American Journal of Geriatric Psychiatry最新文献

{"title":"Where Do Plasma Biomarkers fit in With Current Alzheimer's Disease Detection?","authors":"Ariel Gildengers, Andrea M Weinstein, Swathi Gujral, Xuemei Zeng, Jihui L Diaz, Tara K Lafferty, Matthew Cowie, James E Emanuel, Oscar Lopez, Sarah K Royse, Brian Lopresti, Thomas K Karikari","doi":"10.1016/j.jagp.2024.09.015","DOIUrl":"10.1016/j.jagp.2024.09.015","url":null,"abstract":"<p><strong>Objectives: </strong>We examine the clinical utility of plasma-based detection for Alzheimer's disease (AD) pathophysiology in older adults with mild cognitive impairment (MCI) and whether cognitive screening can inform when to use plasma-based AD tests.</p><p><strong>Methods: </strong>Seventy-four community-dwelling older adults with MCI had testing with plasma phosphorylated tau (p-tau) 217 and 181, positron emission tomography (PET) imaging for amyloid beta (Aβ), and cognitive assessment. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of plasma p-tau.</p><p><strong>Results: </strong>Plasma p-tau217 distinguished MCI participants who had PET imaging evidence of Aβ accumulation from those without (AUC of 0.92, specificity of 0.96, and sensitivity of 0.90), outperforming plasma p-tau181 (AUC of 0.76, specificity of 0.87 and sensitivity of 0.59) for the same purpose. Of the 60 MCI participants that were amnestic, 22 were Aβ+. The 14 participants that were nonamnestic were all Aβ-.</p><p><strong>Conclusions: </strong>Our findings support the clinical use of plasma p-tau, particularly p-tau217, for patient detection of AD pathophysiology in older adults with amnestic MCI, but not in those who are nonamnestic.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513490","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(24)00457-3","DOIUrl":"10.1016/S1064-7481(24)00457-3","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"32 11","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322132","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":"Treatment of Cognitive Impairment in Late Life Depression.","authors":"Paul A Newhouse, Steven P Roose","doi":"10.1016/j.jagp.2024.09.011","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.09.011","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402084","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":"Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.","authors":"Audrey D Zhang, Lindsay Zepel, Sandra Woolson, Katherine E M Miller, Loren J Schleiden, Megan Shepherd-Banigan, Joshua M Thorpe, Susan Nicole Hastings","doi":"10.1016/j.jagp.2024.09.010","DOIUrl":"10.1016/j.jagp.2024.09.010","url":null,"abstract":"<p><strong>Objectives: </strong>Adults with dementia are frequently prescribed antipsychotic medications despite concerns that risks outweigh benefits. Understanding conditions where antipsychotics are initially prescribed, such as hospitalization, may offer insights into reducing inappropriate use.</p><p><strong>Design, setting, participants: </strong>Retrospective cohort study of community-dwelling veterans with dementia aged ≥68 with VA hospitalizations in 2014, using Veterans Health Administration (VA) and Medicare data.</p><p><strong>Measurements: </strong>The primary outcome was new outpatient antipsychotic prescription at hospital discharge. We used generalized estimating equations to study associations between antipsychotic initiation and patient, hospitalization, and facility characteristics. Among veterans with antipsychotic initiation, we used a cumulative incidence function to evaluate discontinuation in the year following hospitalization, accounting for competing risks.</p><p><strong>Results: </strong>4,719 community-dwelling veterans with dementia had VA hospitalizations in 2014; 264 (5.6%) filled new antipsychotic prescriptions at discharge. Antipsychotic initiation was associated with discharge unit (surgical vs medical, OR 0.41, 95% CI 0.19-0.87; psychiatric vs medical, OR 6.58, 95% CI 4.48-9.67), length of stay (OR 1.03/day, 95% CI 1.02-1.05), and delirium diagnosis (OR 2.61, 95% CI 1.78-3.83), but not demographic or facility characteristics. Among veterans with antipsychotic initiation, the 1-year cumulative incidence of discontinuation was 18.2% (n = 47); 15.9% (n = 42) of those who were alive and not censored remained on antipsychotics at 1 year.</p><p><strong>Conclusions: </strong>Antipsychotic initiation at hospital discharge was uncommon among community-dwelling veterans with dementia; however, once initiated, antipsychotic persistence at 1 year was common among those who remained community-dwelling. Hospitalization is a contributor to potentially-inappropriate medications in the community, suggesting an opportunity for medication review after hospitalization.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513488","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":"Acknowledgment of Triage Editors and Reviewers 2024","authors":"Charles Reynolds","doi":"10.1016/j.jagp.2024.09.008","DOIUrl":"10.1016/j.jagp.2024.09.008","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"32 12","pages":"Pages 1473-1475"},"PeriodicalIF":4.