International Journal of Geriatric Psychiatry最新文献

{"title":"Incidence and Risk Factors of Postoperative Delirium in Elderly Patients Following Hip Fracture Surgery: A Nationwide Retrospective Cohort Study in Taiwan","authors":"Chien-An Shih,&nbsp;Deng-Chi Yang,&nbsp;Wei-Ming Wang,&nbsp;Yi-Lin Wu,&nbsp;Yi-Ching Yang,&nbsp;Han-Chang Ku","doi":"10.1002/gps.70094","DOIUrl":"https://doi.org/10.1002/gps.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Delirium is an acute cognitive change characterized by behavioral and psychological features, such as visual and auditory hallucinations, sleep disturbances, and emotional confusion. It can lead to extended hospital stays, increased mortality risk, and higher nursing costs. In postoperative hip fracture patients, delirium results in a higher complication rate, poorer functional recovery, increased readmission rates, repeat surgeries, and elevated mortality. Despite these serious consequences, the literature provides limited information on the incidence of postoperative delirium following hip fracture surgeries in Asians. Additionally, there is a lack of long-term, comprehensive nationwide population-based studies, highlighting an important area for future research. This study aims to understand the incidence and risk factors of postoperative delirium in hip fracture patients using representative population data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database (NHIRD) from 2009 to 2020. The cohort consisted of 118,682 patients aged 65 years or older who were diagnosed with hip fractures. The delirium incidence was observed per 1000 person-years. The Cox proportional hazards model was used to investigate the incidence of delirium among hip fracture patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of the first episode of delirium after hip surgery in the elderly was 1.87 events per 1000 PYs. Factors associated with delirium included being female (adjusted hazard ratio [aHR]: 0.59; 95% confidence interval [CI]: 0.53–0.64), age ≥ 95 years (aHR: 3.52; 95% CI: 2.74–4.51), comorbid dementia (aHR: 2.63; 95% CI: 2.38–2.92), and ICU stay 2–3 days (aHR: 2.85; 95% CI: 1.28–6.37). The occurrence of delirium was significantly associated with an ICU stay of ≥ 4 days, dementia, as well as 30-day, 90-day, and 1-year mortality (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the relatively low incidence of postoperative delirium in elderly hip fracture patients in Taiwan. Key risk factors identified include advanced age, female gender, comorbid dementia, and prolonged ICU stays. These findings underscore the need for targeted prevention and early intervention strategies to improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939080","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 Association of Apathy With Incident Dementia: A Multiple Mediation Analysis of Cardiovascular Risk Factors","authors":"Josephine E. Lindhout,&nbsp;Jan Willem van Dalen,&nbsp;Willem A. van Gool,&nbsp;Edo Richard,&nbsp;Marieke P. Hoevenaar-Blom","doi":"10.1002/gps.70092","DOIUrl":"https://doi.org/10.1002/gps.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Despite established links between apathy, cardiovascular disease, and dementia, it remains unclear if cardiovascular risk factors (CVRF) play a mediating role in the association between apathy and dementia. If apathy increases dementia risk via lifestyle-related dementia risk factors, targeted lifestyle interventions could help high-risk individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the preDIVA study including 3303 individuals aged 70–78 years. Apathy was assessed using the geriatric depression scale, and CVRF (cardiovascular risk factors) (systolic blood pressure, cholesterol, diabetes, body mass index (BMI), smoking, and physical activity) were considered as potential mediators. Outcome was incident dementia during 12 years of follow-up. We assessed mediation using Multiple Mediation Analysis (MMA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the association between apathy and dementia (HR 1.49 [95% CI 0.99–2.41]), 27% was mediated by physical inactivity, BMI and diabetes combined. Of this total, physical inactivity mediated 28% of the effect (HR 1.12, 95% CI 1.03–1.29), diabetes 9% of the effect (HR 1.04, 95% CI 1.02–1.10), and BMI counteracted these effects by −12% (HR 0.95, 95% CI 0.88–0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The relationship between apathy and dementia is partly mediated by physical inactivity, BMI and diabetes. Apathy is an important clinical marker that signals the existence of potentially modifiable pathways, providing an opportunity for lifestyle interventions. To potentially reduce dementia risk via lifestyle modification in patients with apathy, a tailored approach should be taken to overcome the characterizing symptom of diminished motivation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932271","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":"Age Trajectories of Mental and Cognitive Health From Midlife to Older Adulthood: Examination of Cohort and Gender Roles in Taiwan","authors":"Ching-Ju Chiu,&nbsp;Linda A. Wray,&nbsp;Jou-Yin Chen,&nbsp;Szu-Yu Hou","doi":"10.1002/gps.70095","DOIUrl":"https://doi.org/10.1002/gps.