International Journal of Geriatric Psychiatry最新文献

Exploring Determinants of Institutionalization Among Germany's Oldest Old 探索德国高龄老人入托的决定因素

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-22 DOI: 10.1002/gps.70024

Ruigang Wei

引用次数: 0

Plasminogen Activator Inhibitor-1 in the Pathophysiology of Late Life Depression 晚年抑郁症病理生理学中的凝血酶原激活物抑制剂-1

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-22 DOI: 10.1002/gps.70015

L. Métivier, D. Vivien, R. Goy, V. Agin, E. Bui, S. Benbrika

Introduction

Late life depression (LLD) is characterized by specific clinical features including a high frequency of vascular form and frequent antidepressant treatment resistance. The expression and functions of the serine protease inhibitor, Plasminogen Activator Inhibitor-1 (PAI-1) is known to be altered by aging, vascular damage, insulin levels associated with a sedentary lifestyle, chronic stress leading to hypercortisolemia, and inflammatory changes linked to stress responses. These phenomena would be implicated in LLD like vascular depression. This article thus aims to review the existing literature regarding the association between LLD and plasmatic levels of PAI-1, a marker of hypofibrinolysis. We hypothesize that increased age would be associated with changes in PAI-1 plasma level and function which influence LLD pathogenesis and its treatment.

Results

Although a large number of studies on PAI-1 changes in the elderly exist, studies about its implications in LLD are sparse. Despite heterogeneous findings regarding the direction of variation in plasmatic PAI-1 levels among elderly participants with LLD, all studies demonstrated an association between PAI-1 levels and current or remitted depressive symptoms. Moreover, disruptions in the concentrations of other biological markers influencing PAI-1 expression, such as cytokines or adipokines, were also observed, notably an increase in the levels of interleukins 6 and 8.

Discussion

LLD genesis appears to be influenced by PAI-1 regulatory loops which are implicated in senescence or cell death. The resistance to antidepressant treatment appears to be linked to distinct biological profiles involving inflammatory and fibrinolytic factors. Taken together these data suggest that PAI-1 pathway may be a promising target of treatment development efforts for LLD, and depression in general.

导言晚期抑郁症（LLD）具有特殊的临床特征，包括高频率的血管病变和频繁的抗抑郁治疗抵抗。众所周知，丝氨酸蛋白酶抑制剂--血浆酶原激活物抑制剂-1（PAI-1）的表达和功能会因衰老、血管损伤、与久坐生活方式相关的胰岛素水平、导致高皮质醇血症的慢性压力以及与压力反应相关的炎症变化而发生改变。这些现象都会牵连到类似血管抑郁的 LLD。因此，本文旨在回顾有关低密度脂蛋白血症与纤溶不足标志物 PAI-1 血浆水平之间关系的现有文献。我们假设年龄的增长与 PAI-1 血浆水平和功能的变化有关，而这些变化会影响 LLD 的发病机制和治疗。结果尽管存在大量有关老年人 PAI-1 变化的研究，但有关其对 LLD 影响的研究却很少。尽管关于患有 LLD 的老年人血浆 PAI-1 水平变化方向的研究结果不尽相同，但所有研究都表明 PAI-1 水平与当前或缓解的抑郁症状之间存在关联。此外，还观察到影响 PAI-1 表达的其他生物标记物（如细胞因子或脂肪因子）的浓度发生了变化，尤其是白细胞介素 6 和白细胞介素 8 的浓度增加。讨论 LLD 的形成似乎受到 PAI-1 调节环路的影响，而 PAI-1 与衰老或细胞死亡有关。抗抑郁剂治疗的抗药性似乎与涉及炎症和纤维蛋白溶解因子的不同生物特征有关。综上所述，这些数据表明 PAI-1 通路可能是开发治疗 LLD 和一般抑郁症的一个有希望的靶点。

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引用次数: 0

Female Reproductive Period Length, Parity and Hormonal Replacement Therapy and Dementia: The Elsi-Brazil Study 女性生殖期长度、奇偶性和荷尔蒙替代疗法与痴呆症：巴西埃尔西研究

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-22 DOI: 10.1002/gps.70023

Matheus Ghossain Barbosa, Ana Ágata Mezzomo Keinert, Andrew Christopher Claro Miguel, Marcos Antônio Costa Ferreira de Macêdo, Lucas Martins Teixeira, Laiss Bertola, Maria Fernanda Lima-Costa, Cleusa Pinheiro Ferri

Introduction

Alzheimer's disease and other dementia have a higher incidence among women and that risk factors specific to the female sex could be involved. Few studies looked into female reproductive factors and their association with dementia in low-and middle-income countries.

