American Journal of Geriatric Psychiatry最新文献

{"title":"Commentary on “Study Partner Report of Apathy in Older Adults is Associated With AD Biomarkers: Findings From the Harvard Aging Brain Study”","authors":"Siddharth Khasnavis M.D., Ryan S. O'Dell M.D., Ph.D., Christopher H. van Dyck M.D., Adam P. Mecca M.D., Ph.D.","doi":"10.1016/j.jagp.2024.03.017","DOIUrl":"10.1016/j.jagp.2024.03.017","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140613599","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 Association of Plasma Leptin, Soluble Leptin Receptor and Total and High-Molecular Weight Adiponectin With the Risk of Perioperative Neurocognitive Disorders","authors":"","doi":"10.1016/j.jagp.2024.03.015","DOIUrl":"10.1016/j.jagp.2024.03.015","url":null,"abstract":"<div><h3>Background</h3><p>Perioperative neurocognitive disorders (NCD) are poorly characterized in terms of their risk factor profiles. Leptin and adiponectin are adipose-tissue-derived hormones with a role in inflammation and atherosclerosis whose function in perioperative NCD is unclear. Here, we used a cohort of older adults to examine the association of preoperative plasma concentrations of these biomarkers with the risk of perioperative NCD.</p></div><div><h3>Methods</h3><p>Prospective analysis of 768 participants aged ≥ 65 years of the BioCog study. Blood was collected before surgery for measurement of plasma total and high-molecular-weight (hmw) adiponectin, leptin, and soluble leptin receptor (sOB-R). The free leptin index (FLI, leptin:sOB-R) was calculated. Postoperative delirium (POD) was assessed twice daily until postoperative day 7/discharge. Five hundred twenty-six patients (68.5%) returned for 3-month follow-up and provided data on postoperative cognitive dysfunction (POCD). POCD was defined as a decline on six neuropsychological tests that exceeded that of a nonsurgical control group. Logistic regression analyses examined the associations of each exposure with POD and POCD risk, in separate models adjusted for age, sex, fasting, surgery type, and body mass index (BMI).</p></div><div><h3>Results</h3><p>Of 768 patients, 152 (19.8%) developed POD. Of 526 attendants of the follow-up, 54 (10.3%) had developed POCD. Leptin, sOB-R, and total and hmw adiponectin were each not associated with POD. For POCD, we observed reduced risk in patients in FLI quartile 4 compared with quartile 1 (odds ratio, 0.26; 95% CI 0.08, 0.89). Sensitivity analyses for the outcome POD revealed statistically significant interaction terms of sOB-R and total adiponectin with obesity (BMI≥30kg/m² versus BMI&lt;30kg/m²). For the outcome POCD, a higher sOB-R was associated with an increased risk in the obese subgroup (odds ratio, 4.00; 95% CI 1.01, 15.86).</p></div><div><h3>Conclusions</h3><p>We did not find consistent evidence for the role of leptin, its receptor, and total and hmw adiponectin in POD and POCD risk. Future research should be used to support or refute our findings and to fully characterize any differences in the associations of these hormones with POD/POCD between obese and nonobese individuals.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002975/pdfft?md5=b7b7e3f031687340b0ce00b03ea832e5&pid=1-s2.0-S1064748124002975-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407591","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":"A New Window to the Brain: Exosomes as a Promising Approach to Understand Mechanisms of Cognitive Deficits Associated With Obstructive Sleep Apnea","authors":"Ellen E. Lee M.D.","doi":"10.1016/j.jagp.2024.03.013","DOIUrl":"10.1016/j.jagp.2024.03.013","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403133","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":"National Estimates of Incremental Work Absenteeism Costs Associated With Adult Children of Parents With Alzheimer's Disease and Related Dementias","authors":"Seyeon Jang M.S. ,&nbsp;Jie Chen Ph.D.","doi":"10.1016/j.jagp.2024.03.011","DOIUrl":"10.1016/j.jagp.2024.03.011","url":null,"abstract":"<div><h3>Objective</h3><p>More than half of primary caregivers for ADRD patients are adult children, yet there is little empirical evidence on how caring for parents with ADRD affects their employment. Using a nationally representative dataset, this study aimed to estimate incremental work absenteeism costs for adult children of parents with ADRD.</p></div><div><h3>Design, Setting, and Participants</h3><p>The study used the data from the 2015–2021 Medical Expenditure Panel Survey (MEPS). Multivariate regressions and two-part models were employed to estimate the incremental work absenteeism costs among adult children aged 40 to 64 who had at least one parent diagnosed with ADRD, compared with those who did not have ADRD parents.