Jinwei Bian, Zi Chen, Daniel Yee Tak Fong, Edmond Pui Hang Choi, Pui Hing Chau
Background: Cognitive frailty (CF) is the coexistence of physical frailty and cognitive impairment. Transition to institutional care (TIC) refers to the move from home to a long-term care institution and represents a major change in living arrangement and care needs among older adults. Both CF and TIC are pressing challenges in ageing populations; however, evidence on their association remains limited.
Objectives: This study aimed to explore the longitudinal relationship between CF and TIC among community-dwelling older adults, using the Chinese population as an example.
Methods: This retrospective cohort study utilised data from four waves (2008-2018) of the Chinese Longitudinal Healthy Longevity Survey. Community-dwelling participants aged between 65 and 100 years at baseline were included. CF was defined based on the modified Fried criteria and the Chinese version Mini-Mental State Examination. The Fine-Grey subdistribution regression models were used, treating mortality and lost to follow-up as competing risks and controlling for gender, age, living area, marital status, living arrangement, multimorbidity, household income, and preference for institutional care.
Results: The baseline prevalence of CF was 2.3% (95% CI: 2.0%-2.6%). During follow-up, 1.2% (95% CI: 1.0%-1.4%) transitioned to institutional care, 47.1% (95% CI: 46.1%-48.2%) died before TIC and 32.1% (95% CI: 31.1%-33.0%) were lost to follow-up. Incidence rate of TIC was 2.3 (95% CI: 1.9-2.8) per 1000 person-years. Individuals with CF had a higher risk of TIC (SHR 3.51, 95% CI: 1.49 to 8.28; p = 0.004) compared to those without physical frailty and cognitive impairment.
Conclusion: Our findings demonstrated the positive association between CF and TIC, highlighting the need for appropriate and timely management of CF and personalised interventions for this vulnerable group to delay premature institutionalisation.
{"title":"Increased Risk of Transition to Institutional Care Among Community-Dwelling Older Adults With Cognitive Frailty: A Competing Risks Survival Analysis.","authors":"Jinwei Bian, Zi Chen, Daniel Yee Tak Fong, Edmond Pui Hang Choi, Pui Hing Chau","doi":"10.1002/gps.70197","DOIUrl":"10.1002/gps.70197","url":null,"abstract":"<p><strong>Background: </strong>Cognitive frailty (CF) is the coexistence of physical frailty and cognitive impairment. Transition to institutional care (TIC) refers to the move from home to a long-term care institution and represents a major change in living arrangement and care needs among older adults. Both CF and TIC are pressing challenges in ageing populations; however, evidence on their association remains limited.</p><p><strong>Objectives: </strong>This study aimed to explore the longitudinal relationship between CF and TIC among community-dwelling older adults, using the Chinese population as an example.</p><p><strong>Methods: </strong>This retrospective cohort study utilised data from four waves (2008-2018) of the Chinese Longitudinal Healthy Longevity Survey. Community-dwelling participants aged between 65 and 100 years at baseline were included. CF was defined based on the modified Fried criteria and the Chinese version Mini-Mental State Examination. The Fine-Grey subdistribution regression models were used, treating mortality and lost to follow-up as competing risks and controlling for gender, age, living area, marital status, living arrangement, multimorbidity, household income, and preference for institutional care.</p><p><strong>Results: </strong>The baseline prevalence of CF was 2.3% (95% CI: 2.0%-2.6%). During follow-up, 1.2% (95% CI: 1.0%-1.4%) transitioned to institutional care, 47.1% (95% CI: 46.1%-48.2%) died before TIC and 32.1% (95% CI: 31.1%-33.0%) were lost to follow-up. Incidence rate of TIC was 2.3 (95% CI: 1.9-2.8) per 1000 person-years. Individuals with CF had a higher risk of TIC (SHR 3.51, 95% CI: 1.49 to 8.28; p = 0.004) compared to those without physical frailty and cognitive impairment.</p><p><strong>Conclusion: </strong>Our findings demonstrated the positive association between CF and TIC, highlighting the need for appropriate and timely management of CF and personalised interventions for this vulnerable group to delay premature institutionalisation.</p>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 2","pages":"e70197"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aafra T. Ter Horst, Marleen J. J. Gerritsen, Jacoba M. Spikman
Objectives
Aggressive behaviour and decreased empathy occur in many dementia syndromes. This may be related to lowered overall cognitive functioning which is a common feature of dementia. However, to date, the role of social cognitive impairments such as facial emotion recognition (FER) deficits in dementias other than behavioural variant frontotemporal dementia (bvFTD) remains largely elusive. This study focusses on people who were recently diagnosed with dementia in the memory clinic of a regional hospital, excluding bvFTD. The first question was whether FER was impaired in this group. Next the relation between FER, cognitive functioning and proxy-rated levels of empathic and aggressive behaviour was examined.
