International Journal of Geriatric Psychiatry最新文献

{"title":"Evaluating the Regional and Demographic Variations in Dementia-Related Mortality Trends in the United States: 1999 to 2020","authors":"Muhammad Mukarram Shoaib,&nbsp;Malik Saad Hayat,&nbsp;Zain Ali Nadeem,&nbsp;Muhammad Mohtasham Shoaib,&nbsp;Sara Sohail,&nbsp;Abdullah Tahir Mirza,&nbsp;Fatima Shahid","doi":"10.1002/gps.70004","DOIUrl":"10.1002/gps.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dementia, a term for a range of cognitive impairments impacting memory, thinking, and social abilities, represents a formidable challenge to healthcare systems worldwide. Analysing the temporal trends in dementia-related mortality among individuals, identifying the populations at high risk, and guiding the implementation of tailored interventions to address the escalating effects of dementia on public health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from CDC WONDER database was examined from 1999 to 2020 for the four causes of dementia mortality: unspecified dementia (F03), Alzheimer's disease (G30), vascular dementia (F01), and other degenerative diseases of nervous system not elsewhere classified (G31). Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by geographic region, year, age groups, sex, and race/ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4,077,973 reported deaths were related to dementia from 1999 to 2020 in the United States. The greatest proportion of deaths was associated with Alzheimer's disease (45.9%), followed by unspecified dementia (43.8%). Very low proportion of deaths were associated with vascular dementia (4.9%) or other neurodegenerative diseases (5.3%). The AAMR increased in two distinct periods: a steep incline from 1999 to 2010 (APC: 6.95, 95% CI: 6.00–7.90), followed by a modest incline till 2020 (APC: 1.41, 95% CI: 0.80–2.04). Overall, females had a higher AAMR than males. AAMRs were highest among NH Whites patients and lowest in NH Asians or Pacific Islanders. A significant geographical difference was also observed among different US census regions. Nearly equal AAMRs were seen in non-metropolitan areas and metropolitan areas. States with AAMRs in the top 90th percentile included South Carolina, North Carolina, Maine, Tennessee, Georgia, and Alabama while states with AAMRs in the bottom 10th percentile included South Dakota, Florida, Hawaii, New Jersey, District of Columbia, and New York (33.1). Individuals aged above 85 had the highest AAMRs. Most deaths occurred in nursing homes and least in hospice facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The dementia related deaths are continuously increasing. Highest AAMRs were observed among the NH White people, females, and in the southern areas of the United States. People aged 85+ were most affected. To stop the rising death rates, targeted interventions and awareness are required for both prevention and treatment of dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464687","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 Mediating Effect of Physical Performance on Physical Activity and Mild Cognitive Impairment Among Older Adults With Type 2 Diabetes in Rural China","authors":"Xueyan Liu,&nbsp;Yingjuan Cao","doi":"10.1002/gps.70001","DOIUrl":"10.1002/gps.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the intermediary role of physical performance in the association between physical activity and mild cognitive impairment (MCI) in older adults with type 2 diabetes mellitus (T2DM), residing in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study employed a random sampling method to select 316 patients aged 65 years and older, all diagnosed with T2DM, from 24 different rural areas in China. The relationships between physical activity, physical performance, and MCI were analyzed using a logistic regression model, and the proposed mediation model was validated through bootstrap test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, the prevalence of MCI in the rural-based older adults with T2DM was 53.48%. A significant correlation was observed between the levels of physical activity and physical performance. Moreover, diminished physical performance was positively correlated with an increased propensity for MCI, even after adjusting for relevant covariates. Physical performance was discerned to exert a partial mediating influence on the relationship between physical activity and MCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The empirical evidence generated by this study posits that the impact of physical activity on MCI is partially mediated through physical performance in an aging population with T2DM residing in rural environments. Consequently, interventional strategies aimed at ameliorating physical performance may serve as a viable approach to mitigate the