American Journal of Geriatric Psychiatry最新文献

{"title":"101. EFFECTS OF PSYCHIATRIC DIAGNOSIS ON MEDICAL DIRECTIVE USAGE IN OLDER ADULTS: A LARGE DATASET EMR ANALYSIS AT A SAFETY-NET METROPLEX HOSPITAL","authors":"Vivek Mathesh ,&nbsp;Kayla Murphy ,&nbsp;Mashal Ali ,&nbsp;Christopher Clark ,&nbsp;Natalie Provenzale ,&nbsp;Abhisek Khandai ,&nbsp;Mustafa Husain","doi":"10.1016/j.jagp.2025.04.103","DOIUrl":"10.1016/j.jagp.2025.04.103","url":null,"abstract":"<div><h3>Introduction</h3><div>Background: It is estimated that only 1/3rd of US adults will detail an Advance Directive in their lifetime. Advance directive completion is associated with a decreased risk of hospitalization, higher concordance between the individual’s end-of-life wishes with the provided care, and amelioration of the caregiver’s stress (Sedini et al., 2022). However, little is known about the intersection of psychiatric diagnoses, including neurocognitive disorders, on MAD usage. Thus, the goal of this study is to establish a robust framework on MAD usage through a novel EMR analysis of a large metroplex city population and elucidate how the adoption of MADs is influenced by psychiatric diagnoses.</div></div><div><h3>Methods</h3><div>Methods: A retrospective analysis of electronic record encounters for all adults (age &gt; = 18 years) with a 2022 inpatient admission (n = 41,421) at Parkland Memorial hospital was conducted. To identify the presence of an Advance Directive, these records were queried for attachments with MAD-related titles. MAD adoption rates among patients with and without psychiatric diagnoses were compared.</div></div><div><h3>Results</h3><div>Results: 41,421 patients were included in the study (age= 43.75 ± 17.53 years, mean ± SD) from which 15,143 patients identified as male, and 26,278 patients identified as female. Across all patients, the adoption of medical advance directives was 8.75%. Among those who had a psychiatric diagnosis, 14.0% of patients utilized a form of advance directive while, among those who did not have a psychiatric diagnosis, only 6.1% had an advance directive (p &lt; 0.001). Compared to the population without a psychiatric diagnosis, those that had diagnoses related to neurocognitive disorders had a 25.7% higher use rate of advance directives (p &lt; 0.001). Similarly, comparing patients from other psychiatric disorder groups to the general population, the Anxiety/Depression, Substance Use Disorder, and Schizophrenia/Bipolar, had a 17.6%, 11.7%, and 10.5% increase in MAD usage, respectively (p &lt; 0.001 for all three comparisons).</div></div><div><h3>Conclusions</h3><div>Conclusion: Despite known healthcare disparities for patients with psychiatric disorders, our results indicated that MAD usage is greater amongst those who have a psychiatric diagnosis compared to patients who do not. In particular, patients with neurocognitive disorders had higher rates of MAD usage, especially in comparison to patients with other psychiatric diagnoses. Further studies will investigate the potential confounding effects of age, race, and gender on MAD usage in patients with psychiatric comorbidities. Particularly given the health disparities faced by patients with neurocognitive disorders and other psychiatric diagnoses, medical centers must create systems-level interventions to promote inclusive and empowering MAD usage amongst older adults.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S75"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614270","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":"54. REWARD LEARNING IN LATE-LIFE DEPRESSION: A NOVEL LATENT-CAUSE INFERENCE APPROACH","authors":"Courtney Lee ,&nbsp;Yutong Zhu ,&nbsp;Heather Doherty ,&nbsp;Oded Bein ,&nbsp;Nili Solomonov","doi":"10.1016/j.jagp.2025.04.056","DOIUrl":"10.1016/j.jagp.2025.04.056","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Older adults with depression experience deficits in processing socially rewarding experiences. These deficits include blunted reward anticipation – reduced expectation that pleasurable social experiences will occur in the future. Reduced reward anticipation is associated with greater anhedonia severity and lower tendency to seek rewarding experiences. We leveraged latent-cause inference, a computational and conceptual framework for cognitive learning processes, to investigate social reward deficits in late-life depression. We hypothesized that blunted reward anticipation might result from clustering rewarding and non-rewarding events together, instead of accurately distinguishing them. This clustering in turn could lead to anticipation of negative or neutral, rather than positive, social experiences in the future. We aimed to investigate whether depressed older adults, compared to healthy controls, show poorer social reward learning (i.e. reduced segregation between rewarding and non-rewarding social stimuli).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Fifty-eight participants (mean age: 64.2 years [SD: 7.0], 42 female [72.4%]) were included in the study: 25 older adults with late-life depression (mean age: 65.0 [SD: 7.0] years, 23 female [92.0%]) and 33 healthy controls (mean age: 63.6 [SD: 7.0] years, 19 female [57.6%]). Participants completed our novel “Social Task for Assessment of Reward” (STAR) task four times over 9 weeks (baseline, week 3, 6, and 9). The task consisted of 70 trials: 35 social reward trials (a cue of anticipating social reward feedback); 35 non-reward trials (a cue of anticipating no social reward feedback). We applied mixed-level linear models to investigate differential effects of cue response over time in depressed older adults vs. healthy controls.