Journal of Geriatric Psychiatry and Neurology最新文献

{"title":"Impact of Care-Recipient Relationship Type on Quality of Life in Community-Dwelling Older Adults With Dementia Over Time.","authors":"Aiping Lai, Lauren E Griffith, Ayse Kuspinar, Jenna-Smith Turchyn, Julie Richardson","doi":"10.1177/08919887231215044","DOIUrl":"10.1177/08919887231215044","url":null,"abstract":"<p><strong>Introduction: </strong>Maintaining quality of life (QoL) has been identified as the primary goal of care services for person living with dementia (PLWD).</p><p><strong>Methods: </strong>A secondary analysis was conducted on five rounds of the National Health and Aging Trends Study (NHATS) over 4 years. A generalized estimating equation (GEE) was used to examine the prediction of relationship type on older adults' QoL through four domains: mental health, general health, functional limitations, and pain.</p><p><strong>Results: </strong>older adults cared for by an adult-child or multiple caregivers predicted increased risk for functional limitations after adjustment for their socio-demographic and dementia status (IRR = 1.53, CI [1.26, 1.86]; IRR = 1.36, CI [1.14, 1.61], respectively). The interaction between the relationship type and education was significant. Older adults with a high school education or below, who were cared for by an adult child, had a significantly higher risk of increasing functional limitations over 4 years compared to those cared for by a spouse/partner (contrast = .50, <i>P</i> = .01, 95% CI [.07, .93]; contrast=.52, <i>P</i> = .03, 95% CI [.03, 1.02]; respectively). Similarly, older adults with a high school education, who were cared for by multiple caregivers, also experienced a significantly higher risk of increasing functional limitations than those cared for by a spouse/partner (contrast = .44, <i>P</i> = .03, 95% CI [.02, .85]).</p><p><strong>Conclusion: </strong>Our findings provide evidence of the significant contribution of relationship type on PLWD's QoL changes over time. They also help to prioritize resource allocation while addressing PLWD's demands by socio-demographics such as education level.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"294-306"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reward and Punishment Learning as Predictors of Cognitive Behavioral Therapy Response in Parkinson's Disease Comorbid with Clinical Depression.","authors":"Rokas Perskaudas, Catherine E Myers, Alejandro Interian, Mark A Gluck, Mohammad M Herzallah, Allan Baum, Roseanne D Dobkin","doi":"10.1177/08919887231218753","DOIUrl":"10.1177/08919887231218753","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Depression is highly comorbid among individuals with Parkinson's Disease (PD), who often experience unique challenges to accessing and benefitting from empirically supported interventions like Cognitive Behavioral Therapy (CBT). Given the role of reward processing in both depression and PD, this study analyzed a subset (N = 25) of participants who participated in a pilot telemedicine intervention of PD-informed CBT, and also completed a Reward- and Punishment-Learning Task (RPLT) at baseline. At the conclusion of CBT, participants were categorized into treatment responders (n = 14) and non-responders (n = 11). Responders learned more optimally from negative rather than positive feedback on the RPLT, while this pattern was reversed in non-responders. Computational modeling suggested group differences in learning rate to negative feedback may drive the observed differences. Overall, the results suggest that a within-subject bias for punishment-based learning might help to predict response to CBT intervention for depression in those with PD.&lt;b&gt;Plain Language Summary&lt;/b&gt; Performance on a Computerized Task may predict which Parkinson's Disease Patients benefit from Cognitive Behavioral Treatment of Clinical Depression&lt;b&gt;Why was the study done?&lt;/b&gt; Clinical depression regularly arises in individuals with Parkinson's Disease (PD) due to the neurobiological changes with the onset and progression of the disease as well as the unique psychosocial difficulties associated with living with a chronic condition. Nonetheless, psychiatric disorders among individuals with PD are often underdiagnosed and likewise undertreated for a variety of reasons. The results of our study have implications about how to improve the accuracy and specificity of mental health treatment recommendations in the future to maximize benefits for individuals with PD, who often face additional barriers to accessing quality mental health treatment.&lt;b&gt;What did the researchers do?