International Journal of Geriatric Psychiatry最新文献_第3页

Association of Caregiver Types With General and Health-Related Indicators of Subjective Well-Being in a Longitudinal Cohort of Middle-Aged and Older Adults in China 在中国中老年纵向队列中，照顾者类型与主观幸福感的一般和健康相关指标的关系

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-11-14 DOI: 10.1002/gps.70176

Qing Su, Cheng Cheng

Objectives

With the increased demand for care services, understanding how the association between caregiving and subjective well-being varies at different ages becomes a crucial policy concern. This study examined the longitudinal associations between informal caregiving (and different caregiver types) and selected subjective well-being outcomes. Furthermore, gender and household wealth heterogeneity were explored.

Methods

Based on the China Health and Retirement Longitudinal Study data, we used growth curve models to examine how the association between informal caregiving and subjective well-being varies across age.

Results

Overall, caregivers reported higher life satisfaction at age 60 compared to non-caregivers, although the positive association between caregiving and life satisfaction becomes weaker and even turns negative as people age. In contrast, caregivers consistently had lower health-related quality of life (HRQoL) than non-caregivers. When examining different caregiving types, grandparent caregivers initially had higher life satisfaction at age 60 than non-caregivers, but this advantage became less evident with age. Adult child caregivers generally showed higher life satisfaction than non-caregivers, whereas spousal caregivers consistently reported lower life satisfaction. Regarding HRQoL, there were no significant differences between adult child caregivers, grandparent caregivers, and non-caregivers, but spousal caregivers had significantly lower HRQoL than their non-caregiving counterparts. Furthermore, the relationship between caregiving and subjective well-being was influenced by both gender and household wealth.

Conclusions

The relationship between informal caregiving and subjective well-being is dynamic, and different types of caregivers display distinct age-related patterns. These findings can provide practical policy recommendations for policymakers to structure and improve sustainable informal care systems.

目的：随着对护理服务需求的增加，了解护理与主观幸福感之间的关系在不同年龄段的变化成为一个重要的政策问题。本研究考察了非正式照顾（和不同类型的照顾者）和选定的主观幸福感结果之间的纵向关联。此外，还探讨了性别和家庭财富的异质性。方法：基于中国健康与退休纵向研究数据，采用增长曲线模型考察非正式养老与主观幸福感之间的关系。结果：总体而言，照顾者在60岁时的生活满意度高于非照顾者，尽管照顾与生活满意度之间的正相关关系随着年龄的增长而减弱，甚至变为负相关。相比之下，护理人员的健康相关生活质量（HRQoL）始终低于非护理人员。当研究不同的照顾类型时，祖父母照顾者最初在60岁时的生活满意度高于非照顾者，但随着年龄的增长，这种优势变得不那么明显。成人儿童照顾者普遍比非照顾者表现出更高的生活满意度，而配偶照顾者的生活满意度一直较低。在HRQoL方面，成人儿童照顾者、祖父母照顾者和非照顾者之间无显著差异，但配偶照顾者的HRQoL显著低于非照顾者。此外，照顾与主观幸福感之间的关系受到性别和家庭财富的影响。结论：非正式照顾与主观幸福感的关系是动态的，不同类型的照顾者表现出不同的年龄相关模式。这些发现可以为决策者提供实用的政策建议，以构建和改进可持续的非正式护理系统。

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引用次数: 0

Physical Versus Cognitive Impairment in Stroke-Free Older Adults Living in Rural Settings: Relative Contributions to Decreased Functionality 生活在农村的无中风老年人的身体与认知障碍：对功能下降的相对贡献

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-30 DOI: 10.1002/gps.70173

Oscar H. Del Brutto, Robertino M. Mera, Mark J. Sedler, Denisse A. Rumbea, Emilio E. Arias, José Gutierrez, Víctor J. Del Brutto

Objectives

Both physical and cognitive impairments contribute to disability. However, their relative impact on functional decline among older adults in low-resource settings has not been adequately studied. This study aims to explore the role of these factors on functionality.

Methods

Following a population-based, cross-sectional design, older adults living in rural Ecuador underwent a handgrip strength (HGS) test for physical performance, the Montreal Cognitive Assessment (MoCA) to evaluate cognitive performance, and a Functional Assessment Questionnaire (FAQ) assessed functionality. A generalized structural equation modeling (GSEM) approach was utilized to evaluate a predefined set of causal assumptions and integrate hypothesized latent constructs, providing a comprehensive explanation of the relationships among multiple interconnected variables and their association with dysfunctionality.