Methods
80 persons with non-bvFTD dementia were included. FER, overall cognitive functioning, mental speed and executive functioning (mental flexibility, working memory), were measured with respectively The Ekman 60 faces Test, the Mini Mental State Examination (MMSE), the Oral version of the Letter Digit Substitution Test, the Controlled Word Association Test, and the Digit Span test. Empathic and aggressive behaviour were measured using proxy ratings on the Empathic Concern scale of the Interpersonal Reactivity Index, and the Aggression Questionnaire, respectively.
Results
Persons with non-bvFTD dementia were significantly impaired in FER compared to healthy controls, but impaired FER was not significantly related to proxy ratings of aggressive or unempathic behaviour. Neither were cognitive impairments in mental speed and executive functions significantly related to these behaviours. However, we did find a significant association between lower MMSE-scores with higher proxy ratings of unempathic behaviour.
Conclusions
Levels of emphatic behaviour in persons with non-bvFTD dementia as indicated by proxies might be primarily related to disease severity and not directly to impairments in FER as a measure of social cognition.
{"title":"Social Cognition in Community Dwelling Persons With Dementia; Is Facial Emotion Recognition Related to Proxy Rated Empathy and Aggression?","authors":"Aafra T. Ter Horst, Marleen J. J. Gerritsen, Jacoba M. Spikman","doi":"10.1002/gps.70194","DOIUrl":"10.1002/gps.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Aggressive behaviour and decreased empathy occur in many dementia syndromes. This may be related to lowered overall cognitive functioning which is a common feature of dementia. However, to date, the role of social cognitive impairments such as facial emotion recognition (FER) deficits in dementias other than behavioural variant frontotemporal dementia (bvFTD) remains largely elusive. This study focusses on people who were recently diagnosed with dementia in the memory clinic of a regional hospital, excluding bvFTD. The first question was whether FER was impaired in this group. Next the relation between FER, cognitive functioning and proxy-rated levels of empathic and aggressive behaviour was examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>80 persons with non-bvFTD dementia were included. FER, overall cognitive functioning, mental speed and executive functioning (mental flexibility, working memory), were measured with respectively The Ekman 60 faces Test, the Mini Mental State Examination (MMSE), the Oral version of the Letter Digit Substitution Test, the Controlled Word Association Test, and the Digit Span test. Empathic and aggressive behaviour were measured using proxy ratings on the Empathic Concern scale of the Interpersonal Reactivity Index, and the Aggression Questionnaire, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Persons with non-bvFTD dementia were significantly impaired in FER compared to healthy controls, but impaired FER was not significantly related to proxy ratings of aggressive or unempathic behaviour. Neither were cognitive impairments in mental speed and executive functions significantly related to these behaviours. However, we did find a significant association between lower MMSE-scores with higher proxy ratings of unempathic behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Levels of emphatic behaviour in persons with non-bvFTD dementia as indicated by proxies might be primarily related to disease severity and not directly to impairments in FER as a measure of social cognition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Zuliani, Francesca Boscolo Bragadin, Tommaso Romagnoli, Michele Polastri, Carlo Cervellati, Francesco di Paola Dario, Gloria Brombo, Marco Zuin
Objective
Behavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based first on a non-pharmacological and subsequently on a pharmacological approach. We explored the potential effect of long-term treatment with acetylcholinesterase inhibitors (AChEI) on BPSD severity over time.
