American Journal of Geriatric Psychiatry最新文献

{"title":"Investigating the Multidimensional Structure of Apathy in Cognitive Decline: An Exploratory Network Analysis of the Apathy Evaluation Scale","authors":"Claudia Savia Guerrera Ph.D. ,&nbsp;Giuseppe Alessio Platania Ph.D. ,&nbsp;Simone Varrasi M.Sc. ,&nbsp;Pierfrancesco Sarti M.Sc. ,&nbsp;Francesco Maria Boccaccio M.Sc. ,&nbsp;Vittoria Torre M.Sc. ,&nbsp;Mario Santagati M.D. ,&nbsp;Giovanna Furneri Ph.D. ,&nbsp;Concetta Pirrone Ph.D. ,&nbsp;Santo Di Nuovo Ph.D. ,&nbsp;Johanna M.C. Blom Ph.D. ,&nbsp;Filippo Caraci Ph.D. ,&nbsp;Sabrina Castellano Ph.D.","doi":"10.1016/j.jagp.2025.07.010","DOIUrl":"10.1016/j.jagp.2025.07.010","url":null,"abstract":"<div><h3>Objective</h3><div>Apathy is a multidimensional syndrome present in neurodegenerative disorders such as Alzheimer’s disease and mild cognitive impairment, distinct from depression. It requires targeted assessment tools able to explore and measure it as a complex system. This study aimed to explore the latent structure of apathy in individuals with cognitive decline using Exploratory Graph Analysis (EGA) applied to the Apathy Evaluation Scale – Clinician version (AES-C), and to compare this structure with traditional factorial models.</div></div><div><h3>Methods</h3><div>A total of 214 individuals, including patients with mild cognitive impairment (MCI), Alzheimer’s disease (AD), and healthy controls, completed the AES-C and a standardized neuropsychological battery. EGA was used to estimate the network-based factor structure of the AES-C. Confirmatory factor analysis compared the EGA-derived model with both the original structure proposed by Marin et al. and a model derived through exploratory factor analysis (EFA).</div></div><div><h3>Results</h3><div>EGA revealed a four-factor structure: interest and motivation, autonomy, novelty, and social apathy. This solution demonstrated better fit, parsimony, and conceptual clarity than both the original and EFA-derived models. The EGA model showed good internal consistency, convergent and discriminant validity, and performed consistently across MCI and AD subgroups.</div></div><div><h3>Conclusions</h3><div>EGA provided a clearer understanding of apathy by identifying specific, clinically relevant, and objective dimensions that differ in disease progression. This precise characterization facilitates targeted and timely interventions and has the potential to initiate the development of new test batteries fully validated through network methods, allowing more complex analysis of apathy symptoms.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 450-461"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885035","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 Effect of Displacement During Extreme Circumstances on Digital Engagement and Well-Being Among Older Adults","authors":"Ittay Mannheim Ph.D. ,&nbsp;Rinat Lifshitz Ph.D. ,&nbsp;Yaacov G. Bachner Ph.D. ,&nbsp;Ella Cohn-Schwartz Ph.D.","doi":"10.1016/j.jagp.2025.03.004","DOIUrl":"10.1016/j.jagp.2025.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Currently, there are increasing instances of forced displacement due to extreme circumstances such as armed conflicts. Under threatening conditions, certain factors, such as displacement, can decrease one's well-being. On the other hand, specific capabilities and resources such as digital engagement, may serve as coping mechanisms. This study examines the associations between digital engagement and the well-being of older adults during armed conflict situations, comparing displaced persons to those who were not displaced.</div></div><div><h3>Methods</h3><div>Ninety-three displaced and 150 nondisplaced older Israeli adults aged 60 and above completed an online or paper questionnaire two months after the beginning of the Israel-Hamas war on 7th of October 2023. Measurements included indicators of well-being (loneliness, depressive symptoms, subjective health, and sense of control), rocket threat, digital engagement, digital ageism, and socio-demographic characteristics.