International psychogeriatrics最新文献

{"title":"Determinants of suicidal behavior in dementia: A Swedish national register-based study.","authors":"Khedidja Hedna, Robert Sigström, Kristina Johnell, Margda Waern","doi":"10.1017/S1041610223000583","DOIUrl":"10.1017/S1041610223000583","url":null,"abstract":"<p><strong>Objectives: </strong>To examine predictors of suicidal behavior (SB) in adults aged 75 years and above with dementia.</p><p><strong>Design: </strong>Longitudinal national register-based study.</p><p><strong>Participants and setting: </strong>Swedish residents aged ≥75 years with dementia identified in the Swedish Dementia Registry (SveDem) between 1 January 2007 and 31 December 2017 (<i>N</i> = 59 042) and followed until 31 December 2018. Data were linked with numerous national registers using personal identity numbers.</p><p><strong>Measurements: </strong>Outcomes were nonfatal self-harm and suicide. Fine and Gray regression models were used to investigate demographics, comorbidities, and psychoactive medications associated with fatal and nonfatal SB.</p><p><strong>Results: </strong>Suicidal behavior was observed in 160 persons after dementia diagnosis; 29 of these died by suicide. Adjusted sub-hazard ratio (aSHRs) for SB was increased in those who had a previous episode of self-harm (aSHR = 14.42; 95% confidence interval [CI] = 7.06-29.46), those with serious depression (aSHR = 4.33, 95%CI = 2.94-6.4), and in those born outside Sweden (aSHR = 1.53; 95% CI = 1.03-2.27). Use of hypnotics or anxiolytics was also associated with a higher risk of SB; use of antidepressants was not. Milder dementia and higher frailty score also increased risk of SB. Risk was decreased in those who received home care (aSHR = 0.52; 95%CI = 0.38-0.71) and in the oldest group (aSHR = 0.35; 95%CI = 0.25-0.49).</p><p><strong>Conclusion: </strong>In addition to established targets for suicidal behavior prevention (improved identification and treatment of depression and previous self-harm), several new risk factors were suggested. There is a need for innovative public health strategies to meet the needs of older dementia patients with a foreign background. Home care may have a potential positive effect to prevent SB in people with dementia, but this needs to be further explored.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"415-426"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma in childhood: therapeutic implications of the differences between early-life and late-life suicidal behavior.","authors":"Gary J Kennedy","doi":"10.1017/S1041610223000984","DOIUrl":"10.1017/S1041610223000984","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"326-328"},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of psychosocial protective factors against suicide and suicidality among older adults.","authors":"Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara","doi":"10.1017/S104161022300443X","DOIUrl":"10.1017/S104161022300443X","url":null,"abstract":"<p><strong>Background: </strong>Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults.</p><p><strong>Method: </strong>First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis.</p><p><strong>Results: </strong>A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures.</p><p><strong>Conclusion: </strong>Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"346-370"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Symptoms and White Matter Hyperintensities in Older Adults without Dementia","authors":"Ioannis Liampas, Vasileios Siokas, Elli Zoupa, Panayiota Kyriakoulopoulou, Polyxeni Stamati, Antonios Provatas, Zisis Tsouris, Vana Tsimourtou, Constantine G. Lyketsos, Efthimios Dardiotis","doi":"10.1017/s1041610224000607","DOIUrl":"https://doi.org/10.1017/s1041610224000607","url":null,"abstract":"Objective: We aimed to examine associations between neuropsychiatric symptoms (NPS) and white matter hyperintensities (WMH) status in older adults without dementia under the hypothesis that WMH increased the odds of having NPS. Design: Longitudinal analysis of data acquired from the National Alzheimer’s Coordinating Center Uniform Data Set. Settings: Data were derived from 46 National Institute on Aging - funded Alzheimer’s Disease Research Centers. Participants: NACC participants aged ≥50 years with available data on WMH severity with a diagnosis of mild cognitive impairment (MCI) or who were cognitively unimpaired (CU) were studied. Among 4617 CU participants, 376 had moderate and 54 extensive WMH. Among 3170 participants with MCI, 471 had moderate and 88 had extensive WMH. Measurements: