Judith E. Bosmans, Iris van der Heide, Hein P. J. van Hout, Karlijn J. Joling
Objectives
To provide insight into the health and social care costs during the disease trajectory in persons with dementia and the impact of institutionalization and death on healthcare costs compared with matched persons without dementia.
Methods
Electronic health record data from family physicians were linked with national administrative databases to estimate costs of primary care, medication, secondary care, mental care, home care and institutional care for people with dementia and matched persons from the year before the recorded dementia diagnosis until death or a maximum of 4 years after the diagnosis.
Results
Total mean health and social care costs among persons with dementia increased substantially during the disease trajectory, mainly due to institutional care costs. For people who remained living in the community, mean health and social care costs are higher for people with dementia than for those without dementia, while for those who are admitted to a long-term care facility, mean health and social care costs are higher for people without dementia than for those with dementia.
Conclusions
The steep rise in health and social care costs across the dementia care trajectory is mainly due to increasing costs for institutional care. For those remaining in the community, home care costs and hospital care costs were the main cost drivers. Future research should adopt a societal perspective to investigate the influence of including social costs.
{"title":"Costs of care trajectories of people with dementia compared with matched controls. Longitudinal analysis of linked health and administrative data","authors":"Judith E. Bosmans, Iris van der Heide, Hein P. J. van Hout, Karlijn J. Joling","doi":"10.1002/gps.6094","DOIUrl":"https://doi.org/10.1002/gps.6094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To provide insight into the health and social care costs during the disease trajectory in persons with dementia and the impact of institutionalization and death on healthcare costs compared with matched persons without dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic health record data from family physicians were linked with national administrative databases to estimate costs of primary care, medication, secondary care, mental care, home care and institutional care for people with dementia and matched persons from the year before the recorded dementia diagnosis until death or a maximum of 4 years after the diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total mean health and social care costs among persons with dementia increased substantially during the disease trajectory, mainly due to institutional care costs. For people who remained living in the community, mean health and social care costs are higher for people with dementia than for those without dementia, while for those who are admitted to a long-term care facility, mean health and social care costs are higher for people without dementia than for those with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The steep rise in health and social care costs across the dementia care trajectory is mainly due to increasing costs for institutional care. For those remaining in the community, home care costs and hospital care costs were the main cost drivers. Future research should adopt a societal perspective to investigate the influence of including social costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648144","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}
Neurological conditions such as Alzheimer's disease and stroke represent a substantial health burden to the world's ageing population. Cerebrovascular dysfunction is a key contributor to these conditions, affecting an individual's risk profile, age of onset, and severity of neurological disease. Recent data shows that early-life events, such as maternal health during pregnancy, birth weight and exposure to environmental toxins can ‘prime’ the vascular system for later changes. With age, blood vessels can become less flexible and more prone to damage. This can lead to reduced blood flow to the brain, which is associated with cognitive decline and an increased risk of stroke and other cerebrovascular diseases. These in turn increase the risk of vascular dementia and Alzheimer's disease.
Objectives
We aim to explore how early life factors influence cerebrovascular health, ageing and disease.
Methods
We have reviewed recently published literature from epidemiological studies, clinical cases and basic research which explore mechanisms that contribute to cerebrovascular and blood-brain barrier dysfunction, with a particularly focus on those that assess contribution of early-life events or vascular priming to subsequent injury.
Results
Perinatal events have been linked to acute cerebrovascular dysfunction and long-term structural reorganisation. Systemic disease throughout the lifetime that produce inflammatory or oxidative stress may further sensitise the cerebrovasculature to disease and contribute to neurodegeneration.
Conclusions
By identifying these early-life determinants and understanding their mechanisms, scientists aim to develop strategies for preventing or mitigating cerebrovascular ageing-related issues.