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407244","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":"Duties of a Friend and to the Profession are Many and Great- “Amici et Professionis Officia Multa et Magna Sunt”","authors":"Christopher C. Colenda M.D., M.P.H.","doi":"10.1016/j.jagp.2024.08.019","DOIUrl":"10.1016/j.jagp.2024.08.019","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"32 12","pages":"Pages 1484-1494"},"PeriodicalIF":4.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333037","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":"Social Cognition and Aging: The Importance of Performance Based Assessment Strategies to Detect Impairment Across Aging Related Conditions and Functional Domains.","authors":"Philip D Harvey","doi":"10.1016/j.jagp.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.09.007","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367642","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":"Trends in Hyperpolypharmacy Before and After Nursing Home Admission Among Older Adults in Ontario, Canada.","authors":"Laura C Maclagan, Abby Emdin, Anjie Huang, Michael A Campitelli, Mina Tadrous, Andrea Iaboni, Luis Viana, Colleen J Maxwell, Susan E Bronskill","doi":"10.1016/j.jagp.2024.09.005","DOIUrl":"10.1016/j.jagp.2024.09.005","url":null,"abstract":"<p><strong>Objectives: </strong>To examine trends in the prevalence of hyperpolypharmacy prior to and following nursing home admission in Ontario, Canada.</p><p><strong>Methods: </strong>We conducted a cohort study of adults aged 75+ years admitted to nursing homes between 2017 and 2020 using health administrative data (n = 61,470). The prevalence of hyperpolypharmacy (≥10 dispensed drugs) was assessed quarterly from ten years prior to 1.5 years following admission.</p><p><strong>Results: </strong>Over ten years, the prevalence of hyperpolypharmacy increased from 4.4% to 12.0% (+0.2% per quarter, [p <0.001]) and further increased after admission (13.8%). Antidepressants (three-fold), antipsychotics (seven-fold) and cholinesterase inhibitors (14-fold) increased significantly over ten years prior to admission, while cardiovascular medications peaked 4 to 5 years prior to admission.</p><p><strong>Conclusions: </strong>While hyperpolypharmacy increased nearly three-fold in the ten years prior to nursing home admission, patterns varied by drug class. Increasing hyperpolypharmacy throughout the life course suggests opportunities exist for medication reconciliation in community and nursing home settings.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376383","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":"Temporal Associations Between Specific Depressive Symptoms and Physical Inactivity in Middle Aged and Older Adults.","authors":"Eetu Soini, Tom H Rosenström, Ilmari Määttänen, Markus Jokela","doi":"10.1016/j.jagp.2024.08.020","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.08.020","url":null,"abstract":"<p><p>Being physically inactive can worsen mental health. Physical inactivity and depression are associated, but the temporal precedence and underlying mechanism are unclear; symptoms affecting future physical activity may not be the same symptoms as those associated with and affected by it. We used large European cohort (Survey of Health, Ageing, and Retirement in Europe, SHARE, N = 124, 526) to study temporal associations between physical inactivity and individual depressive symptoms. Multivariate regression with robust standard errors were used to analyze how physical inactivity is associated with later depression and how depressive symptoms predict later physical inactivity. After adjusting the models for demographics, other health behaviors, BMI, and chronic diseases, physical inactivity was prospectively associated with 10 of the 12 depressive symptoms and 7 of the 12 baseline depressive symptoms were prospectively associated with physical inactivity. These findings were robust for adjusting for antidepressant medication. Age-stratified analyses suggested that the associations between physical inactivity and depressive symptoms were independent of age. Omitting the most influential symptom, lack of enjoyment, from the sum score attenuated the association by 13% in the longitudinal and by 26% in the cross-sectional analyses. These findings suggest that physical inactivity and depression are bidirectionally associated even at symptom-level.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333038","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":"Facing a Catastrophic Illness: A Perspective from Contemporary Philosophy","authors":"George S. Alexopoulos M.D.","doi":"10.1016/j.jagp.2024.08.017","DOIUrl":"10.1016/j.jagp.2024.08.017","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"32 12","pages":"Pages 1477-1483"},"PeriodicalIF":4.4,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367641","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}