International Journal of Geriatric Psychiatry最新文献

{"title":"ApoE Genotype, Age, and Cognitive Decline in Old Chinese Individuals Without Dementia: A Population-Based Study With Five-Year Follow-Up","authors":"Hao Wu,&nbsp;Xingzhong Gu,&nbsp;Shuai Liu,&nbsp;Pan Wang,&nbsp;Hui Lu,&nbsp;Yalin Guan,&nbsp;Zhihong Shi,&nbsp;Yong Ji","doi":"10.1002/gps.70045","DOIUrl":"10.1002/gps.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Apolipoprotein E (ApoE) ε4 genotype is a well-known risk factor for Alzheimer's disease (AD). However, its effect on predicting cognitive decline in individuals without dementia and its association with age are unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the relationship between ApoE polymorphism and risk of cognitive decline and dementia incidence in the elderly without dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This population-based prospective study was conducted between 2011 and 2016. The study involved 767 dementia-free individuals who had undergone ApoE genotype analysis, were aged ≥ 60 years, and lived in rural China. Participants were divided into three ApoE groups: E3 (genotype 3/3), E4 (genotypes 3/4 and 4/4), and E2 (genotype 2/3) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 5 years, 666 (86.8%) individuals were followed up. The rate of change in MMSE score was faster in the E4 group than in the E3 and E2 groups (5.0 ± 4.4 vs. 3.5 ± 3.8 vs. 3.9 ± 3.9, <i>p</i> = 0.001), after adjusting for age, sex, educational level and baseline MMSE scores, especially in the 70–79 years age group. In the same age group, the incidence rate of dementia was higher in the E4 group than in the E3 group (OR = 2.850; 95% CI: 1.146–7.090). After adjusting for age, sex, hypertensive status, educational level, marital status, engagement in social activities, and past history of stroke, the ApoE ε4 allele remained an independent risk factor for dementia incidence (OR = 3.070; 95% CI: 1.162–8.110) in individuals aged 70–79 years after follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ApoE ε4 carriers with age ≥ 60 years had faster cognitive decline. The ApoE ε4 allele was an independent risk factor for dementia incidence in extremely old individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005160","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":"Housing Relocation and Residential Satisfaction After Relocation: Effects of Dwelling Condition Changes on Older Adults in the Community","authors":"Gum-Ryeong Park,&nbsp;Bo Kyong Seo,&nbsp;Eun Ha Namkung","doi":"10.1002/gps.70044","DOIUrl":"10.1002/gps.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study seeks to analyze the trajectories of residential satisfaction among older adults before and after relocation and explore the variability in the relationship between relocation and residential satisfaction based on changes in housing conditions during the relocation process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing a nationally representative longitudinal dataset of older adults (<i>N</i> = 2718), this study employs individual-level fixed effect regression models to estimate the association between the timing of relocation and residential satisfaction. Stratified analyses are also conducted to explore how this association varies based on changes in housing conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Residential satisfaction tends to decrease before relocation, peaks at the time of relocation, and maintain higher levels as older adults adapt to their new environment. This adaptation process varies depending on changes in dwelling conditions during relocation, with transitions from poor to non-poor housing conditions positively affecting psychological responses, while moves from non-poor to poor conditions can lead to increased psychological burden and prolonged adjustment periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Aging policies can prioritize programs that facilitate adjustment to new environments to improve residential satisfaction of older adults, thereby promoting healthy aging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005161","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":"Welfare to Meaningful Work","authors":"Tsuyoshi Okamura,&nbsp;Ai Iizuka,&nbsp;Mihoko Mitsui,&nbsp;Hana Sakurai,&nbsp;Mariko Nishi,&nbsp;Chiaki Ura","doi":"10.1002/gps.70043","DOIUrl":"10.1002/gps.70043","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983464","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":"Caregiver Psychosocial Factors & Stroke Survivor Cognitive Outcomes: A REGARDS-CARES Cohort Study","authors":"Jason A. Blake,&nbsp;D. Leann Long,&nbsp;Amy J. Knight,&nbsp;Burel R. Goodin,&nbsp;Michael Crowe,&nbsp;Suzanne E. Judd,&nbsp;J. David Rhodes,&nbsp;Olivio J. Clay","doi":"10.1002/gps.70046","DOIUrl":"10.1002/gps.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Caring for an individual with cognitive impairment carries a physical, mental, and emotional toll. This manuscript examines the relationship between caregiver psychosocial measures and longitudinal cognitive outcomes of stroke survivors, as well as analyzing the psychosocial factors as moderators of stroke severity and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis was conducted on caregiver and stroke survivor dyads (<i>n</i> = 157) that participated in the Caring for Adults Recovering from the Effects of Stroke (CARES) project, an ancillary study of the REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study. Stroke severity at hospitalization discharge was included as the primary predictor of cognitive outcomes and caregiver psychosocial factors were included as additional predictors. Cognition was assessed biennially and measured the domains of learning, memory, and executive functioning. Individual mixed-effect models included each psychosocial factor and were covariate-adjusted for pre-stroke cognitive