{"title":"Developmental priming of early cerebrovascular ageing: Implications across a lifetime","authors":"Helen B. Stolp, Egle Solito","doi":"10.1002/gps.6090","DOIUrl":"https://doi.org/10.1002/gps.6090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neurological conditions such as Alzheimer's disease and stroke represent a substantial health burden to the world's ageing population. Cerebrovascular dysfunction is a key contributor to these conditions, affecting an individual's risk profile, age of onset, and severity of neurological disease. Recent data shows that early-life events, such as maternal health during pregnancy, birth weight and exposure to environmental toxins can ‘prime’ the vascular system for later changes. With age, blood vessels can become less flexible and more prone to damage. This can lead to reduced blood flow to the brain, which is associated with cognitive decline and an increased risk of stroke and other cerebrovascular diseases. These in turn increase the risk of vascular dementia and Alzheimer's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to explore how early life factors influence cerebrovascular health, ageing and disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We have reviewed recently published literature from epidemiological studies, clinical cases and basic research which explore mechanisms that contribute to cerebrovascular and blood-brain barrier dysfunction, with a particularly focus on those that assess contribution of early-life events or vascular priming to subsequent injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Perinatal events have been linked to acute cerebrovascular dysfunction and long-term structural reorganisation. Systemic disease throughout the lifetime that produce inflammatory or oxidative stress may further sensitise the cerebrovasculature to disease and contribute to neurodegeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By identifying these early-life determinants and understanding their mechanisms, scientists aim to develop strategies for preventing or mitigating cerebrovascular ageing-related issues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559495","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}
Nobuhiro Handa, Tatsuro Ishizaki, Seigo Mitsutake, Koki Ono, Masahiro Akishita
Objective
The purpose of the study is to assess if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture among relatively healthy individuals aged 75 years or older who lead independent lives in the community.
Method and Patients
Of the adults aged 75 years or older residing in Hokkaido prefecture of Japan (n = 705,538), those who did not meet several exclusion criteria were eligible for generating propensity score-matched cohorts (n = 214,723). Exclusion criteria included co-prescribed medications acting on the central nervous system, diagnoses of malignant neoplasm, dementia, depression, etc. We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score-matched cohort without a prescription (control group). Participants were followed for more than 42 months.
Results
During the 42-month follow-up period, the incidence of the three outcome measures in the hypnotics group was significantly higher than that in the control group (aspiration pneumonia p < 0.001, hip fracture p = 0.007, and all-cause mortality p < 0.001). Sensitivity analyses utilizing inverse probability weighting demonstrated hazard ratios of 1.083 [1.023–1.146] for mortality, 1.117 [1.014–1.230] for aspiration pneumonia, and 1.720 [1.559–1.897] for hip fracture. Meanwhile, the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient-years, respectively.
Conclusions
Although daily use of hypnotics increased the risk of three events, their attribute risk differences were fewer than 3.0 per 1000 patient-years. The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community.
{"title":"Safety profile of hypnotics or sedatives on community-dwelling older adults aged 75 or older in Japan: A retrospective propensity-matched cohort study","authors":"Nobuhiro Handa, Tatsuro Ishizaki, Seigo Mitsutake, Koki Ono, Masahiro Akishita","doi":"10.1002/gps.6085","DOIUrl":"https://doi.org/10.1002/gps.6085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of the study is to assess if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture among relatively healthy individuals aged 75 years or older who lead independent lives in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method and Patients</h3>\u0000 \u0000 <p>Of the adults aged 75 years or older residing in Hokkaido prefecture of Japan (<i>n</i> = 705,538), those who did not meet several exclusion criteria were eligible for generating propensity score-matched cohorts (<i>n</i> = 214,723). Exclusion criteria included co-prescribed medications acting on the central nervous system, diagnoses of malignant neoplasm, dementia, depression, etc. We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score-matched cohort without a prescription (control group). Participants were followed for more than 42 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the 42-month follow-up period, the incidence of the three outcome measures in the hypnotics group was significantly higher than that in the control group (aspiration pneumonia <i>p</i> < 0.001, hip fracture <i>p</i> = 0.007, and all-cause mortality <i>p</i> < 0.001). Sensitivity analyses utilizing inverse probability weighting demonstrated hazard ratios of 1.083 [1.023–1.146] for mortality, 1.117 [1.014–1.230] for aspiration pneumonia, and 1.720 [1.559–1.897] for hip fracture. Meanwhile, the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient-years, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although daily use of hypnotics increased the risk of three events, their attribute risk differences were fewer than 3.0 per 1000 patient-years. The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical trial registration</h3>\u0000 \u0000 <p>UMIN-CTR UMIN000048398.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140556333","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}
There is a paucity of population-level data on marijuana use and mental health and functioning in older adults.