Materials and Methods

We analyzed the baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and included data from 2594 women aged 60 years and older. We used an algorithm approach to determine dementia status and performed logistic regressions using as predictors the self-reported total length of the reproductive period, total parity and use of hormonal replacement therapy. We also analyzed the effects of hormonal replacement therapy use for different age groups and the effects of number of living children.

Results

Reproductive period length, hormonal replacement therapy use and parity as a continuous measure were not significantly associated with dementia status. When compared with 0 births, the group with 5–8 had more dementia while the other groups displayed no differences. For the number of living children, but a higher occurrence of dementia was found among women with more children.

Conclusions

We did not find any association between continuous parity, reproductive period length or hormonal replacement therapy use and dementia. Social factors of motherhood appear to play an important role, and group specific effects of parity and hormonal replacement therapy require further study.

导言：阿尔茨海默病和其他痴呆症在女性中的发病率较高，这可能与女性特有的风险因素有关。在中低收入国家，很少有研究探讨女性生殖因素及其与痴呆症的关系。材料和方法我们分析了巴西老龄化纵向研究（ELSI-Brazil）的基线数据，其中包括 2594 名 60 岁及以上女性的数据。我们使用算法来确定痴呆状态，并使用自我报告的生育期总长度、总奇偶数和激素替代疗法的使用情况作为预测因素进行了逻辑回归。我们还分析了使用激素替代疗法对不同年龄组的影响以及对在世子女人数的影响。结果生育期长短、激素替代疗法的使用情况和作为连续测量指标的奇偶性与痴呆状态无明显关系。与 0 次分娩相比，5-8 次分娩组患痴呆症的人数较多，而其他组别则没有差异。就在世子女数量而言，子女较多的妇女患痴呆症的比例较高。结论我们没有发现连续奇偶数、生育期长短或使用荷尔蒙替代疗法与痴呆症之间有任何关联。做母亲的社会因素似乎起着重要作用，而奇偶性和荷尔蒙替代疗法对特定群体的影响还需要进一步研究。

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引用次数: 0

Comparative Post-Marketing Surveillance of Memantine and Cholinesterase Inhibitors: Cardiovascular Adverse Events With a Focus on Sex Differences Using the FDA Adverse Event Reporting System Database 美金刚和胆碱酯酶抑制剂上市后监测比较：使用 FDA 不良事件报告系统数据库，关注心血管不良事件的性别差异。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-19 DOI: 10.1002/gps.70018

Zinnet Şevval Aksoyalp, Dilara Nemutlu-Samur

Objectives

The aim of this study was to conduct a comparative analysis of the proportion of cardiovascular adverse events (AEs) associated with the utilization of memantine and cholinesterase inhibitors and to highlight the potential impact of sex differences in these AEs.

Methods

Cardiac and vascular disorders AEs with antidementia medications were obtained from the FDA Adverse Event Reporting System database. The reporting odds ratio and its corresponding 95% confidence intervals were calculated. The chi-squared test was used to evaluate differences in categorical variables, and a two-way ANOVA followed by a Bonferroni post-test was used to compare the AEs reported for antidementia medications.

Results

Memantine was associated with 544 selected cardiac and vascular disorder AEs. A signal for bradycardia, myocardial infarction, atrial fibrillation and cardiac arrest has been observed in patients receiving choline esterase inhibitors compared to those receiving memantine. On the other hand, cardiac failure and deep vein thrombosis AEs were found to be more common in patients receiving memantine. The majority of reported cardiac and vascular AEs were reported more frequently in female patients. More cases of cardiac failure, cardiac arrest, and deep vein thrombosis were reported in females than males taking memantine, but bradycardia was more common in males than females.

Conclusion

Healthcare professionals should be aware of the potential for cardiovascular AEs during treatment with antidementia medications and the possibility of sex differences in this regard. Memantine differs from cholinesterase inhibitors in terms of cardiovascular AEs, and there may be sex-related differences in the proportion of these AEs.

