American Journal of Geriatric Psychiatry最新文献

{"title":"Gluing Together a Fragmented Healthcare System for Geriatrics Will Be Hard. It's Time for United Action","authors":"Christopher C. Colenda M.D., M.P.H. ,&nbsp;William B. Applegate M.D., M.P.H.","doi":"10.1016/j.jagp.2024.01.026","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.01.026","url":null,"abstract":"<div><p>“Gluing” together integrated Geriatric<span> Clinical Service lines (GCSL) within the US healthcare system is a significant challenge. Reasons encompass health professional workforce shortages, inconsistent requirements for geriatric educational competencies among the health professional disciplines, preconceived ageist attitudes about older adults with complex illnesses, and a US healthcare system infrastructure that is not aligned with longitudinal and interdisciplinary care needs for older adults. This review focuses on three major characteristics of the US healthcare system that have impeded widespread dissemination of GCSLs: 1) the US's historical fee for service (FFS) reimbursement system; 2) increasing reliance upon disease specific specialty care services for older patients that have resulted from advances in medicine; and 3) rising consolidation of US healthcare systems over the last 30 years. Three specific options are also provided that might help change the current and future trajectories of GCSLs: 1) local political advocacy to implement health policy legislation; 2) expand geriatric physician and health professional workforce by nontraditional means; and 3) reprioritize expansionist healthcare systems corporate behavior. Each of these interventions will be hard to achieve, but it is time to unite if GCSLs are to thrive as pathways to improve care outcomes for older adults with complex medical, cognitive and neuropsychiatric disorders.</span></p></div>","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":"140141843","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)00254-9","DOIUrl":"https://doi.org/10.1016/S1064-7481(24)00254-9","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":"140141840","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":"Reverse Innovation, Partnerships, and The Role of Academic Health Systems in Creating a Sustainable Geriatric Health Care System","authors":"Stephen J. Bartels MD, MS ,&nbsp;Charles F. Reynolds III MD","doi":"10.1016/j.jagp.2024.02.005","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.02.005","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":"140141844","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":"From AI With Love","authors":"Zhaohui Su Ph.D.","doi":"10.1016/j.jagp.2024.03.006","DOIUrl":"10.1016/j.jagp.2024.03.006","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140200089","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":"Artificial Intelligence and the Sense of Self of Older Adults: A Philosophy of Science Perspective","authors":"George S. Alexopoulos M.D.","doi":"10.1016/j.jagp.2024.03.005","DOIUrl":"10.1016/j.jagp.2024.03.005","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190457","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":"Depressive Symptoms and Plasma Markers of Alzheimer's Disease and Neurodegeneration: A Coordinated Meta-Analysis of 8 Cohort Studies","authors":"","doi":"10.1016/j.jagp.2024.03.004","DOIUrl":"10.1016/j.jagp.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><p>Depressive symptoms are associated with an increased risk of Alzheimer's disease (AD). There has been a recent emergence in plasma biomarkers for AD pathophysiology, such as amyloid-beta (Aβ) and phosphorylated tau (p-tau), as well as for axonal damage (neurofilament light, NfL) and astrocytic activation (glial fibrillary acidic protein, GFAP). Hypothesizing that depressive symptoms may occur along the AD process, we investigated associations between plasma biomarkers of AD with depressive symptoms in individuals without dementia.</p></div><div><h3>Methods</h3><p>A two-stage meta-analysis was performed on 2 clinic-based and 6 population-based cohorts (N = 7210) as part of the Netherlands Consortium of Dementia Cohorts. Plasma markers (Aβ42/40, p-tau181, NfL, and GFAP) were measured using Single Molecular Array (Simoa; Quanterix) assays. Depressive symptoms were measured with validated questionnaires. We estimated the cross-sectional association of each standardized plasma marker (determinants) with standardized depressive symptoms (outcome) using linear regressions, correcting for age, sex, education, and APOE ε4 allele presence, as well as subgrouping by sex and APOE ε4 allele. Effect estimates were entered into a random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Mean age of participants was 71 years. The prevalence of clinically relevant depressive symptoms ranged from 1% to 22%. None of the plasma markers were associated with depressive symptoms in the meta-analyses. However, NfL was associated with depressive symptoms only in APOE ε4 carriers (β 0.11; 95% CI: 0.05–0.17).</p></div><div><h3>Conclusions</h3><p>Late-life depressive symptoms did not show an association to plasma biomarkers of AD pathology. However, in APOE ε4 allele carriers, a more profound role of neurodegeneration was suggested with depressive symptoms.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002744/pdfft?md5=af34ef140dd601b3687bd7e79a991b1f&pid=1-s2.0-S1064748124002744-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140151518","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":"Cognitive and Hippocampal Changes in Older Adults With Subjective Cognitive Decline After Acupuncture Intervention","authors":"Xu Wang Ph.D. ,&nbsp;Hang Zhou B.M. ,&nbsp;Chao-Qun Yan M.D. ,&nbsp;Guang-Xia Shi M.D., Ph.D. ,&nbsp;Ping Zhou M.M. ,&nbsp;Jian-Wei Huo B.M. ,&nbsp;Jing-Wen Yang M.D., Ph.D. ,&nbsp;Ya-Nan Zhang M.D. ,&nbsp;Lu Wang B.M. ,&nbsp;Yan Cao M.M. ,&nbsp;Cun-Zhi Liu M.D., Ph.D.","doi":"10.1016/j.jagp.2024.03.001","DOIUrl":"10.1016/j.jagp.2024.