Methods
We analyzed cross-sectional data (n = 910) from a well-characterized cohort, the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study. MYHAT is an age-stratified random sample of the population age 65 years and older from a small-town in the USA. Half the sample was female and half were over 75 (Mean age = 77). Most participants were non-Hispanic White. Marijuana use was assessed by self-report and symptoms of mood disorders were screened using the modified Centers for Epidemiological Studies-Depression Scale and the Generalized Anxiety Disorder screener. Cognition was assessed by the Mini-Mental State Examination and a neuropsychological test battery; functioning using the OARS Activities of Daily Living and Instrumental Activities of Daily Living; and overall assessment using the Clinical Dementia Rating (CDR®).
Results
One in five MYHAT participants had a history of marijuana use and 5% reported recent use, primarily for pain (41%) and recreation/relaxation (37%). Recent use was associated with cigarette and alcohol use, symptoms of depression or anxiety, and impairments in attention.
Conclusions
Twenty-percent of community-dwelling older adults living in a US state where recreational marijuana use is illegal had a history of marijuana use. Recent marijuana use was less common but, consistent with prior research, associated with other substance use and poorer mental health.
{"title":"Marijuana use among community-dwelling older adults: A population-based study","authors":"Natacha M. De Genna, Erin Jacobsen, Mary Ganguli","doi":"10.1002/gps.6086","DOIUrl":"https://doi.org/10.1002/gps.6086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is a paucity of population-level data on marijuana use and mental health and functioning in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed cross-sectional data (<i>n</i> = 910) from a well-characterized cohort, the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study. MYHAT is an age-stratified random sample of the population age 65 years and older from a small-town in the USA. Half the sample was female and half were over 75 (Mean age = 77). Most participants were non-Hispanic White. Marijuana use was assessed by self-report and symptoms of mood disorders were screened using the modified Centers for Epidemiological Studies-Depression Scale and the Generalized Anxiety Disorder screener. Cognition was assessed by the Mini-Mental State Examination and a neuropsychological test battery; functioning using the OARS Activities of Daily Living and Instrumental Activities of Daily Living; and overall assessment using the Clinical Dementia Rating (CDR®).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One in five MYHAT participants had a history of marijuana use and 5% reported recent use, primarily for pain (41%) and recreation/relaxation (37%). Recent use was associated with cigarette and alcohol use, symptoms of depression or anxiety, and impairments in attention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Twenty-percent of community-dwelling older adults living in a US state where recreational marijuana use is illegal had a history of marijuana use. Recent marijuana use was less common but, consistent with prior research, associated with other substance use and poorer mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550041","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}
Lauren Ka Shun Lei, Yi Nam Suen, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Wong Tak Hing Michael, Eric Yu Hai Chen
Objective
This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID-19 pandemic.
Methods
Complete data of interest from two telephone surveys conducted in 2020 (n = 1182) and 2021 (n = 1108) were analysed. Participants self-reported depressive and anxiety symptoms using the Patient Health Questionnaire 4-item version (PHQ), psychotic-like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor-Davidson Resilience Scale 2-item version (CD-RISC-2).
Results
We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between-year differences. Resilience and age interaction effects were significant when comparing the high PHQ-high PQB group to the low PHQ-low PQB group only in 2021 but not in 2020.
Conclusions
This study provides valuable insights into the impact of the COVID-19 pandemic on mental health in Hong Kong, emphasising the age-dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well-being and identify ways to enhance resilience among older individuals during public health crises.
{"title":"Age-related differences in the impact of resilience on mental health outcomes during the COVID-19 pandemic in Hong Kong","authors":"Lauren Ka Shun Lei, Yi Nam Suen, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Wong Tak Hing Michael, Eric Yu Hai Chen","doi":"10.1002/gps.6087","DOIUrl":"https://doi.org/10.1002/gps.6087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Complete data of interest from two telephone surveys conducted in 2020 (<i>n</i> = 1182) and 2021 (<i>n</i> = 1108) were analysed. Participants self-reported depressive and anxiety symptoms using the Patient Health Questionnaire 4-item version (PHQ), psychotic-like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor-Davidson Resilience Scale 2-item version (CD-RISC-2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between-year differences. Resilience and age interaction effects were significant when comparing the high PHQ-high PQB group to the low PHQ-low PQB group only in 2021 but not in 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides valuable insights into the impact of the COVID-19 pandemic on mental health in Hong Kong, emphasising the age-dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well-being and identify ways to enhance resilience among older individuals during public health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550042","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}
Stroke survivors are at high risk of coping with cognitive problems after stroke. In recent decades, the relationship between socioeconomic status (SES) and health-related outcomes has been a topic of considerable interest. Learning more about the potential impact of SES on poststroke cognitive dysfunction is of great importance.
