Johannes Trabert, Elena Bauer, Rejane Golbach, Katrin Jekel, Christina Wunner, Katrin Singler, Sandra Schütze
Objective
The aim of the study is to investigate sensitivity and specificity of the two-item Whooley questions compared to the 15-item Geriatric Depression Scale (GDS-15) for the detection of depressive symptoms in acutely hospitalized geriatric patients.
Methods
Patients were prospectively recruited. Two-item Whooley questions and GDS-15 were performed within 24 h of admission, the GDS-15 being part of the routine geriatric assessment. Montgomery-Asberg Depression Rating Scale (MADRS) served as gold standard in the form of a structured interview which was performed within 48 h of admission. In addition, all patients were examined for independence (Barthel Index), cognition (mini-mental status examination), vision and hearing (finger rub test) and multimorbidity (Charlson Comorbidity Index).
Results
248 patients were recruited. Median (Q1/3) age was 83 (/3 79/86) years, 157 patients (63%) were female. Whooley questions had a sensitivity of 0.95 (95% CI: 0.81–0.99) and specificity of 0.49 (95% CI: 0.43–0.56) identifying moderate depressive symptoms (MADRS ≥ 20 points) with a negative predictive value (NPV) of 0.99. This is compared to a sensitivity of 0.57 (95% CI: 0.37–0.75) and specificity of 0.62 (95% CI: 0.56–0.68) using GDS-15 to identify moderate depressive symptoms. Both functional impairment and cognitive deficits had an impact on the result of GDS-15, but did not influence the result of Whooley questions.
Conclusions
Compared to the GDS-15, the two-item Whooley questions are more accurate to screen for symptoms of depression in acutely hospitalized geriatric patients.
{"title":"Simplified Screening for Depression in Acutely Hospitalized Geriatric Patients: Comparison of the Two-Item Whooley Questions With the Geriatric Depression Scale-15","authors":"Johannes Trabert, Elena Bauer, Rejane Golbach, Katrin Jekel, Christina Wunner, Katrin Singler, Sandra Schütze","doi":"10.1002/gps.70083","DOIUrl":"https://doi.org/10.1002/gps.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the study is to investigate sensitivity and specificity of the two-item Whooley questions compared to the 15-item Geriatric Depression Scale (GDS-15) for the detection of depressive symptoms in acutely hospitalized geriatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were prospectively recruited. Two-item Whooley questions and GDS-15 were performed within 24 h of admission, the GDS-15 being part of the routine geriatric assessment. Montgomery-Asberg Depression Rating Scale (MADRS) served as gold standard in the form of a structured interview which was performed within 48 h of admission. In addition, all patients were examined for independence (Barthel Index), cognition (mini-mental status examination), vision and hearing (finger rub test) and multimorbidity (Charlson Comorbidity Index).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>248 patients were recruited. Median (Q1/3) age was 83 (/3 79/86) years, 157 patients (63%) were female. Whooley questions had a sensitivity of 0.95 (95% CI: 0.81–0.99) and specificity of 0.49 (95% CI: 0.43–0.56) identifying moderate depressive symptoms (MADRS ≥ 20 points) with a negative predictive value (NPV) of 0.99. This is compared to a sensitivity of 0.57 (95% CI: 0.37–0.75) and specificity of 0.62 (95% CI: 0.56–0.68) using GDS-15 to identify moderate depressive symptoms. Both functional impairment and cognitive deficits had an impact on the result of GDS-15, but did not influence the result of Whooley questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to the GDS-15, the two-item Whooley questions are more accurate to screen for symptoms of depression in acutely hospitalized geriatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861514","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}
This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psychological Symptoms of Dementia (BPSD).
Methods
A total of 280 dementia patients (130 with BPSD, 150 without) and their caregivers were included. Patients with Clinical Dementia Rating scores from 0.5 to 2 were assessed. Caregivers’ psychological symptoms, sleep quality, and burden were evaluated using the Symptom Checklist-90-Revised, Pittsburgh Sleep Quality Index, and Caregiver Burden Inventory.
Results
Caregivers of patients with BPSD reported significantly greater psychological distress, burden, and poorer sleep quality than those caring for patients without BPSD. Their distress spanned multiple symptom dimensions, including depression and anxiety. Somatization and phobic anxiety were also more pronounced in caregivers of mild and moderate dementia with BPSD. Among caregivers of patients with BPSD, those of individuals with moderate dementia experienced the highest distress, burden, and poorest sleep quality compared to those with very mild dementia.
Conclusions
BPSD is a major contributor to greater caregiver distress, sleep disturbances, and burden, regardless of dementia severity, or duration alone. These findings highlight the need for targeted interventions to manage BPSD, which may help alleviate caregiver psychological distress and improve sleep quality.