progression of cognitive decline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464689","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":"Projected Annual Lecanemab Treatment Eligibility in an Irish Regional Specialist Memory Clinic","authors":"Eimear Connolly,&nbsp;Antoinette O'Connor,&nbsp;Helena Dolphin,&nbsp;Adam H. Dyer,&nbsp;Aoife Fallon,&nbsp;Sean O'Dowd,&nbsp;Sean P. Kennelly","doi":"10.1002/gps.6157","DOIUrl":"10.1002/gps.6157","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 advent of Disease Modifying Therapies (DMTs) for the treatment of Alzheimer's Disease (AD) has the potential to transform the lives of those with early AD. Timely identification of eligible patients is needed to ensure treatments are delivered during a narrow window of therapeutic opportunity. Appropriate clinical service design will hinge on improved understanding of future demands, thus there is a pressing need to investigate patient eligibility in real world clinical cohorts. The primary aim of this study is to assess the eligibility by appropriate use criteria (AUC) for lecanemab therapy in a real-world, undifferentiated clinical patient cohort attending a Regional Specialist Memory Clinic (RSMC), with the secondary aims of determining the proportion of patients with biomarker positive Alzheimer's Disease (AD) who would be eligible for lecanemab therapy by AUC. Clinical trial eligibility criteria were also applied to both groups and discrepancies that exist between eligibility rates explored.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective cohort study of all new patients attending a RSMC from 1st January 2022 to 31st December 2022 was conducted. Data collected included demographic details, outcomes of diagnostic assessments and comorbidities. MRI images, where indicated, were reviewed. Amyloid positivity was defined as either Amyloid and Tau positive (A+T+) or Amyloid positive with a positive P-Tau/Ab42 ratio on cerebrospinal fluid (CSF) testing. Appropriate use criteria (AUC) and clinical trial criteria for lecanemab were applied. Proportion of eligible patients was calculated.&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;Eleven (5.9%) of 188 new patient attenders were eligible (average age 66.7 years [SD 8.9], 63.6% female) by AUC, with 26.2% of patients with biomarker positive Alzheimer's Disease eligible for lecanemab therapy. The most common reason for exclusion was a lack of biomarker confirmation of AD pathology followed by cognitive ineligibility (based on defined cognitive testing cut-offs) at the time of referral and/or initial assessment. Only 40.4% of patients had CSF testing for AD biomarkers while almost 20% of the patients with biomarker positive AD were excluded due to lack of a screening MRI in the previous 12 months.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this study, the potential eligibility rate by AUC of the entire patient cohort (5.9%) was limited by the small proportion of patients who had CSF testing for AD biomarkers. So while disease-modification ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390421","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 the COVID-19 Pandemic on Suicidal Ideation and Depression in Community-Dwelling Elderly","authors":"Kyungmin Kim,&nbsp;Bo-Hyun Yoon,&nbsp;Young-Hwa Sea,&nbsp;Suhee Park,&nbsp;Haran Jung,&nbsp;Yuran Jung,&nbsp;Je-Heon Song,&nbsp;Hyunju Yun,&nbsp;Hangoeunbi Kang","doi":"10.1002/gps.6150","DOIUrl":"10.1002/gps.6150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380794","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":"Bidirectional Relationship Between Long Sleep Duration and Cardiac Autonomic Control in Community-Dwelling Older Adults: The Yilan Study, Taiwan","authors":"Ruei-An Lin,&nbsp;Chia-Ling Liao,&nbsp;Po-Jung Pan,&nbsp;Nai-Wei Hsu,&nbsp;Hsi-Chung Chen","doi":"10.1002/gps.6155","DOIUrl":"10.1002/gps.6155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Long sleep duration predicts adverse health outcomes in older adults. Impaired cardiac autonomic control (CAC) is a potential pathomechanism that links this relationship; however, the causal relationship between long sleep duration and CAC remains unclear. This study aimed to determine the temporal relationship between long sleep duration and poor CAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a community-based, fixed-cohort, follow-up study that recruited community-dwelling older adults aged ≥ 65 years. Self-reported sleep duration was categorized as short (≤ 5 h), mid-range (6–7 h), and long (≥ 8 h). Participants with short or long sleep duration were defined as cases. CAC was measured using heart rate variability (HRV), and cases were classified using cutoffs defined by the lowest quintiles of four HRV parameters. Non-case participants for sleep duration or CAC