Objective
The purpose of this systematic review and meta-analysis was to summarize the association between SES and poststroke cognitive function by quantifying the effect sizes of the existing studies.
Method
We searched studies from PubMed, Ovid, Embase, Cochrane, Scopus, and PsychINFO up to January 30th 2024 and the references of relevant reviews. Studies reporting the risk of poststroke cognitive dysfunction as assessed by categorized SES indicators were included. The Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the study quality. Meta-analyses using fixed-effect models or random-effect models based on study heterogeneity were performed to estimate the influence of SES on cognitive function after stroke, followed by subgroup analyses stratified by study characteristics.
Results
Thirty-four studies were eligible for this systematic review and meta-analysis. Of which, 19 studies reported poststroke cognitive impairment (PSCI) as the outcome, 13 reported poststroke dementia (PSD), one reported both PSCI and PSD, and one reported vascular cognitive impairment no dementia. The findings showed that individuals with lower SES levels had a higher risk of combined poststroke cognitive dysfunction (odds ratio (OR) = 1.91, 95% confidence interval (CI) = 1.59–2.29), PSCI (OR = 2.09, 95% CI = 1.57–2.78), and PSD (OR = 1.95, 95% CI = 1.48–2.57). Subgroup analyses stratified by SES indicators demonstrated the protective effects of education and occupation against the diagnoses of combined poststroke cognitive dysfunction, PSCI, and PSD.
Conclusions
Stroke survivors belonging to a low SES are at high risk of poststroke cognitive dysfunction. Our findings add evidence for public health strategies to reduce the risk of poststroke cognitive dysfunction by reducing SES inequalities.
背景：中风幸存者在中风后应对认知问题的风险很高。近几十年来，社会经济地位（SES）与健康相关结果之间的关系一直是备受关注的话题。进一步了解社会经济地位对脑卒中后认知功能障碍的潜在影响具有重要意义：本系统综述和荟萃分析旨在通过量化现有研究的效应大小，总结 SES 与脑卒中后认知功能之间的关系：我们检索了 PubMed、Ovid、Embase、Cochrane、Scopus 和 PsychINFO 中截至 2024 年 1 月 30 日的研究以及相关综述的参考文献。纳入了通过分类 SES 指标评估卒中后认知功能障碍风险的研究。研究质量采用纽卡斯尔-渥太华量表和美国医疗保健研究与质量机构（Agency for Healthcare Research and Quality）进行评估。使用固定效应模型或基于研究异质性的随机效应模型进行元分析，以估计 SES 对卒中后认知功能的影响，然后根据研究特征进行亚组分析：34 项研究符合本系统综述和荟萃分析的条件。其中，19 项研究以卒中后认知功能障碍（PSCI）为研究结果，13 项研究以卒中后痴呆（PSD）为研究结果，1 项研究同时以卒中后认知功能障碍和卒中后痴呆为研究结果，1 项研究以血管性认知功能障碍和痴呆为研究结果。研究结果显示，社会经济地位较低的人合并卒中后认知功能障碍（比值比 (OR) = 1.91，95% 置信区间 (CI) = 1.59-2.29）、PSCI（比值比 = 2.09，95% 置信区间 (CI) = 1.57-2.78）和 PSD（比值比 = 1.95，95% 置信区间 (CI) = 1.48-2.57）的风险较高。根据社会经济地位指标进行的分组分析表明，教育和职业对脑卒中后认知功能障碍、脑卒中后认知功能障碍和脑卒中后认知功能障碍具有保护作用：结论：社会经济地位低的脑卒中幸存者是脑卒中后认知功能障碍的高危人群。我们的研究结果为通过减少社会经济地位不平等来降低卒中后认知功能障碍风险的公共卫生策略提供了证据。
{"title":"Association of socioeconomic status and poststroke cognitive function: A systematic review and meta-analysis","authors":"Jingyuan Tian, Qiuyi Wang, Shuang Guo, Xiaoqing Zhao","doi":"10.1002/gps.6082","DOIUrl":"10.1002/gps.6082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stroke survivors are at high risk of coping with cognitive problems after stroke. In recent decades, the relationship between socioeconomic status (SES) and health-related outcomes has been a topic of considerable interest. Learning more about the potential impact of SES on poststroke cognitive dysfunction is of great importance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this systematic review and meta-analysis was to summarize the association between SES and poststroke cognitive function by quantifying the effect sizes of the existing studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We searched studies from