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We found that both depressed and healthy control individuals showed faster reaction times for anticipated social reward vs. non-reward trials (F1, 13288 = 7.89, p = 0.004989). Further, the depressed group, vs. healthy controls, showed smaller differences in reaction times between social reward and non-reward trials (F1, 13288 = 6.13, p = 0.01333). This effect did not change over time (F1, 13288 = 0.665, p = 0.5737), suggesting persistent diminished segregation of social reward and non-reward trials.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our findings suggest that depressed older adults, compared to healthy controls, show reduced segregation between rewarding and non-rewarding social stimuli. This lower segregation might indicate poorer social reward learning in late-life depression, specifically reduced anticipation of socially rewarding outcomes. Our results can inform the development of interventions to restore adaptive segregation between rewarding and non-rewarding events to improve social reward learning. Specifically, future work will investigate whether psychotherapy for increasing engagement in socially ","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S40"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614397","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":"56. BACK TO THE FUTURE: VISUAL HALLUCINATIONS CAPTURED ON FDG-PET IN ADVANCE OF GROSS COGNITIVE IMPAIRMENT: A CASE FOR ETIOPATHOLOGICAL REDEFINITION OF ALZHEIMER'S DISEASE.","authors":"Karisma Pathak ,&nbsp;Ricardo Salazar","doi":"10.1016/j.jagp.2025.04.058","DOIUrl":"10.1016/j.jagp.2025.04.058","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurobiological studies to date suggest that psychosis in AD and related dementias may be associated with distinct imaging, genetic, neuropathological, and CSF biomarkers. Notably, most of the neurobiological studies to date have focused on patients with established dementia, given that psychotic symptoms are much rarer in prodromal states and may be confused with primary psychiatric pathology. Further study of psychosis-associated biomarkers in patients with prodromal conditions is clearly required.</div></div><div><h3>Methods</h3><div>We describe the case of a previously healthy woman in her middle 70s with new-onset and prominent visual hallucinations referred for neuropsychiatric evaluation after an extensive medical work-up by neurology to rule out organic causes. A thorough psychiatric, neurological, and cognitive evaluation was conducted. We conducted an FDG-PET evaluation to further elucidate the underlying pathophysiology.</div></div><div><h3>Results</h3><div>We report for the first time in the literature a case of the Phantom Boarder Phenomenon (PB), in which animals (snakes) and insects (spiders) have entered or are living in the patient's home despite evidence to the contrary. The patient experiences fear, anxiety, social isolation, living alone with no interpersonal relationships, and personal loss. Extensive medical, neurological, ophthalmological, and psychiatric workup and evaluation was completely normal, except for the FDG-PET findings that demonstrated early signs of synaptic dysfunction on bilateral temporal lobes.</div></div><div><h3>Conclusions</h3><div>Our case report supports the notion found in other studies that identified the temporal lobes as the neurobiological substrate of positive BPSD and FDG-PET as a potential instrument to predict their development.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S42"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614399","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":"84. EVALUATION OF A DIDACTIC SESSION ON CULTURAL HUMILITY FOR GERIATRIC PSYCHIATRY TRAINEES AND PRACTITIONERS","authors":"Woo Ri Bae ,&nbsp;Katharine Brewster","doi":"10.1016/j.jagp.2025.04.086","DOIUrl":"10.1016/j.jagp.2025.04.086","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Culturally attuned care is crucial in providing effective psychiatric care to a diverse population of older adults and is considered a requirement under demonstrable knowledge in geriatric psychiatry fellowship training per the guidelines of the Accreditation Council for Graduate Medical Education. However, the availability and tailoring of teaching in culturally attuned psychiatric practice for geriatric populations vary greatly and are often limited. This project aims to address these concerns by administering a didactic session focusing on cultural humility. Cultural humility focuses on deconstructing power imbalance in the patient-physician relationship and committing to lifelong learning and self-reflection that enhances collaboration with patients from diverse backgrounds, acknowledges historical injustices, and promotes equitable care. Cultural humility emphasizes a patient-centered approach where the attitude of physician as student and patient as expert of the patient’s own experience are promoted. This in contrast to cultural competency which may imply that patient diversity and cultures can be mastered within a limited body of knowledge and time, such as impressions about different ethnic groups which in turn may continue to counterproductively foster harmful stereotypes and a narrow, stagnant stance toward caring for patients from different cultural backgrounds.