American Journal of Geriatric Psychiatry最新文献

{"title":"Chasing Causality: Understanding the Link Between Benzodiazepine Exposure and Dementia Risk","authors":"Helmet T. Karim Ph.D.","doi":"10.1016/j.jagp.2024.02.012","DOIUrl":"10.1016/j.jagp.2024.02.012","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140056498","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 Parallel Roads of Neuroprogression and Somatoprogression: Implications for Clinical Care","authors":"Michael Berk M.B.B.Ch., Ph.D., Malcolm Forbes M.B.B.S.","doi":"10.1016/j.jagp.2024.02.011","DOIUrl":"10.1016/j.jagp.2024.02.011","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140056408","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":"Vitamin D and Depression: Racial Differences Suggest an Alternate Biomarker","authors":"Candida J. Rebello Ph.D.","doi":"10.1016/j.jagp.2024.02.008","DOIUrl":"10.1016/j.jagp.2024.02.008","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040917","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":"Ableism: A Conversation Starter","authors":"Leslie P. Scheunemann M.D., M.P.H.","doi":"10.1016/j.jagp.2024.02.010","DOIUrl":"10.1016/j.jagp.2024.02.010","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051164","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":"Lifetime Estrogen Exposure and Dementia Risk: A Commentary on Park et al. (2024)","authors":"Julie A. Dumas Ph.D.","doi":"10.1016/j.jagp.2024.02.009","DOIUrl":"10.1016/j.jagp.2024.02.009","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051166","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":"Is Social Connection the Solution for Reducing Widower Suicide in Late Life?","authors":"Katalin Szanto M.D. , Holly G. Prigerson Ph.D. , Sarah T. Stahl Ph.D.","doi":"10.1016/j.jagp.2024.02.007","DOIUrl":"10.1016/j.jagp.2024.02.007","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051165","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 of Depression With the Progression of Multimorbidity in Older Adults: A Population-Based Cohort Study","authors":"Dae Jong Oh M.D., Ph.D. ,&nbsp;Ji Won Han M.D., Ph.D. ,&nbsp;Tae Hui Kim M.D. ,&nbsp;Kyung Phil Kwak M.D., Ph.D. ,&nbsp;Bong Jo Kim M.D., Ph.D. ,&nbsp;Shin Gyeom Kim M.D. ,&nbsp;Jeong Lan Kim M.D., Ph.D. ,&nbsp;Seok Woo Moon M.D., Ph.D. ,&nbsp;Joon Hyuk Park M.D., Ph.D. ,&nbsp;Seung-Ho Ryu M.D., Ph.D. ,&nbsp;Jong Chul Youn M.D., Ph.D. ,&nbsp;Dong Woo Lee M.D., Ph.D. ,&nbsp;Seok Bum Lee M.D., Ph.D. ,&nbsp;Jung Jae Lee M.D., Ph.D. ,&nbsp;Jin Hyeong Jhoo M.D., Ph.D. ,&nbsp;Ki Woong Kim M.D., Ph.D.","doi":"10.1016/j.jagp.2024.02.006","DOIUrl":"10.1016/j.jagp.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><p>The relationship between depression and the risk of multimorbidity progression has rarely been studied in older adults. This study was aimed to determine whether depression is associated with progression in the severity and complexity of multimorbidity, considering the influence of depression's severity and subtype.</p></div><div><h3>Methods</h3><p>As a part of the Korean Longitudinal Study on Cognitive Aging and Dementia, this population-based cohort study followed a random sample of community-dwelling Koreans aged 60 and older for 8 years at 2-year intervals starting in 2010. Participants included those who completed mood and multimorbidity assessments and did not exhibit complex multimorbidity at the study's outset. Depression was assessed using the Geriatric Depression Scale, while multimorbidity was evaluated using the Cumulative Illness Rating Scale. The study quantified multimorbidity complexity by counting affected body systems and measured multimorbidity severity by averaging scores across 14 body systems.</p></div><div><h3>Findings</h3><p>The 2,486 participants (age = 69.1 ± 6.5 years, 57.6% women) were followed for 5.9 ± 2.4 years. Linear mixed models revealed that participants with depression had a faster increase in multimorbidity complexity score (<em>β</em> = .065, SE = 0.019, p = 0.001) than those without depression, but a comparable increase in multimorbidity severity score (<em>β</em> = .001, SE = .009, p = 0.870) to those without depression. Cox proportional hazard models revealed that depression was associated with the risk of developing highly complex multimorbidity affecting five or more body systems, particularly in severe or anhedonic depression.</p></div><div><h3>Interpretation</h3><p>Depression was associated with the worsening of multimorbidity in Korean older adults, particularly when severe or anhedonic. Early screening and management of depression may help to reduce the burden of multimorbidity in older adults.