{"title":"The Impact of Behavioral and Psychological Symptoms of Dementia on Mental Health, Sleep Quality, and Caregiver’s Burden","authors":"I-Wen Chen, Jia-Ying Sung, Wei-Han Wang","doi":"10.1002/gps.70080","DOIUrl":"https://doi.org/10.1002/gps.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psychological Symptoms of Dementia (BPSD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 280 dementia patients (130 with BPSD, 150 without) and their caregivers were included. Patients with Clinical Dementia Rating scores from 0.5 to 2 were assessed. Caregivers’ psychological symptoms, sleep quality, and burden were evaluated using the Symptom Checklist-90-Revised, Pittsburgh Sleep Quality Index, and Caregiver Burden Inventory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Caregivers of patients with BPSD reported significantly greater psychological distress, burden, and poorer sleep quality than those caring for patients without BPSD. Their distress spanned multiple symptom dimensions, including depression and anxiety. Somatization and phobic anxiety were also more pronounced in caregivers of mild and moderate dementia with BPSD. Among caregivers of patients with BPSD, those of individuals with moderate dementia experienced the highest distress, burden, and poorest sleep quality compared to those with very mild dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BPSD is a major contributor to greater caregiver distress, sleep disturbances, and burden, regardless of dementia severity, or duration alone. These findings highlight the need for targeted interventions to manage BPSD, which may help alleviate caregiver psychological distress and improve sleep quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857169","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}
Alejandra Ospina-Lehmann, María Camila Castañeda-Gómez, Eduardo José Pabón-Martínez, Juan Pablo Vigoya-Aponte, Santiago Orozco-Castro, Diego Andrés Chavarro-Carvajal, Carlos Alberto Cano-Gutiérrez
Objective
This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia, between June 2019 and June 2022.
Methods
We conducted a retrospective analytical study. Data were extracted from the hospital's electronic medical records. The primary outcome was delirium upon admission. Exposure variables included clinical (e.g., malnutrition, dementia, oropharyngeal dysphagia) and social factors (e.g., living alone, social networks). Associations between delirium and exposure variables were assessed using a multivariate logistic regression model.
Results
The studied cohort comprised 4601 patients, mean age of 83.93 years and 56.26% were women. The prevalence of delirium upon admission was 22.39%. Key factors associated with delirium included older age (OR 1.04, 95% CI 1.01–1.06), malnutrition (OR 2.42, 95% CI 1.93–2.79), dementia (OR 2.57, 95% CI 2.02–3.38), functional impairment (OR 2.50, 95% CI 1.74–3.59), and oropharyngeal dysphagia (OR 1.49, 95% CI 1.08–1.99). Social determinants such as female sex, limited social networks, living alone, and enrollment in the subsidized health regime were not significantly associated with delirium.
Conclusion
Delirium upon admission is highly prevalent among elderly inpatients and is associated with clinical factors, particularly malnutrition, dementia, and oropharyngeal dysphagia. Although no significant associations were found between social determinants of health (SDH) and delirium in this cohort, further research in diverse healthcare settings is needed to better understand the broader impact of SDH on delirium risk.
目的 本研究旨在描述 2019 年 6 月至 2022 年 6 月期间在哥伦比亚波哥大圣伊格纳西奥大学医院（HUSI）老年病科住院的老年患者中与谵妄相关的临床和社会决定因素。 方法 我们进行了一项回顾性分析研究。数据提取自医院的电子病历。主要结果是入院时出现谵妄。暴露变量包括临床因素（如营养不良、痴呆、口咽吞咽困难）和社会因素（如独居、社交网络）。谵妄与暴露变量之间的关系采用多变量逻辑回归模型进行评估。 结果 研究对象包括 4601 名患者，平均年龄为 83.93 岁，56.26% 为女性。入院时谵妄的发生率为 22.39%。与谵妄相关的主要因素包括年龄较大（OR 1.04，95% CI 1.01-1.06）、营养不良（OR 2.42，95% CI 1.93-2.79）、痴呆（OR 2.57，95% CI 2.02-3.38）、功能障碍（OR 2.50，95% CI 1.74-3.59）和口咽吞咽困难（OR 1.49，95% CI 1.08-1.99）。女性性别、有限的社交网络、独居和参加补贴医疗制度等社会决定因素与谵妄无显著相关性。 结论 入院时谵妄在老年住院患者中非常普遍，与临床因素有关，尤其是营养不良、痴呆和口咽吞咽困难。虽然在本组人群中未发现健康的社会决定因素（SDH）与谵妄之间存在明显关联，但仍需在不同的医疗环境中开展进一步研究，以更好地了解 SDH 对谵妄风险的广泛影响。
{"title":"Delirium in Elderly Hospitalized Patients: Analyzing Clinical and Social Determinants in a Colombian Retrospective Cohort","authors":"Alejandra Ospina-Lehmann, María Camila Castañeda-Gómez, Eduardo José Pabón-Martínez, Juan Pablo Vigoya-Aponte, Santiago Orozco-Castro, Diego Andrés Chavarro-Carvajal, Carlos Alberto Cano-Gutiérrez","doi":"10.1002/gps.70079","DOIUrl":"https://doi.org/10.1002/gps.