International psychogeriatrics最新文献

{"title":"Comparative analysis of striatal subregions in behavioral variant frontotemporal dementia and late-life schizophrenia: A multimodal MRI study.","authors":"Huizi Li, Xingyu Zhang, Mingyang Yao, Tao Li, Guoliang Pan, Huali Wang","doi":"10.1016/j.inpsyc.2026.100273","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2026.100273","url":null,"abstract":"<p><strong>Objective: </strong>Behavioral variant frontotemporal dementia (bvFTD) and schizophrenia share similar clinical manifestations, cognitive profiles and overlapping brain lesions. The striatal subregions play critical roles in both disorders, yet relevant comparative investigations remain limited. This study aimed to explore the distinct neural mechanisms between bvFTD and late-life schizophrenia by comparing striatal subregional structure, function and spatial correlations of neurotransmitters.</p><p><strong>Methods: </strong>A total of 36 patients with bvFTD, 21 patients with late-life schizophrenia and 56 healthy comparison group were enrolled. All participants underwent neurocognitive assessment, behavioral evaluation and magnetic resonance imaging (MRI). Voxel-Based Morphometry and Resting-state functional connectivity (RSFC) analyses based on the Human Brainnetome Atlas. Partial correlation analysis was performed to evaluate the associations of imaging metrics with neuropsychological and behavioral measures. JuSpace was used to compare RSFC-neurotransmitter spatial correlation differences between bvFTD and schizophrenia groups.</p><p><strong>Results: </strong>A graded reduction in gray matter volume was observed across most striatal subregions: the bvFTD group showed the smallest volume, then the schizophrenia group. Both bvFTD and schizophrenia groups exhibited similar RSFC in the right nucleus accumbens and bilateral dorsolateral putamen. Specifically, the bvFTD group presented unique aberrant intra-striatal functional connectivity, including connections between the left nucleus accumbens and right putamen, as well as between the left dorsal caudate nucleus and left ventral caudate. Significant partial correlations were detected: Hamilton Depression Rating Scale scores negatively correlated with bilateral dorsal caudate volume in the schizophrenia group. Additionally, the bvFTD group exhibited lower spatial correlations between RSFC and the density maps of 5-HT₆, α4β2, M₁, mGluR5 and D₂ receptors, compared with the schizophrenia group.</p><p><strong>Conclusions: </strong>These findings suggest similar striatal impairment patterns but divergent underlying neural mechanisms in bvFTD and schizophrenia, offering new insights into the neural circuits of clinical phenotypes and the pathophysiological basis of the two disorders.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100273"},"PeriodicalIF":6.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929968","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":"Comparative characteristics of mental health networks in older adults across care models: A cross-sectional study of community home-based and institutional care.","authors":"Beibei Chen, Yufeng Wang, Jing Hu, Wenbin Feng, Mengxuan Wu, Jie Wu","doi":"10.1016/j.inpsyc.2026.100269","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2026.100269","url":null,"abstract":"<p><strong>Background: </strong>Care models significantly impact older adults' mental health, yet the dynamic interplay among symptoms remains unclear. This study compared the integrated sleep-psychological-social support networks between older adults in community home-based and institutional care.</p><p><strong>Methods: </strong>We included 973 adults aged ≥ 60 years (home-based: n = 727; institutional: n = 246). Mental health networks were estimated using Gaussian Graphical Models. We evaluated node centrality, bridge expected influence, and assessed between-group differences using the Network Comparison Test (NCT) and stability analyses.</p><p><strong>Results: </strong>The home-based network was denser (density = 0.576), featuring subjective sleep quality as the core node, with anxiety and life satisfaction acting as key cross-domain bridges. Conversely, the institutional network was sparser (density = 0.348), with core nodes shifting toward objective indicators (e.g., sleep duration) and weakened bridging functions. NCT revealed no statistically significant between-group differences in global strength (p = 0.233) or overall structure (p = 0.124). The home-based network demonstrated good stability, whereas the institutional network's stability was limited by sample size.</p><p><strong>Conclusions: </strong>Mental health networks differ descriptively across care models. Home-based networks are driven by subjective experiences and show strong cross-domain integration, while institutional networks rely on objective indicators and exhibit modular separation. These findings highlight the need for personalized, context-specific psychological interventions targeting core symptoms in different care settings.