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We will design a one hour-long didactic to be given to geriatric psychiatry faculty, geriatric psychiatry fellows, and general psychiatry resident trainees following the format shown in Table 1. Pre- and post-session surveys regarding knowledge and self-assessment on aspects relevant to cultural humility using Likert scales will be administered. Surveys will also include open-ended questions on perceived necessity of and objective feedback on didactic session. Learning objectives are as following; after the didactic session, learners will be able to 1) define the key attitudes of cultural humility, 2) discuss at least two ways that historical origins of inequity and discrimination toward different cultural identities impacts mental health of older persons, 3) apply the concept of identity and social location to discuss power dynamics in the patient-physician relationship, 4) identify cultural dimensions of the self and consider how these dimensions impact how the self moves through the world, and 6) show future interest in continuing the practice of cultural humility practice in professional endeavors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Results are pending as the didactic and pre- and post-didactic surveys will be administered in December, 2024 and all data will be collected by January, 2025 for presentation at AAGP in March, 2025.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Continued efforts are needed to integrate cultural humility training into broader educational frameworks to better serve the needs of a di","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S61-S62"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614412","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":"9. MENTAL HEALTHCARE STRATEGIES FOR SOCIAL ISOLATION AND LONELINESS IN PARKINSON’S DISEASE","authors":"Laura van Dyck ,&nbsp;Parnika Saxena","doi":"10.1016/j.jagp.2025.04.012","DOIUrl":"10.1016/j.jagp.2025.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson's disease (PD) symptoms, including emotional and communication challenges, can impair social functioning. Social isolation and loneliness have been linked to greater symptom severity and reduced quality of life in individuals with PD. We aim to highlight interventions by providers to improve social isolation and loneliness in patients with PD.</div></div><div><h3>Methods</h3><div>A comprehensive literature and policy review was conducted, examining clinical research, advocacy projects, and relevant legislative efforts focused on addressing loneliness and socioemotional symptoms in PD.</div></div><div><h3>Results</h3><div>The growing focus on recognizing and mitigating loneliness in PD has led to recommendations from experts, including the need for heightened awareness, routine screening, and targeted interventions. Among these interventions, social prescribing—a systematic approach addressing patients' social needs via community-based interventions—has gained attention. However, existing evidence supporting social prescribing primarily stems from single-payer healthcare systems, with limited research investigating its effectiveness in the context of U.S. healthcare payment models. Furthermore, literature highlights the importance of enhancing awareness not only of loneliness in PD but also of broader socio-emotional symptoms, such as difficulties with emotional facial expressions, emotional recognition, and vocal expressions.</div></div><div><h3>Conclusions</h3><div>Healthcare providers should prioritize screening and identification of loneliness and socioemotional symptoms in PD. Recommendations include patient and caregiver education, vocal and respiratory exercises (e.g., group singing), psychological interventions (e.g. mindfulness, ACT, CBT), and social prescribing, such as the VA Compassionate Contact Corps Program. Providers may widen their reach by advocating for policies, including reimbursement for care companions in PD.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S7"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613899","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":"13. OPTIMIZING THE DESIGN AND MEASUREMENT OF A MULTI-MODULE GROUP INTERVENTION TO IMPROVE WELL-BEING IN OLDER ADULTS","authors":"Ira Yenko ,&nbsp;Feng Vankee Lin ,&nbsp;Christine Gould ,&nbsp;Ryan Pate ,&nbsp;Maryam Makowski ,&nbsp;Oceanna Li ,&nbsp;Vanessa Silva ,&nbsp;Dolores Gallagher-Thompsom ,&nbsp;Erin Cassidy-Eagle","doi":"10.1016/j.jagp.2025.04.016","DOIUrl":"10.1016/j.jagp.2025.04.016","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Well-being is defined broadly, but typically includes promoting a combination of health, resilience, quality of life and connection. Positive psychological interventions move beyond the goal of simply