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia, between June 2019 and June 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analytical study. Data were extracted from the hospital's electronic medical records. The primary outcome was delirium upon admission. Exposure variables included clinical (e.g., malnutrition, dementia, oropharyngeal dysphagia) and social factors (e.g., living alone, social networks). Associations between delirium and exposure variables were assessed using a multivariate logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The studied cohort comprised 4601 patients, mean age of 83.93 years and 56.26% were women. The prevalence of delirium upon admission was 22.39%. Key factors associated with delirium included older age (OR 1.04, 95% CI 1.01–1.06), malnutrition (OR 2.42, 95% CI 1.93–2.79), dementia (OR 2.57, 95% CI 2.02–3.38), functional impairment (OR 2.50, 95% CI 1.74–3.59), and oropharyngeal dysphagia (OR 1.49, 95% CI 1.08–1.99). Social determinants such as female sex, limited social networks, living alone, and enrollment in the subsidized health regime were not significantly associated with delirium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delirium upon admission is highly prevalent among elderly inpatients and is associated with clinical factors, particularly malnutrition, dementia, and oropharyngeal dysphagia. Although no significant associations were found between social determinants of health (SDH) and delirium in this cohort, further research in diverse healthcare settings is needed to better understand the broader impact of SDH on delirium risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852901","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}
Early management of risk factors related to social health such as social frailty and social isolation could modify the progression of dementia and reduce its impact on people with dementia. However, due to overlapping definitions and interchangeable use of measurement tools, the precise distinction between these two concepts is unclear. This simultaneous concept analysis aimed to examine the definitions and interrelationships between the concepts of social frailty and social isolation within the context of dementia.
Methods
The simultaneous concept analysis method developed by Haase et al. was employed. A literature search was conducted across six databases (Ovid Medline, CINAHL, PsycINFO, Scopus, Embase and Cochrane Library) to retrieve original research, review and theoretical papers, published in English. Data from the literature was synthesised and analysed thematically following Braun and Clarke's six steps.
Results
The attributes of concepts of social frailty and social isolation overlap, including being alone and having limited or less social activities, engagements or interactions. The specific attributes of social frailty are financial difficulties and less talk while social isolation is distinctly marked by a lack of social networks or social relationships. Socio-economic welfare is a specific antecedent of social frailty, while decreased access to social resources and lower social well-being are distinctive consequences of social isolation. Cognitive decline and dementia are distinctive antecedents of social isolation; however, they also exist as shared consequences of both social frailty and social isolation.
Conclusions
This simultaneous concept analysis clarified the similarities and differences between social frailty and social isolation in the context of dementia. A clearer understanding of the interrelationships between social frailty and social isolation and distinct and overlapping characteristics of them will support strategies to comprehensively address social health issues experienced by people with dementia.
{"title":"Social Frailty and Social Isolation in the Context of Dementia: A Simultaneous Concept Analysis","authors":"Ziyue Wang, Dympna Casey, Duygu Sezgin","doi":"10.1002/gps.70074","DOIUrl":"https://doi.org/10.1002/gps.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Early management of risk factors related to social health such as social frailty and social isolation could modify the progression of dementia and reduce its impact on people with dementia. However, due to overlapping definitions and interchangeable use of measurement tools, the precise distinction between these two concepts is unclear. This simultaneous concept analysis aimed to examine the definitions and interrelationships between the concepts of social frailty and social isolation within the context of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The simultaneous concept analysis method developed by Haase et al. was employed. A literature search was conducted across six databases (Ovid Medline, CINAHL, PsycINFO, Scopus, Embase and Cochrane Library) to retrieve original research, review and theoretical papers, published in English. Data from the literature was synthesised and analysed thematically following Braun and Clarke's six steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The attributes of concepts of social frailty and social isolation overlap, including being alone and having limited or less social activities, engagements or interactions. The specific attributes of social frailty are financial difficulties and less talk while social isolation is distinctly marked by a lack of social networks or social relationships. Socio-economic welfare is a specific antecedent of social frailty, while decreased access to social resources and lower social well-being are distinctive consequences of social isolation. Cognitive decline and dementia are distinctive antecedents of social isolation; however, they also exist as shared consequences of both social frailty and social isolation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This simultaneous concept analysis clarified the similarities and differences between social frailty and social isolation in the context of dementia. A clearer understanding of the interrelationships between social frailty and social isolation and distinct and overlapping characteristics of them will support strategies to comprehensively address social health issues experienced by people with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849309","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}
