International psychogeriatrics最新文献

{"title":"Development and validation of prediction model (VALOR-m) for all-cause mortality following very late-onset schizophrenia-like psychosis: A 23-year population-based study.","authors":"Chris Chit Sze Fung, Joe Kwun Nam Chan, Wai Chi Chan, Calvin Pak Wing Cheng, Wing Chung Chang","doi":"10.1016/j.inpsyc.2026.100244","DOIUrl":"10.1016/j.inpsyc.2026.100244","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals with very late-onset schizophrenia-like psychosis (VLOSLP) experience a persistent mortality gap compared to the general population, yet no validated prognostic tools tailored to this growing population exist. We aimed to develop and validate a 3-year all-cause mortality prediction model (VALOR-m) for individuals with VLOSLP.</p><p><strong>Design: </strong>We developed VALOR-m with LASSO-penalised Cox regression. To evaluate temporal drift and geographic generalisability, we employed a two-stage approach: 1)temporal validation stratified by two time periods (period 1: 2002-2013; period 2: 2014-2024), and 2)temporal recalibration with internal-external cross-validation (IECV) stratified by seven catchment areas in period 2. Discrimination was assessed by time-dependent AUC and Harrell's c-statistic; calibration by calibration slope and observed-to-expected ratio (O/E ratio).</p><p><strong>Participants: </strong>Using a population-based electronic health record cohort from Hong Kong (2002-2024), we identified 33,594 older adults (aged≥60 years) with VLOSLP.</p><p><strong>Results: </strong>Of 33,594 individuals included (16,262[48·4%] male; mean age of onset 76·4 years), 11,272 (33·6%) died within 3 years. VALOR-m retained 11 predictors and demonstrated good discrimination (pooled time-dependent AUC:0·772 95%CI[0·765-0·779]; Harrell's c-statistic 0·734 95%CI[0·728-0·741]) and satisfactory calibration (calibration slope 0·885 95%CI[0·859-0·911]; O/E ratio 0·972 95%CI[0·908-1·041]) in IECV.</p><p><strong>Conclusions: </strong>VALOR-m provides the first validated individualised mortality risk estimates for individuals with VLOSLP, applicable to real-world clinical practice using routinely collected data. VALOR-m achieved comparable discrimination to conventional comorbidity indices with fewer predictors, suggesting that it better captures the unique mortality profile of VLOSLP, and supporting its use to guide antipsychotic treatment decisions, personalised healthcare management in this understudied yet growing population.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100244"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578615","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":"Between vulnerabilities and strengths: International research in gerontology and geriatrics in the 21st century.","authors":"Liat Ayalon","doi":"10.1016/j.inpsyc.2026.100271","DOIUrl":"10.1016/j.inpsyc.2026.100271","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100271"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919810","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":"Pre-psychosis in later life as a risk factor for progressive cognitive decline: Findings from the IPA psychosis in neurodegenerative disease working group.","authors":"Byron Creese, Jeffrey Cummings, Corinne Fischer, Dilip Jeste, Manabu Ikeda, Kathryn Mills, Zahinoor Ismail, Clive Ballard","doi":"10.1016/j.inpsyc.2025.100094","DOIUrl":"10.1016/j.inpsyc.2025.100094","url":null,"abstract":"<p><p>Pre-clinical Alzheimer's disease (AD) has traditionally been characterized by subtle cognitive deficits alongside biomarker changes. However, emerging evidence suggests a spectrum of neuropsychiatric changes, including apathy, affective disturbances, agitation, impulse control deficits, and psychosis, may precede cognitive decline. Late-onset psychotic disorders, such as Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP), differ from pre-psychosis, the latter presenting with subtle symptoms and retained insight. These subtler late-life onset symptoms are associated with incident cognitive decline, particularly in APOE4 carriers. Screening with tools such as the Mild Behavioral Impairment Checklist (MBI-C) enables the standardisation of measurement, facilitating identification of at-risk individuals. Plasma biomarkers and neuropsychological assessments further aid diagnosis and risk stratification. Understanding the link between pre-psychosis and dementia-related psychosis will be crucial, as AD with psychosis is associated with a more aggressive disease course. Identifying and treating these individuals early may improve clinical outcomes and facilitate timely intervention with disease-modifying therapies. Moreover, there remains a need to better define in what circumstances treatment interventions are indicated and what those interventions should be.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100094"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293763","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}

