American Journal of Geriatric Psychiatry最新文献

{"title":"Undue Influence in Financial Decision Making.","authors":"Oliver M Glass","doi":"10.1016/j.jagp.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.012","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830930","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":"Pandemic Impacts on Paid and Unpaid Dementia Caregivers: Mental Health, Resilience, and Policy Needs.","authors":"Seyeon Jang, Jie Chen","doi":"10.1016/j.jagp.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.006","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824890","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":"Ringing in the Ears: A Harbinger Not of Gossip but of Suicidality.","authors":"Jane P Gagliardi","doi":"10.1016/j.jagp.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.008","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808710","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":"Do Caregivers Value the New Antiamyloid Treatments for Alzheimer's Disease More Than Home-Based Care?","authors":"Caroline R Morehouse, Saskia Hendriks, Nusrat Rabbee, Scott Yh Kim","doi":"10.1016/j.jagp.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.011","url":null,"abstract":"<p><strong>Objective: </strong>The new antiamyloid medications Lecanemab (Leqembi) and donanemab (Kisunla) are the first disease-modifying treatments for Alzheimer's disease (AD) to receive full FDA approval. However, some commentators question whether the drugs' benefits outweigh their risks, burdens, and costs to patients. This study assessed the perceived value of these medications by asking caregivers of persons with AD to compare them to a widely used intervention in AD management: home-based care.</p><p><strong>Design: </strong>Online survey (March 27th-April 17th, 2024) of 392 AD caregivers recruited via CloudResearch Prime Panels to match the U.S. public in education, household income, race, and ethnicity. The survey used vignettes describing antiamyloid medication and 25 hours/week of home-based care (estimated to be of similar monetary value). After rating the desirability of medication and home-based care, respondents indicated their preference for which intervention they wanted their loved one's insurance to cover.</p><p><strong>Results: </strong>Respondents expressed a desire for their loved ones to receive both the medication and home-based care. Over half (56.9%) favored home-based care coverage. Those preferring medication coverage were more likely to believe its benefits outweigh its risks and burdens. Preference for medication coverage was also associated with being male, Hispanic, less educated, and correctly answering fewer comprehension questions.</p><p><strong>Conclusions: </strong>Our findings show most caregivers perceive modest clinical value in the novel antiamyloid therapies, and the decision to use these drugs will be preference-sensitive, pointing to the need for thorough informed consent discussions.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873530","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 Between Multimorbidity and Depression in Older Adults: Evidence From Six Large Longitudinal Cohorts.","authors":"Qianqian Du, Menghan Yao, Wei Wang, Junyu Wang, Sheng Li, Kai Lu, Chen Li, Yuxin Wei, Tao Zhang, Fei Yin, Yue Ma","doi":"10.1016/j.jagp.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.010","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity may increase the risk of depression in older adults, but the global average effect of multimorbidity on depression remains unknown. This research aimed to exclude the regional heterogeneity to quantify the exposure-response association between multimorbidity and depression in older adults worldwide.</p><p><strong>Method: </strong>We collected 23,947 participants aged 65 years or above from six large prospective cohorts from developed and developing countries, including Mexico, South Korea, Europe, America, China, and England. Multimorbidity was defined as an individual experiencing two or more chronic conditions simultaneously at baseline. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) or the EURO-D scale in each wave. We utilized Stratified Cox proportional hazards models to assess the effects of multimorbidity on depression in each cohort. Meta-analysis was then applied to obtain the average effects across cohorts.