Methods
The initial sample included 4032 older patients with mild-moderate dementia (Alzhemier's disease - AD, Lewy body dementia - LBD, or vascular dementias - VaD) from the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS). After propensity score matching, a cohort of 1408 patients (704 treated with AChEI = AChEI+ and 704 not treated = AChEI−) was generated. The mean age was 73.2 years (females: 50.4%). The mean follow-up duration was 4.3 ± 1.6 years (range: 2.2–8.3 years). Patients were evaluated at baseline, T1 (2 years), T2 (4 years), T3 (6.2 years), and T4 (8.1 years). BPSD severity was assessed by Neuropsychiatric Inventory (NPI-Q).
Results
The baseline mean NPI-Q severity score was 1.33. At T4, the score increased to 1.41 in AChEI− patients (+6% from baseline), while it decreased to 1.26 in AChEI+ (−6%) (all p < 0.01 from T1 to T4). As regards the NPI-Q sub-items, six of them (hallucinations, agitation/aggression, depression/dysphoria, anxiety, disinhibition and irritability/lability) exhibited significant differences over time (all p < 0.01) in favor of the AChEI + group (stabilization or improvement). Similar trends were observed when LOAD, LBD and VaD were considered separately. In contrast, for five domains (delusions, elation/euphoria, motor disturbances, night-time behaviors, and appetite/eating changes) no differences were observed.
Conclusions
Our study supports the potential role for AChEI in BPSD management, demonstrating a trend toward symptoms stabilization or improvement in patients with mild-moderate dementia. Although the effects were not uniform across all NPI-Q domains, and the limitations of the study, our results reinforces the relevance of AChEI in the comprehensive treatment of dementia.
{"title":"Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia","authors":"Giovanni Zuliani, Francesca Boscolo Bragadin, Tommaso Romagnoli, Michele Polastri, Carlo Cervellati, Francesco di Paola Dario, Gloria Brombo, Marco Zuin","doi":"10.1002/gps.70195","DOIUrl":"10.1002/gps.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Behavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based first on a non-pharmacological and subsequently on a pharmacological approach. We explored the potential effect of long-term treatment with acetylcholinesterase inhibitors (AChEI) on BPSD severity over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The initial sample included 4032 older patients with mild-moderate dementia (Alzhemier's disease - AD, Lewy body dementia - LBD, or vascular dementias - VaD) from the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS). After propensity score matching, a cohort of 1408 patients (704 treated with AChEI = AChEI+ and 704 not treated = AChEI−) was generated. The mean age was 73.2 years (females: 50.4%). The mean follow-up duration was 4.3 ± 1.6 years (range: 2.2–8.3 years). Patients were evaluated at baseline, T1 (2 years), T2 (4 years), T3 (6.2 years), and T4 (8.1 years). BPSD severity was assessed by Neuropsychiatric Inventory (NPI-Q).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The baseline mean NPI-Q severity score was 1.33. At T4, the score increased to 1.41 in AChEI− patients (+6% from baseline), while it decreased to 1.26 in AChEI+ (−6%) (all <i>p</i> < 0.01 from T1 to T4). As regards the NPI-Q sub-items, six of them (hallucinations, agitation/aggression, depression/dysphoria, anxiety, disinhibition and irritability/lability) exhibited significant differences over time (all <i>p</i> < 0.01) in favor of the AChEI + group (stabilization or improvement). Similar trends were observed when LOAD, LBD and VaD were considered separately. In contrast, for five domains (delusions, elation/euphoria, motor disturbances, night-time behaviors, and appetite/eating changes) no differences were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study supports the potential role for AChEI in BPSD management, demonstrating a trend toward symptoms stabilization or improvement in patients with mild-moderate dementia. Although the effects were not uniform across all NPI-Q domains, and the limitations of the study, our results reinforces the relevance of AChEI in the comprehensive treatment of dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anxiety disorders in older adults impose a markedly greater disease burden than in younger individuals. This study provides an overview and analysis of temporal trends in the prevalence of anxiety disorders in older adults over the past 30 years, examining global, regional, and national patterns with a particular focus on age, period, and birth cohort effects.
