International Journal of Geriatric Psychiatry最新文献

{"title":"Comparative Post-Marketing Surveillance of Memantine and Cholinesterase Inhibitors: Cardiovascular Adverse Events With a Focus on Sex Differences Using the FDA Adverse Event Reporting System Database","authors":"Zinnet Şevval Aksoyalp,&nbsp;Dilara Nemutlu-Samur","doi":"10.1002/gps.70018","DOIUrl":"10.1002/gps.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to conduct a comparative analysis of the proportion of cardiovascular adverse events (AEs) associated with the utilization of memantine and cholinesterase inhibitors and to highlight the potential impact of sex differences in these AEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cardiac and vascular disorders AEs with antidementia medications were obtained from the FDA Adverse Event Reporting System database. The reporting odds ratio and its corresponding 95% confidence intervals were calculated. The chi-squared test was used to evaluate differences in categorical variables, and a two-way ANOVA followed by a Bonferroni post-test was used to compare the AEs reported for antidementia medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Memantine was associated with 544 selected cardiac and vascular disorder AEs. A signal for bradycardia, myocardial infarction, atrial fibrillation and cardiac arrest has been observed in patients receiving choline esterase inhibitors compared to those receiving memantine. On the other hand, cardiac failure and deep vein thrombosis AEs were found to be more common in patients receiving memantine. The majority of reported cardiac and vascular AEs were reported more frequently in female patients. More cases of cardiac failure, cardiac arrest, and deep vein thrombosis were reported in females than males taking memantine, but bradycardia was more common in males than females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Healthcare professionals should be aware of the potential for cardiovascular AEs during treatment with antidementia medications and the possibility of sex differences in this regard. Memantine differs from cholinesterase inhibitors in terms of cardiovascular AEs, and there may be sex-related differences in the proportion of these AEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675705","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":"Balancing Duty, Stigma, and Caregiving Needs of People With Neurodevelopmental or Neurocognitive Disorders During a Public Health Emergency in South Asia: A Qualitative Study of Carer Experiences","authors":"Anna Tjin,&nbsp;Anna Goodwin,&nbsp;Carol Troy,&nbsp;Selvie Yeo,&nbsp;Sanjib Saha,&nbsp;Roger O'Sullivan,&nbsp;Iracema Leroi,&nbsp;Yaohua Chen,&nbsp;the CLIC Caregiver Study Group","doi":"10.1002/gps.70010","DOIUrl":"10.1002/gps.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Individuals with neurodevelopmental and/or neurocognitive disorders (NNDs) have complex, long-term care needs. In Bangladesh, India, and Pakistan, informal carers shoulder the responsibility and strain of providing care for people with NNDs. Intense care demand, societal and cultural care expectations, and lack of support infrastructure often lead to psychosocial strain in this inadequately researched community, particularly during crises such as the COVID-19 pandemic. This study explored and identified specific features of the coping styles exhibited by informal carers of people with NNDs from Bangladesh, India, and Pakistan during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>Between June and November 2020, 245 carers in India, Pakistan, and Bangladesh responded to open-ended questions in the CLIC (Coping with Loneliness, Isolation, and COVID-19) survey. A reflexive thematic analysis was conducted to uncover the underlying themes and identify coping strategies and stressors. A frequency analysis was performed to examine the associations between these themes and carer nationality. Significant tests identified coping styles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three coping styles: religiosity (Pakistan), caregiving as a natural life path (Bangladesh), and self-care (India). The religiosity and natural life path styles reside on the fatalism/acceptance continuum and suggest an insight-oriented therapeutic approach. Self-care is a problem-solving strategy that calls for a behaviorally oriented approach. Family overreliance on the carer was a concern across all three groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings underscore the need for accessible support pathways to sustain care standards, ensuring the well-being of carers and care recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667924","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":"Childhood Peer Relationships and Dementia Risk in Chinese Older Adults: A Mediation Analysis","authors":"Zi Zhou,&nbsp;Haoyu Zhao","doi":"10.1002/gps.70022","DOIUrl":"10.1002/gps.