</p><p><strong>Results: </strong>Multimorbidity was significantly associated with depression in each cohort and the pooled HR for depression excluding the heterogeneity among six cohorts was 1.30 (95% CI: 1.25-1.37, Z = 10.28, p < 0.001). Compared with participants without any chronic condition, those with 1, 2, and ≥3 chronic conditions had HRs for depression of 1.15 (95% CI: 1.09-1.21, Z = 5.10, p < 0.001), 1.37 (95% CI: 1.29-1.45, Z = 10.00, p < 0.001), and 1.57 (95% CI: 1.45-1.70, Z = 10.9, p < 0.001), respectively. The effects of multimorbidity on depression were more pronounced in males (HR: 1.40 in males vs. 1.25 in females) and participants aged between 65 and 74 years (HR: 1.36 in 65-74 years vs. 1.22 in 75 years and older).</p><p><strong>Conclusion: </strong>Older adults with multimorbidity are more likely to suffer depression. Effective strategies should be developed for older adults, including preventing and managing chronic conditions and improving mental health services.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822968","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 Dr. Kawada's Letter \"Suicidal Behavior in Older Adults With Cognitive Impairment.\"","authors":"Laura Kenneally, Anna Szücs, Hanga Galfalvy, Katalin Szántó","doi":"10.1016/j.jagp.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.007","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824892","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":"Predicting Progression to Dementia Using Auditory Verbal Learning Test in Community-Dwelling Older Adults Based On Machine Learning.","authors":"Xin-Yan Xie, Lin-Ya Huang, Dan Liu, Gui-Rong Cheng, Fei-Fei Hu, Juan Zhou, Jing-Jing Zhang, Gang-Bin Han, Jing-Wen Geng, Xiao-Chang Liu, Jun-Yi Wang, De-Yang Zeng, Jing Liu, Qian-Qian Nie, Dan Song, Shi-Yue Li, Cheng Cai, Yu-Yang Cui, Lang Xu, Yang-Ming Ou, Xing-Xing Chen, Yan-Ling Zhou, Yu-Shan Chen, Jin-Quan Li, Zhen Wei, Qiong Wu, Yu-Fei Mei, Shao-Jun Song, Wei Tan, Qian-Hua Zhao, Ding Ding, Yan Zeng","doi":"10.1016/j.jagp.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.10.016","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare institutions find identifying individuals with dementia particularly challenging. This study aimed to develop machine learning models for identifying predictive features of older adults with normal cognition to develop dementia.</p><p><strong>Methods: </strong>We developed four machine learning models: logistic regression, decision tree, random forest, and gradient-boosted trees, predicting dementia of 1,162 older adults with normal cognition at baseline from the Hubei Memory and Aging Cohort Study. All relevant variables collected were included in the models. The Shanghai Aging Study was selected as a replication cohort (n = 1,370) to validate the performance of models including the key features after a wrapper feature selection technique. Both cohorts adopted comparable diagnostic criteria for dementia to most previous cohort studies.</p><p><strong>Results: </strong>The random forest model exhibited slightly better predictive power using a series of auditory verbal learning test, education, and follow-up time, as measured by overall accuracy (93%) and an area under the curve (AUC) (mean [standard error]: 088 [0.07]). When assessed in the external validation cohort, its performance was deemed acceptable with an AUC of 0.81 (0.15). Conversely, the logistic regression model showed better results in the external validation set, attaining an AUC of 0.88 (0.20).</p><p><strong>Conclusion: </strong>Our machine learning framework offers a viable strategy for predicting dementia using only memory tests in primary healthcare settings. This model can track cognitive changes and provide valuable insights for early intervention.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792993","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":"Brexpiprazole for the Treatment of Agitation in Alzheimer's Disease Dementia: Clinical Uncertainties and the Path Forward.","authors":"Vimal M Aga","doi":"10.1016/j.jagp.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.11.003","url":null,"abstract":"<p><p>Brexpirazole was approved for the treatment of nonpsychotic agitation in Alzheimer's disease (AD) dementia by the United States Food and Drug Administration (FDA) in May 2023 after three phase 3 clinical trials found brexpiprazole 2 to 3 mg/day to be an effective and well-tolerated treatment for agitation in AD dementia, albeit with small effect sizes. It appeared to especially benefit dementia patients with severe agitation/aggression, but it took between 6 and 12 weeks across the three studies for the medication to separate from placebo. However, much remains unknown about its place in the psychopharmacological armamentarium for the treatment of AD dementia-related agitation, including the optimal duration of a brexpiprazole trial, bridging options during the time it takes for brexpiprazole to become effective, and whether it should be continued in the presence of or upon emergence of psychosis during treatment. This Research in Action article uses a case vignette to synthesize the findings of the brexpiprazole trials and apply them to clinical practice, highlight the current uncertainties associated with its use, and compare it with other psychopharmacological options for the treatment of agitation in AD dementia.