Using Cardiovascular Health Study (CHS) scores, WMH were coded as no to mild (CHS score: 0-4), moderate (score: 5-6) or extensive (score: 7-8). NPS were quantified on the Neuropsychiatric Inventory Questionnaire. Binary logistic regression models estimated the odds of reporting each of 12 NPS by WMH status separately for individuals with MCI or who were CU. Results: Compared to CU individuals with no to mild WMH, the odds of having elation [9.87,(2.63-37.10)], disinhibition [4.42,(1.28-15.32)], agitation [3.51,(1.29-9.54)] or anxiety [2.74,(1.28-5.88)] were higher for the extensive WMH group, whereas the odds of having disinhibition were higher for the moderate WMH group [1.94,(1.05-3.61)]. In the MCI group, he odds of NPS did not vary by WMH status. Conclusions: Extensive WMH were associated with higher odds of NPS in CU older adults but not in those with MCI.","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":"34 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive symptoms and cognitive decline in older adults","authors":"Malcolm Forbes, Mojtaba Lotfaliany, Mohammadreza Mohebbi, Charles F. Reynolds, Robyn L. Woods, Suzanne Orchard, Trevor Chong, Bruno Agustini, Adrienne O’Neil, Joanne Ryan, Michael Berk","doi":"10.1017/s1041610224000541","DOIUrl":"https://doi.org/10.1017/s1041610224000541","url":null,"abstract":"<span>Objectives:</span><p>Few studies have examined the impact of late-life depression trajectories on specific domains of cognitive function. This study aims to delineate how different depressive symptom trajectories specifically affect cognitive function in older adults.</p><span>Design:</span><p>Prospective longitudinal cohort study</p><span>Setting:</span><p>Australia and the United States of America</p><span>Participants:</span><p>In total, 11,035 community-dwelling older adults with a mean age of 75 years</p><span>Measurements:</span><p>Depressive trajectories were modelled from depressive symptoms according to annual Centre for Epidemiological Studies Depression Scale 10 (CES-D-10) surveys. Four trajectories of depressive symptoms were identified: low (“nondepressed”), consistently mild (“subthreshold depression”), consistently moderate (“persistent depression”), and initially low but increasing (“emerging depression”). Global cognition (Modified Mini-Mental State Examination [3MS]), verbal fluency (Controlled Oral Word Association Test [COWAT]), processing speed (Symbol Digit Modalities Test [SDMT]), episodic memory (Hopkins Verbal Learning Test – Revised [HVLT-R]), and a composite z-score were assessed over a subsequent median 2 years.</p><span>Results:</span><p>Subthreshold depression predicted impaired performance on the SDMT (Cohen’s <span>d</span> −0.04) and composite score (−0.03); emerging depression predicted impaired performance on the SDMT (−0.13), HVLT-R (−0.09), 3 MS (−0.08) and composite score (−0.09); and persistent depression predicted impaired performance on the SDMT (−0.08), 3 MS (−0.11), and composite score (−0.09).</p><span>Conclusions:</span><p>Depressive symptoms are associated with later impaired processing speed. These effects are small. Diverse depression trajectories have different impacts on cognitive function.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":"38 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social participation, loneliness, and physical inactivity over time: evidence from SHARE.","authors":"Zaira Torres, José M Tomás, Trinidad Sentandreu-Mañó, Irene Fernández, Nuria Pla-Sanz","doi":"10.1017/S1041610224000504","DOIUrl":"https://doi.org/10.1017/S1041610224000504","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old.</p><p><strong>Design: </strong>A longitudinal study with a six-year follow-up period was conducted.</p><p><strong>Setting: </strong>Four waves of the Survey of Health, Ageing and Retirement in Europe project were used.</p><p><strong>Participants: </strong>This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time.</p><p><strong>Measurements: </strong>The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables.</p><p><strong>Results: </strong>A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (<i>χ</i>² = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness.</p><p><strong>Conclusions: </strong>These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"1-9"},"PeriodicalIF":7.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities for falls prevention in older adults with mild cognitive impairment.","authors":"Susan W Hunter","doi":"10.1017/S1041610223000649","DOIUrl":"10.1017/S1041610223000649","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"235-237"},"PeriodicalIF":7.