&lt;/b&gt; We explored whether performance on a computerized task called the Reward- and Punishment-Learning Task (RPLT) helped to predict response to Cognitive Behavioral Therapy (CBT) for depression better than other predictors identified in previous studies. Twenty-five individuals with PD and clinical depression that completed a 10-week telehealth CBT program were assessed for: Demographics (Age, gender, etc.); Clinical information (PD duration, mental health diagnoses, levels of anxiety/depression, etc.); Neurocognitive performance (Memory, processing speed, impulse control, etc.); and RPLT performance.&lt;b&gt;What did the researchers find?&lt;/b&gt; A total of 14 participants significantly benefitted from CBT treatment while 11 did not significantly benefit from treatment.There were no differences before treatment in the demographics, clinical information, and neurocognitive performance of those participants who ended up benefitting from the treatment versus those who did not.There were, however, differences before treatm","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"282-293"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139074302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms are Associated With C-Reactive Protein in Older Adults With Obesity.","authors":"Henry D Heisey, Clifford Qualls, Dennis T Villareal, Martha Belen Segoviano-Escobar, Maria Liza Duremdes Nava, Jennifer R Gatchel, Mark E Kunik","doi":"10.1177/08919887231215041","DOIUrl":"10.1177/08919887231215041","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypothesis that depressive symptoms vary with high-sensitivity C-reactive protein (hs-CRP), among older adults with obesity.</p><p><strong>Methods: </strong>This was a cross-sectional, secondary analysis of baseline data from two related lifestyle intervention trials. The study sample comprises 148 consecutively recruited, community-dwelling older adults (age >=65 years) without severe psychiatric illness and with body mass index >=30 kg/m². Logarithmically transformed GDS was analyzed as the dependent variable. Independent variables included log-transformed hs-CRP and covariates: sex, age, and concurrent use of antidepressant medication at baseline. An additional analysis was performed using binary conversion of the GDS scores, wherein a cutoff score of 5 was considered positive for depressive symptoms.</p><p><strong>Results: </strong>Sample mean GDS score was 2.7 (SD 3.0, range 0 - 14). A significant multivariate model of GDS scores (R² = .089, F = 3.5, <i>P</i> = .010) revealed log-transformed hs-CRP (<i>P</i> = .017) and male sex (<i>P</i> = .012) as associated with depressive symptoms. Supplemental analysis demonstrated associations between depressive symptoms and log-transformed hs-CRP (OR 2.17, <i>P</i> = .001) and between depressive symptoms and male sex (OR 3.78, <i>P</i> = .013). Univariate logistic regression found hs-CRP to be associated with depressive symptoms.</p><p><strong>Conclusions: </strong>In older adults with obese BMI, male sex and higher hs-CRP are associated with depression, even in a group with relatively minimal depressive symptoms. Hs-CRP may offer clinical utility as a biomarker for depression among older adults with obese BMI, even among those with non-severe psychiatric symptomatology.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"332-338"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11087374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Mid-arm Muscle Circumference and Cognitive Function: A Longitudinal Study of Chinese Adults.","authors":"Hillary B Spangler, David H Lynch, Annie Green Howard, Hsiao-Chuan Tien, Shufa Du, Bing Zhang, Huijun Wang, Penny Gordon Larsen, John A Batsis","doi":"10.1177/08919887231218087","DOIUrl":"10.1177/08919887231218087","url":null,"abstract":"<p><strong>Background: </strong>Dementia affects 55 million people worldwide and low muscle mass may be associated with cognitive decline. Mid-arm muscle circumference (MAMC) correlates with dual-energy Xray absorptiometry and bioelectrical impedance analyses, yet are not routinely available. Therefore, we examined the association between MAMC and cognitive performance in older adults.</p><p><strong>Methods: </strong>We included community-dwelling adults ≥55 years from the China Health and Nutrition Survey. Cognitive function was estimated based on a subset of the modified Telephone Interview for Cognitive Status (0-27, low-high) during years (1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, 2018). A multivariable linear mixed-effects model was used to test whether MAMC was associated with rate of cognitive decline across age groups and cognitive function overall.