American Journal of Geriatric Psychiatry最新文献

{"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":"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 Ph.D.","doi":"10.1016/j.jagp.2025.02.003","DOIUrl":"10.1016/j.jagp.2025.02.003","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 6","pages":"Pages 635-637"},"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}

{"title":"Commentary: Problem Adaptation Therapy for Older Adults With Chronic Pain and Negative Emotions in Primary Care (PATH-Pain): A Randomized Clinical Trial","authors":"Mirnova E. Ceïde M.D., M.S.","doi":"10.1016/j.jagp.2025.02.002","DOIUrl":"10.1016/j.jagp.2025.02.002","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 4","pages":"Pages 358-360"},"PeriodicalIF":4.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473260","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":"Telemedicine for the Management of Neuropsychiatric Symptoms in Patients With Dementia Living in Long Term Care Facilities: Secondary and Exploratory Analyses From the DETECT Interventional Pilot Study.","authors":"Adélaïde de Mauleon, Antoine Piau, Marion Baziard, Clive Ballard, Pascal Saidlitz, Thierry Voisin, Pierre Rumeau, Achille Tchalla, Christelle Cantet, Fati Nourashemi, Benoît Lepage, Maria Soto","doi":"10.1016/j.jagp.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.01.012","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the effects of telemedicine use in management of neuropsychiatric symptoms (NPS) in patients with dementia in long-term care facilities (LTCFs) versus usual care.</p><p><strong>Design: </strong>DETECT is a prospective randomized controlled cluster pilot study with two arms: \"usual care\" and \"intervention arm\" utilizing telemedicine for NPS management. Our study includes secondary and exploratory analyses from the DETECT study (primary analyses were the subject of a separate publication).</p><p><strong>Setting: </strong>Nineteen LTCFs participated. Patient outcomes included total hospitalizations including emergency room admittance, psychotropic drug prescriptions, NPS based on NPI-NH, quality of life based on QolAD, and functional status based on Activity Daily Living (ADL).</p><p><strong>Measurements: </strong>Analyses were conducted on a modified intention-to-treat population. Mixed models were used for outcome measures, considering data correlation over time and intra-LTCF correlation.</p><p><strong>Results: </strong>One hundred forty-one patients were included: 65 in the control group and 76 in the intervention group, 99 women (70.2%) with a mean age of 86.8 years ± 6.6 (SD). No difference was identified regarding hospitalizations and psychotropic drug prescriptions in the intervention group. During exploratory analyses, telemedicine showed significant improvement in the intervention group for NPI frequency × severity score (p = 0.001), NPI distress score (p = 0.03), ADL (p = 0.006), and several quality-of-life items compared to usual care.</p><p><strong>Conclusions: </strong>Secondary analyses form DETECT study show no difference in the use of telemedicine on management of NPS in patients with dementia in LTCFs, in terms of hospitalizations and psychotropic drug prescription. However, some exploratory analyses indicated a positive effect of Telemedicine, including severity, frequency, distress, and functional autonomy compared to usual care.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525178","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)00005-3","DOIUrl":"10.1016/S1064-7481(25)00005-3","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 3","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349118","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 Patient Is the Poem","authors":"David L. Coulter M.D.","doi":"10.1016/j.jagp.2025.02.001","DOIUrl":"10.1016/j.jagp.2025.02.001","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 5","pages":"Pages 591-599"},"PeriodicalIF":4.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469901","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 American Journal of Geriatric Psychiatry Disclosure of Competing Interests for 2024","authors":"","doi":"10.1016/j.jagp.2025.01.010","DOIUrl":"10.1016/j.jagp.2025.01.010","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 4","pages":"Pages 468-471"},"PeriodicalIF":4.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness and Solitude: The Yin and Yang of Social Disconnection","authors":"Dan Blazer M.D., M.P.H., Ph.D.","doi":"10.1016/j.jagp.2025.01.013","DOIUrl":"10.1016/j.jagp.2025.01.013","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 4","pages":"Pages 476-482"},"PeriodicalIF":4.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434382","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":"Psychological Resilience, Cognitive Function, and Physical Activity: A Longitudinal Mediation Study.","authors":"Chenguang Du, Zhibo Shen, Marrium Mansoor, Qiong Chen, Benjamin Katz","doi":"10.1016/j.jagp.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.01.009","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although recent research has consistently shown that psychological resilience is positively associated with cognitive function among older adults, the underlying mechanisms are still largely unclear. In this study, we assessed the potential mediating role of physical activity between psychological resilience and cognition using a longitudinal, population dataset of US older adults.</p><p><strong>Research design and methods: </strong>Data were derived from three time points (2010-2012, 2014-2016, and 2018-2020) of the Health and Retirement Study (HRS), with 8,296 older adults at baseline included (aged 65 or above). Cognitive function was measured by 35-point Telephone Interview Cognitive Screen (TICS). psychological resilience was measured using a previously established simplified resilience score.</p><p><strong>Results: </strong>Psychological resilience at baseline was positively associated with physical activity at T2, 4 years later (β=0.08,SE=0.01,p<0.001). In addition, physical activity predicted an increase in cognitive function from T2 to T3 (4 years to 8 years later) (β=0.05,SE=0.07,p<0.001). Finally, a significant indirect effect of psychological resilience (T1) on cognitive function (T3) through physical activity from (T2) was observed (β = 0.01, 95% CI [0.01, 0.02], p <0.001).</p><p><strong>Discussion and implications: </strong>Physical activity may function as a protective factor for the cognitive functioning of older adults. This association is partially mediated by enhanced physical activity.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426704","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}