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10235132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward international consensus on the definition of agitation in cognitive disorders.","authors":"Diego De Leo, Josephine Zammarrelli","doi":"10.1017/S1041610223000212","DOIUrl":"10.1017/S1041610223000212","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"221-223"},"PeriodicalIF":7.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment for people living with dementia: a systematic review.","authors":"Juanita Hoe, Elena Profyri, Charlotte Kemp, Monica Manela, Lucy Webster, Justine Anthony, Sergi Costafreda, Frank Arrojo, Helen Souris, Gill Livingston","doi":"10.1017/S1041610223004398","DOIUrl":"10.1017/S1041610223004398","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review identified key components of risk assessment for people with dementia, examined attitudes toward risk identification and risk assessment, and appraised existing risk assessment tools.</p><p><strong>Methods: </strong>Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesized using thematic synthesis.</p><p><strong>Results: </strong>Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualized, with views being shaped by media perceptions, personal experiences, socio-cultural influences, dementia knowledge, and dementia severity. We found that mobilization (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organizational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute toward adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful.</p><p><strong>Conclusion: </strong>Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"263-288"},"PeriodicalIF":4.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction and prevention of agitation in persons with neurocognitive disorders: an international psychogeriatric association consensus algorithm.","authors":"Jeffrey Cummings, Mary Sano, Stefanie Auer, Sverre Bergh, Corinne E Fischer, Debby Gerritsen, George Grossberg, Zahinoor Ismail, Krista Lanctôt, Maria I Lapid, Jacobo Mintzer, Rebecca Palm, Paul B Rosenberg, Michael Splaine, Kate Zhong, Carolyn W Zhu","doi":"10.1017/S104161022200103X","DOIUrl":"10.1017/S104161022200103X","url":null,"abstract":"<p><strong>Objectives: </strong>To develop an agitation reduction and prevention algorithm is intended to guide implementation of the definition of agitation developed by the International Psychogeriatric Association (IPA).</p><p><strong>Design: </strong>Review of literature on treatment guidelines and recommended algorithms; algorithm development through reiterative integration of research information and expert opinion.</p><p><strong>Setting: </strong>IPA Agitation Workgroup.</p><p><strong>Participants: </strong>IPA panel of international experts on agitation.</p><p><strong>Intervention: </strong>Integration of available information into a comprehensive algorithm.</p><p><strong>Measurements: </strong>None.</p><p><strong>Results: </strong>The IPA Agitation Work Group recommends the Investigate, Plan, and Act (IPA) approach to agitation reduction and prevention. A thorough investigation of the behavior is followed by planning and acting with an emphasis on shared decision-making; the success of the plan is evaluated and adjusted as needed. The process is repeated until agitation is reduced to an acceptable level and prevention of recurrence is optimized. Psychosocial interventions are part of every plan and are continued throughout the process. Pharmacologic interventions are organized into panels of choices for nocturnal/circadian agitation; mild-moderate agitation or agitation with prominent mood features; moderate-severe agitation; and severe agitation with threatened harm to the patient or others. Therapeutic alternatives are presented for each panel. The occurrence of agitation in a variety of venues-home, nursing home, emergency department, hospice-and adjustments to the therapeutic approach are presented.</p><p><strong>Conclusions: </strong>The IPA definition of agitation is operationalized into an agitation management algorithm that emphasizes the integration of psychosocial and pharmacologic interventions, reiterative assessment of response to treatment, adjustment of therapeutic approaches to reflect the clinical situation, and shared decision-making.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"251-262"},"PeriodicalIF":4.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10529164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}