</p><p><strong>Results: </strong>Of 3702 adults (53% female, 63.2 ± 7.3 years), mean MAMC was 21.4 cm ± 3.0 and baseline cognitive score was 13.6 points <u>±</u>6.6. We found no evidence that the age-related rate of cognitive decline differed by MAMC (<i>P</i> = .77). Declines between 5-year age groups ranged from -.80 [SE (standard error) .18] to -1.09 [.22] for those at a mean MAMC, as compared to -.86 [.25] to -1.24 [.31] for those at a 1 MAMC 1 standard deviation above the mean. Higher MAMC was associated with better cognitive function with .13 [.06] higher scores for each corresponding 1 standard deviation increase in MAMC across all ages.</p><p><strong>Conclusion: </strong>Higher MAMC at any age was associated with better cognitive performance in older adults. Understanding the relationship between muscle mass and cognition may identify at-risk subgroups needing targeted interventions to preserve cognition.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"272-281"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138295292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rapid Access Memory Program for Addressing Concerns of Incipient Dementia in Academic Primary Care Settings.","authors":"Travis H Turner, Emmi P Scott, Katherine Barlis, Federico Rodriguez-Porcel, Andrea C Sartori, Jane Joseph","doi":"10.1177/08919887231225482","DOIUrl":"10.1177/08919887231225482","url":null,"abstract":"<p><strong>Background: </strong>Expedient diagnosis of incipient dementia is often hindered by time constraints in primary care visits, shortage of dementia specialists, and extended waitlists for comprehensive neuropsychological evaluations.</p><p><strong>Methods: </strong>We developed the Rapid Access Memory Program (RAMP) to improve access of neuropsychological services for older adults presenting to our institutional primary care clinics with concerns of cognitive decline. RAMP provides abbreviated neurocognitive assessment, same-day patient feedback, expedited reporting to referring providers, and is financially self-supported. Here, we describe development of RAMP and clinical outcomes from the first 3 years.</p><p><strong>Results: </strong>Of 160 patients seen, dementia was diagnosed in 30% and Mild Cognitive Impairment in 50%; Alzheimer's disease was the most common suspected etiology. New psychiatric diagnosis was made in about one-third (n = 54). Most frequent recommendations involved medication adjustments (initiating cholinesterase inhibitors, deprescribing anticholinergics), safety (driving, decision-making), and specialist referrals. Additionally, 27 (17%) subsequently enrolled in local research.</p><p><strong>Conclusions: </strong>Results support feasibility and utility of RAMP for connecting older adults in primary care with neuropsychological services.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"255-262"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidementia Medication Use in Nursing Home Residents.","authors":"Brian R Ott, Carl Hollins, Jennifer Tjia, Jonggyu Baek, Qiaoxi Chen, Kate L Lapane, Matthew Alcusky","doi":"10.1177/08919887231202948","DOIUrl":"10.1177/08919887231202948","url":null,"abstract":"<p><strong>Background: </strong>Antidementia medication can provide symptomatic improvements in patients with Alzheimer's disease, but there is a lack of consensus guidance on when to start and stop treatment in the nursing home setting.</p><p><strong>Methods: </strong>We describe utilization patterns of cholinesterase inhibitors (ChEI) and memantine for 3,50,197 newly admitted NH residents with dementia between 2011 and 2018.</p><p><strong>Results: </strong>Overall, pre-admission use of antidementia medications declined from 2011 to 2018 (ChEIs: 44.5% to 36.9%; memantine: 27.4% to 23.2%). Older age, use of a feeding tube, and greater functional dependency were associated with lower odds of ChEI initiation. Coronary artery disease, parenteral nutrition, severe aggressive behaviors, severe cognitive impairment, and high functional dependency were associated with discontinuation of ChEIs. Comparison of clinical factors related to anti-dementia drug treatment changes from pre to post NH admission in 2011 and 2018 revealed a change toward lower likelihood of initiation of treatment among residents with more functional dependency and those with indicators of more complex illness as well as a change toward higher likelihood of discontinuation in residents having 2 or more hospital stays.</p><p><strong>Conclusions: </strong>These prescribing trends highlight the need for additional research on the effects of initiating and discontinuing antidementia medications in the NH to provide clear guidance for clinicians when making treatment decisions for individual residents.