Neda Rashidi-Ranjbar, Nathan W. Churchill, Sandra E. Black, Sanjeev Kumar, Maria C. Tartaglia, Morris Freedman, Anthony Lang, Joel Ramirez, Gustavo Saposnik, Paula M. McLaughlin, Sean Symons, Bruce G. Pollock, Tarek K. Rajji, Michael Borrie, Mario Masellis, Stephen H. Pasternak, Andrew Frank, Dallas Seitz, Zahinoor Ismail, David F. Tang-Wai, Christopher J. M. Scott, Dar Dowlatshahi, Ayman Hassan, David G. Munoz, Luis Fornazzari, Corinne E. Fischer, Tom A. Schweizer
<div> <section> <h3> Introduction</h3> <p>Mild Behavioral Impairment (MBI) is characterized by later-life emergent and persistent neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a potential precursor to various forms of dementia. This study explores the association between NPS and functional connectivity (FC) of the default mode network (DMN), executive control network (ECN), and salience network (SN) across three cohorts: mild cognitive impairment due to AD (MCI), cerebrovascular disease (CVD), and Parkinson's disease (PD). Additionally, the effect of CNS medication on NPS-FC associations was explored.</p> </section> <section> <h3> Methods</h3> <p>Participants were recruited from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). NPS were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). We used dual regression to generate subject-specific whole-brain FC maps of the DMN, ECN, and SN. Using permutation testing we examined the association between NPS scores and FC maps at baseline (<i>n</i> = 349) and over a 2-year period (<i>n</i> = 225), controlling for age, sex, and years of education. A post-hoc linear model was used to assess the effect of CNS medication on each significant NPI-FC association within each group.</p> </section> <section> <h3> Results</h3> <p>In the MCI group (<i>n</i> = 73), baseline disturbed nighttime behavior was positively correlated with functional connectivity (FC) between the anterior sensorimotor network. Longitudinally (<i>n</i> = 46), appetite changes were positively associated with FC between the anterior SN and fusiform gyrus. Disinhibition and apathy correlated with FC between the posterior SN and DMN. In the CVD group (<i>n</i> = 144), baseline anxiety was negatively associated with FC within the DMN and between the right ECN and DMN in the left hippocampus. Longitudinally (<i>n</i> = 99), agitation/aggression changes were negatively associated with FC between the right ECN and left anterior cerebellum. Irritability, the most common symptom in both MCI and CVD, did not have identifiable neural correlates, possibly due to its complexity or analysis limitations. In the PD group (<i>n</i> = 132), baseline disturbed nighttime behavior was positively associated with FC between the right ECN and DMN in the precuneus and left ECN and fusiform gyrus. Longitudinally (<i>n</i> = 80), changes in nighttime behavior correlated with FC between the left ECN and DMN in the precuneus. CNS medications had no effect on NPI-FC associations in the MCI group. In the CVD group, the absence of CNS medications was linked to decreased right ECN FC. In the PD group, Parkinson's
{"title":"A Cross Sectional and Longitudinal Assessment of Neuropsychiatric Symptoms and Brain Functional Connectivity in Patients With Mild Cognitive Impairment, Cerebrovascular Disease and Parkinson Disease","authors":"Neda Rashidi-Ranjbar, Nathan W. Churchill, Sandra E. Black, Sanjeev Kumar, Maria C. Tartaglia, Morris Freedman, Anthony Lang, Joel Ramirez, Gustavo Saposnik, Paula M. McLaughlin, Sean Symons, Bruce G. Pollock, Tarek K. Rajji, Michael Borrie, Mario Masellis, Stephen H. Pasternak, Andrew Frank, Dallas Seitz, Zahinoor Ismail, David F. Tang-Wai, Christopher J. M. Scott, Dar Dowlatshahi, Ayman Hassan, David G. Munoz, Luis Fornazzari, Corinne E. Fischer, Tom A. Schweizer","doi":"10.1002/gps.70075","DOIUrl":"https://doi.org/10.1002/gps.