</div></div><div><h3>Results</h3><div>Displaced older adults reported lower subjective health, higher levels of loneliness, and a diminished sense of control, compared to those not displaced. Following the war, individuals who were displaced reported using fewer digital devices, exhibited different patterns of use, and reported twice as many limitations in using technology. A hierarchical regression analysis revealed that various aspects of digital engagement were associated with different well-being components, mitigating the initial negative effects of displacement on loneliness and subjective health.</div></div><div><h3>Conclusions</h3><div>This study highlights the importance of digital engagement as a potential protective factor for the well-being of older adults during extreme circumstances such as armed conflicts.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 522-532"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765951","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(26)00044-8","DOIUrl":"10.1016/S1064-7481(26)00044-8","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Page A1"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388037","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":"Is the Time Right to Start Testing if Late-Onset Depression is Associated With the Development of an α-Synucleinopathy Like Parkinson’s Disease? A Double Systematic Review and Meta-Analysis","authors":"Jan Booij M.D., Ph.D. ,&nbsp;Rik Schalbroeck Ph.D. ,&nbsp;Madeleine Wartenhorst B.Sc. ,&nbsp;Carmen F.M. van Hooijdonk Ph.D. ,&nbsp;Youssef Chahid Ph.D. ,&nbsp;Robin Cobben M.D. ,&nbsp;Annemieke Dols M.D., Ph.D. ,&nbsp;Natasja Schutter M.D., Ph.D. ,&nbsp;Mardien L. Oudega M.D., Ph.D. ,&nbsp;Rob M.A. de Bie M.D., PhD. ,&nbsp;Sem E. Cohen M.D. ,&nbsp;Jasper Zantvoord M.D., Ph.D. ,&nbsp;Karel Scheepstra M.D., Ph.D.","doi":"10.1016/j.jagp.2025.07.014","DOIUrl":"10.1016/j.jagp.2025.07.014","url":null,"abstract":"<div><div>Parkinson’s disease (PD) is characterized by two neurobiological markers: pathological α-synuclein and/or a dopaminergic deficit. Depression is common in PD, and may precede motor signs, particularly in late-onset depression (LOD). We conducted two systematic reviews and a meta-analysis to examine the relationship between depression and PD development. First, we evaluated whether depression is associated with an increased risk of developing PD, and whether pathological α-synuclein or dopaminergic deficits were observed in depressed patients prior to PD diagnosis. Second, we evaluated whether studies examined neurobiological markers in LOD patients, regardless of subsequent PD development. Our first review identified 39 studies showing a positive association between depression and subsequent PD. This was supported by an exploratory meta-analysis, stratified by index condition: 1) retrospective studies of patients with PD reporting prior depression (odds ratio [OR] = 2.17, 95% CI: 1.92–2.46) and 2) prospective studies of depressed patients who developed PD (OR = 2.01, 95% CI: 1.20–3.38). Importantly, none of these studies examined neurobiological data. Our second review identified three cross-sectional studies reporting that 24%–79% of the LOD patients had a dopaminergic deficit as detected by dopamine transporter (DAT) imaging. We found no studies in LOD in which α-synuclein was determined. Given the observed moderately elevated risk for developing PD in depressed patients, the high incidence of abnormal DAT scans in LOD, and ageing as a major risk factor for developing PD, longitudinal studies in LOD patients are essential to establish neurobiological evidence that depression can be an early manifestation of an α-synucleinopathy like PD.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 611-623"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034771","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":"Association of Social Relationships and Genetic Risk With Frailty","authors":"Wei-Qi Song Ph.D. ,&nbsp;Wen-Fang Zhong Ph.D. ,&nbsp;Hao-Yu Yan M.P.H. ,&nbsp;Zhi-Hao Li Ph.D. ,&nbsp;Jian Gao Ph.D. ,&nbsp;Xiao-Meng Wang Ph.D. ,&nbsp;Pei-Liang Chen Ph.D. ,&nbsp;Fang-Fei You Ph.D. ,&nbsp;Chuan Li Ph.D. ,&nbsp;Huan Chen Ph.D. ,&nbsp;Jia-Hao Xie M.P.H. ,&nbsp;Yue-Bin Lv Ph.D. ,&nbsp;Xiao-Ming Shi Ph.D. ,&nbsp;Chen Mao Ph.D.","doi":"10.1016/j.jagp.2025.02.015","DOIUrl":"10.1016/j.jagp.2025.02.