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100269"},"PeriodicalIF":6.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912026","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":"Networks of episodic and persistent/recurrent depressive symptoms in older adults: Results from the survey of health, ageing, and retirement in Europe.","authors":"M W Stratmann, J Petter, L Kriston, B C Schneider, H-H König, A Hajek","doi":"10.1016/j.inpsyc.2026.100266","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2026.100266","url":null,"abstract":"<p><strong>Objective: </strong>The network theory of psychopathology proposes that dense symptom networks foster persistent symptoms. Studies testing this hypothesis in late-life depression (LLD) are lacking. This study examined whether, and how, cross-sectional networks of episodic and persistent/recurrent depressive symptoms in older adults differ.</p><p><strong>Method: </strong>Data of adults aged 60 + were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE). Depressive symptoms were assessed using the EURO-D scale. Participants were classified as episodic or persistent/recurrent based on their EURO-D score at wave 5 (2013) and wave 6 (2015) (EURO-D ≥4). For each group, separate cross-sectional symptom networks at wave 5 were estimated as Ising models and corrected for selection on the sum-score (Berkson's bias). The permutation-based Network Comparison Test was used to compare global strength and network structure.</p><p><strong>Results: </strong>Of 8519 participants, 3746 (44.0%) participants showed episodic depressive symptoms, while 4773 (56.0%) showed persistent/recurrent depressive symptoms. Neither global network strength nor network structure differed statistically significantly between groups (p = .17 and p = .60, respectively). In both networks, lack of interest, depressive mood, and suicidality showed highest strength and expected influence. Findings were consistent across sensitivity analyses.</p><p><strong>Conclusion: </strong>Our results showed no difference in global strength and network structure between episodic and persistent/recurrent depressive symptoms in older adults, complementing mixed evidence from younger and middle-aged adults. Causal symptom interactions may play a smaller role in the persistence/recurrence of depressive symptoms in later life. Future studies should examine longitudinal networks, subtypes of LLD, and consider external factors.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100266"},"PeriodicalIF":6.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897421","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":"Predicting longitudinal depressive symptom trajectories among older Chinese adults with chronic health conditions: An interpretable machine learning study.","authors":"Zhan Yu, Anao Zhang, Kaipeng Wang, Qiuling An, Meiyan Chen, Yuting Wang, Zeqiang Wang","doi":"10.1016/j.inpsyc.2026.100270","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2026.100270","url":null,"abstract":"<p><strong>Objective: </strong>This study leveraged interpretable machine learning (ML) to map heterogeneous trajectories of depressive symptoms in Chinese older adults with chronic diseases, aiming to develop an interpretable, prediction-oriented framework for personalized mental health interventions.</p><p><strong>Methods: </strong>We analyzed four-wave longitudinal data from 5492 participants in the China Health and Retirement Longitudinal Study. Following trajectory identification, 10 ML algorithms were compared. A 50-iteration bootstrap Recursive Feature Elimination (RFE) distilled 10 core predictors from 39 baseline features. Models were evaluated using an 80:20 stratified split, with MICE imputation strictly preventing data leakage. Model interpretability was extracted via SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>Three distinct trajectories emerged: Consistently Low, Chronically High, and Rapidly Escalating Risk. The Elastic Net model demonstrated optimal discriminative power (ROC-AUC = 0.710, PR-AUC = 0.468) and a Brier score of 0.337. SHAP analysis indicated that extremely low life satisfaction, severe instrumental functional limitations, and poor self-rated health were strongly associated with higher predicted probabilities of high-risk trajectories, whereas high household income robustly protected the low-risk group. We translated these insights into an interactive web-based risk calculator.</p><p><strong>Conclusion: </strong>This study identified critical depressive trajectory classes and established an interpretable predictive model. By translating complex analytics into an interpretable predictive framework, this approach provides a foundation for individualized risk profiling and highlights distinct patterns of risk that may inform future targeted mental health interventions for older adults with chronic conditions.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100270"},"PeriodicalIF":6.