PubMed, Ovid, Embase, Cochrane, Scopus, and PsychINFO up to January 30<sup>th</sup> 2024 and the references of relevant reviews. Studies reporting the risk of poststroke cognitive dysfunction as assessed by categorized SES indicators were included. The Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the study quality. Meta-analyses using fixed-effect models or random-effect models based on study heterogeneity were performed to estimate the influence of SES on cognitive function after stroke, followed by subgroup analyses stratified by study characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four studies were eligible for this systematic review and meta-analysis. Of which, 19 studies reported poststroke cognitive impairment (PSCI) as the outcome, 13 reported poststroke dementia (PSD), one reported both PSCI and PSD, and one reported vascular cognitive impairment no dementia. The findings showed that individuals with lower SES levels had a higher risk of combined poststroke cognitive dysfunction (odds ratio (OR) = 1.91, 95% confidence interval (CI) = 1.59–2.29), PSCI (OR = 2.09, 95% CI = 1.57–2.78), and PSD (OR = 1.95, 95% CI = 1.48–2.57). Subgroup analyses stratified by SES indicators demonstrated the protective effects of education and occupation against the diagnoses of combined poststroke cognitive dysfunction, PSCI, and PSD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stroke survivors belonging to a low SES are at high risk of poststroke cognitive dysfunction. Our findings add evidence for public health strategies to reduce the risk of poststroke cognitive dysfunction by reducing SES inequalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335600","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}
Yannick Stephan, Angelina R. Sutin, Antonio Terracciano
Objective
Urinary incontinence (UI) is a common condition with a substantial negative impact on older adults' quality of life. This study examines whether individual differences in behavioral, cognitive, and emotional traits assessed by the five major dimensions of personality are related to the risk of concurrent and incident UI.
Methods
Participants were older women and men (N > 26,000) from the Midlife in the United States Survey, the Health and Retirement Study, and the English Longitudinal Study of Aging. In each cohort, personality traits (measured with the Midlife Development Inventory) and demographic (age, sex, education, and race), clinical (body mass index, diabetes, blood pressure), and behavioral (smoking) factors were assessed at baseline. UI was assessed at baseline and again 8–20 years later. Results for each cohort were combined in random-effect meta-analyses.
Results
Consistently across cohorts, higher neuroticism and lower conscientiousness were related to a higher risk of concurrent and incident UI. To a lesser extent, extraversion, openness, and agreeableness were also related to lower risk of concurrent and incident UI. BMI, diabetes, blood pressure, and smoking partially accounted for these associations. There was little evidence that age or sex moderated the associations.
Conclusions
The present study provides novel, robust, and replicable evidence linking personality traits to UI. The higher vulnerability for UI for individuals who score higher on neuroticism and lower on conscientiousness is consistent with findings for other multifactorial geriatric syndromes. Personality traits can help identify individuals at risk and may help contextualize the clinical presentation of comorbid emotional, cognitive, and behavioral symptoms.