scores and demographic variables. Caregiver psychosocial factors included caregiver strain, depressive symptoms, life and leisure time satisfaction, and overall quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Decreased caregiver strain (<i>b</i> = −0.230, 95% CI: −0.39 to −0.07; <i>p</i> = 0.006) and increased leisure time satisfaction (<i>b</i> = 0.045, 95% CI: 0.01 to 0.08; <i>p</i> = 0.005) were both found to be significant predictors, alongside stroke severity (<i>b</i> = −0.137, 95% CI: −0.22 to −0.05; <i>p</i> = 0.002), of better stroke survivor cognition overall. No variables were found to be moderating factors of the relationship between stroke severity and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding the caregiver psychosocial factors that predict stroke outcomes will help clinicians to identify stroke survivor and caregiver dyads at higher risk for worst longitudinal cognitive outcomes following stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970653","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":"Preliminary Evidence for Perturbation-Based tACS-EEG Biomarkers of Gamma Activity in Alzheimer's Disease","authors":"Annalisa Palmisano,&nbsp;Luke R. Pezanko,&nbsp;Davide Cappon,&nbsp;Elisa Tatti,&nbsp;Joanna Macone,&nbsp;Giacomo Koch,&nbsp;Carmelo L. Smeralda,&nbsp;Sara M. Romanella,&nbsp;Giulio Ruffini,&nbsp;Davide Rivolta,&nbsp;Daniel Z. Press,&nbsp;Alvaro Pascual-Leone,&nbsp;Georges El-Fakhri,&nbsp;Emiliano Santarnecchi","doi":"10.1002/gps.70025","DOIUrl":"10.1002/gps.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alzheimer's disease (AD) is characterized by impaired inhibitory circuitry and GABAergic dysfunction, which is associated with reduced fast brain oscillations in the gamma band (γ, 30–90 Hz) in several animal models. Investigating such activity in human patients could lead to the identification of novel biomarkers of diagnostic and prognostic value. The current study aimed to test a multimodal “Perturbation-based” transcranial Alternating Current Stimulation-Electroencephalography (tACS)-EEG protocol to detect how responses to tACS in AD patients correlate with patients' clinical phenotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen participants with mild to moderate dementia due to AD underwent a baseline assessment including cognitive status, peripheral neuroinflammation, and resting-state (rs)EEG. The tACS-EEG recordings included brief (6′) tACS blocks of gamma (i.e., 40 Hz) stimulation administered through 4 different montages, with Pre/Post 32-Channels EEG for each block. Changes in tACS-EEG and rsEEG γ band power with respect to baseline were adopted as a metric of induction and compared with cognitive scores and neuroinflammatory biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found positive correlations between 40 Hz-induced γ activity in fronto-central-parietal areas and patient cognitive status and negative ones with neuroinflammatory markers. Participants with greater cognitive impairment exhibited less γ induction and higher peripheral neuroinflammation. The same analysis performed with spectral power from baseline rsEEG resulted in no significant correlations, promoting the value of tACS-based perturbation for capturing individual differences in pathology-related brain features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our work suggests a link between tACS-induced γ band spectral power and clinical severity, with weaker γ induction corresponding to more severe clinical/cognitive impairment. This study provides preliminary support for the development of novel physiological biomarkers and therapeutic targets based on disease severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970657","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":"Variation of the Risk Associated With Potentially Modifiable Risk Factors for Dementia Between Ethnic Groups Within One Country. A Retrospective Cohort Study Using Routinely Collected Health Data in Aotearoa New Zealand","authors":"Etuini Ma'u,&nbsp;Sarah Cullum,&nbsp;Gary Cheung,&nbsp;Jade Tamatea,&nbsp;Gill Livingston,&nbsp;Naaheed Mukadam","doi":"10.1002/gps.70042","DOIUrl":"10.1002/gps.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>While risk factor prevalence of individual risk factors for dementia varies between ethnic groups in New Zealand (NZ), it is not known whether the effect of these risks is the same in each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study identified incident cases of dementia. Cox regression models calculated the hazard ratio for dementia for each of the risk factors, after adjustment for age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Education, smoking, diabetes, depression, physical activity and social isolation were associated with a 1.13–1.55 times increased risk of dementia. We did not demonstrate an association between dementia risk and hypertension, alcohol, or air pollution. Differences between ethnic groups is suggested but not confirmed due to study power.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Differences in dementia prevention potential between ethnic groups in NZ are potentially contributed to by both differential prevalence and risk factor effects. Public health strategies must be tailored for the ethnic populations at most risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948522","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":"Prevention Is Better Than Cure: Public Understanding of Preventing Neurodegenerative Disorders","authors":"Alison Thomson,&nbsp;Charlotte Kenten,&nbsp;Sube Banerjee,&nbsp;Sallyann Browning,&nbsp;Tommy Pouncey,&nbsp;Rachel Horne,&nbsp;Claudia Cooper,&nbsp;DeNPRU-QM","doi":"10.1002/gps.70038","DOIUrl":"10.1002/gps.70038","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948508","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":"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}