decreasing symptoms and disorder rates and gravitate towards life enhancing and skill development. This psychological wellness group focuses on improving quality of life and skill development that aim to build resilience to life’s challenges, increase motivation to engage in positive self-care and drive to find purpose in engaging with and helping others. Our multi-modal well-being group targets a broad range of well-being dimensions including cognitive, behavioral, emotional, social, and physical health parameters. Group interventions harness the power of social connection while offering a cost effective and efficient means to reach a broad range of older patients that might otherwise be unable to access care. The overall aim of this project is to utilize an iterative process to continually improve and innovate a rotating psychological wellness group for older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This program includes a psychological wellness group offering for older adults with 8 modules covering a collection of topics that support optimal psychological wellness and promote health and resilience (i.e. digital tools and mobile apps, value-based behavioral activation to improve your mood, eating for a healthy brain, caring for the caregiver, introduction to mindfulness, improving your sleep, physical activity and strategies for managing anxiety) that are held weekly, ranging in duration from 2-4 weeks, over a 7 month period. Well-being is broadly defined, including the existence of over 100 self-report measures to date, and our shift in measurement aims to provide clarity in definition and impact of our intervention. Having tried various well-being, loneliness, affect based, depression, anxiety, coping and resilience-based surveys, the team has worked to identify evidenced based measures that will capture our variables of interest and reflect change within the duration of the intervention. Evidence-based and lifestyle interventions target skill development, create opportunities for practice and provide expert feedback within the context of a socially engaged and supportive peer environment. Participants were referred from outpatient psychiatry clinics, geriatric medicine providers in medical centers and local community organizations servicing older adults. Inclusion criteria: Participants must be 65+ years old, English speaking, absent a diagnosis of dementia and open to group treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Older adults (N=19) were enrolled in the second wave of the psychological wellness group, including 9 males and 10 females with a mean age of 71. Summarized in Table One, the baseline (T1) and follow-up measures collected for T2 (6 weeks), T3 (12 weeks), T4 (18 weeks) and T5 (23 weeks) inclu","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S10"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613903","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":"24. CHALLENGES FACING CAREGIVERS OF INDIVIDUALS DIAGNOSED WITH FRONTOTEMPORAL DEMENTIA IN THE UNITED STATES","authors":"Grace Mausisa ,&nbsp;Annick de Bruin ,&nbsp;Devon Chenette ,&nbsp;Susan Gorky ,&nbsp;Tiffany Chow","doi":"10.1016/j.jagp.2025.04.026","DOIUrl":"10.1016/j.jagp.2025.04.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Caregivers or care partners often experience challenges while caring for persons diagnosed with FTD. We surveyed caregivers to better understand their specific challenges and identify gaps in existing services.</div></div><div><h3>Methods</h3><div>Alector developed the FTD Caregiver Survey, an online self-administered questionnaire, consisting of informed consent, eligibility screening, and questions regarding caregiver burden and strains. The survey was distributed with support from patient groups, individual advocates and an FTD website community. Eligible responders were adults who could read and write in English, reside in the United States, and who have been an unpaid primary caregiver for a person diagnosed with FTD. The first 90 surveys, completed from May to June 2024, were analyzed.</div></div><div><h3>Results</h3><div>Of all respondents, 47% self-identified as a sole caregiver. Over one third of all respondents spent over 40 hours per week providing direct care. Many respondents (41%) also provided care for other family members, with a majority (92%) reporting difficulty managing those responsibilities. Most caregivers reported difficulty attending to their own healthcare.</div><div>Respite services, in-home care, or adult day care were identified as the most needed and the most difficult to access amongst a list of services. Care planning and symptom management were highlighted as areas of need. FTD-specific websites or organizations were identified as being the most helpful source of assistance and information.</div></div><div><h3>Conclusions</h3><div>Patient organizations and healthcare professionals can help address the need for strategies to overcome barriers and expand on FTD-specific support, ranging from caregiver support groups to financial assistance and additional support in the day-to-day caregiving at home.