at baseline were followed. Binary and multinomial logistic regression analyses were conducted to examine baseline variables that predicted incident CAC decline and changes in sleep duration, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 772 individuals were recruited, with a mean follow-up period of 5.8 ± 1.7 years. In multivariable analyses, long sleep duration at baseline predicted a higher risk of cardiac vagal control decline in the follow-up visit (odds ratio: 1.86, 95% confidence interval: 1.00–3.44). Conversely, all HRV parameters at baseline failed to predict changes in sleep duration at the follow-up visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long sleep duration seems to precede the decline in CAC in community-dwelling older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375430","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":"Mild Behavioral Impairment and Quality of Life in Community Dwelling Older Adults","authors":"Ibadat Warring,&nbsp;Dylan Guan,&nbsp;Clive Ballard,&nbsp;Bryon Creese,&nbsp;Anne Corbett,&nbsp;Ellie Pickering,&nbsp;Pamela Roach,&nbsp;Eric E. Smith,&nbsp;Zahinoor Ismail","doi":"10.1002/gps.6153","DOIUrl":"10.1002/gps.6153","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 behavioral impairment (MBI) is a dementia risk indicator in older adults characterized by later-life emergent and persistent neuropsychiatric symptoms. Quality of life (QoL) is a multi-dimensional concept encompassing physical, spiritual, and emotional well-being. QoL aims to measure and quantify perceptions of individual health, well-being, standard of living, personal fulfillment, and satisfaction. As MBI symptoms may arise from early-stage neurodegenerative disease, MBI may contribute to declining QoL before dementia onset. In this study, we investigated the relationship between symptoms of MBI and QoL in older adults.&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;The sample comprised 1107 individuals aged ≥ 50 years from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN-PROTECT). Multivariable linear regressions were used to model the associations between MBI symptom severity (exposure), measured using the MBI Checklist (MBI-C), and QoL (outcome) assessed by the EuroQol-5D (EQ-5D, higher score = poorer QoL) and the novel Quality of Life and Function Five Domain Scale (QFS-5) (QFS-5, lower score = poorer QoL). Covariates were age, sex, cognition, education, ethnocultural origin, marital status, employment status, high blood pressure, heart disease, and diabetes. Moderation analysis explored potential sex differences. A sensitivity analysis was performed removing anxiety/depression items from the EQ-5D score.&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;Across the sample (mean age = 64.4 ± 7.2, 79.4% female) every 1-point increase in MBI-C score was associated with a 0.06-point standard deviation (SD) increase in EQ-5D score (95% confidence interval (CI): 0.05–0.06, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and 0.08 SD decrease in QFS-5 score (95% CI: −0.09 to −0.08, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Neither association depended on sex (&lt;i&gt;p&lt;/i&gt; = 0.59 and &lt;i&gt;p&lt;/i&gt; = 0.41, respectively). The association remained significant after removing anxiety/depression items from the EQ-5D score (&lt;i&gt;β&lt;/i&gt; = 0.04, 95% CI: 0.03– 0.04, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&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 study shows that MBI is associated with poorer QoL, independent of sex, on two QoL scales. We addressed depression/anxiety items in the EQ-5D as a potential confounder for the observed MBI-QoL association by conducting a sensitivity analysis that excluded those items from the EQ-5D total score and by employing a novel measure of QoL (QFS-5) that exclud","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346199","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":"Exploring the Neural Mechanisms of Mirrored-Self Misidentification in Alzheimer's Disease","authors":"Zhen Sun,&nbsp;Gang Chen,&nbsp;Jinghuan Gan,&nbsp;Yuqiao Tang,&nbsp;Hao Wu,&nbsp;Zhihong Shi,&nbsp;Tingting Yi,&nbsp;Yaqi Yang,&nbsp;Shuai Liu,&nbsp;Yong Ji","doi":"10.1002/gps.6148","DOIUrl":"10.1002/gps.6148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Alzheimer's disease (AD) is a complex neurodegenerative condition that causes a range of cognitive disturbances, including mirror-self misidentification syndrome (MSM), in which patients cannot recognize themselves in a mirror. However, the mechanism of action of MSM is not precisely known. This study aimed to explore the possible neural mechanisms of action of MSM in AD using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 48 AD patients, 13 in the MSM group and 35 in the non-MSM group. The