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"194-205"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10321851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson's Disease Patients Over Time.","authors":"Adrianna M Ratajska, Connor B Etheridge, Francesca V Lopez, Lauren E Kenney, Katie Rodriguez, Rachel N Schade, Joshua Gertler, Dawn Bowers","doi":"10.1177/08919887231204542","DOIUrl":"10.1177/08919887231204542","url":null,"abstract":"<p><strong>Background: </strong>Autonomic dysfunction is prevalent in Parkinson's disease (PD) and can worsen quality of life. We examined: (a) whether specific autonomic symptoms were more strongly associated with anxiety or depression in PD and (b) whether overall autonomic dysfunction predicted mood trajectories over a 5-year period.</p><p><strong>Methods: </strong>Newly diagnosed individuals with PD (<i>N</i> = 414) from the Parkinson's Progression Markers Initiative completed self-report measures of depression, anxiety, and autonomic symptoms annually. Cross-sectional linear regressions examined relationships between specific autonomic subdomains (gastrointestinal, cardiovascular, thermoregulatory, etc.) and mood. Multilevel modeling examined longitudinal relationships with total autonomic load.</p><p><strong>Results: </strong>Gastrointestinal symptoms were associated with both higher anxiety (<i>b</i> = 1.04, 95% CI [.55, 1.53], <i>P</i> < .001) and depression (<i>b</i> = .24, 95% CI [.11, .37], <i>P</i> = .012), as were thermoregulatory symptoms (anxiety: <i>b</i> = 1.06, 95% CI [.46, 1.65], <i>P</i> = .004; depression: <i>b</i> = .25, 95% CI [.09, .42], <i>P</i> = .013), while cardiovascular (<i>b</i> = .36, 95% CI [.10, .62], <i>P</i> = .012) and urinary symptoms (<i>b</i> = .10, 95% CI [.01, .20], <i>P</i> = .037) were associated only with depression. Longitudinally, higher total autonomic load was associated with increases in both depression (<i>b</i> = .01, 95% CI [.00, .02], <i>P</i> = .015) and anxiety (<i>b</i> = .04, 95% CI [.01, .06], <i>P</i> < .001) over time, as well as occasion-to-occasion fluctuations (depression: <i>b</i> = .08, 95% CI [.05, .10], <i>P</i> < .001; anxiety: <i>b</i> = .24, 95% CI [.15, .32], <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Findings suggest autonomic dysfunction, particularly gastrointestinal and thermoregulatory symptoms, may be an indicator for elevated anxiety/depression and a potential treatment target early on in PD.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"242-252"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Approach to Monitoring Cognitive Adverse Events for Interventional Studies Involving Advanced Dementia Patients: Insights From the Electroconvulsive Therapy for Agitation in Dementia Study.","authors":"Soohyun Park, Brent P Forester, Maria I Lapid, David G Harper, Adriana P Hermida, Sharon K Inouye, Shawn M McClintock, Louis Nykamp, Georgios Petrides, Eva M Schmitt, Stephen J Seiner, Martina Mueller, Regan E Patrick","doi":"10.1177/08919887231207641","DOIUrl":"10.1177/08919887231207641","url":null,"abstract":"<p><strong>Objective: </strong>To develop an individualized method for detecting cognitive adverse events (CAEs) in the context of an ongoing trial of electroconvulsive therapy for refractory agitation and aggression for advanced dementia (ECT-AD study).</p><p><strong>Methods: </strong>Literature search aimed at identifying (a) cognitive measures appropriate for patients with advanced dementia, (b) functional scales to use as a proxy for cognitive status in patients with floor effects on baseline cognitive testing, and (c) statistical approaches for defining a CAE, to develop CAEs monitoring plan specifically for the ECT-AD study.</p><p><strong>Results: </strong>Using the Severe Impairment Battery-8 (SIB-8), baseline floor effects are defined as a score of ≤5/16. For patients <i>without</i> floor effects, a decline of ≥6 points is considered a CAE. For patients <i>with</i> floor effects, a decline of ≥30 points from baseline on the Barthel Index is considered a CAE. These values were derived using the standard deviation index (SDI) approach to measuring reliable change.</p><p><strong>Conclusions: </strong>The proposed plan accounts for practical and statistical challenges in detecting CAEs in patients with advanced dementia. While this protocol was developed in the context of the ECT-AD study, the general approach can potentially be applied to other interventional neuropsychiatric studies that carry the risk of CAEs in patients with advanced dementia.