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040916","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":"Access to Psychiatric Care for Late Life Hoarding Patients","authors":"Asher Etheridge BS,&nbsp;Mary Dozier PhD","doi":"10.1016/j.jagp.2024.01.134","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.01.134","url":null,"abstract":"<div><h3>Introduction</h3><p>The purpose of this investigation is to examine the availability of psychiatric care for rural-dwelling older adults with hoarding disorder. Across the United States there is a dearth of psychiatrists. This issue is amplified in rural areas where there is less access to medical care overall. Comparing the situation in Northeast Mississippi to other areas across the United States will allow us to determine the severity of the issue specifically for older adults in this area.</p></div><div><h3>Methods</h3><p>Forty-five adults, the majority of which were aged 50 and over, were recruited for a treatment study for hoarding disorder. The zip codes of participants’ addresses were used to determine available psychiatric care in their area or distance to such care. Thirty-five participants completed a semi-structured interview at the baseline assessment to determine presence of psychiatric co-morbidities. In determining availability to psychiatric care, the number of licensed psychiatrists in the participant zip codes was determined. We used one hour driving distance as our a priori acceptable range for older adults to travel to seek treatment, and licensed psychiatrists in that range were counted as well. The access to psychiatrists was then compared to other rural and urban areas in the United States.</p></div><div><h3>Results</h3><p>On average, participants met criteria for at least one psychiatric co-morbid condition (range 0-5). 31% of participants met criteria for two or more psychiatric co-morbid conditions. The most common co-morbid diagnoses were major depressive disorder (n = 14; 40%), generalized anxiety disorder (n = 5; 14%), and history of a manic episode (n = 6; 17%). 0% percent of participants had access to a psychiatrist for in person outpatient care in their zip code, or within 1 hour of their zip code.</p></div><div><h3>Conclusions</h3><p>Older rural adults with hoarding disorder in Northeast Mississippi must overcome significant barriers to receive access to psychiatric care. Like many rural areas, the lack of psychiatrists in Northeast Mississippi means the burden of care falls on those without the necessary means to treat hoarding disorder, and co-morbid psychiatric conditions. This includes the families and friends of older adults with hoarding disorder, and other professional caregivers in the area. With a lack of psychiatrists, these people will see an increase in the amount of people they care for as well. This increased burden on them can lead to decreased quality of care for older adults and a decreased quality of living for caregivers.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907767","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":"Apathy Endorsement in Late Life Depression is Associated with Executive Dysfunction","authors":"Maria Kryza-Lacombe PhD ,&nbsp;Michelle Kassel PhD ,&nbsp;Susanna Fryer PhD ,&nbsp;Philip S. Insel PhD ,&nbsp;Branwen Vang BA ,&nbsp;Meryl A. Butters PhD ,&nbsp;Paul Aisen MD ,&nbsp;Rema Raman PhD ,&nbsp;Susan Landau PhD ,&nbsp;Andrew J. Saykin PsyD ,&nbsp;Arthur W. Toga MD ,&nbsp;Clifford R. Jack Jr. MD ,&nbsp;Michael W. Weiner MD ,&nbsp;Craig Nelson MD ,&nbsp;Duygu Tosun PhD ,&nbsp;R. Scott Mackin PhD","doi":"10.1016/j.jagp.2024.01.120","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.01.120","url":null,"abstract":"<div><h3>Introduction</h3><p>Executive function deficits are prevalent in late life depression (LLD) and linked to poorer outcomes. Little is known about the underlying factors that contribute to greater executive dysfunction in LLD, yet understanding these factors is critical for identifying new intervention targets to reduce the public health burden associated with depression and cognitive impairment in late life. Although negative affect has traditionally been the focus of scientific inquiry related to depressive symptomatology, emerging work is highlighting associations of Positive Valence System (PVS) dysfunction with depression. PVS functions are characterized by positive affect and approach behaviors toward potentially rewarding stimuli and are associated with better cognitive control in non-depressed adults. PVS deficits such as apathy are common in LLD and present as diminished goal-directed behavior, decreased interest in activities, and flattened affect. One prior study found that greater apathy was significantly associated with lower executive function performance in LLD, but more work is needed to characterize associations between PVS functions and executive dysfunction, including impairment rates. To this end, we examined associations between apathy endorsement in LLD and 1) performance on executive function measures and 2) rates of executive function impairment.