</p></div><div><h3>Measurements</h3><p>The incremental work absenteeism costs due to caregiving for adult children with ADRD parents was a cumulated estimation of labor productivity cost at three stages: (1) the likelihood of not working due to unemployment, (2) the likelihood of missing any workdays for caregiving, and (3) the number of workdays missed due to caregiving.</p></div><div><h3>Results</h3><p>Adult children with ADRD parents were more likely to be unemployed (OR = 1.80, <em>p</em> = 0.024) and 2.95 times more likely to miss work for caregiving (<em>p</em> = 0.002) than those with non-ADRD parents. The difference in the number of workdays missed for caregiving between children with and without ADRD parents was not significant. The incremental effects of having ADRD parents were estimated to be $4,510.29 ($1,702.09–$6,723.69) per person per year.</p></div><div><h3>Conclusions</h3><p>Having ADRD parents significantly increases the chances of unemployment and missing any workdays for caregiving, leading to higher lost labor productivity costs for adult children with ADRD parents.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400943","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 Role of State Versus Trait Anxiety on Cognition in Older Adults With Major Depressive Disorder","authors":"","doi":"10.1016/j.jagp.2024.03.014","DOIUrl":"10.1016/j.jagp.2024.03.014","url":null,"abstract":"<div><h3>Objective</h3><p>Anxiety superimposed on late life depression (LLD) results in greater changes to prefrontal and medial temporal brain regions compared to depression alone. Yet, the combined impact of anxiety and depression on cognition in LLD has not been thoroughly investigated. The current study investigated whether annual changes in state and trait anxiety were associated with cognitive changes in older adults with major depression. We hypothesized that the presence of anxiety among older depressed adults would be associated with worse cognitive performance in the domains of memory and executive functioning over time.</p></div><div><h3>Design</h3><p>Three-year longitudinal observational study of older adults with LLD who were offered antidepressant treatment.</p></div><div><h3>Setting</h3><p>Academic Health Center.</p></div><div><h3>Methods</h3><p>Participants included 124 adults aged 60+ who met criteria for major depression at baseline. The association between anxiety and cognition was examined with separate multilevel linear models that addressed both between-subject and within-person effects of state and trait anxiety on cognitive functioning tests.</p></div><div><h3>Results</h3><p>Individuals who experienced annual increases in anxiety above his/her personal average also experienced cognitive decline. Increases in state anxiety were associated with declines in memory and global cognition. By contrast, increases in trait anxiety were associated with declines in mental flexibility and memory. These findings remained significant even when controlling for changes in depression over time.</p></div><div><h3>Conclusion</h3><p>In LLD, individual increases in state and trait anxiety were associated with cognitive declines in different domains.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406907","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":"Thwarting Undue Influence: Testamentary Capacity in the Elderly","authors":"Oliver M. Glass M.D.","doi":"10.1016/j.jagp.2024.03.012","DOIUrl":"10.1016/j.jagp.2024.03.012","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Accuracy of Serum Neurofilament Light to Differentiate Frontotemporal Dementia from Primary Psychiatric Disorders is Age-Dependent","authors":"Victoria Light M.Sc. ,&nbsp;Sherri Lee Jones Ph.D. ,&nbsp;Elham Rahme Ph.D. ,&nbsp;Katerine Rousseau M.D. ,&nbsp;Sterre de Boer M.D. ,&nbsp;Lisa Vermunt M.D., Ph.D. ,&nbsp;Mahdie Soltaninejad M.Sc. ,&nbsp;Charlotte Teunissen Ph.D. ,&nbsp;Yolande Pijnenburg Ph.D. ,&nbsp;Simon Ducharme M.D., M.Sc. ,&nbsp;For Signature Consortium and CCNA","doi":"10.1016/j.jagp.2024.03.008","DOIUrl":"10.1016/j.jagp.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Symptoms of behavioral variant frontotemporal dementia (bvFTD) overlap with primary psychiatric disorders (PPD) making diagnosis challenging. Serum neurofilament light (sNfL) is a candidate biomarker to distinguish bvFTD from PPD, but large-scale studies in PPD are lacking.</p></div><div><h3>Objective</h3><p>Determine factors that influence sNfL from a large database of PPD patients, and test its diagnostic accuracy.</p></div><div><h3>Design, Settings, Subjects, Measurements</h3><p>Clinical data of people aged 40–81 were obtained from healthy subjects (n = 69), and patients with PPD (n = 848) or bvFTD (n = 82). sNfL was measured using Simoa technology on an HD-X instrument. Data were analyzed using general linear models, and Receiver Operating Characteristic (ROC) curve analyses to determine global and age-specific sNfL cutoffs to distinguish bvFTD from PPD, using the Youden Index.