研究目的本研究的目的是对美金刚和胆碱酯酶抑制剂的心血管不良事件（AEs）比例进行比较分析，并强调性别差异对这些不良事件的潜在影响：方法：从美国食品和药物管理局不良事件报告系统数据库中获取抗痴呆药物引起的心脏和血管疾病不良事件。计算报告的几率比例及其相应的 95% 置信区间。采用卡方检验评估分类变量的差异，采用双向方差分析和Bonferroni后检验比较抗痴呆药物的AEs报告：结果：美金刚与 544 例选定的心脏和血管紊乱 AEs 有关。与服用美金刚的患者相比，服用胆碱酯酶抑制剂的患者出现心动过缓、心肌梗塞、心房颤动和心跳骤停的信号。另一方面，心力衰竭和深静脉血栓 AEs 在接受美金刚的患者中更为常见。大多数报告的心脏和血管不良反应在女性患者中更为常见。与男性相比，服用美金刚的女性发生心力衰竭、心跳骤停和深静脉血栓的病例更多，但男性心动过缓的发生率高于女性：结论：医护人员应注意在使用抗痴呆药物治疗期间可能出现的心血管不良反应，以及在这方面可能存在的性别差异。美金刚与胆碱酯酶抑制剂的心血管不良反应不同，这些不良反应的比例可能存在性别差异。

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引用次数: 0

Balancing Duty, Stigma, and Caregiving Needs of People With Neurodevelopmental or Neurocognitive Disorders During a Public Health Emergency in South Asia: A Qualitative Study of Carer Experiences 在南亚突发公共卫生事件中平衡神经发育障碍或神经认知障碍患者的责任、耻辱感和护理需求：对照顾者经历的定性研究》。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-18 DOI: 10.1002/gps.70010

Anna Tjin, Anna Goodwin, Carol Troy, Selvie Yeo, Sanjib Saha, Roger O'Sullivan, Iracema Leroi, Yaohua Chen, the CLIC Caregiver Study Group

Objective

Individuals with neurodevelopmental and/or neurocognitive disorders (NNDs) have complex, long-term care needs. In Bangladesh, India, and Pakistan, informal carers shoulder the responsibility and strain of providing care for people with NNDs. Intense care demand, societal and cultural care expectations, and lack of support infrastructure often lead to psychosocial strain in this inadequately researched community, particularly during crises such as the COVID-19 pandemic. This study explored and identified specific features of the coping styles exhibited by informal carers of people with NNDs from Bangladesh, India, and Pakistan during the COVID-19 pandemic.

Material and methods

Between June and November 2020, 245 carers in India, Pakistan, and Bangladesh responded to open-ended questions in the CLIC (Coping with Loneliness, Isolation, and COVID-19) survey. A reflexive thematic analysis was conducted to uncover the underlying themes and identify coping strategies and stressors. A frequency analysis was performed to examine the associations between these themes and carer nationality. Significant tests identified coping styles.

Results

We identified three coping styles: religiosity (Pakistan), caregiving as a natural life path (Bangladesh), and self-care (India). The religiosity and natural life path styles reside on the fatalism/acceptance continuum and suggest an insight-oriented therapeutic approach. Self-care is a problem-solving strategy that calls for a behaviorally oriented approach. Family overreliance on the carer was a concern across all three groups.

Conclusions

The findings underscore the need for accessible support pathways to sustain care standards, ensuring the well-being of carers and care recipients.

目的：神经发育障碍和/或神经认知障碍（NNDs）患者有复杂的长期护理需求。在孟加拉国、印度和巴基斯坦，非正规照护者承担着照护 NNDs 患者的责任和压力。密集的护理需求、社会和文化对护理的期望以及支持性基础设施的缺乏，往往会导致这一研究不足的社区出现社会心理压力，尤其是在 COVID-19 大流行等危机期间。本研究探讨并确定了 COVID-19 大流行期间孟加拉国、印度和巴基斯坦 NND 患者的非正式照护者所表现出的应对方式的具体特征：2020 年 6 月至 11 月间，印度、巴基斯坦和孟加拉国的 245 名照护者回答了 CLIC（应对孤独、隔离和 COVID-19）调查中的开放式问题。我们进行了反思性主题分析，以揭示潜在主题并确定应对策略和压力源。此外，还进行了频率分析，以研究这些主题与照顾者国籍之间的关联。通过显著性检验确定了应对方式：我们确定了三种应对方式：宗教信仰（巴基斯坦）、将照顾作为一种自然的生活方式（孟加拉国）和自我照顾（印度）。宗教信仰和自然生活方式属于宿命论/接受连续体，建议采用以洞察力为导向的治疗方法。自我照顾是一种解决问题的策略，需要采用行为导向的方法。家庭对照顾者的过度依赖是所有三个群体都关注的问题：研究结果表明，有必要提供便捷的支持途径，以维持护理标准，确保照护者和受照护者的福祉。