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study examined the age trajectories of mental and cognitive health from midlife to older adulthood, and how age and gender impacted mental and cognitive health change across age cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multilevel modeling was used to analyze the panel data on cognitive function, life satisfaction, and depressive symptoms from the 1996-2011 Taiwan Longitudinal Study on Aging (<i>N</i> = 5131).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cognitive function gradually declined with chronological age (β_age = −0.041, <i>p</i> &lt; 0.001), and declined faster in earlier-born cohorts (β_{age*cohort 7} = −0.168, <i>p</i> &lt; 0.001). Life satisfaction showed the opposite effect with age and cohort: while earlier-born cohorts reported lower life satisfaction (β_{cohort 7} = −0.498, <i>p</i> &lt; 0.05), life satisfaction increased with chronological age (β_age = 0.015, <i>p</i> &lt; 0.05). Older adults reported more depressive symptoms, but this phenomenon was only significantly associated with age cohort (β_{cohort 7} = 3.530, <i>p</i> &lt; 0.001). Widened differences between men and women in life satisfaction and depressive symptoms were associated with age cohort but not chronological age per se.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Men and later-born cohorts experienced significantly better mental and cognitive health than women and earlier-born cohorts. Age- and gender-related changes in mental and cognitive health in later life should be considered within the socio-culturally contextualized birth cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932272","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 Role of Social Media in Mitigating the Long-Term Impact of Social Isolation on Mental and Cognitive Health in Older Adults During the COVID-19 Pandemic: The HUNT Study","authors":"Tanja Louise Ibsen,&nbsp;Ekaterina Zotcheva,&nbsp;Sverre Bergh,&nbsp;Debby Gerritsen,&nbsp;Gill Livingston,&nbsp;Hilde Lurås,&nbsp;Svenn-Erik Mamelund,&nbsp;Anne Marie Mork Rokstad,&nbsp;Bjørn Heine Strand,&nbsp;Pernille Thingstad,&nbsp;Richard C. Oude Voshaar,&nbsp;Geir Selbæk","doi":"10.1002/gps.70097","DOIUrl":"https://doi.org/10.1002/gps.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic increased social isolation in older adults, promoting mental and cognitive decline. The impact of social media on these effects remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the long-term association of social isolation with mental and cognitive health in older adults and whether social media use mitigated this association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data from the Norwegian Trøndelag Health Study before (2017–2019), during (January 2021), and after the pandemic (2021–2023) were analysed (<i>N</i> = 4844, 53% women, mean age 80 years). Multi-adjusted mixed-effects linear regression estimated differences in changes in mental (CONOR-MHI) and cognitive (MoCA) health related to self-reported social isolation and social media use. Beta (<i>β</i>) represents differences in change in z-score of CONOR-MHI or MoCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Social isolation was associated with a steeper decline in mental health than no social isolation (<i>β</i> = 0.07, 95% CI 0.01, 0.13) but was not associated with change in cognitive health. Daily social media use was not related to change in mental health, whereas it was associated with a less steep cognitive decline than no social media use (&lt; 1 h: <i>β</i> = 0.13, 95% CI 0.05, 0.20; ≥ 1 h: <i>β</i> = 0.10, 95% CI 0.01, 0.15). Stratified by social isolation, daily social media use &lt; 1 h was related to a less steep cognitive decline than no social media use in both isolated (<i>β</i> = 0.15, 95% CI 0.02, 0.28) and non-isolated individuals (<i>β</i> = 0.13, 95% CI 0.03, 0.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Individuals experiencing social isolation during the pandemic had a steeper decline in mental, but not cognitive health, compared to those not isolated. Social media use did not buffer the decline in mental health but was associated with less steep cognitive decline. The pandemic showed limits of relying solely on digital solutions for social contact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The study is registered in ClinicalTrials.gov 18.02.2021, with the identification number NCT 04792086</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919380","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":"Facility-Level Variation of Resident Loneliness in Assisted Living and Associated Organizational Context Factors: A Repeated Cross-Sectional Study","authors":"Matthias Hoben,&nbsp;Hana Dampf,&nbsp;Rashmi Devkota,&nbsp;Kyle Corbett,&nbsp;David B. Hogan,&nbsp;Kimberlyn M. McGrail,&nbsp;Colleen J. Maxwell","doi":"10.1002/gps.70093","DOIUrl":"https://doi.org/10.1002/gps.70093","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Loneliness is common among nursing home residents, and it is also thought to be a problem in assisted living (AL). However, we lack research on loneliness in AL. Our objectives were to assess changes in risk-adjusted prevalence of loneliness in AL, and facility-level variations in loneliness before and during the COVID-19 pandemic, and facility-level factors associated with AL resident loneliness during the pandemic.