Results

We included 603 individuals (mean age: 67.5 ± 7 years; 54% women). According to the GSEM approach, a 10% rise in HGS (2.4 kg) was associated with a 3.68% improvement in functionality (p < 0.001), whereas a 10% increase in MoCA scores resulted in a 2.06% improvement in functionality (p < 0.001). One standard deviation (SD) in HGS comprised 18% of the distribution, which yielded a 6.5% shift in functionality. Similarly, one SD difference in MoCA scores accounted for 19% of the distribution, and a 3.91% change in functionality.

Conclusions

Both physical and cognitive impairments significantly contribute to decreased functionality. However, physical performance exerts a greater influence on functional independence than cognitive performance. These findings highlight the importance of a holistic approach to interventions aimed at enhancing quality of life in older adults residing in low-resource rural settings.

身体和认知障碍都会导致残疾。然而，它们对低资源环境中老年人功能下降的相对影响尚未得到充分研究。本研究旨在探讨这些因素对功能的影响。方法采用以人群为基础的横断面设计，对生活在厄瓜多尔农村的老年人进行了握力（HGS）体力测试，蒙特利尔认知评估（MoCA）评估认知表现，功能评估问卷（FAQ）评估功能。利用广义结构方程建模（GSEM）方法评估一组预定义的因果假设，并整合假设的潜在构念，为多个相互关联的变量之间的关系及其与功能障碍的关联提供全面的解释。结果纳入603例患者，平均年龄67.5±7岁，女性占54%。根据GSEM方法，HGS （2.4 kg）增加10%与功能改善3.68%相关（p < 0.001），而MoCA评分增加10%导致功能改善2.06% （p < 0.001）。HGS的一个标准差（SD）占分布的18%，这产生了6.5%的功能变化。同样，MoCA分数的一个SD差异占分布的19%，功能变化为3.91%。结论：身体和认知障碍都是导致功能下降的重要原因。然而，身体表现比认知表现对功能独立性的影响更大。这些发现强调了对旨在提高生活在资源匮乏的农村地区老年人生活质量的干预采取整体方法的重要性。

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引用次数: 0

Religious Attendance, Psychological Well-Being, and Mental Health Issues Among Older Adults: A Seven-Year Longitudinal Study in the United States 参加宗教活动、心理健康和老年人的心理健康问题：美国一项为期7年的纵向研究

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-28 DOI: 10.1002/gps.70171

Zhiya Hua

Objectives

Although studies have reported an association between attending religious services and diminished mental health issues, the underlying mechanisms have not been thoroughly explored. Additionally, longitudinal evidence supporting this association is limited. This study aimed to examine whether psychological well-being mediates the longitudinal association between religious attendance and mental health issues.

Methods

A total of 2767 older adults (baseline mean age = 75.02 years, 57.9% female) from the National Health and Aging Trends Study (NHATS) were included in the analysis. Respondents' religious attendance, psychological well-being, and depressive and anxiety symptoms were measured annually across 7 years. Based on descriptive statistics, a longitudinal mediation analysis within a Bayesian framework was conducted.

Results

Results indicated that, controlling for sociodemographic variables and autoregressive effects, attending religious services was significantly and longitudinally associated with improved psychological well-being (β = 0.13, 95% CI: [0.10, 0.17]), which, in turn, significantly predicted subsequent reductions in depressive and anxiety symptoms (β = −0.30, 95% CI: [–0.33, −0.28]). On average, psychological well-being accounted for 26.7% of the total effect of religious attendance on mental health issues.

Conclusions

Hence, supporting older adults who wish to attend religious services may be linked to better psychological well-being and mental health.

虽然研究报告了参加宗教服务与减少心理健康问题之间的联系，但其潜在机制尚未得到彻底探索。此外，支持这种关联的纵向证据有限。本研究旨在探讨心理健康是否介导宗教出席与心理健康问题之间的纵向关联。方法选取全国健康与老龄化趋势研究（NHATS）中2767名老年人（基线平均年龄75.02岁，57.9%为女性）进行分析。受访者的宗教出席、心理健康、抑郁和焦虑症状在7年内每年进行一次测量。基于描述性统计，在贝叶斯框架内进行纵向中介分析。结果表明，在控制社会人口学变量和自回归效应的情况下，参加宗教仪式与改善心理健康显著纵向相关（β = 0.13, 95% CI:[0.10, 0.17]），这反过来又显著预测随后抑郁和焦虑症状的减少（β = - 0.30, 95% CI:[-0.33, - 0.28]）。平均而言，参加宗教活动对心理健康问题的总影响中，心理健康占26.7%。因此，支持希望参加宗教服务的老年人可能与更好的心理健康和心理健康有关。

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引用次数: 0

Development of the Clinical Insight Questionnaire: A Novel Clinical Tool for the Assessment of Insight Into Cognitive Symptoms and Everyday Functioning in People With Neurodegeneration 临床洞察力问卷的开发：一种评估神经退行性疾病患者认知症状和日常功能洞察力的新型临床工具