Methods
Estimates and 95% uncertainty intervals (UI) of anxiety disorder prevalence in older adults from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed. Age-period-cohort (APC) models were used to estimate the overall annual percentage change in prevalence (net drift), the annual percentage change within each age group (local drift), and longitudinal age-specific ratios adjusted for stage bias (age effect) and period/cohort relative risk (period/cohort effect) from 1992 to 2021 at global, regional, and national levels. Nordpred APC model was utilized for forecasting future epidemiological trajectories.
Results
From 1992 to 2021, the global prevalence of anxiety disorders in older adults increased markedly, with prevalence among women approximately double that among men. Age-standardized prevalence rates (ASPR) rose globally, particularly in low-middle socio-demographic index (SDI) regions, while high SDI regions saw smaller or even negative changes. In age groups, prevalence decreased in those aged 65–69 to 85–89, with little change in the 90+ group. High SDI regions exhibited stable or declining prevalence in younger age groups, whereas low SDI regions saw increased prevalence in older age groups. Gender differences were observed, with women showing higher and more consistent prevalence trends, while men exhibited rising rates in low SDI regions. Projections suggest that global cases of anxiety disorders among older adults will rise to 73.24 million by 2045, characterized by a higher prevalence in females and an increasing ASPR.
Conclusion
This study highlights the complex epidemiology of anxiety disorders in older adults, with global prevalence and ASPR projected to rise, demonstrating regional and national heterogeneity. Anxiety disorders will remain a concern for older adults through 2045. Gender differences, especially the increasing prevalence among men, should be considered in intervention strategies.
{"title":"Global Temporal Trends and Projections of Anxiety Disorders Prevalence Among the Older Adults: An Age-Period-Cohort Analysis Based on the GBD 2021","authors":"Junwen Wang, Dianmei Yang, Peng Pan, Liangliang Ping, Ying Huang, Qing Shan, Yiming Wang, Kaide Xia","doi":"10.1002/gps.70193","DOIUrl":"10.1002/gps.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anxiety disorders in older adults impose a markedly greater disease burden than in younger individuals. This study provides an overview and analysis of temporal trends in the prevalence of anxiety disorders in older adults over the past 30 years, examining global, regional, and national patterns with a particular focus on age, period, and birth cohort effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Estimates and 95% uncertainty intervals (UI) of anxiety disorder prevalence in older adults from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed. Age-period-cohort (APC) models were used to estimate the overall annual percentage change in prevalence (net drift), the annual percentage change within each age group (local drift), and longitudinal age-specific ratios adjusted for stage bias (age effect) and period/cohort relative risk (period/cohort effect) from 1992 to 2021 at global, regional, and national levels. Nordpred APC model was utilized for forecasting future epidemiological trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1992 to 2021, the global prevalence of anxiety disorders in older adults increased markedly, with prevalence among women approximately double that among men. Age-standardized prevalence rates (ASPR) rose globally, particularly in low-middle socio-demographic index (SDI) regions, while high SDI regions saw smaller or even negative changes. In age groups, prevalence decreased in those aged 65–69 to 85–89, with little change in the 90+ group. High SDI regions exhibited stable or declining prevalence in younger age groups, whereas low SDI regions saw increased prevalence in older age groups. Gender differences were observed, with women showing higher and more consistent prevalence trends, while men exhibited rising rates in low SDI regions. Projections suggest that global cases of anxiety disorders among older adults will rise to 73.24 million by 2045, characterized by a higher prevalence in females and an increasing ASPR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the complex epidemiology of anxiety disorders in older adults, with global prevalence and ASPR projected to rise, demonstrating regional and national heterogeneity. Anxiety disorders will remain a concern for older adults through 2045. Gender differences, especially the increasing prevalence among men, should be considered in intervention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isla Rippon, Christina R. Victor, Laura D. Gamble, Anthony Martyr, Catherine Quinn, Fiona E. Matthews, Linda Clare, the IDEAL programme team
Objective
To identify predictors of loneliness and social isolation experienced by people with dementia at baseline and over time.
