive impairment were 12.3% among the 65–74 years old, 27.3% among the 75–84 years old, and 40.4% among the 85 years and above old. Compared with those with no transport restriction, the other two trajectories with either low or moderate transport restrictions were more likely to belong to increasing cognitive impairment. The odds ratio was 3.06 (95% CI 2.0–4.68) for low &amp; increasing transport restrictions versus 1.57 (95% CI 0.96–2.56) for moderate &amp; decreasing transport restrictions among 65–74 years old. The odds ratio was 2.38 (95% CI 1.68–3.38) for low &amp; increasing transport restrictions versus 1.88 (95% CI 1.39–2.55) for moderate &amp; decreasing transport restrictions among 75–84 years old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cognitive impairment was more likely to co-occur with those with low and increasing transport restrictions than with those with moderate and decreasing transport restrictions. Addressing transport restriction among older adults holds the potential to ameliorate cognitive outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800682","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 Janus Face of Person-Centred Care","authors":"Joshua Gallagher,&nbsp;Catherine Evans,&nbsp;Elizabeth Sampson,&nbsp;Stephen Barclay,&nbsp;Jane Ward","doi":"10.1002/gps.70030","DOIUrl":"10.1002/gps.70030","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 12","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794655","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}