{"title":"Personality traits and the risk of urinary incontinence: Evidence from three longitudinal samples","authors":"Yannick Stephan, Angelina R. Sutin, Antonio Terracciano","doi":"10.1002/gps.6084","DOIUrl":"10.1002/gps.6084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Urinary incontinence (UI) is a common condition with a substantial negative impact on older adults' quality of life. This study examines whether individual differences in behavioral, cognitive, and emotional traits assessed by the five major dimensions of personality are related to the risk of concurrent and incident UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were older women and men (<i>N</i> > 26,000) from the Midlife in the United States Survey, the Health and Retirement Study, and the English Longitudinal Study of Aging. In each cohort, personality traits (measured with the Midlife Development Inventory) and demographic (age, sex, education, and race), clinical (body mass index, diabetes, blood pressure), and behavioral (smoking) factors were assessed at baseline. UI was assessed at baseline and again 8–20 years later. Results for each cohort were combined in random-effect meta-analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Consistently across cohorts, higher neuroticism and lower conscientiousness were related to a higher risk of concurrent and incident UI. To a lesser extent, extraversion, openness, and agreeableness were also related to lower risk of concurrent and incident UI. BMI, diabetes, blood pressure, and smoking partially accounted for these associations. There was little evidence that age or sex moderated the associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study provides novel, robust, and replicable evidence linking personality traits to UI. The higher vulnerability for UI for individuals who score higher on neuroticism and lower on conscientiousness is consistent with findings for other multifactorial geriatric syndromes. Personality traits can help identify individuals at risk and may help contextualize the clinical presentation of comorbid emotional, cognitive, and behavioral symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335601","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}
In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena.
Methods
The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting.
Results
The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = −0.172, T = 0.65, p = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves.
Conclusions
In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies.
背景：在全球老龄化挑战的背景下，越来越多的中老年人（MAOAs）开始从事祖辈养育工作。然而，祖辈养育对照顾者心理健康的影响研究结果并不一致。为了有效地促进健康老龄化，必须采用全面的视角和严谨的方法来进一步研究这两种社会现象之间的关系：方法：分析了《中国健康与退休纵向研究》（Harmonized China Health and Retirement Longitudinal Study）的数据，重点关注至少有一名孙辈的 MAOA。心理健康评估采用流行病学研究中心抑郁量表。考虑到个人和家庭特征等协变量，研究采用了一系列差分（DID）模型，并特别辅以倾向得分匹配，以评估被治疗者对照顾者心理健康的平均治疗效果（ATT）。干预视角包括提供和停止祖孙护理：研究发现，与从未从事过孙辈照料的祖父母相比，提供孙辈照料对祖父母的心理健康没有显著影响（ATT = -0.172，T = 0.65，PSM-DID 模型中的 p = 0.517）。此外，相对于一直照顾孙辈的人而言，停止这种照顾似乎也不会对照顾者的心理健康产生实质性影响（ATT = 0.060，T = 0.26，PSM-DID 模型中 p = 0.795）。此外，即使考虑到不同调查波次的数据，后续的稳健性分析也一致支持这些发现：与之前许多研究报告的积极或消极影响不同，我们的研究表明，祖父母养育子女对亚博app客服生的心理健康没有显著影响。因此，医疗工作者和政策制定者在制定干预措施和支持策略时，应仔细考虑不同的文化背景。
{"title":"Revisiting the association between grandparenting and mental health in China: New evidence from the harmonized CHARLS","authors":"Youhua Wang, Chunhong Xiao, Di Wu, Yue Li","doi":"10.1002/gps.6083","DOIUrl":"10.1002/gps.6083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = −0.172, <i>T</i> = 0.65, <i>p</i> = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, <i>T</i> = 0.26, <i>p</i> = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318248","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}
To investigate the accuracy of longitudinal trajectories of blood biomarkers for predicting future onset of AD among MCI participants as well as to demonstrate dynamic prediction of the individual conversion risk applying joint modeling.
Methods
A total of 446 participants with MCI at baseline from the Alzheimer's Disease Neuroimaging Initiative database were included. We introduced joint modeling to analyze the effects of the longitudinal blood biomarkers on the conversion risk to AD, and further to build individual-specific prediction risk model.
Results
During the follow-up, 345 participants remained with MCI and 101 progressed to AD, and were categorized as non-progression and progression group, respectively. Longitudinally, the positive association of the concentration dynamics of plasma p-tau181 and NfL with the conversion risk to AD from MCI was also demonstrated, with Hazard Ratio (HR) = 5.83 and HR = 4.18, respectively. When incorporating plasma p-tau181 and NfL together to predict AD progression, we observed improved performance (AUC = 0.701, Brier Score = 0.119). Two participants were chosen to exemplify the individual-specific risk prediction at different follow-up time for comparative analysis.
Conclusions
Plasma p-tau181 and NfL could serve as biomarkers for the prediction of AD onset, and the individualized prediction opens up the possibility to provide clinical information at a personal level.