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mild Behavioral Impairment (MBI) is characterized by later-life emergent and persistent neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a potential precursor to various forms of dementia. This study explores the association between NPS and functional connectivity (FC) of the default mode network (DMN), executive control network (ECN), and salience network (SN) across three cohorts: mild cognitive impairment due to AD (MCI), cerebrovascular disease (CVD), and Parkinson's disease (PD). Additionally, the effect of CNS medication on NPS-FC associations was explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were recruited from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). NPS were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). We used dual regression to generate subject-specific whole-brain FC maps of the DMN, ECN, and SN. Using permutation testing we examined the association between NPS scores and FC maps at baseline (<i>n</i> = 349) and over a 2-year period (<i>n</i> = 225), controlling for age, sex, and years of education. A post-hoc linear model was used to assess the effect of CNS medication on each significant NPI-FC association within each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MCI group (<i>n</i> = 73), baseline disturbed nighttime behavior was positively correlated with functional connectivity (FC) between the anterior sensorimotor network. Longitudinally (<i>n</i> = 46), appetite changes were positively associated with FC between the anterior SN and fusiform gyrus. Disinhibition and apathy correlated with FC between the posterior SN and DMN. In the CVD group (<i>n</i> = 144), baseline anxiety was negatively associated with FC within the DMN and between the right ECN and DMN in the left hippocampus. Longitudinally (<i>n</i> = 99), agitation/aggression changes were negatively associated with FC between the right ECN and left anterior cerebellum. Irritability, the most common symptom in both MCI and CVD, did not have identifiable neural correlates, possibly due to its complexity or analysis limitations. In the PD group (<i>n</i> = 132), baseline disturbed nighttime behavior was positively associated with FC between the right ECN and DMN in the precuneus and left ECN and fusiform gyrus. Longitudinally (<i>n</i> = 80), changes in nighttime behavior correlated with FC between the left ECN and DMN in the precuneus. CNS medications had no effect on NPI-FC associations in the MCI group. In the CVD group, the absence of CNS medications was linked to decreased right ECN FC. In the PD group, Parkinson's ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846003","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}
Walter D. Dawson, Natasha Spoden, Sarah Gothard, Nora Mattek, Jeffrey Kaye, Kirsten Wright
<div> <section> <h3> Background</h3> <p>Wider screening and assessment for Alzheimer's disease and other related dementias (ADRD) may increase access to supportive care, improve allocation of medical care, and foster the use of interventions that prevent or delay disease progression. Yet, the effect of diagnostic timing on clinical and utilization outcomes is poorly understood. Community-based settings such as a hospital emergency department (ED) may be an underrecognized opportunity to assess cognition and impacts on individuals and health systems. This study assessed the feasibility of recruiting older adults for telephone-based trials following presentation to the ED and administering telephone based cognitive assessments over the phone in this population.</p> </section> <section> <h3> Methods</h3> <p>Medicare-enrolled individuals 65+ years of age (<i>n</i> = 160) presenting to the Oregon Health & Science University Emergency Department (Portland, Oregon) between May 2022 and February 2023 were recruited by telephone. Participants were administered the Telephone Interview for Cognitive Status (TICS) Assessment and the Patient Reported Outcomes Measurement Information System (PROMIS) Cognitive Measure Questions on Mental Clarity via telephone 1–12 weeks post-discharge to evaluate cognition. Electronic medical records (EMR) were reviewed for medical care utilization including primary care provider (PCP) visits, hospital admissions, and ED visits for the 3 years prior to ED presentation.</p> </section> <section> <h3> Results</h3> <p>Twenty-six percent of eligible ED users contacted elected for study enrollment. The TICS Assessment score had a significant relationship with the three evaluated health care utilization measures (ED, PCP visits, or hospitalizations); the PROMIS Assessment had significant but weak correlations to ED and PCP visits.</p> </section> <section> <h3> Conclusions</h3> <p>Older adults 65+ years presenting to the ED are amenable to enroll in telephone-based cognition-focused trials and cognitive assessments can be carried out over the telephone in this population. The PROMIS Assessment may be a better cognition assessment tool when evaluating for cognition and care utilization in this population. In addition to the limits of the screening tools used in this study, a lack of a representative sample is a limitation of the study design. Future studies could use other validated cognitive assessment tools and utilize a study design with a recruitment strategy focused on obtaining a representative sample of older ED patients.</p>