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S18"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613981","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":"31. THE BURDEN OF TARDIVE DYSKINESIA IN LONG-TERM CARE SETTINGS: RESULTS FROM A REAL-WORLD STUDY OF UNITED STATES CLAIMS DATA","authors":"Morgan Bron ,&nbsp;Gideon Aweh ,&nbsp;Darlene Salas ,&nbsp;Eric Jen ,&nbsp;Amita Patel","doi":"10.1016/j.jagp.2025.04.033","DOIUrl":"10.1016/j.jagp.2025.04.033","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure, can have disabling impacts on social, physical, and emotional functioning. Older adults have a higher risk for TD and may be particularly vulnerable to its physical impacts (e.g., difficulty swallowing), potentially complicating clinical management in long-term care (LTC) settings. However, data on the prevalence and burden of TD in LTC settings are limited. Therefore, a real-world study was conducted using United States (US) claims data to characterize patients with TD in LTC settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The STATinMED Real-World Data Insights Database, which captures 80% of US claims data, was used for analysis. The study period was defined as Jan 2016-Dec 2022 (inclusive). Patients with ≥1 LTC stay and an ICD-10 code indicative of TD (G24.01) during the study period were identified and analyzed descriptively by LTC setting for each LTC stay during the study period. Additional analyses related to comorbidities, medication use, and healthcare visits were analyzed descriptively in a subpopulation of patients who met a more stringent set of inclusion criteria: ≥1 LTC stay from Jan 2017 to Dec 2021 (identification period), with “index stay” defined as the first LTC stay; ICD-10 code of G24.01 on or before the index stay; and continuous capture of medical and pharmacy benefits for 1 year pre-index stay and 1 year post-index stay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;20,183 patients had an ICD-10 code indicative of TD and ≥1 LTC stay during the study period. Skilled nursing facilities were the most common type of LTC stay, with 14,235 (70.5%) patients having ≥1 skilled nursing facility stay during the study period. LTC stays in nursing homes (55.2%) and assisted living facilities (20.4%) were also common. Among 2,294 patients who met the criteria for additional analysis, 1,483 (64.6%) were ≥65 years and 1,544 (67.3%) were female. The mean (±SD) Charlson Comorbidity Index (CCI) score was 3.72 (±4.2), and 753 (32.8%) had a CCI score ≥4, indicating high comorbidity burden and increased mortality risk. Common comorbidities included mood disorders (66.1%), schizophrenia (38.8%), sleep disorders (35.0%), substance abuse (28.4%), urinary tract infections (26.7%), and dysphagia (18.5%). The use of antidepressants (56.1%), anticonvulsants (52.3%), antipsychotics (50.4%), and anticholinergics (50.0%) was common. Moreover, polypharmacy was common, with 47.9% of patients being prescribed ≥3 medications that may increase risk of falls or cognitive impairment in elderly adults (e.g., anticholinergics, anticonvulsants, antihistamines, benzodiazepines, sedative-hypnotics). Within 1 year after the index LTC stay, 1,085 (47.3%) patients had ≥1 emergency department (ED) visit, with a median of 2 visits/patient and median time to first visit of 143 days. Additional longitudinal real-world analyses on anticholinergic use, the pre","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S22"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613996","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":"33. USING NOVEL WEARABLES AND ECOLOGICAL MOMENTARY ASSESSMENT TO TRACK PHYSIOLOGICAL BIOMARKERS IN PSYCHOTHERAPY FOR LATE-LIFE DEPRESSION","authors":"Parhesh Kumar ,&nbsp;Joohyun Kang ,&nbsp;Jordan Serrano-Guedea ,&nbsp;Faith Gunning ,&nbsp;Oded Bein ,&nbsp;Nili Solomonov","doi":"10.1016/j.jagp.2025.04.035","DOIUrl":"10.1016/j.jagp.2025.04.035","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Late-life depression is common, debilitating, and linked with poor mental health and medical outcomes. Individuals with depression experience high baseline heart rates and sleep disturbances, including fluctuations in circadian rhythm and sleep cycles. Depression is typically measured using weekly or periodic interviewer-rated or self-reported measures. These scales are limited by recall bias and low time sensitivity and accuracy, especially among older adults. Novel wearable devices and real-time mood scales measured multiple times a day (ecological momentary assessments; EMAs) can improve the precision and accuracy of depression severity measurement. There is little work on the application of these methods in the aging population, with only a few studies examining changes during treatment for late-life depression. We aimed to examine whether wearables and EMAs are feasible and can track precisely the changes across multiple domains during psychotherapy for late-life depression&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We implemented a novel wearable biometric ring (Oura Ring) and EMAs (measured twice daily) in an ongoing randomized controlled trial of psychotherapies for late-life suicidality. Three patients with major depression and suicidality completed 9 weeks of psychotherapy while wearing the Oura Ring and completing two EMA surveys a day (afternoon and evening surveys). Oura Ring data collected daily measures of average heart rate (beats per minute), heart rate variability, and hours of sleep. EMAs measured number of hours they slept, negative affect (stress, anxiety, irritability, depression, and loneliness), and positive affect (energy, motivation, excitement, interest, and satisfaction).