</p></div><div><h3>Methods</h3><p>Baseline assessments of older adults with Major Depressive Disorder (N=228, Ages 65-91) were pooled across two studies: a longitudinal observational study (n=127) and a psychotherapy study (n=101). Participants completed measures of depression (15-item Geriatric Depression Scale [GDS], Hamilton Depression Rating Scale [HDRS]) and executive functions (EF; Trail Making Test B [TMTB], Stroop Color Word Interference [SCWI]) yielding raw scores and demographically corrected impairment ratings (i.e., performance at least 1 standard deviation below the normative mean). Apathy was defined as endorsement of having dropped many activities and interests (GDS, item 2). Differences in EF test performance by apathy status (present vs. absent) were first assessed by comparing raw scores (log-transformed for TMTB due to skewness) via independent samples t-tests (adjusted for unequal variances in performance scores between apathy groups). Linear regression analyses were additionally conducted to assess performance differences by apathy status after adjusting for demographic characteristics (age, gender, education) and concurrent depression severity (HDRS). Chi-square tests compared rates of demographically corrected EF impairment by apathy status and were followed up by logistic regression analyses to examine whether apathy status is associated with EF impairment differences after adjusting for concurrent depression severity.</p></div><div><h3>Results</h3><p>Apathy was endorsed by 67.5% of participants and was associated with significantly poorer performance","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907838","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":"AAGP/AJGP Diversity, Equity, and Inclusion in Action: Historic Perspective and Future Goals","authors":"Linda Mah MHSc ,&nbsp;Olivia Okereke MS ,&nbsp;Helen Lavretsky MD, MS, MS ,&nbsp;Charles Reynolds III MD ,&nbsp;Tatyana Shteinlukht PhD","doi":"10.1016/j.jagp.2024.01.058","DOIUrl":"https://doi.org/10.1016/j.jagp.2024.01.058","url":null,"abstract":"<div><p>Diversity, Equity, and Inclusion (DEI) are important objectives in all professional fields, and they are exceptionally important and impactful within healthcare. Every day, patients and their families put their trust in our hands. When doing so, they deserve to be treated at all times with the utmost respect and compassion. DEI principles create an environment of safety, belonging, and positive health outcomes.</p><p>Diversity of health providers allows for better care of diverse patients and helps to promote health equity and reduce disparities. Since healthcare is ultimately built upon relationships, it is important that all our patients trust us to understand and meet their unique needs. Achieving our diversity, equity and inclusion objectives for the betterment of all healthcare is an ongoing process, and we are steadfastly committed to its success.</p><p>AAGP remains committed to developing and fostering a culture of compassion, inclusivity, belonging, and acceptance. For many years AAGP had a Diversity Caucus, which since 2020 became AAGP Inclusion, Diversity, Equity in Action (IDEA) committee with representation on the AAGP Board.</p><p>The AAGP IDEA committee promotes a welcoming environment for all, by prioritizing respectful diversity, equity and inclusion across AAGP and its membership; advises the AAGP Board on the establishment of policies related to these principles; serves as a consulting body to AAGP components; creates and identifies opportunities that advance diversity, equity and inclusion for members; identifies outreach opportunities to enhance diversity, equity and inclusion of current AAGP membership and potential members; forms subcommittees or workgroups as needed to focus on specific diversity, equity and inclusion efforts.</p><p>AAGP through its flagship publication <em>American Journal of Psychiatry</em> (AJGP) provides readers with DEI updates in the areas of clinical practice, research, teaching and public policy in geriatric psychiatry.</p><p>This session will provide the audience with overview of current AAGP/AGJP DEI initiatives and outline plans for creation of mentorship programs and outreach efforts for the benefit of geriatric psychiatry providers, patients and caregivers.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139908315","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}