{"title":"Feasibility of Telephone-Based Cognitive Assessments and Healthcare Utilization in US Medicare-Enrolled Older Adults Following Emergency Department Discharge","authors":"Walter D. Dawson, Natasha Spoden, Sarah Gothard, Nora Mattek, Jeffrey Kaye, Kirsten Wright","doi":"10.1002/gps.70078","DOIUrl":"https://doi.org/10.1002/gps.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Wider screening and assessment for Alzheimer's disease and other related dementias (ADRD) may increase access to supportive care, improve allocation of medical care, and foster the use of interventions that prevent or delay disease progression. Yet, the effect of diagnostic timing on clinical and utilization outcomes is poorly understood. Community-based settings such as a hospital emergency department (ED) may be an underrecognized opportunity to assess cognition and impacts on individuals and health systems. This study assessed the feasibility of recruiting older adults for telephone-based trials following presentation to the ED and administering telephone based cognitive assessments over the phone in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medicare-enrolled individuals 65+ years of age (<i>n</i> = 160) presenting to the Oregon Health & Science University Emergency Department (Portland, Oregon) between May 2022 and February 2023 were recruited by telephone. Participants were administered the Telephone Interview for Cognitive Status (TICS) Assessment and the Patient Reported Outcomes Measurement Information System (PROMIS) Cognitive Measure Questions on Mental Clarity via telephone 1–12 weeks post-discharge to evaluate cognition. Electronic medical records (EMR) were reviewed for medical care utilization including primary care provider (PCP) visits, hospital admissions, and ED visits for the 3 years prior to ED presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six percent of eligible ED users contacted elected for study enrollment. The TICS Assessment score had a significant relationship with the three evaluated health care utilization measures (ED, PCP visits, or hospitalizations); the PROMIS Assessment had significant but weak correlations to ED and PCP visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older adults 65+ years presenting to the ED are amenable to enroll in telephone-based cognition-focused trials and cognitive assessments can be carried out over the telephone in this population. The PROMIS Assessment may be a better cognition assessment tool when evaluating for cognition and care utilization in this population. In addition to the limits of the screening tools used in this study, a lack of a representative sample is a limitation of the study design. Future studies could use other validated cognitive assessment tools and utilize a study design with a recruitment strategy focused on obtaining a representative sample of older ED patients.</p>\u0000 ","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840833","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}
Irina Mindlis, Dimitris Kiosses, M. Carrington Reid
{"title":"Primary Care Provider Perspectives on Depression Management in Older Adults With Multimorbidity","authors":"Irina Mindlis, Dimitris Kiosses, M. Carrington Reid","doi":"10.1002/gps.70073","DOIUrl":"https://doi.org/10.1002/gps.70073","url":null,"abstract":"","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840780","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}
Liqiong Zhou, Aijie Zhang, Qi Liu, Qianqian Ji, Meijie Ye, Yue Xu, Yasi Zhang, Yaxian Meng, Zhao Hu, Yiqiang Zhan
Objectives
Religious service attendance has previously been associated with greater levels of well-being, as well as milder symptoms of depression and anxiety. However, few studies have explored this association within the Amdo Tibetan population. This study aims to estimate the association between religious service attendance and psychiatric symptoms among older Amdo Tibetans.
Methods
A cross-sectional face-to-face field survey was conducted in the Tibetan Plateau of China, focusing on older Amdo Tibetans from May 21 to July 26, 2023. The study utilized self-reported data on religious service attendance (never, < 1/week, ≥ 1/week) alongside validated scales, including Center for Epidemiological Studies Depression-8 (CESD-8) and the Generalized Anxiety Disorder-7 (GAD-7), to assess depressive and anxiety symptoms. These instruments demonstrated robust psychometric validity. Generalized linear mixed models were used to estimate the odds ratio (OR) of depression and anxiety associated with religious service attendance, adjusting for potential confounders including sociodemographic characteristics, lifestyle factors, and medical history.
Results
This study included 538 older Amdo Tibetans, among whom the prevalence of depressive (scores ≥ 3) and anxiety symptoms (scores ≥ 5) was 46.10% and 24.91%, respectively. In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week showed significantly less severe symptoms of depression (OR = 0.43, 95% CI: 0.20, 0.96) and anxiety (OR = 0.20, 95% CI: 0.05, 0.75). Moreover, ≥ 1/week attendees (vs. never-attendees) also had lower levels of depression (OR = 0.64, 95% CI: 0.43, 0.96).
Conclusions
Our findings suggest that religious service attendance was associated with lower risks of depression and anxiety among older Amdo Tibetans. This highlights the importance of considering religious and spiritual practices as potential factors in promoting mental well-being, particularly within unique cultural and ethnic contexts such as the Amdo Tibetan community.