{"title":"Impact of antidementia medicines on the dispensing of antidepressants, anxiolytics and antipsychotics.","authors":"Osvaldo P Almeida, Amy Page, Christopher Etherton-Beer","doi":"10.1016/j.inpsyc.2025.100182","DOIUrl":"10.1016/j.inpsyc.2025.100182","url":null,"abstract":"<p><p>Behavioural and psychological disturbances are common among individuals with dementia. It is unclear if the use of antidementia medicines reduces their presence. This study aimed to clarify if the introduction of antidementia medicines leads to a decline in the dispensing of antidepressants, anxiolytics and antipsychotics. We used time-series analyses to examine the association between the supply of cholinesterase inhibitors or memantine and psychotropics. Participants were males and females aged 60 years or over included in the Australian 10 % Pharmaceutical Benefits Scheme database between 2013 and 2024. The outcomes of interest were the dispensing of antidepressants, anxiolytics and antipsychotics, and the exposure the dispensing of antidementia medicines. The panel dataset included 466,210 individuals. The odds ratio of being dispensed a psychotropic in association with the supply of an antidementia medicine was 8.40 (95 %CI=8.05-8.78) for antidepressants, 1.99 (95 %CI=1.89-2.09) for anxiolytics, and 24.31 (22.54-26.22) for antipsychotics. Interrupted time-series analyses showed that the introduction of an antidementia medicine decreased the annual rate of dispensing of antidepressants (-0.7 % per year), but increased the dispensing of anxiolytics by 0.8 % per year and antipsychotics by 1.0 % per year. Contrary to our hypothesis, interrupted time series analyses showed that the supply of antidementia medicines was associated with subsequent increased rate of dispensing of psychotropic agents, particularly anxiolytics and antipsychotics. Antidementia medicines are not effective at reducing the clinical use of anxiolytics and antipsychotics.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100182"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943970","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":"Temporal pattern of dementia with lewy bodies diagnostic labels around electroconvulsive therapy: A nationwide claims-based study.","authors":"Masahiro Hata, Yuki Miyazaki, Shun Takahashi, Manabu Ikeda","doi":"10.1016/j.inpsyc.2026.100224","DOIUrl":"10.1016/j.inpsyc.2026.100224","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is widely used for severe depression. Dementia with Lewy bodies (DLB) may initially present with depressive symptoms, and ECT may be administered in some patients during the course of the disease. However, the timing of DLB diagnosis in relation to ECT treatment has not been well characterized.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using a nationwide administrative claims database in Japan, including records from 564 acute care hospitals between April 2008 and March 2025. Analyses were restricted to patients with a mood disorder diagnosis (ICD-10 F30-F39) recorded in the same month as the first ECT session, and patients with both DLB and Alzheimer disease (AD) diagnostic codes were excluded. The primary analysis examined the timing of recorded DLB diagnostic labels relative to ECT initiation, with AD diagnoses analyzed as a comparator.</p><p><strong>Results: </strong>Among 3733 patients who underwent ECT, 71 met the analytic criteria for DLB. The median interval between ECT initiation and the first DLB diagnosis was 8 days prior to ECT initiation. Recorded DLB diagnostic labels occurred significantly more often within ±90 and ±180 days of ECT initiation than AD diagnoses, whereas AD diagnoses were distributed more broadly across the observation period.</p><p><strong>Conclusion: </strong>Recorded DLB diagnostic labels showed a distinct temporal pattern around ECT initiation. Clinical evaluation associated with ECT may facilitate recognition of underlying DLB in patients presenting with severe psychiatric symptoms. Clinicians should remain attentive to evolving DLB when treating late-life treatment-resistant mood disorders with ECT, as recognition of DLB may occur several years after treatment initiation.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100224"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156400","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":"Atrophy of specific amygdala subregion precedes the conversion from mild cognitive impairment with neuropsychiatric symptoms to dementia.","authors":"Chenxi Pan, Jing Ma, Xiao Yuan, Renren Li, Xiaoran Zheng, Jiaxin Yan, Zengmai Xie, Meng Liu, Junxi Xu, Ying Su, JiYu Li, Yunxia Li","doi":"10.1016/j.inpsyc.2026.100234","DOIUrl":"10.1016/j.inpsyc.2026.100234","url":null,"abstract":"<p><strong>Background: </strong>The amygdala is known to exhibit early signs of Alzheimer's disease (AD) pathology. However, it remains unclear whether atrophy in its specific subregions contributes to the transition from mild cognitive impairment (MCI) with neuropsychiatric symptoms (NPS) to dementia.</p><p><strong>Methods: </strong>We recruited 376 participants at baseline: 130 MCI with NPS (MCI+NPS), 154 MCI without NPS (MCI-NPS), and 92 cognitively unimpaired (CU) individuals. Upon clinical follow-up, the MCI cohort was classified into 17 converters who progressed to dementia (MCI-c) and 96 non-converters who remained stable (MCI-nc). All participants underwent baseline and follow-up neuropsychological evaluations and multimodal magnetic resonance imaging (MRI). From the MRI data, we extracted volumes of amygdala subregions and used partial Spearman's correlations to assess their associations with NPS and cognitive alterations.</p><p><strong>Results: </strong>Compared to the CU group, the MCI + NPS group exhibited more extensive bilateral amygdala atrophy, involving all subregions, whereas the MCI-NPS group showed atrophy confined to the bilateral centromedial (CeM) amygdala. Furthermore, relative to the MCI-nc group, the MCI-c group exhibited greater annual volume loss in the bilateral amygdalae and their subregions, except for the right CeM. The annual atrophy rate of the right basolateral (BLA) amygdala correlated with more severe affective (r = -0.274, p = 0.005) and hyperactivity symptoms (r = -0.343, p < 0.001). The annual atrophy rate of the left superficial (SUP) amygdala correlated with more severe affective symptoms (r = -0.273, p = 0.011).