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Our preliminary results show that all three participants experienced a reduction in negative affect and an increase in positive affect during psychotherapy. There was variability in trajectories of positive affect: Patients A and C showed a pronounced increase in positive affect, while Patient B showed an initial increase followed by a decrease. Further, for all three participants, hours slept (measured by Oura Ring) and self-reported hours slept followed a similar pattern over time, indicating these two measures may be linked. Finally, Patients A and C showed a consistent increase in heart rate variability, while patient B experienced a decrease over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our preliminary case studies suggest that integrating wearables with daily EMA self-reports can provide a feasible, precise, and granular assessment of daily changes in affect and biometrics, such as sleep and heart rate, during psychotherapy for late-life depression. The strong alignment between wearable-measured and self-reported sleep data, along with observable trends in heart rate variability and negative valence mood responses, highlights the powerful potential of these methods. This potenti","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S23"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614140","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":"42. POSITIVE PSYCHOLOGICAL CORRELATES OF SUCCESSFUL AGING: A CROSS-SECTIONAL STUDY OF MENTAL, PHYSICAL, COGNITIVE, AND SOCIAL FUNCTIONING AMONG COMMUNITY-DWELLING OLDER ADULTS.","authors":"Nikki Bloch ,&nbsp;Stephanie Ibrahim ,&nbsp;Elizabeth W. Twamley ,&nbsp;Colin Depp ,&nbsp;Ellen Lee","doi":"10.1016/j.jagp.2025.04.044","DOIUrl":"10.1016/j.jagp.2025.04.044","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;While successful aging remains nebulously defined, research definitions commonly include domains of mental health, physical health, cognitive health, and social functioning. Positive psychological factors such as self-compassion and resilience have been shown to be important predictors of these same successful aging domains. However, the literature is mixed regarding which predictors impact which successful aging domains. Discerning the specific positive psychological factors that influence certain domains may allow for more targeted, individualized interventions. Our study aimed to understand the associations of positive psychological factors (e.g., resilience, self-compassion) with successful aging domains. We hypothesized that self-compassion and resilience would be associated with better mental health outcomes, physical health outcomes, social functioning, and cognitive functioning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a cross-sectional, retrospective study of prospectively collected registry data of independent-living older adults in a continuing care senior housing community in San Diego County. Inclusion criteria were: English speaking, age ³65, no known diagnosis of dementia or disabling illness, and ability to complete study assessments. Positive psychological factors were assessed using validated scales: Neff Self-Compassion Scale and Connor-Davidson Resilience Scale. Outcome measures were assessed through validated self-administered and clinician administered instruments for: depression (Patient Health Questionnaire); physical health: frailty (Fried Frailty Index), comorbidities (Cumulative Illness Rating Scale), mobility (Timed Up and Go test), subjective physical well-being (Medical Outcomes Survey); cognitive health: overall (Montreal Cognitive Assessment), executive functioning (Delis-Kaplan Executive Function System); social functioning: social support (Social Support Index), Emotional Support (Perceived Support Scale, PSS), Instrumental Support (PSS), negative social interactions (PSS), loneliness (UCLA Loneliness Scale 8-item); and overall successful aging (Self Rated Successful Aging Scale, SRSA).&lt;/div&gt;&lt;div&gt;The dataset was limited to the first visit from individuals who completed the SRSA. Statistical analyses were conducted using SPSS software. Descriptive statistics characterizing the sample were calculated with means and standard deviations for numerical variables and percentages for categorical variables. General Linear Models were used to assess associations of positive psychological factors to successful aging domains and covaried for age, sex, years of education, and relationship status.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The sample included 118 participants with mean age of 82.92 (range 66-98). The majority were female (66.9%), white (90.7%), and unpartnered (59.3%). Self-compassion was positively associated with better mental health (p &lt; 0.05) and was not associated with phy","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S30-S31"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614144","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}