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early-life social experiences significantly influence later-life health, yet the association between childhood peer relationships and dementia, as well as the underlying mechanisms, remains underexplored. This study aimed to investigate this association and the mediating roles of social disengagement and loneliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Leveraging data from 7574 adults aged ≥ 60 in the China Health and Retirement Longitudinal Study (2011–2018), we employed marginal structural models to assess the associations between childhood peer relationships and dementia risk in later life. Inverse odds ratio weighting was used to examine the mediating roles of formal and informal social disengagement and loneliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals with deficits in childhood peer relationships had a higher risk of dementia (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.10–1.34) compared with those with more positive experiences. This association was partially mediated by formal social disengagement (proportion mediated, 21.44%; 95% CI, 12.20%–40.94%), loneliness (proportion mediated, 22.00%; 95% CI, 13.42%–33.82%), and their combination with informal social disengagement (proportion mediated, 41.50%; 95% CI, 30.76%–66.07%). Informal social disengagement alone did not show a significant mediating effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cohort study of older Chinese adults, negative childhood peer relationship experiences were associated with an elevated risk of dementia in later life. Formal social disengagement and loneliness partially mediated this association. These findings underscore the importance of fostering positive social relationships in early life and suggest potential psychosocial strategies to mitigate dementia risk in older adults due to childhood peer relationship deficits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667935","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 of Psychotropic Prescriptions With Non-Registered Indications and the Risk of Mortality in Older Adults: A Danish Nationwide Cohort Study","authors":"Kazi Ishtiak-Ahmed,&nbsp;Christina Jensen-Dahm,&nbsp;Kaj Sparle Christensen,&nbsp;Gunhild Waldemar,&nbsp;Christiane Gasse","doi":"10.1002/gps.70014","DOIUrl":"10.1002/gps.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Psychotropic drug use is common in older adults, with off-label use reported despite limited understanding of the safety outcomes compared to on-label use. Incomplete recordings of treatment indications in the Danish National Prescription Register (DNPR) raise concerns about potential off-label medication use, particularly among older adults. We, therefore, investigated the association between psychotropic prescriptions with non-registered indications in DNPR and the 1-year all-cause mortality in older adults, including subgroups with any psychiatric disorders, depression, or dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Register-based cohort study following all older adults (≥ 65) who redeemed a first-time (since 1995) prescription of either antidepressants, antipsychotics, or benzodiazepine during 2006–2017. Redemption of a prescription with non-registered indications in the DNPR was the exposure. The outcome, 1-year all-cause mortality was analyzed using Poisson regression, estimating incidence rate ratios with 95% confidence intervals, adjusting for socio-demographics and clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>32% of prescriptions filled by 202,067 individuals for antidepressants, 37% of 97,387 for antipsychotics, and 22% of 130,471 for benzodiazepines had non-registered indications. No significant differences in mortality rates were found for antidepressants and antipsychotics with non-registered indications, while higher mortality rates were associated with benzodiazepines, mitigated when excluding individuals receiving intravenous administrations representing end-of-life treatment. The results remained consistent in subgroup analyses in patients with any psychiatric disorders, depression, or dementia and further stratified analyses by sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that while psychotropic prescriptions with non-registered indications in DNPR were prevalent in older adults, they were not associated with excess mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643962","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":"Comparing 30 Versus 60 min Cognitively Loaded Physical Exercise on Cognitive Function and Physical Health in Community-Dwelling Older Adults With Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial","authors":"Sung-Hyeon Kim,&nbsp;Ho-Jin Shin,&nbsp;Ji-Eun Baek,&nbsp;Ji Young Park,&nbsp;May Kim,&nbsp;Suk-Chan Hahm,&nbsp;Hwi-Young Cho","doi":"10.1002/gps.70012","DOIUrl":"10.1002/gps.70012","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;Mild cognitive impairment (MCI) is characterized by a mild decline in cognitive function and represents a risk stage for dementia in community-dwelling older adults. Exercise and dual-task training have been used to improve physical health, psychosocial health, and cognitive and learning functions in various subjects. However, the optimal time for these interventions has yet to be clearly identified. This study investigated the effects of cognitively loaded physical exercise (CLPE) on cognitive function and physical health in community-dwelling older adults with mild cognitive impairment and compared the differences according to exercise time.&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;Fifty-one community-dwelling aged 60 years or older with MCI were randomly assigned to 30-min CLPE (30CLPE, &lt;i&gt;n&lt;/i&gt; = 17), 60-min CLPE (60CLPE, &lt;i&gt;n&lt;/i&gt; = 17), and control (&lt;i&gt;n&lt;/i&gt; = 17) groups. The CLPE program consisted of a twice-weekly exercise program for 8 weeks. During the exercise, a dual task was performed to assess cognitive load. The control group performed a typical exercise program at a dementia center during the same period. The Korean version of the Montreal Cognitive Assessment was used to evaluate cognitive function, and various physical health factors were assessed using the handgrip dynamometer and pinch gauge, Senior Fitness Test, dynamic and static balance abilities, and gait variables.