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引用次数: 0

Childhood Peer Relationships and Dementia Risk in Chinese Older Adults: A Mediation Analysis 中国老年人的童年同伴关系与痴呆症风险：中介分析

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-18 DOI: 10.1002/gps.70022

Zi Zhou, Haoyu Zhao

Background

Early-life social experiences significantly influence later-life health, yet the association between childhood peer relationships and dementia, as well as the underlying mechanisms, remains underexplored. This study aimed to investigate this association and the mediating roles of social disengagement and loneliness.

Methods

Leveraging data from 7574 adults aged ≥ 60 in the China Health and Retirement Longitudinal Study (2011–2018), we employed marginal structural models to assess the associations between childhood peer relationships and dementia risk in later life. Inverse odds ratio weighting was used to examine the mediating roles of formal and informal social disengagement and loneliness.

Results

Individuals with deficits in childhood peer relationships had a higher risk of dementia (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.10–1.34) compared with those with more positive experiences. This association was partially mediated by formal social disengagement (proportion mediated, 21.44%; 95% CI, 12.20%–40.94%), loneliness (proportion mediated, 22.00%; 95% CI, 13.42%–33.82%), and their combination with informal social disengagement (proportion mediated, 41.50%; 95% CI, 30.76%–66.07%). Informal social disengagement alone did not show a significant mediating effect.

Conclusions

In this cohort study of older Chinese adults, negative childhood peer relationship experiences were associated with an elevated risk of dementia in later life. Formal social disengagement and loneliness partially mediated this association. These findings underscore the importance of fostering positive social relationships in early life and suggest potential psychosocial strategies to mitigate dementia risk in older adults due to childhood peer relationship deficits.

背景：早年的社会经历会对晚年的健康产生重大影响，但童年同伴关系与痴呆症之间的关联及其内在机制仍未得到充分探讨。本研究旨在探讨这种关联以及脱离社会和孤独的中介作用：利用中国健康与退休纵向研究（2011-2018年）中7574名年龄≥60岁的成年人的数据，我们采用边际结构模型来评估童年同伴关系与晚年痴呆风险之间的关联。我们采用反比例加权法研究了正式和非正式社会脱离与孤独的中介作用：结果：童年时期同伴关系有缺陷的人与有更多积极经历的人相比，患痴呆症的风险更高（几率比 [OR]，1.21；95% 置信区间 [CI]，1.10-1.34）。这种关联部分受到正式脱离社会（调解比例为 21.44%；95% CI，12.20%-40.94%）、孤独（调解比例为 22.00%；95% CI，13.42%-33.82%）以及它们与非正式脱离社会的组合（调解比例为 41.50%；95% CI，30.76%-66.07%）的影响。单独的非正式社会脱离并未显示出明显的中介效应：结论：在这项针对中国老年人的队列研究中，童年时期的负面同伴关系经历与晚年痴呆症风险的升高有关。正式脱离社会和孤独感在一定程度上调节了这种关联。这些发现强调了在生命早期培养积极的社会关系的重要性，并提出了潜在的社会心理策略，以降低老年人因童年同伴关系缺陷而患痴呆症的风险。

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引用次数: 0

Association of Psychotropic Prescriptions With Non-Registered Indications and the Risk of Mortality in Older Adults: A Danish Nationwide Cohort Study 非注册适应症的精神药物处方与老年人死亡风险的关系：丹麦全国队列研究》。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-16 DOI: 10.1002/gps.70014

Kazi Ishtiak-Ahmed, Christina Jensen-Dahm, Kaj Sparle Christensen, Gunhild Waldemar, Christiane Gasse

Background and Objective

Psychotropic drug use is common in older adults, with off-label use reported despite limited understanding of the safety outcomes compared to on-label use. Incomplete recordings of treatment indications in the Danish National Prescription Register (DNPR) raise concerns about potential off-label medication use, particularly among older adults. We, therefore, investigated the association between psychotropic prescriptions with non-registered indications in DNPR and the 1-year all-cause mortality in older adults, including subgroups with any psychiatric disorders, depression, or dementia.

