American Journal of Geriatric Psychiatry最新文献

{"title":"Information for Subscribers","authors":"","doi":"10.1016/S1064-7481(25)00044-2","DOIUrl":"10.1016/S1064-7481(25)00044-2","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 5","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578588","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":"Information for Subscribers","authors":"","doi":"10.1016/S1064-7481(25)00021-1","DOIUrl":"10.1016/S1064-7481(25)00021-1","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 4","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512064","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":"Clinical Needs of Older Adults With Personality Disorders: Insights From State-Funded Mental Health Care Systems.","authors":"Emily R Edwards, Ashley L Greene, Lillian A Steedman","doi":"10.1016/j.jagp.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.010","url":null,"abstract":"<p><strong>Objectives: </strong>Due to a longstanding focus on early to middle adulthood, research into the clinical needs of older adults with personality disorders remains limited. This study sought to further understandings into the potentially unique needs of this population.</p><p><strong>Methods: </strong>Analyses compared comorbid psychiatric diagnoses, settings of utilized mental health treatment, and sociodemographic variables among older (aged 65+, n = 11,426) and younger (aged 18-35, n = 57,847) adults diagnosed with a personality disorder who received state-funded mental health care in the United States in 2022.</p><p><strong>Results: </strong>Older adults with personality disorder diagnoses were more likely to have comorbid psychotic and delirium/dementia disorder diagnoses, less likely to have comorbid trauma and stressor, anxiety, and attention-deficit/hyperactivity disorder diagnoses, and less likely to experience homelessness than younger adults with personality disorder diagnoses.</p><p><strong>Conclusions: </strong>Findings highlight the importance of interventions to address co-occurring cognitive disorganization among older adults experiencing personality disorder pathology.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659964","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":"Developing Treatment Models for the Delivery of the Antiamyloid Therapy, Lecanemab: Considerations for Implementation of Lecanemab in Healthcare Systems.","authors":"Michael Weber, Heidi L Roth, Amy Abramowitz, Kim G Johnson","doi":"10.1016/j.jagp.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.007","url":null,"abstract":"<p><p>We describe the model developed by two separate healthcare systems to deliver the antiamyloid therapy, lecanemab, to patients with mild cognitive impairment and mild dementia. Based on current guidelines, the experience of two separate healthcare systems that developed lecanemab clinical care delivery programs is described in detail including the development of patient eligibility criteria, cooperation with specialty services, patient monitoring, and practical steps required to safely implement lecanemab programs at a systems level. Geriatric psychiatrists have a prominent role in prescribing and monitoring antiamyloid therapy in both systems and we highlight the unique role of the geriatric psychiatrist in the future delivery of antiamyloid therapies as memory care specialists.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588355","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 Dynamics of Depressive Symptoms, Apathy, Daily Activities, and Cognitive Decline in Older People From the General Population: A Network Analysis.","authors":"Abe J C van der Slot, Simon P Mooijaart, Jan-Willem van Dalen, Marieke Hoevenaar, Edo Richard, Erik J Giltay","doi":"10.1016/j.jagp.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.011","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of depressive symptoms, apathy, and cognitive decline increases with age. Understanding the temporal dynamics of these symptoms could provide valuable insights into the early stages of cognitive decline, allowing for more timely and effective treatment and management.</p><p><strong>Methods: </strong>Participants from the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial cohort with baseline and ≥3 follow-up measurements were included, with a median of 7.8 (0.68) years of follow-up. Dynamic Time Warping (DTW) analysis was used to model temporal dynamics of cognition using the Mini Mental State Exam (MMSE), activities of daily living (ADL) using the Amsterdam Linear Disability Scale (ALDS), and apathy and depressive symptoms using the 15-item Geriatric Depression Scale (GDS-15) at the individual and group level.</p><p><strong>Results: </strong>The 1,537 participants were aged 74 (2.0) years at baseline, 56.5% were female, and 19.9% had finished higher education. A decline in ADL and increase in apathy tended to precede most indicators of cognitive decline, with all apathy items (i.e. being 'dropped activities/interests', 'not feeling energetic' and 'not doing new things') and ADL showing significant outstrength (all p's < 0.001). Many mood-related symptoms other than apathy, and the MMSE items 'immediate memory', 'verbal comprehension' and 'naming objects' tended to be the last to deteriorate, showing significant instrength (all p's < 0.001).</p><p><strong>Conclusion: </strong>An increase apathy and a decline in ADL tended to precede mood-related symptoms and cognitive impairment in older adults from the general population. These changes may thus serve as potential early warning signs of both depression and dementia, and may allow for timely intervention.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617890","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":"Associations of Self-Reported Deterrents to Suicide Attempts in Depressed Older Adults.","authors":"Emma J O'Brien, Sarah T Stahl, Meghan T Wong, Michelle Perry-Falconi, Hanga Galfalvy, Katalin Szanto","doi":"10.1016/j.jagp.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>This study examined deterrents to suicide in depressed older adults with and without a lifetime suicide attempt.</p><p><strong>Methods: </strong>Older adults (N=264, M±SD age = 62.5±7.9 years) participating in a study on late-life suicide risk provided deterrents to suicide via free-response item. Two independent raters categorized participant responses based on Linehan's Reasons for Living scale. Logistic regression compared deterrent categories between attempters and nonattempters.