{"title":"Association Between Religious Service Attendance and Depression, Anxiety Among Older Amdo Tibetans","authors":"Liqiong Zhou, Aijie Zhang, Qi Liu, Qianqian Ji, Meijie Ye, Yue Xu, Yasi Zhang, Yaxian Meng, Zhao Hu, Yiqiang Zhan","doi":"10.1002/gps.70076","DOIUrl":"https://doi.org/10.1002/gps.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Religious service attendance has previously been associated with greater levels of well-being, as well as milder symptoms of depression and anxiety. However, few studies have explored this association within the Amdo Tibetan population. This study aims to estimate the association between religious service attendance and psychiatric symptoms among older Amdo Tibetans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional face-to-face field survey was conducted in the Tibetan Plateau of China, focusing on older Amdo Tibetans from May 21 to July 26, 2023. The study utilized self-reported data on religious service attendance (never, < 1/week, ≥ 1/week) alongside validated scales, including Center for Epidemiological Studies Depression-8 (CESD-8) and the Generalized Anxiety Disorder-7 (GAD-7), to assess depressive and anxiety symptoms. These instruments demonstrated robust psychometric validity. Generalized linear mixed models were used to estimate the odds ratio (OR) of depression and anxiety associated with religious service attendance, adjusting for potential confounders including sociodemographic characteristics, lifestyle factors, and medical history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 538 older Amdo Tibetans, among whom the prevalence of depressive (scores ≥ 3) and anxiety symptoms (scores ≥ 5) was 46.10% and 24.91%, respectively. In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week showed significantly less severe symptoms of depression (OR = 0.43, 95% CI: 0.20, 0.96) and anxiety (OR = 0.20, 95% CI: 0.05, 0.75). Moreover, ≥ 1/week attendees (vs. never-attendees) also had lower levels of depression (OR = 0.64, 95% CI: 0.43, 0.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that religious service attendance was associated with lower risks of depression and anxiety among older Amdo Tibetans. This highlights the importance of considering religious and spiritual practices as potential factors in promoting mental well-being, particularly within unique cultural and ethnic contexts such as the Amdo Tibetan community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830968","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}
Daphne Sze Ki Cheung, Hau Yi Jodie Tse, Paul Hong Lee, Ken Hok Man Ho, Xue Bai, Claudia Kam Yuk Lai
Objectives
To evaluate the feasibility of the Individualized Music Playlist based on Iso-Principle for de-escalating agitation of people with dementia and provide preliminary evidence about its efficacy.
Methods
The randomized participants listened to either a 30-min music playlist or a book-reading audio script twice weekly for six weeks, and when agitation occurred. Their agitation level was observed every 5 min from the beginning of an agitation episode for an hour to monitor its trajectory over a 2-week period. Multilevel models with maximum likelihood analysis was conducted. The frequency of agitation and other behavioural symptoms was assessed at baseline and the 6th week and analysed with Generalized Estimating Equations.
Results
Twenty-four participants were recruited, and 10 presented 36 agitation episodes during the first two weeks of observation. The recruitment and retention rates were 85.7% and 83.3%, respectively. A total of 97.2% of the intervention and control conditions were delivered as planned. The intervention was not more effective than the control condition in de-escalating agitation or reducing agitation and other behavioural symptoms. Overall, agitation symptoms were apparently alleviated in the first 10 min, with a decelerated pace observed thereafter.
Conclusions
The intervention was feasible, and its efficacy in de-escalating agitation is yet to be confirmed.
{"title":"Individualized Music Playlist Based on Iso-Principle for De-Escalating Agitation of People With Dementia: A Randomized Controlled Feasibility Study","authors":"Daphne Sze Ki Cheung, Hau Yi Jodie Tse, Paul Hong Lee, Ken Hok Man Ho, Xue Bai, Claudia Kam Yuk Lai","doi":"10.1002/gps.70070","DOIUrl":"https://doi.org/10.1002/gps.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility of the Individualized Music Playlist based on Iso-Principle for de-escalating agitation of people with dementia and provide preliminary evidence about its efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The randomized participants listened to either a 30-min music playlist or a book-reading audio script twice weekly for six weeks, and when agitation occurred. Their agitation level was observed every 5 min from the beginning of an agitation episode for an hour to monitor its trajectory over a 2-week period. Multilevel models with maximum likelihood analysis was conducted. The frequency of agitation and other behavioural symptoms was assessed at baseline and the 6th week and analysed with Generalized Estimating Equations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four participants were recruited, and 10 presented 36 agitation episodes during the first two weeks of observation. The recruitment and retention rates were 85.7% and 83.3%, respectively. A total of 97.2% of the intervention and control conditions were delivered as planned. The intervention was not more effective than the control condition in de-escalating agitation or reducing agitation and other behavioural symptoms. Overall, agitation symptoms were apparently alleviated in the first 10 min, with a decelerated pace observed thereafter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intervention was feasible, and its efficacy in de-escalating agitation is yet to be confirmed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717392","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}