permeability of the blood–brain barrier (BBB) was quantitatively monitored by measuring the transfer rate (<i>K</i>_trans) of the contrast agent from the vasculature to the surrounding tissue using DCE-MRI. The concentration of contrast agents in different brain regions was measured, and the Patlak model was used to calculate <i>K</i>_trans. <i>K</i>_trans values were compared between the left and right cerebral hemispheres in different brain areas between the MSM and non-MSM groups. Additionally, the difference in <i>K</i>_trans values between mild and severe MSM was assessed. Logistic regression analysis was used to examine the risk factors for MSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Mann‒Whitney <i>U</i> test was used to compare two groups and revealed elevated <i>K</i>_trans values in the left thalamus, left putamen, left globus pallidus, left corona radiata, and right caudate in the MSM group (<i>p</i> &lt; 0.05). Logistic regression analysis revealed that increased <i>K</i>_trans values in the left putamen (OR = 1.53, 95% CI = 1.04, 2.26) and left globus pallidus (OR = 1.54, 95% CI = 1.02, 2.31) may be risk factors for MSM. After dividing MSM patients into mild and moderate-severe groups, the <i>K</i>_trans values of the thalamus in the moderate-severe group were greater than those in the mild group (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study revealed the relationship between BBB permeability and MSM in AD. MSM is associated with BBB breakdown in the left putamen and globus pallidus. The left putamen and globus pallidus may function in mirror self-recognition. Higher BBB permeability in the thalamus may reflect the severity of AD in MSM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346198","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":"Paid Employment and Mental Health in 65–74-Year-Olds: Analysis of National Data From 2000, 2007 and 2014","authors":"Gayan Perera,&nbsp;Karen Glaser,&nbsp;Giorgio Di Gessa,&nbsp;Robert Stewart","doi":"10.1002/gps.6143","DOIUrl":"https://doi.org/10.1002/gps.6143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Employment rates for people aged 65 and over have been changing rapidly in many countries, but little is known about associations of employment status with mental health status and their stability over time. We therefore investigated mental health associations with employment status in 65–74-year-olds in three national samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data for these analyses were drawn from three national surveys of psychiatric morbidity among adults in England living in private households carried out in 2000, 2007, and 2014. Employment status was the primary exposure of interest. Common mental disorder (CMD) and constituent symptoms were ascertained identically in the three surveys from the revised Clinical Interview Schedule. Covariates included identical demographic, social and physical health measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant association between non-employment and CMD was present in 2007 (odds ratio 2.66 [95% CI: 1.02–7.83]) but there was no significant association between non-employment and CMD in 2000 or 2014. The largest attenuation in the association between non-employment and CMD was seen when adjusted for physical health related factors. In combined samples, non-employment was most strongly associated with self-reported cognitive difficulties (OR 1.25, 1.01–1.61), depressive ideas (1.30, 1.01–1.67), worry (1.30, 1.01–1.68), and anxiety (1.27, 1.00–1.64) as constituent CMD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evidence is still unclear whether employment after statutory retirement ages is associated with better mental health, and associations may be symptom-specific. In the light of policies to encourage older workers to remain active in the labour market, more research is needed into the interrelationships between paid work and mental health, as well as other outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324714","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":"Young Onset Dementia in New South Wales, Australia in 1891: What has Changed Since Then?","authors":"Brian Michael Draper,&nbsp;Samantha Loi","doi":"10.1002/gps.6154","DOIUrl":"10.1002/gps.6154","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;This study aimed to determine the prevalence and types of young onset dementia (YOD) in New South Wales (NSW), Australia, in 1891 with comparisons to 21st century estimates. Changes might inform future service planning for persons with YOD.