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>Converging evidence indicates that subjective cognitive decline (SCD) could be an early indicator of dementia. The hippocampus is the earliest affected region during the progression of cognitive impairment. However, little is known about whether and how acupuncture change the hippocampal structure and function of SCD individuals.</p></div><div><h3>Methods</h3><p>Here, we used multi-modal MRI to reveal the mechanism of acupuncture in treating SCD. Seventy-two older participants were randomized into acupuncture or sham acupuncture group and treated for 12 weeks.</p></div><div><h3>Results</h3><p>At the end of the intervention, compared to sham acupuncture, participants with acupuncture treatment showed improvement in composite Z score from multi-domain neuropsychological tests, as well as increased hippocampal volume and functional connectivity. Moreover, the greater white matter integrity of the fornix, which is the major output tract of the hippocampus, was shown in the acupuncture group.</p></div><div><h3>Conclusion</h3><p>These findings suggest that acupuncture may improve the cognitive function of SCD individuals, and increase hippocampal volume on the regional level and enhance the structural and functional connectivity of hippocampus on the connective level.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089507","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":"Time to Diagnosis and Its Predictors in Syndromes Associated With Frontotemporal Lobar Degeneration","authors":"Ilenia Libri M.D. ,&nbsp;Daniele Altomare Ph.D. ,&nbsp;Valeria Bracca M.S. ,&nbsp;Jasmine Rivolta M.S. ,&nbsp;Valentina Cantoni Ph.D. ,&nbsp;Irene Mattioli M.D. ,&nbsp;Antonella Alberici M.D. ,&nbsp;Barbara Borroni M.D.","doi":"10.1016/j.jagp.2024.03.002","DOIUrl":"10.1016/j.jagp.2024.03.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Frontotemporal Lobar Degeneration (FTLD) causes a heterogeneous group of neurodegenerative disorders with a wide range of clinical features. This might delay time to diagnosis. The aim of the present study is to establish time to diagnosis and its predictors in patients with FTLD-associated syndromes.</p></div><div><h3>Design</h3><p>Retrospective study.</p></div><div><h3>Setting</h3><p>Tertiary referral center.</p></div><div><h3>Participants</h3><p>A total of 1029 patients with FTLD-associated syndromes (age: 68 [61–73] years, females: 46%) from 1999 to 2023 were included in the present study.</p></div><div><h3>Measurements</h3><p>Time to diagnosis was operationalized as the time between symptom onset and the diagnosis of a FTLD-associated syndrome. The associations between time to diagnosis and possible predictors (demographic and clinical variables) were investigated through univariate and multivariate linear models.</p></div><div><h3>Results</h3><p>Median time to diagnosis was 2 [1-3] years. We observed that younger age at onset (β = -0.03, p &lt;0.001), having worked as a professional rather than as a blue (β = 0.52, p = 0.024) or a white (β = 0.46, p = 0.050) collar, and having progressive supranuclear palsy (p &lt;0.05) or the semantic variant of primary progressive aphasia (p &lt;0.05) phenotypes were significantly associated with increased time to diagnosis. No significant changes of time to diagnosis have been observed over 20 years.</p></div><div><h3>Conclusions</h3><p>The identification of predictors of time to diagnosis might improve current diagnostic algorithms, resulting in a timely initiation of symptomatic treatments, early involvement in clinical trials, and more adequate public health policies for patients and their families.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002719/pdfft?md5=474decbac204c06949c51808d368c928&pid=1-s2.0-S1064748124002719-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087078","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":"Review of Management Considerations for Excoriation Disorder in Older Adults","authors":"Michael J. Mandarino PharmD, BCPS, BCPP ,&nbsp;Lauren Stummer PharmD, BCPP ,&nbsp;Ana F. Trueba PhD ,&nbsp;Ipsit Vahia MD ,&nbsp;Alexis Freedberg MD","doi":"10.1016/j.jagp.2024.02.013","DOIUrl":"10.1016/j.jagp.2024.02.013","url":null,"abstract":"<div><p>Excoriation disorder (ED) is defined as compulsive skin picking that results in skin damage and emotional distress. Optimal management of ED includes individualized treatment plans consisting of psychotherapies, behavioral and pharmacologic interventions. Compared with younger populations, older adults are at increased risk for poor outcomes, such as infection and hospitalization, and require unique management considerations. Risk factors that contribute to disease burden include age-related changes to the skin and underlying medical and psychiatric comorbidities. A literature review was conducted on ED yielding limited evidence exclusive to older adults. The authors suggest a therapeutic approach to ED in older adults based on available evidence and experience from inpatient and outpatient psychiatric settings. Finally, opportunities for future research are highlighted.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140151323","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":"Erratum to “Gender and Ethnicity Differences in Loneliness: Looking at Older Adults With Schizophrenia and Non-Psychiatric Comparisons”","authors":"Stephanie Ibrahim B.A. ,&nbsp;Jerry McDonald B.A. ,&nbsp;Lisa Eyler Ph.D. ,&nbsp;Ellen Lee M.D.","doi":"10.1016/j.jagp.2024.02.014","DOIUrl":"10.1016/j.jagp.2024.02.014","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002707/pdfft?md5=c42cf324f605ece890b9944027562d82&pid=1-s2.0-S1064748124002707-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140056507","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}