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"234-241"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Apathy and Cognitive Impairment Among Hispanic/Latin Americans: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses Systematic Review.","authors":"Joshua M Garcia, Jai Sehgal, Jennifer L Thompson, Steven Paul Woods, Luis D Medina","doi":"10.1177/08919887231207640","DOIUrl":"10.1177/08919887231207640","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim was to evaluate apathy assessment measures in relation to cognitive impairment among Hispanic/Latin Americans.</p><p><strong>Methods: </strong>A systematic review on the relationship between apathy and cognitive impairment among Hispanic/Latin Americans across normal aging and neurocognitive disorders was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and using APA PsycInfo, Embase, and PubMed databases. Inclusion criteria required (1) a sample of English or Spanish-speaking adults ages 18 years and older, (2) with measures of apathy, (3) assessment of cognitive functioning or diagnosis of neurocognitive disorder, (4) with at least 18.5% Hispanic/Latin American represented in the sample.</p><p><strong>Results: </strong>Only 14 papers met criteria to be included in this review. Of the 12 cross-sectional studies, 9 demonstrated significant associations between increased apathy and cognitive impairment, 1 demonstrated a descriptive difference between apathy and cognitive status (ie, no hypothesis test conducted), while 2 demonstrated null effects. These cross-sectional studies consisted of community and clinic samples of participants across North and South America. Two longitudinal studies conducted in North America demonstrated non-significant associations of apathy with cognitive status.</p><p><strong>Conclusions: </strong>The Neuropsychiatric Inventory (NPI) and Neuropsychiatric Inventory Questionnaire (NPI-Q) apathy subscales were the most used measures for apathy in this review (85.7% of included studies). However, validity evidence from a review of apathy measures has warranted caution against the use of the NPI outside the context of screening for apathy. This potential measurement bias with Hispanic/Latin Americans apathy research limits conclusions drawn from the present review.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"175-193"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49678330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder?","authors":"Ellen M J Gielkens, Gina Rossi, Sebastiaan P J van Alphen, Sjacko Sobczak","doi":"10.1177/08919887231207639","DOIUrl":"10.1177/08919887231207639","url":null,"abstract":"<p><strong>Objectives: </strong>In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events).</p><p><strong>Design: </strong>Multicenter design with pre-post measurements.</p><p><strong>Setting: </strong>Psychiatric Dutch hospitals Mondriaan Mental Health Center and Altrecht.</p><p><strong>Participants: </strong>22 treatment-seeking PTSD-outpatients (60-84 years).</p><p><strong>Intervention: </strong>Weekly one-hour EMDR session during 3, 6, or 9 months.</p><p><strong>Measurements: </strong>PTSD was assessed with Clinician-Administered PTSD-scale for DSM-5 (CAPS-5). Verbal learning memory was measured with Auditory Verbal Learning Test (RAVLT), interference with Stroop Colour-Word Test (SCWT) and working memory with Wechsler Adult Intelligence Scale-Digit Span (WAIS-IV-DS).</p><p><strong>Results: </strong>A Linear mixed-model showed significant improvement on RAVLT immediate-recall (F (1, 21) = 15.928, <i>P</i> = .001, 95% CI -6.98-2.20), delayed-recall (F (1, 21) = 7.095, <i>P</i> = .015, 95% CI -2.43-.30), recognition (F (21) = 8.885, <i>P</i> = .007, 95% CI -1.70- -.30), and SCWT (F (1 ,21) = 5.504, <i>P</i> = .029, 95% CI 4.38-72.78) but not on WAIS-IV-DS (F (20) = -1.237, <i>P</i> = .230, 95% CI -3.07-.78). There was no significant influence of therapy duration and CAPS-5 pre-treatment scores. There were small-medium nonsignificant correlations between CAPS-5 and cognitive performance pre-post differences, and between most cognitive measures and sleep problems, depressive disorder, and physical inactivity.</p><p><strong>Conclusions: </strong>Cognitive functioning on memory and attention possible increased in older adults with PTSD after EMDR treatment. Further research is needed with a larger sample and a control condition to corroborate these findings and to identify the possible mediating role of modifiable risk factors.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"206-221"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49690852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}