Methods
Using data from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (2014–2018), we examined the prevalence and predictors of loneliness and social isolation in 1547 people with mild-to-moderate dementia over 24 months. Loneliness was measured using the six-item De Jong Gierveld Scale at baseline and 24 months and social isolation by the six-item Lubben Social Network Scale at baseline, 12 and 24 months. Generalised linear mixed effects models examined possible predictors of loneliness and social isolation including individual characteristics, depression, cognition, cultural participation, and neighbourhood characteristics.
Results
At baseline 35.4% of people with dementia were categorised as being lonely and 28.8% as socially isolated, increasing to 39.3% and 32.0% 2 years later. Over the 24-month follow-up none of these predictors were associated with changes in social isolation scores. Only perceived neighbourhood trust was associated with change in loneliness longitudinally. At baseline, depressive symptoms, living alone, smaller social networks and lower neighbourhood trust were associated with greater loneliness. Cross-sectionally, loneliness and lower cognitive ability were associated with greater social isolation, and greater cultural participation, more green and blue spaces nearby and higher neighbourhood trust were associated with lower social isolation scores.
Conclusions
The findings highlight the importance of the local environment and cultural participation for people with dementia. Enhancing interactions with the local neighbourhood through initiatives such as dementia friendly communities may help to reduce loneliness and social isolation.
目的：确定痴呆患者在基线和长期经历的孤独和社会隔离的预测因素。方法：利用改善痴呆症体验和增强积极生活（IDEAL）队列研究（2014-2018）的数据，研究了1547名轻度至中度痴呆症患者在24个月内的孤独和社会隔离的患病率和预测因素。孤独感在基线和24个月时采用6项De Jong Gierveld量表测量，社会隔离在基线、12个月和24个月时采用6项Lubben社会网络量表测量。广义线性混合效应模型研究了孤独和社会隔离的可能预测因素，包括个体特征、抑郁、认知、文化参与和邻里特征。结果：在基线时，35.4%的痴呆症患者被归类为孤独，28.8%的痴呆症患者被归类为社会孤立，两年后分别增加到39.3%和32.0%。在24个月的随访中，这些预测因素都与社会隔离评分的变化无关。只有感知到的邻里信任与孤独感的变化有纵向关系。在基线上，抑郁症状、独居、较小的社交网络和较低的邻里信任与更大的孤独感有关。从横截面上看，孤独和较低的认知能力与更大的社会隔离有关，而更大的文化参与、更多的附近绿色和蓝色空间以及更高的邻里信任与更低的社会隔离得分有关。结论：研究结果强调了当地环境和文化参与对痴呆症患者的重要性。通过痴呆症友好社区等举措加强与当地社区的互动，可能有助于减少孤独和社会孤立。
{"title":"Predictors and Correlates of Loneliness and Social Isolation in People With Dementia: Longitudinal Findings From the IDEAL Programme","authors":"Isla Rippon, Christina R. Victor, Laura D. Gamble, Anthony Martyr, Catherine Quinn, Fiona E. Matthews, Linda Clare, the IDEAL programme team","doi":"10.1002/gps.70191","DOIUrl":"10.1002/gps.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify predictors of loneliness and social isolation experienced by people with dementia at baseline and over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (2014–2018), we examined the prevalence and predictors of loneliness and social isolation in 1547 people with mild-to-moderate dementia over 24 months. Loneliness was measured using the six-item De Jong Gierveld Scale at baseline and 24 months and social isolation by the six-item Lubben Social Network Scale at baseline, 12 and 24 months. Generalised linear mixed effects models examined possible predictors of loneliness and social isolation including individual characteristics, depression, cognition, cultural participation, and neighbourhood characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline 35.4% of people with dementia were categorised as being lonely and 28.8% as socially isolated, increasing to 39.3% and 32.0% 2 years later. Over the 24-month follow-up none of these predictors were associated with changes in social isolation scores. Only perceived neighbourhood trust was associated with change in loneliness longitudinally. At baseline, depressive symptoms, living alone, smaller social networks and lower neighbourhood trust were associated with greater loneliness. Cross-sectionally, loneliness and lower cognitive ability were associated with greater social isolation, and greater cultural participation, more green and blue spaces nearby and higher neighbourhood trust were associated with lower social isolation scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings highlight the importance of the local environment and cultural participation for people with dementia. Enhancing interactions with the local neighbourhood through initiatives such as dementia friendly communities may help to reduce loneliness and social isolation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Measuring disease severity in persons with severe dementia is essential for clinical care and research. Most instruments encounter issues, for example floor effects in characterising persons with severe dementia. We aimed to evaluate the psychometric properties of the Bedford Alzheimer Nursing-Severity Scale (BANS) and its short version, BANS-6, in community-dwelling persons with severe dementia.
Methods
We used baseline data from a multi-centre prospective longitudinal study. 215 caregivers of community-dwelling persons with severe dementia (≥ FAST stage 6c) were recruited (mean age 83.6 ± 8.2). We evaluated BANS’ construct validity with exploratory factor analysis, correlation with other established measures, and predictive validity.
Results
Factor analysis revealed a two-factor solution (variance 58.35%) with item-2 (sleep-wake cycle) not loading onto any factor. Dropping item-2 (BANS-6) revealed a single-factor solution (variance 49.26%) and Cronbach's α improved from 0.701 to 0.782. FAST did not correlate with the Cohen-Mansfield Agitation Inventory and Quality of Life in Late-Stage Dementia Scale, but both BANS and BANS-6 did. For predictive validity, after adjusting for age, sex and comorbidities, BANS-6 remained significantly associated with key clinical complications of severe dementia: pneumonia (β = 2.09, 95% CI = 0.13–4.05), fever episodes (β = 1.24, 95% CI = 0.10–2.40) and oral antibiotic use (β = 1.33, 95%CI = 0.11–2.55), tube feeding (β = 4.42, 95% CI = 2.62–6.22), pressure sores (β = 2.51, 95% CI = 0.85–4.18), eating problems (β = 3.27, 95%CI = 2.20–4.34), and malnutrition (β = 1.63, 95% CI = 0.24–3.02) in the last 4 months. BANS was not significantly associated with pneumonia, oral antibiotics, and pressure sores, and FAST was not significantly associated with any outcome.
Conclusions
BANS and its short version, BANS-6, are valid, reliable, and clinically relevant tools for assessing dementia severity in community-dwelling persons with severe dementia, warranting further exploration in diverse population settings. The findings suggest that BANS-6 has better psychometrics and clinical utility than BANS.