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Research Design and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This population-based, repeated cross-sectional study used Resident Assessment Instrument—Home Care (RAI-HC) data (01/2017–12/2021) from Alberta, Canada. On a system-level, we estimated quarterly, risk-adjusted loneliness prevalence, and used segmented regressions to assess whether loneliness changed after the start of the pandemic. For risk adjustment, we used resident-covariates known to be associated with loneliness, but out the health system's or AL home's control (e.g., age or cognitive impairment) to enable fair comparisons over time. Linking AL home surveys, collected in COVID-19 waves 1 (March–June 2020) and 2 (October 2020–February 2021) to RAI-HC records, we used covariate-adjusted general estimating equations (GEE) to assess AL home factors (e.g., staffing shortages, social distancing measures) associated with resident-level loneliness during the pandemic.&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;Quarterly samples included 2026–2721 residents. Loneliness [95% confidence interval] fluctuated between 13.6% [11.5%–15.7%], and 16.8% [14.4%–19.2%], with no statistically significant increase during the pandemic. Facility-level median [inter-quartile range] loneliness prevalence varied considerably before (14.9% [8.3%–21.1%) and during the pandemic (13.5% [6.9%–21.3%]). GEEs included 985 residents in 41 facilities (wave 1), and 1134 residents in 42 facilities (wave 2). Facility-factors associated with decreased odds of loneliness included: facilitating caregiver involvement (odds ratio = 0.531 [95% confidence interval: 0.286–0.986]), essential visitor policies (0.672 [0.454–0.994]), and video calls with volunteers or religious/spiritual leaders (0.603 [0.435–0.836]). Facilitating outdoor activities/visits (2.486 [1.561–3.961], and providing hallway-based activities (1.645 [1.183–2.288]) were associated with increased odds of loneliness.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion and Implications&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Loneliness did not change during COVID-19 in AL on a health system level, but varied considerably between fa","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919379","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 Impact of Clean Water Access on Older Adults' Cognitive Function: A Quasi-Experiment in Rural China","authors":"Li Sheng,&nbsp;Junqi Ma","doi":"10.1002/gps.70096","DOIUrl":"https://doi.org/10.1002/gps.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The long-term effect of clean water access on cognitive function of rural older adults is little known. In this paper, we use the implementation of the rural drinking water program in China as a quasi-experiment to explore the impact of clean water access on cognitive function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using longitudinal data from the 2010 to 2020 China Family Panel Studies (CFPS), cognitive function is measured through word tests, math tests, delayed memory, and number series tests. The staggered difference-in-difference (DID) and event study methods are used to test the causal effect of clean water access on cognitive function among rural older adults (aged 60 and above) in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We find that clean water access resulting from this program has a significant positive impact on the cognitive function of rural older adults. Specifically, clean water access increases the scores on the word test, the math test, the delayed memory, and the number series test by 0.104, 0.071, 0.096, and 0.111 standard deviations, respectively. Mechanism analysis shows that clean water access promotes cognitive function through physical health (Including improved self-rated health, increased labor market participation), household income and social participation. Heterogeneity analysis indicates that respondents who are female, older, higher education level and higher income level benefit more from this drinking water program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clean water access significantly improves the cognitive function of rural older adults through physical health, household income, and social participation. This study suggests that the establishment of sustainable rural drinking water program by governments can alleviate cognitive impairment in older adults and promote health equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909257","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":"Experiences and Management of Distress and the Use of Music, Including Music Therapy, on NHS Inpatient Mental Health Dementia Wards: A Qualitative Study","authors":"Naomi Thompson,&nbsp;Rachel Hunt,&nbsp;Helen Odell-Miller,&nbsp;Abdulwarrith Olawale,&nbsp;Lucy Pickering,&nbsp;Chris Pointon,&nbsp;Benjamin R. Underwood,&nbsp;Alison Wilkinson,&nbsp;Christine Wise,&nbsp;Emma Wolverson,&nbsp;Ming-Hung Hsu","doi":"10.1002/gps.70091","DOIUrl":"https://doi.org/10.1002/gps.