{"title":"Blood biomarkers in dynamic prediction of conversion to Alzheimer's disease: An application of joint modeling","authors":"Manqiong Yuan, Shuli Lian, Xueru Li, Xianxian Long, Ya Fang, Alzheimer's Disease Neuroimaging Initiative (ADNI)","doi":"10.1002/gps.6079","DOIUrl":"10.1002/gps.6079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the accuracy of longitudinal trajectories of blood biomarkers for predicting future onset of AD among MCI participants as well as to demonstrate dynamic prediction of the individual conversion risk applying joint modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 446 participants with MCI at baseline from the Alzheimer's Disease Neuroimaging Initiative database were included. We introduced joint modeling to analyze the effects of the longitudinal blood biomarkers on the conversion risk to AD, and further to build individual-specific prediction risk model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the follow-up, 345 participants remained with MCI and 101 progressed to AD, and were categorized as non-progression and progression group, respectively. Longitudinally, the positive association of the concentration dynamics of plasma p-tau181 and NfL with the conversion risk to AD from MCI was also demonstrated, with Hazard Ratio (HR) = 5.83 and HR = 4.18, respectively. When incorporating plasma p-tau181 and NfL together to predict AD progression, we observed improved performance (AUC = 0.701, Brier Score = 0.119). Two participants were chosen to exemplify the individual-specific risk prediction at different follow-up time for comparative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plasma p-tau181 and NfL could serve as biomarkers for the prediction of AD onset, and the individualized prediction opens up the possibility to provide clinical information at a personal level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 3","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206836","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}
Martha Sajatovic, Soham Rej, Osvaldo P. Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G. Barbosa, Alexandra J. M. Beunders, Hilary P. Blumberg, Farren B. S. Briggs, Annemiek Dols, Brent P. Forester, Orestes V. Forlenza, Ariel G. Gildengers, Esther Jimenez, Federica Klaus, Beny Lafer, Benoit Mulsant, Benson Mwangi, Paula Villela Nunes, Andrew T. Olagunju, Stephen Oluwaniyi, Melis Orhan, Regan E. Patrick, Joaquim Radua, Tarek Rajji, Kaylee Sarna, Sigfried Schouws, Christian Simhandl, Harmehr Sekhon, Jair C. Soares, Ashley N. Sutherland, Antonio L. Teixeira, Shangying Tsai, Sonia Vidal-Rubio, Eduard Vieta, Joy Yala, Lisa T. Eyler
Objectives
The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset.
Design/Methods
Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601).
Results
Compared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning.
Conclusions
In a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning.
{"title":"Bipolar symptoms, somatic burden and functioning in older-age bipolar disorder: A replication study from the global aging & geriatric experiments in bipolar disorder database (GAGE-BD) project","authors":"Martha Sajatovic, Soham Rej, Osvaldo P. Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G. Barbosa, Alexandra J. M. Beunders, Hilary P. Blumberg, Farren B. S. Briggs, Annemiek Dols, Brent P. Forester, Orestes V. Forlenza, Ariel G. Gildengers, Esther Jimenez, Federica Klaus, Beny Lafer, Benoit Mulsant, Benson Mwangi, Paula Villela Nunes, Andrew T. Olagunju, Stephen Oluwaniyi, Melis Orhan, Regan E. Patrick, Joaquim Radua, Tarek Rajji, Kaylee Sarna, Sigfried Schouws, Christian Simhandl, Harmehr Sekhon, Jair C. Soares, Ashley N. Sutherland, Antonio L. Teixeira, Shangying Tsai, Sonia Vidal-Rubio, Eduard Vieta, Joy Yala, Lisa T. Eyler","doi":"10.1002/gps.6057","DOIUrl":"10.1002/gps.6057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; <i>n</i> = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; <i>n</i> = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design/Methods</h3>\u0000 \u0000 <p>Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to W1, the W2 sample was younger (<i>p</i> < 0.001), less educated (<i>p</i> < 0.001), more symptomatic (<i>p</i> < 0.001), lower functioning (<i>p</i> < 0.001) and had fewer somatic conditions (<i>p</i> < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania <i>p</i> ≤ 0.001, depression <i>p</i> ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"39 3","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174598","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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