Methods

Register-based cohort study following all older adults (≥ 65) who redeemed a first-time (since 1995) prescription of either antidepressants, antipsychotics, or benzodiazepine during 2006–2017. Redemption of a prescription with non-registered indications in the DNPR was the exposure. The outcome, 1-year all-cause mortality was analyzed using Poisson regression, estimating incidence rate ratios with 95% confidence intervals, adjusting for socio-demographics and clinical factors.

Results

32% of prescriptions filled by 202,067 individuals for antidepressants, 37% of 97,387 for antipsychotics, and 22% of 130,471 for benzodiazepines had non-registered indications. No significant differences in mortality rates were found for antidepressants and antipsychotics with non-registered indications, while higher mortality rates were associated with benzodiazepines, mitigated when excluding individuals receiving intravenous administrations representing end-of-life treatment. The results remained consistent in subgroup analyses in patients with any psychiatric disorders, depression, or dementia and further stratified analyses by sex and age.

Conclusions

We found that while psychotropic prescriptions with non-registered indications in DNPR were prevalent in older adults, they were not associated with excess mortality.

背景和目的：精神药物的使用在老年人中很常见，尽管与标签内用药相比，人们对标签外用药的安全结果了解有限，但仍有标签外用药的报道。丹麦国家处方登记册》（Danish National Prescription Register，DNPR）对治疗适应症的记录不完整，这引起了人们对潜在的标示外用药的担忧，尤其是在老年人中。因此，我们调查了丹麦国家处方登记册中未登记适应症的精神药物处方与老年人（包括患有任何精神疾病、抑郁症或痴呆症的亚组）1 年全因死亡率之间的关系：以登记为基础的队列研究，追踪 2006-2017 年间首次（自 1995 年以来）兑换抗抑郁药、抗精神病药或苯二氮卓处方的所有老年人（≥ 65 岁）。在 DNPR 中未注册适应症的处方兑换为暴露。结果采用泊松回归法分析了1年全因死亡率，估算了发病率比和95%置信区间，并对社会人口统计学和临床因素进行了调整：202,067人开具的抗抑郁药处方中有32%、抗精神病药处方中有97,387人开具了37%、苯二氮卓类药物处方中有130,471人开具了22%的非注册适应症处方。未注册适应症的抗抑郁药和抗抑郁药的死亡率没有发现明显差异，而苯二氮卓类药物的死亡率较高，但在排除代表临终治疗的静脉给药个体后，死亡率有所降低。在对患有任何精神疾病、抑郁症或痴呆症的患者进行亚组分析以及按性别和年龄进一步分层分析后，结果仍然一致：我们发现，虽然未在 DNPR 中登记适应症的精神药物处方在老年人中很普遍，但它们与超额死亡率无关。

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引用次数: 0

Comparing 30 Versus 60 min Cognitively Loaded Physical Exercise on Cognitive Function and Physical Health in Community-Dwelling Older Adults With Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial 比较 30 分钟与 60 分钟认知负荷体育锻炼对社区居住的轻度认知障碍老年人的认知功能和身体健康的影响：双盲随机对照试验》。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-12 DOI: 10.1002/gps.70012

Sung-Hyeon Kim, Ho-Jin Shin, Ji-Eun Baek, Ji Young Park, May Kim, Suk-Chan Hahm, Hwi-Young Cho