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the association between social relationships and their changes with frailty among older adults, and whether genetic risk modifies these associations.</div></div><div><h3>Methods</h3><div>This study included 11,559 older adults (mean age 80.1 years) from the Chinese Longitudinal Healthy Longevity Survey. Social relationships were categorized into three dimensions: social activities, social networks, and social support, each classified as favorable or unfavorable groups. Changes in social relationships were assessed at two time points. The polygenic risk score (PRS) was constructed using 59 single-nucleotide polymorphisms associated with frailty. Cox proportional hazards models were used to assess the effects of social relationships and their changes, and PRS on frailty. Two-sample Mendelian randomization identified causal associations.</div></div><div><h3>Results</h3><div>During a median follow-up of 5.4 years, 4773 participants developed frailty. Unfavorable social relationships, particularly in social activities and social networks, were associated with increased frailty risk, with stronger effects in those with high genetic risk. Mendelian randomization revealed their harmful effects on frailty. An additive interaction between social relationships and genetic risk on frailty was observed. Combined unfavorable social relationships and high genetic risk increased frailty risk by 39% (HR: 1.39, 95% CI: 1.23–1.57). Persistent unfavorable relationships further increased frailty risk by 58% in those with high genetic risk (HR: 1.58, 95% CI: 1.27–1.97).</div></div><div><h3>Conclusion</h3><div>Unfavorable social relationships increase frailty risk, particularly for individuals with high genetic susceptibility. Persistent unfavorable relationships further increase this risk over time, with the highest frailty risk observed in those with both persistent unfavorable social relationships and high genetic risk.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 533-543"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744394","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":"Commentary on “Association Between the Ratio of Triglycerides to HDL-C and Cognitive Impairment: A Longitudinal Population-Based Analysis and Mendelian Randomization Study”","authors":"Shangavi Vellingiri Pharm.D","doi":"10.1016/j.jagp.2025.12.014","DOIUrl":"10.1016/j.jagp.2025.12.014","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 656-657"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115432","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":"Response to the Letter to the Editor by Wu et al. Regarding the Article “Improvements in Depressive Symptoms, Perceived Social Support, and Quality of Life Through an Educational Program in Community-Dwelling Older Adults With Frailty Phenotype”","authors":"Manuel Costilla M.Sc. ,&nbsp;Juan Corral-Pérez Ph.D. ,&nbsp;María Ángeles Vázquez-Sánchez Ph.D. ,&nbsp;Laura Ávila-Cabeza-de-Vaca M.Sc. ,&nbsp;Andrea González-Mariscal M.Sc. ,&nbsp;Cristina Casals Ph.D.","doi":"10.1016/j.jagp.2026.01.002","DOIUrl":"10.1016/j.jagp.2026.01.002","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 649-653"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215538","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":"Humane Intelligence in Geropsychiatric Care: Relational Artificial Intelligence, Clinical Wisdom, and the Moral Grid Operational Index","authors":"Helen H. Kyomen M.D., M.S. ,&nbsp;Group for the Advancement of Psychiatry (GAP) Committee on Aging","doi":"10.1016/j.jagp.2025.12.012","DOIUrl":"10.1016/j.jagp.2025.12.012","url":null,"abstract":"<div><div>Artificial intelligence (AI) already influences how older adults are identified for services, supported between provider visits, and referred for care, yet most AI governance currently focuses on algorithms and infrastructure rather than the actual experiences of older adults and their caregivers. Humane Intelligence is a patient-centered, ethically attuned, relational framework for designing, evaluating, and monitoring AI in older adult care. It rests on four pillars: Relational Intelligence, Transparency with Care, Reciprocity and Consent, and Ethical Governance in Strategic Regions, and applies them from point-of-care encounters to system-level decisions. For each