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inpatient mental health dementia wards in the National Health Service (NHS) provide specialist care for people with dementia experiencing acute levels of distress. There is little research exploring how best to manage and prevent distress. Music therapy may be feasible to deliver and reduce the prevalence of distress behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To further understanding of experiences of distress in inpatient mental health dementia NHS wards, how distress is managed and ways music and music therapy is used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured focus groups and interviews were co-designed and conducted with people with dementia, families, staff, music therapists and managers with experience of this setting. Data were transcribed and analysed using reflexive thematic analysis, with findings corroborated with participants, a co-design group and experts-by-experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>49 people took part from 17 wards. Three overarching themes were identified, with 10 subthemes. The first theme highlighted the complex physical and mental health care needs of people on these wards, including high levels of distress. Secondly, staff and families aimed to personalise care to manage and prevent distress. Thirdly, music, including music therapy, could support the delivery of personalised care and help prevent and deescalate distress behaviours, potentially reducing the need for restrictive interventions. However, managers, staff, families and patients reported that care provision did not always meet patient need and resource limitations often prevented delivery of personalised care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NHS mental health dementia wards provide specialist care for people with dementia experiencing high levels of distress. Personalised care, including the use of music, was essential for preventing and managing distress, and could be enhanced through specialist support from a music therapist. Findings should inform best practice guidelines for NHS inpatient mental health dementia wards, including the use of music and music therapy, to support the prevention and management of distress for this client group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900882","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":"All-Cause Acute Illness Hospitalisations in the Preceding Two Years Are Associated With Cognitive Decline in Older Adults: The Sydney Memory and Ageing Study","authors":"Lucia Chinnappa-Quinn,&nbsp;Ben C. P. Lam,&nbsp;Lara Harvey,&nbsp;Nicole A. Kochan,&nbsp;John D. Crawford,&nbsp;Steve R. Makkar,&nbsp;Henry Brodaty,&nbsp;Perminder S. Sachdev","doi":"10.1002/gps.70077","DOIUrl":"https://doi.org/10.1002/gps.70077","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;Emerging evidence suggests all-cause acute hospitalizations are associated with cognitive decline, rather than being associated only with specific inpatient contexts (surgery, critical care and delirium). This study clarifies this association in an Australian context.&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 study is a secondary analysis of four biennial waves of prospective population-based neuropsychological measures from 1026 functionally independent Sydney Memory and Ageing Study participants aged 70–90 years at baseline, and contemporaneous probabilistically-linked hospitalization data. The outcome measures were global cognition baseline (intercept) and change (slope) and their associations with hospitalization episodes and cumulative length of stay (cLOS) variables in five consecutive 2-year time intervals.&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;One thousand twenty-six individuals had a mean age of 78.8 years, a mean Mini-Mental State Examination score of 28.7, a mean of 3.3 hospitalizations and 18.9 days in hospital over 10 years. Mean global cognition z-score change/year was −0.133, adjusted for age, sex and education. Hospitalizations and cLOS in the final time interval were associated with a change in slope of −0.012 global cognition z-score/hospitalization/year (Standard Error [SE] = 0.005, &lt;i&gt;p&lt;/i&gt; = 0.014) and −0.002 z-score/day-in-hospital/year (SE = 0.001, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Further investigation of these associations with time-lagged models showed that pooled recent hospitalizations were associated with accelerated cognitive decline of −0.036 change in cognition/year/episode-of-hospitalization (SE = 0.012, &lt;i&gt;p&lt;/i&gt; = 0.004) and −0.008 change in cognition/year/day-in-hospital (SE = 0.002, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) rather than non-recent hospitalizations (Wald test for difference between pooled recent and non-recent effects had &lt;i&gt;p&lt;/i&gt;-values of 0.011 and &lt; 0.001 for hospitalization episodes and days respectively).