&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;Medical case books of two Hospitals for the Insane were examined at the State Archives and clinical and sociodemographic information extracted of persons who were under the age of 65 in April 1891, when a NSW Census occurred, and were given a dementia diagnosis or had symptoms consistent with dementia. Consensus 21st century ‘probable’ and ‘possible’ all cause dementia and major neurocognitive disorder diagnoses were determined by two psychiatrists. Prevalence estimates of moderate-severe dementia were determined and compared with 21st century estimates and dementia types.&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;Of 161 potential dementia cases, 123 were given a consensus ‘probable’ dementia diagnosis, 28 a ‘possible’ dementia diagnosis, and ten were given a non-dementia diagnosis, with ‘all cause dementia’ and ‘major neurocognitive disorder’ diagnoses identical. Most dementia cases were male (&lt;i&gt;n&lt;/i&gt; = 119, 78.8%). ‘Unspecified dementia’ was the most frequent diagnosis (&lt;i&gt;n&lt;/i&gt; = 47, 31.1%), followed by dementia secondary to syphilis (&lt;i&gt;n&lt;/i&gt; = 35, 23.2%), epileptic dementia (&lt;i&gt;n&lt;/i&gt; = 30, 19.9%), alcohol-related dementia (&lt;i&gt;n&lt;/i&gt; = 17, 11.3%), and mixed dementia (&lt;i&gt;n&lt;/i&gt; = 16, 10.6%). Epileptic dementia had the youngest average age of admission (34.9 years). Other than epileptic dementia, all other dementia types were more frequent in males. Prominent clinical symptoms included neurological signs (&lt;i&gt;n&lt;/i&gt; = 79, 52.3%), psychosis (&lt;i&gt;n&lt;/i&gt; = 77, 51.0%), agitation (&lt;i&gt;n&lt;/i&gt; = 75, 49.7%), and aggression (&lt;i&gt;n&lt;/i&gt; = 45, 29.8%). Most dementia cases either died in hospital (&lt;i&gt;n&lt;/i&gt; = 79, 52.3%) or were transferred to a long stay hospital (&lt;i&gt;n&lt;/i&gt; = 57, 37.7%). The estimated point prevalence of YOD in persons aged 30–59 in 1891 (86 per 100,000) was higher than current Australian and global estimates in this age group due to the high rates in males (126 per 100,000), but in those aged 60–64, the prevalence in 1891 (159 per 100,000) was much lower than current estimates.&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 first examination of YOD in the nineteenth century found high rates of dementia in those under the age of 60 compared with current estimates, particularly in men aged between 30 and 59 years old, and","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307736","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":"Survival After the Diagnosis of Mild-to-Moderate Alzheimer's Disease Dementia: A 15-Year National Cohort Study in Taiwan","authors":"Yu Sun,&nbsp;Chih-Ching Liu,&nbsp;Chung-Yi Li,&nbsp;Ming-Jang Chiu","doi":"10.1002/gps.6152","DOIUrl":"https://doi.org/10.1002/gps.6152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pharmacological and non-pharmacological interventions are mostly designed for patients with early Alzheimer's disease (AD) dementia. Long-term case management and planning for the remainder of life with disability require an estimation of the survival duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study utilized data from the National Health Insurance Research Database, Taiwan, to identify incident cases of mild-to-moderate AD dementia diagnosed from 2000 to 2002, followed through December 31, 2017. A multivariate Cox proportional hazards regression model was constructed to compare the independent effects of age, sex, and comorbidities on all-cause mortality risk. Cumulative survival rates and survival times were estimated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 5258 incident cases were identified, all treated with cholinesterase inhibitors after diagnosis confirmation by an expert committee. During the 15-year follow-up period, 4331 deaths occurred. The 1-, 3-, 5-, 10-, and 15-year cumulative survival rates were 95, 92, 67, 37, and 18, respectively. The median (95% CI) survival time after diagnosis was 7.69 (7.46–7.90) years overall, 6.37 (6.06–6.65) years in men, and 8.81 (8.49–9.12) years in women. After stratification by age and number of comorbidities, the median survival time ranged from 13.72 (ages 40–64) to 5.29 (ages ≥ 80) years among those without comorbidities. For those with ≥ 3 comorbidities, the median survival times decreased to 6.43 for individuals diagnosed at ages 40–64 and to 2.98 years for those diagnosed at age 80 or older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This nationwide, large, long-term cohort study provided survival rates and durations from diagnosis to death, varying by sex, age group, and presence/number of comorbidities. This information can serve as a foundation for further cost-effectiveness studies on new treatments, and may aid clinicians, patients, and families in shared decision-making and advance personalized care planning for early dementia cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276645","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}