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796252","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 Between Prehip Fracture Antidepressant Use and Posthip Fracture Length of Hospital Stay in Medicare Beneficiaries and Assessing Sex Differences.","authors":"Rhea Mehta, Jason R Falvey, Chixiang Chen, Yu Dong, Michelle D Shardell, Takashi Yamashita, Denise L Orwig","doi":"10.1016/j.jagp.2024.11.001","DOIUrl":"10.1016/j.jagp.2024.11.001","url":null,"abstract":"<p><strong>Objective: </strong>Antidepressants are the first-line treatment for depression among older adults. While antidepressants are associated with increased risk of falls and fractures in older adults, their effect on outcomes after fall-related injuries such as hip fracture, and whether these effects differ by sex, is unknown. Thus, the purpose of this study was to examine the association between prefracture antidepressant use and hospital length of stay (LOS) among hip fracture survivors, and related sex differences.</p><p><strong>Methods: </strong>Participants included 17,936 community-dwelling Medicare fee-for-service beneficiaries with depression and hospitalization claim for hip fracture surgery between 2010 and 2017. Ordinal logistic regression estimated the association between prefracture antidepressant use and hospital LOS in days, categorized into three groups (1-4, 5-8, and 8+ days) during the 30-day postfracture period, adjusting for demographic, medical, facility, and geographic factors. A sex-by-antidepressant use interaction term was included to examine effect heterogeneity by sex.</p><p><strong>Results: </strong>Prefracture antidepressant users (47%, n = 8,350) were more likely to be younger, White females. The adjusted ordinal logistic regression showed beneficiaries who used antidepressants had 8% higher odds of being in a shorter hospital LOS category compared to non-users (OR = 1.08; 95% CI = 1.02, 1.14; p=0.01). The sex-by-antidepressant use interaction was not statistically significant (p=0.92).</p><p><strong>Conclusions: </strong>Among older adults with depression who subsequently experienced a hip fracture, antidepressant use of >30 days in the 6 months prior to fracture was associated with a shorter hospital LOS. These findings indicate that use of antidepressants does not prolong early recovery from hip fracture and may be protective.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752400","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 Between Tinnitus and Suicidal Ideation in Postmenopausal Women: An Observational Study.","authors":"Kexin Wang, Ying Cui, Tong Wu","doi":"10.1016/j.jagp.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.10.012","url":null,"abstract":"<p><strong>Objective: </strong>Tinnitus has been linked to mental health concerns, including suicidal ideation. This study, using data from the National Health and Nutrition Examination Survey (NHANES), investigates the association between tinnitus and suicidal ideation in postmenopausal women, aiming to identify tinnitus as a potential risk factor for suicidal thoughts in this population.</p><p><strong>Method: </strong>A total of 1,792 postmenopausal women were included after excluding males, premenopausal women, and participants with missing data on tinnitus, suicidal ideation, or key covariates. Multivariable logistic regression models were used to examine the relationship between tinnitus and suicidal ideation, with adjustments for relevant confounders. Data were drawn from the NHANES database, specifically from the 2011 to 2012, 2015 to 2016, and 2017 to 2018 survey cycles.</p><p><strong>Results: </strong>Of the 1,792 postmenopausal women, 4.41% reported suicidal ideation. Tinnitus prevalence was significantly higher in women with suicidal ideation (P = 0.007). Weighted multivariable logistic regression revealed that women with tinnitus had 2.43 times higher odds of reporting suicidal ideation compared to those without tinnitus (OR: 2.43, 95% CI: 1.07-5.52, P = 0.035).</p><p><strong>Conclusion: </strong>Tinnitus appears to be a significant factor associated with suicidal ideation in postmenopausal women. These findings underscore the importance of considering tinnitus in mental health assessments, especially among individuals at risk for suicidal thoughts.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677710","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}