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891715","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":"Treatment patterns of agitation associated with Alzheimer's dementia (AAD) patients in Canada.","authors":"Veronique Littmann-Crites, A Marilise Marrache, Ceryl Tan, Natalie Nightingale, Calum S Neish, Francois Therrien, Zahinoor Ismail","doi":"10.1016/j.inpsyc.2026.100209","DOIUrl":"10.1016/j.inpsyc.2026.100209","url":null,"abstract":"<p><strong>Objectives: </strong>Explore treatment patterns of Canadian patients with AAD to understand variability in clinical management.</p><p><strong>Design: </strong>This retrospective study used public claims data from Ontario and New Brunswick in IQVIA databases.</p><p><strong>Setting: </strong>Inferred patients with AAD were identified through claims for cognitive enhancers and medications used off-label to treat AAD, i.e., antipsychotics (AP), anticonvulsants (AC), antidepressants (ADT), benzodiazepines (benzo).</p><p><strong>Participants: </strong>Patients (≥55 years) were identified between 2011-2018, indexed on their first AP/AC/AD/benzo and followed until the earlier of their fourth line (4L) of therapy or September 30, 2023. An all-history lookback to 2003 was used to ensure no prior claims for these therapies.</p><p><strong>Measurements: </strong>Descriptive analyses explored treatment utilization patterns.</p><p><strong>Results: </strong>23,732 patients with AAD were identified, mostly from Ontario (98.7%). Patients with AAD tended to move to long-term care, with these increasing with more treatment trials from 24% (1 L therapy) to 54% (4 L therapy). Patients received between 500 and 2000 unique combinations across therapy lines. Citalopram, escitalopram, gabapentin, lorazepam, mirtazapine, pregabalin, quetiapine, risperidone, sertraline, and trazodone ranked in the top 10 therapies. Risperidone accounted for 7.2% of claims and ranked as the 6th most common 1 L therapy. Although trazodone remained the most common therapy for patients with AAD, it had one of the lowest persistence rates. Most patients remained on their 3 L - 4 L therapy, and ≥ 80% were adherent across all therapy lines. Average daily doses were lower than those described in the product monographs.</p><p><strong>Conclusions: </strong>AAD treatment varies widely, underscoring the need for approved treatments and enhanced clinical education.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100209"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716629","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":"Psychological treatment of depression in older adults: A network meta-analysis.","authors":"Pim Cuijpers, Clara Miguel, Eirini Karyotaki, Mathias Harrer","doi":"10.1016/j.inpsyc.2026.100213","DOIUrl":"10.1016/j.inpsyc.2026.100213","url":null,"abstract":"<p><strong>Objectives: </strong>Several psychological treatments for depression in older adults have been found to be effective compared to control conditions. It is less clear, however, if these treatments have comparable effects. We aimed to examine the relative effects of these treatments.</p><p><strong>Design: </strong>Systematic review and network meta-analysis.</p><p><strong>Setting: </strong>Any outpatient setting.</p><p><strong>Participants, interventions, measurements: </strong>We included randomized controlled trials examining the effects of psychological treatments in older adults with depression, and comparing a treatment with another treatment or a control condition (care-as-usual and waitlist). Only treatments with at least five trials were included.</p><p><strong>Results: </strong>We included 86 randomized trials (10,165 participants) examining five types of treatment: cognitive behavior therapy (CBT), behavioral activation therapy (BAT), problem-solving therapy (PST), supportive therapy (SUP) and life review therapy (LRT). The network was relatively well connected. CBT, BAT, PST and LRT were more effective than CAU (SMD range: 0.52-0.99) and WL (SMD range: (0.62-1.10). SUP was not more effective than WL or CAU. All therapies were more effective than SUP (SMD range: 0.43-0.80), except for BAT. LRT was more effective than CBT and BAT. However, we found a significant difference between direct and indirect evidence. After excluding outliers, the general conclusions were similar, except that LRT was no longer superior to other therapies.</p><p><strong>Conclusions: </strong>CBT, LRT, BAT and PST are effective interventions in the treatment of depression in older adults, and they probably have comparable effects. LRT and CBT have lower drop-out and may be preferrable as first treatment.