&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;After the intervention, both the 30CLPE and 60CLPE groups showed significant improvements in cognitive function, upper limb strength, senior fitness, balance, and gait (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), while the control group showed no significant changes in any of the variables (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). In between-group comparisons, both CLPE groups showed significantly improved cognitive and physical functions compared to the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, there was no significant difference between the 30 CLPE and 60 CLPE groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).&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;The results of this study demonstrate that cognitively loaded physical exercise is effective in improving cognitive and physical function in individuals with MCI. Both the 30-min and 60-min sessions resulted in significant improvements, with no statistically significant differences observed between the two durations. This suggests that persistence and consistency of exercise may be more important than the duration of individual sessions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619396","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":"Family Care Partner's Preparedness in Caring for Hospitalized Persons With Dementia","authors":"Anju Paudel,&nbsp;Azza Mubarak Al Harrasi,&nbsp;Ashley Kuzmik,&nbsp;Diane Berish,&nbsp;Ahmed-Rufai Yahaya,&nbsp;Marie Boltz","doi":"10.1002/gps.70013","DOIUrl":"10.1002/gps.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine care partner preparedness in caring for recently hospitalized persons with dementia and care partner characteristics associated with preparedness at discharge, 2 months, and 6 months post discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Stepwise regression in a sample of 461 care partners of hospitalized persons with dementia who participated in the Fam-FFC clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On average, care partners were 61.81 years old (<i>SD</i> = 14.19) and primarily female (<i>n</i> = 334, 72.5%). Care partners reported having some preparedness in general and it increased from discharge (23.75, <i>SD</i> = 6.78) to 2 months (24.5, <i>SD</i> = 6.49) and 6 months (26.35, <i>SD</i> = 6.73). Multiple care partner characteristics were associated with preparedness at discharge [age (<i>b</i> = −0.071; <i>p</i> &lt; 0.001), burden (<i>b</i> = −0.283; <i>p</i> &lt; 0.001), and depression (<i>b</i> = −0.284; <i>p</i> &lt; 0.01)], 2 months [burden (<i>b</i> = −0.226; <i>p</i> &lt; 0.001), strain (<i>b</i> = −0.144; <i>p</i> &lt; 0.05), depression (<i>b</i> = −0.185; <i>p</i> &lt; 0.05)] and 6 months [burden (<i>b</i> = −0.164; <i>p</i> &lt; 0.01), strain (<i>b</i> = −0.183; <i>p</i> &lt; 0.05), depression (<i>b</i> = −0.279; <i>p</i> &lt; 0.01)] post discharge. While care partners' feelings of greater burden and depression were associated with lower preparedness at all time points, care partners' higher age was associated with lower preparedness at discharge only and care partners' feelings of higher strain was associated with lower preparedness at two and 6 months post discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest the need to address care partners' feelings of burden, strain, and depression with tailored interventions and programs to optimize their preparedness in meeting unique care needs of hospitalized persons with dementia. Resilience-based interventions and programs can be useful to manage feelings of burden, strain, and depression and optimize preparedness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 11","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619412","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":"Loneliness as a Predictor of Disability in Older Adults: Implications of the UCLA Loneliness Scale Cutoff Score Across Cultural Contexts","authors":"Ju-Ling Chiu,&nbsp;Lien-Chung Wei","doi":"10.1002/gps.70011","DOIUrl":"10.1002/gps.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This letter responds to the study by Tomida et al. (2024) that validates the optimal cutoff score for the UCLA Loneliness Scale (UCLA-LS) to predict disability among older Japanese adults. The study identifies a cutoff score of 44, providing a significant indicator for the early detection of at-risk individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To discuss the implications of the identified cutoff score for public health and clinical practice, including its potential for early intervention and cross-cultural validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This commentary critically analyzes the findings of Tomida et al. (2024) and situates them within the broader literature on loneliness, disability, and aging. It also considers the multifactorial aspects of loneliness and disability in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The UCLA-LS cutoff score of 44 serves as a practical benchmark for clinicians, which can be integrated into routine health assessments to identify individuals at risk. We underscore the need for additional research on cross-cultural validation and mechanisms linking loneliness to disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We advocate for incorporating social support measures into standard care for older adults to mitigate the effects of loneliness on disability. This letter suggests future research directions, including exploring the causal pathways between loneliness and disability and developing culturally appropriate interventions.</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":"142619430","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":"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":"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}