目的：测量重度痴呆患者的疾病严重程度对临床护理和研究至关重要。大多数工具都存在问题，例如，在描述严重痴呆症患者的特征时存在地板效应。我们的目的是评估贝德福德阿尔茨海默病护理严重程度量表（ban）及其简短版本ban -6在社区居住的严重痴呆症患者中的心理测量特性。方法：我们使用来自多中心前瞻性纵向研究的基线数据。招募215名社区重度痴呆患者（≥FAST 6c期）的护理人员（平均年龄83.6±8.2岁）。我们通过探索性因子分析、与其他已建立的测量方法的相关性以及预测效度来评估ban的结构效度。结果：因子分析显示双因子解（方差58.35%），项目2（睡眠-觉醒周期）不加载到任何因子上。去掉项目-2 （BANS-6）显示单因素解决方案（方差49.26%），Cronbach's α从0.701提高到0.782。FAST与Cohen-Mansfield躁动量表和晚期痴呆生活质量量表没有相关性，但ban和ban -6都有相关性。对于预测效度，在调整了年龄、性别和合并症后，ban -6仍然与严重痴呆的主要临床并发症显著相关：肺炎(β= 2.09,95% CI -4.05 = 0.13),热事件(β= 1.24,95% CI = 0.10 - -2.40)和口服抗生素的使用(β= 1.33,95% CI = 0.11 - -2.55),胃管喂食(β= 4.42,95% CI = 2.62 - -6.22),压疮(β= 2.51,95% CI = 0.85 - -4.18),饮食问题(β= 3.27,95% CI = 2.20 - -4.34),和营养不良(β= 1.63,95% CI -3.02 = 0.24)在过去的4个月。ban与肺炎、口服抗生素和压疮无显著相关性，FAST与任何结果均无显著相关性。结论：ban及其简短版本ban -6是评估社区重度痴呆患者痴呆严重程度的有效、可靠和临床相关的工具，值得在不同人群环境中进一步探索。研究结果表明，ban -6比ban具有更好的心理测量学和临床实用性。
{"title":"Psychometric Validation of the Bedford Alzheimer Nursing-Severity Scale in Community-Dwelling Persons With Severe Dementia","authors":"Chin Yee Cheong, Philip Yap, Tze Pin Ng, Boon Yeow Tan, Chetna Malhotra","doi":"10.1002/gps.70187","DOIUrl":"10.1002/gps.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Measuring disease severity in persons with severe dementia is essential for clinical care and research. Most instruments encounter issues, for example floor effects in characterising persons with severe dementia. We aimed to evaluate the psychometric properties of the Bedford Alzheimer Nursing-Severity Scale (BANS) and its short version, BANS-6, in community-dwelling persons with severe dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used baseline data from a multi-centre prospective longitudinal study. 215 caregivers of community-dwelling persons with severe dementia (≥ FAST stage 6c) were recruited (mean age 83.6 ± 8.2). We evaluated BANS’ construct validity with exploratory factor analysis, correlation with other established measures, and predictive validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Factor analysis revealed a two-factor solution (variance 58.35%) with item-2 (sleep-wake cycle) not loading onto any factor. Dropping item-2 (BANS-6) revealed a single-factor solution (variance 49.26%) and Cronbach's <i>α</i> improved from 0.701 to 0.782. FAST did not correlate with the Cohen-Mansfield Agitation Inventory and Quality of Life in Late-Stage Dementia Scale, but both BANS and BANS-6 did. For predictive validity, after adjusting for age, sex and comorbidities, BANS-6 remained significantly associated with key clinical complications of severe dementia: pneumonia (<i>β</i> = 2.09, 95% CI = 0.13–4.05), fever episodes (<i>β</i> = 1.24, 95% CI = 0.10–2.40) and oral antibiotic use (<i>β</i> = 1.33, 95%CI = 0.11–2.55), tube feeding (<i>β</i> = 4.42, 95% CI = 2.62–6.22), pressure sores (<i>β</i> = 2.51, 95% CI = 0.85–4.18), eating problems (<i>β</i> = 3.27, 95%CI = 2.20–4.34), and malnutrition (<i>β</i> = 1.63, 95% CI = 0.24–3.02) in the last 4 months. BANS was not significantly associated with pneumonia, oral antibiotics, and pressure sores, and FAST was not significantly associated with any outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BANS and its short version, BANS-6, are valid, reliable, and clinically relevant tools for assessing dementia severity in community-dwelling persons with severe dementia, warranting further exploration in diverse population settings. The findings suggest that BANS-6 has better psychometrics and clinical utility than BANS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hui-Wen Weng, Ching-Sheng Hung, Tsong-Yih Ou, Chia-Mei Chou, Chia-Kwung Fan
{"title":"Preliminary Serological Evidence of Toxocara canis and Toxoplasma gondii Exposure Among Very Elderly Neuropsychiatric Patients in Taiwan","authors":"Hui-Wen Weng, Ching-Sheng Hung, Tsong-Yih Ou, Chia-Mei Chou, Chia-Kwung Fan","doi":"10.1002/gps.70192","DOIUrl":"10.1002/gps.70192","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan C. Melendez, Luis Carlos Venegas, Claire P. de la Fuente
Objectives
To examine the longitudinal association between cognitive reserve (CR)-related proxies and episodic memory in older adults, and to explore the role of sociodemographic and clinical risk factors.