&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 study confirms and adds nuance to international findings that overnight hospitalization is associated with accelerated cognitive decline. This association was dose-dependent, had a recency effect and was independent of illness severity in the case of cLOS. These findings suggest that all-cause acute hospitalization may be a reversible risk factor for cognitive decline. This needs further clarification and the development of interventions to minimise the impact of acute illness hospitalization on cognitive trajec","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896951","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":"Longitudinal Association of Conversion Patterns of Functional Disability With Risk of Depressive Symptoms in Older Chinese Adults","authors":"Jinghong Huang,&nbsp;Dongrui Peng,&nbsp;Yuanjie Gou,&nbsp;Ying Luo,&nbsp;Hui Yao,&nbsp;Hairong Zhang,&nbsp;Huayu Zhang,&nbsp;Jiarui Mei,&nbsp;Xiaohui Wang","doi":"10.1002/gps.70086","DOIUrl":"https://doi.org/10.1002/gps.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Functional disability has been identified as a risk factor for depressive symptoms (DS). However, most studies have measured functional disability at only one time point, and functional disability is dynamic and changeable over the life course, and can vary between individuals. Therefore, we aimed to examine the longitudinal association between conversion patterns of functional disability and the risk of DS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the China Health and Retirement Longitudinal Study (CHARLS) participants in 2013, we retrospectively assessed their functional disability from 2011 to 2013 through activities of daily living ability (ADLs) and instrumental activities of daily living ability (IADLs), which were categorized as ten conversion patterns. A total of 2057 participants who met the inclusion criteria were included in the final analysis and were followed from 2013 to 2018 to determine the incidence of DS, measured by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Cox proportional hazards regression models were applied to estimate association between conversion patterns of functional disability and the risk of DS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 61 months follow-up period, 508 incident DS cases were identified. Three conversion patterns of functional disability were more likely to develop DS than those with never both ADLs and IADLs disabilities: relieved both ADLs and IADLs disabilities (adjusted HR = 2.01, 95% CI = 1.21–3.32), persistent only IADLs disability (adjusted HR = 1.81, 95% CI = 1.04–3.12), and persistent both ADLs and IADLs disabilities (adjusted HR = 4.75, 95% CI = 2.19–10.31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older adults with persistent both ADLs and IADLs disabilities may be at a greater risk of DS. Meanwhile, those with relief should not be ignored for functional disability. Attention should be paid to psychological monitoring of older adults with a history of or current functional disability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889170","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":"Clinical Evolution of Neuropsychiatric Symptoms in Alzheimer's Disease and Dementia With Lewy Bodies in a Post-Mortem Cohort","authors":"Lucy L. Gibson,&nbsp;Ragnhild Eide Skogseth,&nbsp;Tibor Hortobagyi,&nbsp;Audun Osland Vik-Mo,&nbsp;Clive Ballard,&nbsp;Dag Aarsland","doi":"10.1002/gps.70084","DOIUrl":"https://doi.org/10.1002/gps.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Almost all patients with neurodegenerative dementias experience neuropsychiatric symptoms (NPS) but the timing and clinical course is highly variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a prospective cohort study in Western Norway, patients with a new diagnosis of mild dementia were assessed annually in the Neuropsychiatric Inventory (NPI) for up to 9 years until death. Patients with <i>post-mortem</i> neuropathological diagnoses of Alzheimer's disease (pAD) (<i>n</i> = 37), Lewy body disease (pLBD) (<i>n</i> = 14) or meeting criteria for both AD and LBD (mixed AD+LBD) (<i>n</i> = 11) were included in this study. Neuropathological assessment was performed according to standardised protocols and blind to clinical information. In mixed effects logistic regression, longitudinal change in NPS was explored across neuropathological diagnoses and substrates. Additionally, the odds of NPS early and late in disease was evaluated in logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Early onset hallucinations were significantly more common in pLBD than pAD (OR 0.069 [95% CI 0.012–0.397], <i>p</i> = 0.003) or mixed AD+LBD (OR 0.09 [95% CI 0.010–0.771], <i>p</i> = 0.028) and there was a greater increase in the odds of hallucinations over time in pAD and AD+LBD than pLBD such that there was was no difference in the prevalence of late-onset hallucinations between pLBD, pAD or AD+LBD. Hallucinations early in disease were associated with higher LBD α-synuclein stages and neocortical LBD, in addition and sparser amyloid distribution. Higher density of amyloid plaques, tau tangles, cerebrovascular disease and increasing additional co-pathologies were associated with increasing odds of hallucinations over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LBD, without significant comorbid AD pathology, is associated with hallucinations early in the course of disease while multiple other pathologies may be implicated in aetiology of late-onset hallucinations. Hallucinations increase in AD+LBD as disease progresses, a trajectory more closely aligned with AD than LBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883810","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}