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100213"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698633","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":"Psychometric phenotypes of quality of life in community-dwelling older adults: A multivariate segmentation and Monte Carlo validation of the FRAG model.","authors":"Gema Pérez-Rojo, Patricia López-Frutos, Cristina Noriega, Javier López","doi":"10.1016/j.inpsyc.2026.100236","DOIUrl":"10.1016/j.inpsyc.2026.100236","url":null,"abstract":"<p><p>Traditional biomedical paradigms frequently associate aging with an inevitable narrative of systemic decline, often neglecting the intrinsic capacity of older adults to optimize their quality of life (QoL) through psychological strengths. Grounded in Contextual Behavioral Science and the FRAG framework, this study aimed to identify heterogeneous QoL profiles in community-dwelling older adults and cross-validate their structural stability through computational simulation. A sample of Spanish community-dwelling older adults (N = 579, mean age = 69.37 years, 59.2% women) completed standardized instruments assessing QoL, gratitude, resilience, experiential acceptance, and psychological distress. A hierarchical cluster analysis using Ward's method was executed based on standardized psychometric scores. To evaluate parameter convergence and model stability against sampling noise, a single parametric Monte Carlo stochastic simulation (N = 1000) was parameterized using the empirical statistical moments and the Mersenne Twister algorithm. The cluster analysis identified a robust three-profile structure, distinguishing two vulnerability cohorts from a \"functional excellence\" phenotype. The Monte Carlo simulation confirmed excellent replication with parameter convergence metrics below 0.05. A subsequent univariate ANOVA revealed that continuous QoL scores differed significantly across the three empirical profiles, (2, 576) = F(2, 576) = 147.74, p < .001, η2p = .339. Experiential acceptance and gratitude emerged as the primary discriminant anchors of functional excellence, whereas baseline resilience exhibited negligible weight. These findings support the systematic integration of acceptance- and gratitude-based interventions within psychogeriatric community care to foster intrinsic capacity.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100236"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455736","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":"Credentialed art therapy as a non-pharmacological intervention for neuropsychiatric symptoms reduction in persons living with dementia-a systematic review and meta-analysis.","authors":"Elena Guseva, Isabelle Vedel, Genevieve Gore, Ovidiu Lungu, Zahinoor Ismail, Walter Wittich, Machelle Wilchesky","doi":"10.1016/j.inpsyc.2026.100218","DOIUrl":"10.1016/j.inpsyc.2026.100218","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric symptoms (NPS) of dementia contribute to accelerated decline and caregiver burden. Clinical guidelines increasingly recommend non-pharmacological approaches, yet the specific impact of credentialed art therapy (AT) remains unclear because previous reviews have often merged AT with general creative activities delivered outside of a therapeutic framework.</p><p><strong>Objectives: </strong>To synthesize evidence evaluating credentialed AT delivered to reduce NPS in people living with dementia (PLWD).</p><p><strong>Methods: </strong>A mixed-methods systematic review was conducted. Seven databases were searched from inception to April 2022, with updates in November 2022 and April 2025. Eligible studies evaluated AT delivered by credentialed art therapists. A meta-analysis of standardized mean differences was conducted for depression, and qualitative findings for other NPS were synthesized thematically.</p><p><strong>Results: </strong>Eleven studies met inclusion criteria. Meta-analysis of between-group post-intervention differences showed a non-significant pooled effect (random-effects g=-0.11). A sensitivity analysis excluding one low-quality RCT produced a larger but non-significant effect (g=-0.59). A meta-analysis of within-group pre-post changes also showed a non-significant pooled effect (g = -0.42), with a larger non-significant effect after exclusion of the low-quality study (g = -0.80). Qualitative evidence from six studies described in-session improvements in agitation, anxiety, and wandering through mechanisms such as sensory grounding, emotional expression, behavioral redirection, and relational support.</p><p><strong>Conclusions: </strong>Credentialed AT may offer in-session benefits for agitation, anxiety, and wandering; however, quantitative evidence for reducing depressive symptoms remains inconclusive. Given the small and heterogeneous evidence base, rigorous trials using standardized outcome measures are needed to clarify AT's role in dementia care.