Methods
Data were drawn from 2279 participants of the Survey of Health, Aging and Retirement in Europe (SHARE), with baseline in wave 5 (2013) and follow-up in wave 9 (2021–2022). A CR-proxy score was constructed using education, occupation, physical activity, social engagement, and loneliness. Logistic regression models were used to predict immediate and delayed recall performance at follow-up, adjusting for age, sex, depression, vascular risk factors, and sensory impairments.
Results
Higher levels of CR-related proxies significantly reduced the odds of impairment in both immediate recall (OR = 0.55, p < 0.001) and delayed recall (OR = 0.46, p < 0.001). Age was associated with poorer memory outcomes, while women showed better performance in delayed recall being female predicted lower odds of preserved delayed recall. Depression was significantly related to poorer immediate recall, but other health conditions and sensory factors were not significant predictors.
Conclusions
CR-related proxies were strong predictors of memory performance over the 9-year period, particularly for delayed recall. These findings reflect sociobehavioural influences associated with CR development, rather than direct evidence of CR as a neurofunctional mechanism. Promoting cognitively, socially and physically enriching activities, together with addressing depression, may help preserve memory function in aging populations.
{"title":"Cognitive Reserve and Its Relationship With Memory Changes: An Analysis of the Survey of Health, Aging, and Retirement in Europe (SHARE)","authors":"Juan C. Melendez, Luis Carlos Venegas, Claire P. de la Fuente","doi":"10.1002/gps.70190","DOIUrl":"10.1002/gps.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the longitudinal association between cognitive reserve (CR)-related proxies and episodic memory in older adults, and to explore the role of sociodemographic and clinical risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were drawn from 2279 participants of the Survey of Health, Aging and Retirement in Europe (SHARE), with baseline in wave 5 (2013) and follow-up in wave 9 (2021–2022). A CR-proxy score was constructed using education, occupation, physical activity, social engagement, and loneliness. Logistic regression models were used to predict immediate and delayed recall performance at follow-up, adjusting for age, sex, depression, vascular risk factors, and sensory impairments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher levels of CR-related proxies significantly reduced the odds of impairment in both immediate recall (OR = 0.55, <i>p</i> < 0.001) and delayed recall (OR = 0.46, <i>p</i> < 0.001). Age was associated with poorer memory outcomes, while women showed better performance in delayed recall being female predicted lower odds of preserved delayed recall. Depression was significantly related to poorer immediate recall, but other health conditions and sensory factors were not significant predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CR-related proxies were strong predictors of memory performance over the 9-year period, particularly for delayed recall. These findings reflect sociobehavioural influences associated with CR development, rather than direct evidence of CR as a neurofunctional mechanism. Promoting cognitively, socially and physically enriching activities, together with addressing depression, may help preserve memory function in aging populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chutharat Thanchonnang, Schawanya K. Rattanapitoon, Nav La, Nathkapach K. Rattanapitoon
{"title":"The Hidden Arc of Caregiver Decline: Trajectory, Reserve, and Systemic Implications","authors":"Chutharat Thanchonnang, Schawanya K. Rattanapitoon, Nav La, Nathkapach K. Rattanapitoon","doi":"10.1002/gps.70186","DOIUrl":"10.1002/gps.70186","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Music, Leisure and Dementia Risk: Clarifying What is Really Being Measured","authors":"Ryuichi Minoda Sada","doi":"10.1002/gps.70188","DOIUrl":"https://doi.org/10.1002/gps.70188","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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