Annelie Scharf, Bernhard Michalowsky, Anika Rädke, Fabian Kleinke, Stefanie Schade, Moritz Platen, Maresa Buchholz, Michelle Pfaff, Audrey Iskandar, Neeltje van den Berg, Wolfgang Hoffmann
<div> <section> <h3> Objectives</h3> <p>People with dementia often have various unmet care needs across physical, psychological, environmental, and social domains. There’s a need to explore the association between domains of unmet needs and characteristics of people with dementia. The aim of this paper was to describe the domains of unmet and met needs among community-dwelling people living with dementia, focusing on the home environment, physical, psychological, and social areas, and to identify sociodemographic, clinical, and health-related parameters associated with unmet needs.</p> </section> <section> <h3> Methods</h3> <p>We analyzed the InDePendent trial’s baseline data of <i>N</i> = 417 people with dementia. The Camberwell Assessment of Needs for the Elderly (CANE) was used to identify needs. Descriptive statistics were used to evaluate the distribution of needs and Logistic and Poisson regression models to detect sociodemographic and clinical factors associated with unmet needs in the four need domains.</p> </section> <section> <h3> Results</h3> <p>People with dementia were on average 80.6 years old, mostly female (56%) and mildly to moderately cognitively impaired (85%). 98.6% of the participants had at least one need, of which just over a third (36.5%) were rated as met and just under two-thirds (63.5%) as unmet. Lacking a care grade (access to social care) and low education were found to be risk factors for the occurrence of unmet needs in almost all areas. Factors such as increased medication use (OR = 1.10 [95%CI 1.02 to 1.19]) and loneliness (OR = 2.51 [95%CI 1.44 to 4.36]) were associated with a higher likelihood of unmet environmental needs. Similarly, the absence of a caregiver (OR = 2.81 [95%CI 1.03 to 7.64]), lower social support (OR = 1.71 [95%CI 1.02 to 2.84]), and poor physical health (OR = 8.40 [95%CI 3.39 to 20.81]) correlated with unmet physical needs. Participants living alone demonstrated higher levels of unmet physical needs (<i>β</i> = 0.27 [95%CI 0.01 to 0.53]). Depression (OR = 2.13 [95%CI 1.10 to 4.08]), living alone (OR = 1.73 [95%CI 1.04 to 2.86]) and poor physical health (OR = 2.82 [95%CI 1.15 to 6.93]) significantly increased the risk of unmet psychological needs. Social needs are more likely to be unmet in females (OR = 1.88 [95%CI 1.05 to 3.37]). Sensitivity analyses showed the positive effects of regular General Practitioner (GP) visits on the fulfillment of social needs (<i>β</i> = −0.61 [95%CI −1.01 to −0.22]).</p> </section> <section> <h3> Conclusion</h3> <p>Access to comprehensive care, for example, throug
{"title":"Identifying and Addressing Unmet Needs in Dementia: The Role of Care Access and Psychosocial Support","authors":"Annelie Scharf, Bernhard Michalowsky, Anika Rädke, Fabian Kleinke, Stefanie Schade, Moritz Platen, Maresa Buchholz, Michelle Pfaff, Audrey Iskandar, Neeltje van den Berg, Wolfgang Hoffmann","doi":"10.1002/gps.70066","DOIUrl":"https://doi.org/10.1002/gps.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>People with dementia often have various unmet care needs across physical, psychological, environmental, and social domains. There’s a need to explore the association between domains of unmet needs and characteristics of people with dementia. The aim of this paper was to describe the domains of unmet and met needs among community-dwelling people living with dementia, focusing on the home environment, physical, psychological, and social areas, and to identify sociodemographic, clinical, and health-related parameters associated with unmet needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the InDePendent trial’s baseline data of <i>N</i> = 417 people with dementia. The Camberwell Assessment of Needs for the Elderly (CANE) was used to identify needs. Descriptive statistics were used to evaluate the distribution of needs and Logistic and Poisson regression models to detect sociodemographic and clinical factors associated with unmet needs in the four need domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People with dementia were on average 80.6 years old, mostly female (56%) and mildly to moderately cognitively impaired (85%). 98.6% of the participants had at least one need, of which just over a third (36.5%) were rated as met and just under two-thirds (63.5%) as unmet. Lacking a care grade (access to social care) and low education were found to be risk factors for the occurrence of unmet needs in almost all areas. Factors such as increased medication use (OR = 1.10 [95%CI 1.02 to 1.19]) and loneliness (OR = 2.51 [95%CI 1.44 to 4.36]) were associated with a higher likelihood of unmet environmental needs. Similarly, the absence of a caregiver (OR = 2.81 [95%CI 1.03 to 7.64]), lower social support (OR = 1.71 [95%CI 1.02 to 2.84]), and poor physical health (OR = 8.40 [95%CI 3.39 to 20.81]) correlated with unmet physical needs. Participants living alone demonstrated higher levels of unmet physical needs (<i>β</i> = 0.27 [95%CI 0.01 to 0.53]). Depression (OR = 2.13 [95%CI 1.10 to 4.08]), living alone (OR = 1.73 [95%CI 1.04 to 2.86]) and poor physical health (OR = 2.82 [95%CI 1.15 to 6.93]) significantly increased the risk of unmet psychological needs. Social needs are more likely to be unmet in females (OR = 1.88 [95%CI 1.05 to 3.37]). Sensitivity analyses showed the positive effects of regular General Practitioner (GP) visits on the fulfillment of social needs (<i>β</i> = −0.61 [95%CI −1.01 to −0.22]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Access to comprehensive care, for example, throug","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 4","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717260","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}
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