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100218"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015516","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":"Global epidemiological survey, burden of disease assessment and spatio-temporal prediction of bipolar disorder from 1990 to 2021 based on spatial clustering analysis.","authors":"Chengjing Wei, Bo Shang, Ainiwaer Aihemaiti, Hande Li, Yanling Zheng, Chengcheng Wang, Liping Zhang","doi":"10.1016/j.inpsyc.2025.100157","DOIUrl":"10.1016/j.inpsyc.2025.100157","url":null,"abstract":"<p><strong>Background: </strong>Bipolar disorder is a lifelong mental disorder. Late diagnosis increases treatment difficulty and costs, and age-related decline in liver and kidney function may affect drug metabolism and efficacy. This study assesses the global disease burden, geographical distribution, influencing factors, and future trends from 1990 to 2021.</p><p><strong>Methods: </strong>Data from the GBD 2021 were used to evaluate age-standardized incidence, prevalence, and DALYs for bipolar disorder, and analyze influencing factors. Temporal trends were analyzed using Joinpoint regression, while future trends were projected with Bayesian Age-Period-Cohort models. Spatial distribution was assessed via cold-spot and hot-spot analyses.</p><p><strong>Results: </strong>From 1990-2021, the incidence, prevalence, and DALYs of bipolar disorder in individuals aged 60 and older in H-SDI regions were significantly higher than those in L-SDI regions (P < 0.05), with H-SDI regions showing a declining trend, while the increase in these factors in L-SDI regions was substantially greater than in H-SDI regions (P < 0.05). Although the incidence peaks at ages 15-19, the economic burden and prevalence gradually shift towards older adults, with the peak moving from the 20-24 age group to 25-29, and a significant increase in prevalence and DALYs among individuals aged 25 and older in middle and lower SDI regions. By 2021, the spatial dimension of substance abuse and child abuse showed improvement, particularly in Australia and New Zealand, while alcohol abuse in Russia rose to 235.89. Cold-spot and hot-spot analysis highlighted the contraction of cold spots and the expansion of hot spots, especially in Central Africa and the Mediterranean region. Future projections, based on current trends and models, suggest a slight decrease in global disease burden by 2030, with a more significant reduction for males.</p><p><strong>Conclusions: </strong>By 2021, both spatiotemporal trends show signs of deterioration, with significant regional and gender differences. Although projections indicate a decline in disease burden in the future, current focus should remain on the intergenerational impact of child abuse on mania, the accumulation of disease burden among the older adults and the phenomenon of alcoholism in high-latitude regions such as Eurasia.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100157"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318126","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":"White matter and subcortical MRI markers of subsequent cognitive decline in late-life depression: A two-stage study.","authors":"Chaoyue Guo, Yuan Fang, Qi Qiu, Lei Fan, Henry Brodaty, Perminder S Sachdev, Wei Wen, Xia Li","doi":"10.1016/j.inpsyc.2026.100265","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2026.100265","url":null,"abstract":"<p><strong>Background: </strong>Late-life depression (LLD) is associated with increased risk of cognitive decline and dementia, yet clinically relevant neuroimaging markers of short-term cognitive decline remain uncertain.</p><p><strong>Methods: </strong>We conducted a two-stage study. In the Shanghai Action to Prevent the Elderly from Dementia (SHAPE) cohort, baseline MRI was compared among 40 LLD participants with stable cognition (LLDcs), 38 LLD participants with cognitive decline over two years (LLDcd), and 47 healthy controls. Measures included peak width of skeletonized mean diffusivity (PSMD), global and tract-specific difference in distribution function based on mean diffusivity (DDF^MD), grey-matter measures, and regional diffusion tensor image analysis along the perivascular space (ALPS) indices. Within-group partial correlations between MRI measures and cognitive performance were also examined. Candidate markers were then evaluated in the Sydney Memory and Ageing Study (MAS) LLD sample (21 LLDcs, 16 LLDcd) using SHAPE-trained single-marker Firth logistic models applied without refitting.</p><p><strong>Results: </strong>In SHAPE, LLDcd showed greater white-matter microstructural burden than LLDcs and controls, including higher PSMD, lower global and tract-specific DDF^MD, alongside smaller left nucleus accumbens (L_NAcc) volume. Within LLDcd, poorer white-matter integrity was associated with worse orientation and other cognitive domains. In MAS, global DDF^MD and L_NAcc volume were the two markers whose discrimination of LLDcd survived correction for multiple comparisons.</p><p><strong>Conclusions: </strong>White-matter microstructural burden and smaller L_NAcc volume may help characterize LLD patients at higher near-term risk of cognitive decline. These findings warrant evaluation in larger longitudinal LLD cohorts.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100265"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874046","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}