</p><p><strong>Results: </strong>Survival/coping beliefs (54%) and relationships (52%) were the most cited deterrents. Neither the number of categories endorsed, nor the type of deterrent categories were differentially associated with lifetime suicide attempt. Among attempters (n=106) individuals who attempted suicide more recently were less likely to endorse relationship deterrents compared to individuals who attempted suicide in the distal past.</p><p><strong>Conclusions: </strong>Beliefs in one's ability to deal with stressful situations may have long-standing positive effect on suicidal behavior, while social disconnectedness is associated with recent suicide attempts.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627172","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":"Towards Mechanism-Informed Psychotherapies for Reducing Clinical Severity in Late-Life Depression: Promise and Challenges.","authors":"Joseph S Goveas","doi":"10.1016/j.jagp.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.006","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538130","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":"Time to Death by Suicide in an Epidemiological Sample of Veterans With an Inpatient Hospitalization for Heart Failure.","authors":"Melanie L Bozzay, Matthew F Thompson, Lan Jiang, Jennifer M Primack, John E McGeary, Alyssa N De Vito, Julia Browne, Catherine M Kelso, James L Rudolph, Zachary J Kunicki","doi":"10.1016/j.jagp.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>Patients who have experienced an inpatient hospitalization for heart failure are at increased risk of mortality, particularly during the months following discharge. This study described patient characteristics associated with suicide death and examined the time course of death by suicide compared to that of other types of death amongst patients with a recent medical hospitalization for heart failure.</p><p><strong>Method: </strong>Using Department of Veterans Affairs (VA) electronic medical records from 2011 to 2020, we identified a cohort of Veterans hospitalized with a heart failure diagnosis who died after discharge. We merged the VA Mortality Database Record, a compilation of death sources and causes, with the VA electronic health record and compared characteristics of Veterans who died by suicide and by other causes.</p><p><strong>Results: </strong>In the cohort of 348,840 Veterans, 1,097 died by suicide and 347,743 died by other causes. Compared to those who died by other causes, Veterans who died by suicide were, on average, younger, had fewer comorbidities, more likely to have a depression diagnosis, more likely to be White, and had lower prior year healthcare costs (Standardized mean differences [SMD] ranged from 0.25 to 0.46). Unadjusted analyses showed longer length of time between hospital discharge and death for those who died by suicide compared to other causes (SMD = 0.18); however, analyses adjusting for comorbidities revealed no difference in time to death between those who died by suicide versus other causes.</p><p><strong>Conclusions: </strong>Demographic, clinical, and healthcare utilization characteristics distinguished Veterans with heart failure who died by suicide from those who died by other causes. Time to death following hospital discharge did not differ between groups when accounting for relevant factors. Comprehensive suicide screening and intervention is needed following a heart-failure hospital discharge, particularly for Veterans at elevated risk.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532218","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":"Addressing the Clinical Needs of Older Adults With Personality Disorders: A Call for Targeted Scientific Research.","authors":"Sebastiaan P J van Alphen","doi":"10.1016/j.jagp.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.003","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477266","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":"Sociodemographic Characteristics, Dementia, and Familiar Risk in Patients With Paraphrenia: A Danish Register-Based Cohort Study.","authors":"Ida Kim Wium-Andersen, Marie Kim Wium-Andersen, Maarten Rozing, Martin Balslev Jørgensen, Merete Osler","doi":"10.1016/j.jagp.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.02.004","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize patients with paraphrenia, focusing on their risk of dementia compared to patients with schizophrenia and the general population. Additionally, the study examined the risk of psychiatric disorders among the offspring of patients with paraphrenia.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study using the Danish Civil Registration System, the Danish Psychiatric Central Research Register, and the Danish National Patient Registry. Patients diagnosed with paraphrenia from 1969 to 1993 (ICD-8 code 297.19) were identified and matched with schizophrenia and an age matched reference population. Dementia risk was assessed using Cox proportional hazard models, with age as the underlying timescale. Offspring of the populations were followed for psychiatric outcomes.</p><p><strong>Results: </strong>Patients with paraphrenia (n = 989) were predominantly older women, more often unmarried or widowed. Patients with schizophrenia and individuals in the matched reference population had a lower risk of dementia compared to patients with paraphrenia (hazard ratio [HR] = 0.60 (95% confidence interval [CI] = 0.50-0.71) and HR = 0.22 (95% CI = 0.19-0.26, respectively). Offspring of patients with paraphrenia (n = 174) exhibited a higher risk of psychiatric illness than offspring of individuals in the reference population. There was no significant difference between the risk of psychiatric illness in offspring of patients with paraphrenia and patients with schizophrenia.</p><p><strong>Conclusion: </strong>The increased dementia risk associated with paraphrenia is contrary to the traditional description of it and may be due to earlier perhaps age based overdiagnosis of the syndrome including less characteristic clinical presentations. The increased familiar risk of psychiatric illness in offspring underscores the importance of considering familial psychiatric history in the assessment and care of these patients.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538129","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}