</p></div><div><h3>Results</h3><p>sNfL increased with age, while sex, BMI and diabetes status were modestly associated with sNfL. sNfL was slightly higher in PPD than healthy subjects (14.1 versus 11.7 pg/mL), when controlling for covariates. sNfL was markedly lower in PPD than bvFTD (14.1 versus 44.1 pg/mL). sNfL could differentiate PPD from bvFTD with an AUC = 0.868, but the effect was driven by the younger subjects between age 40–60 years at a cutoff of 16.0 pg/mL. No valid cutoff was detected over age 60, however, values of sNfL above 38.5 pg/mL, or below 13.9 pg/mL, provided 90% diagnostic certainty of bvFTD or PPD, respectively.</p></div><div><h3>Conclusion</h3><p>PPD have mildly elevated sNfL compared to healthy subjects but much lower than bvFTD. Results support the use of sNfL as a biomarker to differentiate PPD from bvFTD at age 60 or below, but accuracy decreases in older ages.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002902/pdfft?md5=b11c10b77999e15507a62255ff136e4e&pid=1-s2.0-S1064748124002902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403694","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":"Demographics, Symptoms, Psychotropic Use, and Caregiver Distress in Patients With Early vs Late Onset Dementia","authors":"David R. Lee M.D., M.B.A. ,&nbsp;Tahmineh Romero M.S. ,&nbsp;Katherine Sy Serrano M.P.H. ,&nbsp;Michelle Panlilio D.N.P., G.N.P. ,&nbsp;Abel Rojas-Parra M.D. ,&nbsp;Lauren Matsuno M.D. ,&nbsp;Mario F. Mendez M.D., Ph.D. ,&nbsp;Christine Willinger M.D., M.P.H. ,&nbsp;David B. Reuben M.D.","doi":"10.1016/j.jagp.2024.03.009","DOIUrl":"10.1016/j.jagp.2024.03.009","url":null,"abstract":"<div><h3>Background</h3><p>Understanding experiences and challenges faced by persons living with Early-Onset Dementia (EOD) compared to individuals diagnosed with Late-Onset Dementia (LOD) is important for the development of targeted interventions.</p></div><div><h3>Objective</h3><p>Describe differences in sociodemographic, neuropsychiatric behavioral symptoms, caregiver characteristics, and psychotropic use.</p></div><div><h3>Design, Setting, Participants</h3><p>Cross-sectional, retrospective study including 908 UCLA Alzheimer's Dementia Care Program participants (177 with EOD and 731 with LOD).</p></div><div><h3>Measurements</h3><p>Onset of dementia was determined using age at program enrollment, with EOD defined as age &lt;65 years and LOD defined as age &gt;80 years. Sociodemographic and clinical characteristics were measured once at enrollment. Behavioral symptoms were measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score and caregiver distress was measured using the NPI-Q distress score. Medications included antipsychotic, antidepressant, benzodiazepines and other hypnotics, antiepileptics, and dementia medications.</p></div><div><h3>Results</h3><p>EOD compared to LOD participants were more likely men, college graduates, married, live alone, and have fewer comorbidities. EOD caregivers were more often spouses (56% vs 26%, p &lt;0.01), whereas LOD caregivers were more often children (57% vs 10%, p &lt;0.01). EOD was associated with lower odds of being above the median (worse) NPI-Q severity (adjusted odds ratio [aOR], 0.58; 95% CI 0.35–0.96) and NPI-Q distress scores (aOR, 0.53; 95% CI 0.31–0.88). Psychotropic use did not differ between groups though symptoms were greater for LOD compared to EOD.</p></div><div><h3>Conclusion</h3><p>Persons with EOD compared to LOD had sociodemographic differences, less health conditions, and fewer neuropsychiatric symptoms. Future policies could prioritize counseling for EOD patients and families, along with programs to support spousal caregivers of persons with EOD.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002896/pdfft?md5=f7563899eea2720d1b59875b844ba8f1&pid=1-s2.0-S1064748124002896-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268163","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":"Commentary: Illuminating the Role of Non-English Language Preference in Healthcare Disparities for Older Adults With Cognitive Impairment","authors":"Ladson Hinton M.D.","doi":"10.1016/j.jagp.2024.03.007","DOIUrl":"10.1016/j.jagp.2024.03.007","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275293","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":"Editor's Note","authors":"Charles F. Reynolds III M.D. (Editor)","doi":"10.1016/j.jagp.2024.01.023","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.01.023","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141356","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}