<div> <section> <h3> Objectives</h3> <p>Mild cognitive impairment (MCI) is characterized by a mild decline in cognitive function and represents a risk stage for dementia in community-dwelling older adults. Exercise and dual-task training have been used to improve physical health, psychosocial health, and cognitive and learning functions in various subjects. However, the optimal time for these interventions has yet to be clearly identified. This study investigated the effects of cognitively loaded physical exercise (CLPE) on cognitive function and physical health in community-dwelling older adults with mild cognitive impairment and compared the differences according to exercise time.</p> </section> <section> <h3> Methods</h3> <p>Fifty-one community-dwelling aged 60 years or older with MCI were randomly assigned to 30-min CLPE (30CLPE, <i>n</i> = 17), 60-min CLPE (60CLPE, <i>n</i> = 17), and control (<i>n</i> = 17) groups. The CLPE program consisted of a twice-weekly exercise program for 8 weeks. During the exercise, a dual task was performed to assess cognitive load. The control group performed a typical exercise program at a dementia center during the same period. The Korean version of the Montreal Cognitive Assessment was used to evaluate cognitive function, and various physical health factors were assessed using the handgrip dynamometer and pinch gauge, Senior Fitness Test, dynamic and static balance abilities, and gait variables.</p> </section> <section> <h3> Results</h3> <p>After the intervention, both the 30CLPE and 60CLPE groups showed significant improvements in cognitive function, upper limb strength, senior fitness, balance, and gait (<i>p</i> < 0.05), while the control group showed no significant changes in any of the variables (<i>p</i> > 0.05). In between-group comparisons, both CLPE groups showed significantly improved cognitive and physical functions compared to the control group (<i>p</i> < 0.05). However, there was no significant difference between the 30 CLPE and 60 CLPE groups (<i>p</i> > 0.05).</p> </section> <section> <h3> Conclusions</h3> <p>The results of this study demonstrate that cognitively loaded physical exercise is effective in improving cognitive and physical function in individuals with MCI. Both the 30-min and 60-min sessions resulted in significant improvements, with no statistically significant differences observed between the two durations. This suggests that persistence and consistency of exercise may be more important than the duration of individual sessions.</p> </section> <section> <h3> Trial Registration</h3>

目的：轻度认知障碍（MCI）的特点是认知功能轻度下降，是社区老年人患痴呆症的风险阶段。运动和双任务训练已被用于改善不同对象的身体健康、社会心理健康以及认知和学习功能。然而，这些干预措施的最佳时机尚未明确。本研究调查了认知负荷体育锻炼（CLPE）对患有轻度认知障碍的社区老年人的认知功能和身体健康的影响，并比较了不同锻炼时间的差异：51名60岁或以上患有MCI的社区居民被随机分配到30分钟CLPE组（30CLPE，n = 17）、60分钟CLPE组（60CLPE，n = 17）和对照组（n = 17）。CLPE计划包括每周两次的锻炼计划，为期8周。在运动过程中，进行双重任务以评估认知负荷。对照组则在同一时期在痴呆症中心进行典型的锻炼计划。韩文版蒙特利尔认知评估用于评估认知功能，而各种身体健康因素则通过手握式测力计和捏力计、老年体能测试、动态和静态平衡能力以及步态变量进行评估：干预后，30CLPE 组和 60CLPE 组在认知功能、上肢力量、老年体能、平衡能力和步态方面均有显著改善（P0.05）。在组间比较中，与对照组相比，CLPE 组的认知功能和身体功能均有明显改善（P 0.05）：本研究结果表明，认知负荷体育锻炼能有效改善 MCI 患者的认知和身体功能。30 分钟和 60 分钟的锻炼都能显著改善患者的认知和身体功能，两种锻炼时间之间没有统计学上的显著差异。这表明，运动的持久性和连贯性可能比单个疗程的持续时间更重要：试验注册：Clinical Trials.gov：试验注册：Clinical Trials.gov：KCT0009053。

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引用次数: 0

Family Care Partner's Preparedness in Caring for Hospitalized Persons With Dementia 家庭护理伙伴在护理住院痴呆症患者时的准备情况。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-10 DOI: 10.1002/gps.70013

Anju Paudel, Azza Mubarak Al Harrasi, Ashley Kuzmik, Diane Berish, Ahmed-Rufai Yahaya, Marie Boltz

Objectives

To examine care partner preparedness in caring for recently hospitalized persons with dementia and care partner characteristics associated with preparedness at discharge, 2 months, and 6 months post discharge.

Methods

Stepwise regression in a sample of 461 care partners of hospitalized persons with dementia who participated in the Fam-FFC clinical trial.

Results

On average, care partners were 61.81 years old (SD = 14.19) and primarily female (n = 334, 72.5%). Care partners reported having some preparedness in general and it increased from discharge (23.75, SD = 6.78) to 2 months (24.5, SD = 6.49) and 6 months (26.35, SD = 6.73). Multiple care partner characteristics were associated with preparedness at discharge [age (b = −0.071; p < 0.001), burden (b = −0.283; p < 0.001), and depression (b = −0.284; p < 0.01)], 2 months [burden (b = −0.226; p < 0.001), strain (b = −0.144; p < 0.05), depression (b = −0.185; p < 0.05)] and 6 months [burden (b = −0.164; p < 0.01), strain (b = −0.183; p < 0.05), depression (b = −0.279; p < 0.01)] post discharge. While care partners' feelings of greater burden and depression were associated with lower preparedness at all time points, care partners' higher age was associated with lower preparedness at discharge only and care partners' feelings of higher strain was associated with lower preparedness at two and 6 months post discharge.