pillar, guidelines follow the same sequence: signal a problem, take action, and verify benefit or harm. The framework prioritizes outcomes that matter in geriatric psychiatry, including function, distress, caregiver burden, avoidable utilization, equity, and documented harms or overrides. To protect patients, it draws a firm boundary against fully automated clinical actions and recommends clinical-grade standards for patient-facing programs, including scope-of-action labels, human-in-the-loop safeguards for high-risk situations, postmarket monitoring, and periodic certification. This blueprint aligns with 2025 JAMA Summit on AI priorities, World Health Organization guidance for large multimodal models, United States Food and Drug Administration recommendations for Predetermined Change Control Plans, and Office of the National Coordinator for Health Information Technology decision-support intervention frameworks. The goal is practical: to translate ethics into testable patient-centered routines that clinicians can trust, healthcare systems can implement, and leaders can procure, so that AI augments rather than displaces care.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 674-692"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222758","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":"Mental Health of Older Adults Across the Globe: Addressing Current Challenges in a Cultural Context","authors":"Nhi-Ha Trinh M.D., M.P.H. ,&nbsp;Iqbal Ahmed M.D. ,&nbsp;Dinesh Bhugra M.B.B.S., Ph.D., M.Phil., M.Sc., M.A.","doi":"10.1016/j.jagp.2025.11.009","DOIUrl":"10.1016/j.jagp.2025.11.009","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 660-663"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322746","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":"Functional Recovery and Mortality in Hospitalized Patients With Dementia and Severe Neuropsychiatric Symptoms: A 13-Year Spanish Study","authors":"Kevin O'Hara-Veintimilla M.D. ,&nbsp;Miguel German Borda M.D., Ph.D. ,&nbsp;Leire Martínez-Alderete M.D. ,&nbsp;Mario Salas-Carrillo M.D. ,&nbsp;María Vidal-Millares M.D., Ph.D. ,&nbsp;Raimundo Mateos M.D., Ph.D.","doi":"10.1016/j.jagp.2025.06.004","DOIUrl":"10.1016/j.jagp.2025.06.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine whether functional status in older adults with dementia and severe neuropsychiatric symptoms (NPS), particularly functional improvement during specialised psychogeriatric hospitalisation, is associated with better survival.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Matia Psychogeriatric Hospitalisation Study (PHS-Matia), including 2,283 patients aged ≥60 years hospitalised between 2011 and 2024. Functional status was assessed with a modified Barthel Index (BI) at preadmission, admission, and discharge. Psychotropic burden was measured using the Psychotropic Drug Burden Index (pDBI). Survival was analysed with Kaplan-Meier (KM) curves and Cox regression models, while functional recovery was assessed using linear mixed-effects models.</div></div><div><h3>Results</h3><div>The median age was 83 years, and 51.8% were female. Functional recovery during hospitalization was significant (median BI improvement: +13, p &lt;0.001). Increased pDBI was associated with an 87% lower mortality (HR: 0.13, 95% CI, [0.09–0.21], p &lt;0.001). Among psychotropic<span> subgroups, a higher antipsychotic pDBI correlated with greater functional recovery (coefficient: 2.65, 95% CI, [1.12–4.17], p = 0.001). The Spanish version of the Mini-Mental State Examination (MEC-35) ≥15 was associated with lower mortality (HR: 0.23, p &lt;0.001).</span></div></div><div><h3>Conclusions</h3><div>Functional improvement during hospitalization is a key predictor of survival in older adults with dementia and severe neuropsychiatric symptoms (NPS). The observed association between increased pDBI and reduced mortality challenges conventional views on psychotropic use, warranting further research. These findings underscore the importance of an individualized, symptom-driven approach to treatment in this vulnerable population.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 4","pages":"Pages 486-499"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610909","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}