</p><p><strong>Conclusions: </strong>Progressive atrophy of the BLA and SUP is associated with NPS-related cognitive decline in MCI, suggesting a potential mechanistic role for these subregions and highlighting them as candidates for future targeted intervention.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100234"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329964","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":"Psychotic disorders in older adults.","authors":"D P Devanand","doi":"10.1016/j.inpsyc.2026.100267","DOIUrl":"10.1016/j.inpsyc.2026.100267","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100267"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906060","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":"The goal of psychogeriatrics: facing complex problems with multidimensional answers.","authors":"T Leon","doi":"10.1016/j.inpsyc.2026.100268","DOIUrl":"10.1016/j.inpsyc.2026.100268","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100268"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897411","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":"The role of verbal episodic memory in progression to mild cognitive impairment: The influence of serial position effects.","authors":"María Campos-Magdaleno, Alba Felpete, M Helena Agrafojo-Nieto, Ana Nieto-Vieites, Sabela C Mallo, Onésimo Juncos-Rabadán, Cristina Lojo-Seoane","doi":"10.1016/j.inpsyc.2026.100212","DOIUrl":"10.1016/j.inpsyc.2026.100212","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD) may be linked to subtle memory loss. The aim of this study was to determine the influence of verbal episodic memory measures, particularly serial position effects, on the progression from SCD to mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>Study participants (N = 315), aged ≥ 50, diagnosed as cognitively unimpaired (CU) (N = 211) or with SCD (N = 104) at baseline and then classified as Stable or Worsening at follow-up, were compared using measures from the California Verbal Learning Test (CVLT). ANCOVA was used to compare SCD and CU performance at baseline; General Linear Models (GLMs) with repeated measures were used to compare groups at baseline and at follow-up, considering age, years of education, depressive symptoms, and time between assessments as covariates.</p><p><strong>Results: </strong>SCD participants were older, had fewer years of education, more depressive symptoms, and more subjective cognitive complaints than CU participants. There were no differences between groups at baseline in any of the cognitive measures. The GLMs revealed that the baseline performance of CU and SCD participants who worsened was already poorer than that of the stable participants in free recall measures; only the Worsening SCD participants had significant poorer recall of middle position items at baseline than Stable participants.</p><p><strong>Conclusion: </strong>Free recall CVLT measures at baseline can effectively identify progression of cognitive decline in participants without cognitive objective impairment, and the middle position effect at baseline can differentiate SCD participants who will progress to MCI and those who will remain stable.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100212"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716649","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":"Repetitive transcranial magnetic stimulation combined with Tai Chi improves working memory in older adults with sleep disorders and mild cognitive impairment: An fMRI-based randomized controlled trial.","authors":"Linxin Bai, Zhenxing Guo, Kaifeng Xu, Yuxuan Sun, Lin Zhang, Jiahui Gao, Lidian Chen, Zhizhen Liu","doi":"10.1016/j.inpsyc.2026.100233","DOIUrl":"10.1016/j.inpsyc.2026.100233","url":null,"abstract":"<p><strong>Background: </strong>Working memory impairment has been reported in older adults with sleep disorders and MCI, with the frontoparietal network playing a central role in working memory. The key question is whether integrating Tai Chi with rTMS improves working memory, and whether such improvements result from the modulation of frontoparietal networks plasticity.</p><p><strong>Methods: </strong>Seventy-one participants with sleep disorders and MCI were assigned to the experimental group (Tai Chi + 1-Hz rTMS, n = 37) or sham group (Tai Chi + sham rTMS, n = 34). They completed 6 weeks of Tai Chi combined with neuronavigated rTMS targeted the right DLPFC and underwent fMRI scans. Outcomes included Numerical N-back task, digit span task，Pittsburgh Sleep Quality Index (PSQI), Montreal Cognitive Assessment (MoCA). Task fMRI measured N-back activation patterns, and seed-based resting-state functional connectivity (rsFC) was assessed. Correlations between the activation/rsFC and N-back task performance were explored.</p><p><strong>Results: </strong>Seventy-one participants (mean age 67.6 ± 4.6 years; 30 male [42%], 41 female [58%]) were included. After 6 weeks, the experimental group showed significant improvements versus shams in PSQI, MoCA, 0-back and 2-back task accuracy, 0-back reaction time, and forward digit span (all p < 0.05). The 2-back accuracy was negatively correlated with right precuneus activation (r = -0.381, p = 0.034) and positively correlated with right precuneus connectivity to the left SMA (r = 0.367, p = 0.042).</p><p><strong>Conclusion: </strong>Adjunctive neuronavigated rTMS delivered in addition to Tai Chi training may enhance working memory rehabilitation in older adults with sleep disorders and MCI, with frontoparietal network modulation as a potential neural basis.</p><p><strong>Trial registration: </strong>Clinical trial registration no. ChiCTR 2200063274.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100233"},"PeriodicalIF":6.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283516","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}