Conclusion

Findings suggest the need to address care partners' feelings of burden, strain, and depression with tailored interventions and programs to optimize their preparedness in meeting unique care needs of hospitalized persons with dementia. Resilience-based interventions and programs can be useful to manage feelings of burden, strain, and depression and optimize preparedness.

目的研究护理伙伴在护理刚住院的痴呆症患者时的准备情况，以及出院时、出院后2个月和6个月时与准备情况相关的护理伙伴特征：方法：对参加 Fam-FFC 临床试验的 461 名住院痴呆症患者的护理伙伴样本进行逐步回归：护理伙伴的平均年龄为 61.81 岁（SD = 14.19），以女性为主（n = 334，72.5%）。护理伙伴报告说，他们一般都有一定的准备，而且从出院（23.75，SD = 6.78）到 2 个月（24.5，SD = 6.49）和 6 个月（26.35，SD = 6.73），准备程度都有所提高。护理伙伴的多个特征与出院时的准备情况有关[年龄（b = -0.071; p 结论：护理伙伴的特征与出院时的准备情况有关]：研究结果表明，有必要通过量身定制的干预措施和计划来解决护理伙伴的负担感、压力感和抑郁感，以优化他们的准备状态，满足住院痴呆症患者的独特护理需求。以复原力为基础的干预措施和计划可以有效控制负担感、压力感和抑郁感，并优化准备状态。

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引用次数: 0

Loneliness as a Predictor of Disability in Older Adults: Implications of the UCLA Loneliness Scale Cutoff Score Across Cultural Contexts 孤独是老年人残疾的预测因素：不同文化背景下加州大学洛杉矶分校孤独感量表临界值的意义》（UCLA Loneliness Scale Cutoff Score Implications Across Cultural Contexts）。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2024-11-08 DOI: 10.1002/gps.70011

Ju-Ling Chiu, Lien-Chung Wei

Background

This letter responds to the study by Tomida et al. (2024) that validates the optimal cutoff score for the UCLA Loneliness Scale (UCLA-LS) to predict disability among older Japanese adults. The study identifies a cutoff score of 44, providing a significant indicator for the early detection of at-risk individuals.

Objective

To discuss the implications of the identified cutoff score for public health and clinical practice, including its potential for early intervention and cross-cultural validation.

Methods

This commentary critically analyzes the findings of Tomida et al. (2024) and situates them within the broader literature on loneliness, disability, and aging. It also considers the multifactorial aspects of loneliness and disability in older adults.

Results

The UCLA-LS cutoff score of 44 serves as a practical benchmark for clinicians, which can be integrated into routine health assessments to identify individuals at risk. We underscore the need for additional research on cross-cultural validation and mechanisms linking loneliness to disability.

Conclusion

We advocate for incorporating social support measures into standard care for older adults to mitigate the effects of loneliness on disability. This letter suggests future research directions, including exploring the causal pathways between loneliness and disability and developing culturally appropriate interventions.

背景：这封信回应了 Tomida 等人（2024 年）的研究，该研究验证了 UCLA 孤独量表（UCLA-LS）预测日本老年人残疾的最佳临界值。该研究确定了 44 分的临界值，为早期发现高危人群提供了一个重要指标：讨论所确定的临界值对公共卫生和临床实践的影响，包括其早期干预和跨文化验证的潜力：本评论对 Tomida 等人（2024 年）的研究结果进行了批判性分析，并将其置于有关孤独、残疾和老龄化的更广泛的文献中。它还考虑了老年人孤独和残疾的多因素方面：结果：UCLA-LS 的临界值 44 分可作为临床医生的实用基准，将其纳入常规健康评估以识别高危人群。我们强调需要对跨文化验证以及孤独与残疾的关联机制进行更多研究：我们主张将社会支持措施纳入老年人的标准护理中，以减轻孤独对残疾的影响。这封信提出了未来的研究方向，包括探索孤独与残疾之间的因果关系，以及开发适合不同文化的干预措施。

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引用次数: 0