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-28 DOI: 10.1002/gps.70165

Catherine Pennington, Harriet Ball, Peter Connelly, Elizabeth Coulthard, Gordon Duncan, Chineze Ivenso, Tobias Langheinrich, Vivek Pattan, Terence Quinn, Karen Ritchie, Craig Ritchie, Tom Russ

Objectives

Altered insight into cognitive symptoms and diagnosis is a common feature of neurodegeneration, and can adversely impact on quality of life and ability to access medical care. Affected individuals can lose awareness of their symptoms and therefore decline to engage with medical assessment and treatment. Assessing insight is difficult, and there is a lack of short, easily administered clinical assessment tools. The aim of this study was to develop and evaluate the feasibility of a novel insight assessment questionnaire (The Clinical Insight Questionnaire, CLIQ) which can be independently completed by adults with a range of cognitive abilities.

Methods

A discrepancy score approach was used to evaluate insight. A novel questionnaire targeting the domains of memory, personality and social behaviour, executive function, language, and activities of daily living was devised using the Delphi approach and public feedback. Participant and informant mirror versions of each item were written. The discrepancy between participant and informant scores provides an overall insight score. 12 UK based experts in cognitive disorder diagnosis and assessment were invited to review potential questionnaire items, as was a PPI group. A feasibility study was conducted where people with mild memory or thinking symptoms and an informant completed the questionnaire and the Montreal Cognitive Assessment.

Results

Following an iterative process using the expert Delphi group and public feedback, 20 final questionnaire items were selected from an initial pool of 30 items. 21 people with mild cognitive symptoms but no formally diagnosed cognitive disorder (median MoCA score 24.5) participated in feasibility testing. The mean discrepancy score was 1.14, close to the ideal score of zero. No participants found the assessment upsetting or too long, and 81% rated the questions as easy to understand.

Conclusions

The Clinical Insight Questionnaire (CLIQ) is a novel clinical tool for the assessment of insight in people with mild to moderate neurodegeneration. In feasibility testing it was quick and easy for people with mild cognitive symptoms and informants to self-complete. Initial feasibility testing showed very promising findings for usability and acceptability, and a full validation study is now in progress.

对认知症状和诊断的认识改变是神经退行性疾病的共同特征，并可能对生活质量和获得医疗服务的能力产生不利影响。受影响的个人可能对自己的症状失去意识，因此拒绝接受医疗评估和治疗。评估洞察力是困难的，而且缺乏短期的、易于管理的临床评估工具。本研究的目的是开发和评估一种新的洞察力评估问卷（临床洞察力问卷，CLIQ）的可行性，该问卷可以由具有一系列认知能力的成年人独立完成。方法采用差异计分法对洞察力进行评价。采用德尔菲法和公众反馈设计了一份针对记忆、个性和社会行为、执行功能、语言和日常生活活动等领域的新型问卷。每个项目的被试和被试的镜像版本都被写了出来。参与者和信息提供者得分之间的差异提供了一个整体的洞察力得分。12位英国认知障碍诊断和评估方面的专家被邀请来审查潜在的问卷项目，就像一个PPI组一样。一项可行性研究在有轻度记忆或思维症状的人和一名被调查者一起完成了问卷调查和蒙特利尔认知评估。结果经过专家德尔菲小组和公众反馈的迭代过程，从最初的30个问卷中选出了20个最终问卷。21例轻度认知症状但未被正式诊断为认知障碍的患者（MoCA中位评分24.5）参加了可行性测试。平均差异得分为1.14，接近于零的理想得分。没有参与者觉得评估令人不安或太长，81%的人认为问题很容易理解。结论临床洞察力问卷（CLIQ）是一种评估轻中度神经退行性疾病患者洞察力的新型临床工具。在可行性测试中，轻度认知症状者和举报人能够快速、容易地完成自我完成。最初的可行性测试在可用性和可接受性方面显示了非常有希望的结果，目前正在进行全面的验证研究。

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引用次数: 0

Natural Evolution and Heterogeneity of Neuropsychiatric Symptoms Across Neurocognitive Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies 神经认知障碍患者神经精神症状的自然进化和异质性：纵向研究的系统回顾和荟萃分析。

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-21 DOI: 10.1002/gps.70169

Owen Skoda, Miguel Conant, Vincent Couture, Marie-Andrée Bruneau, Marie-France Forget, Quoc Dinh Nguyen, Philippe Desmarais

Objectives

Neuropsychiatric symptoms (NPS) are common and burdensome manifestations of neurocognitive disorders but the characterization of their natural evolution over time is limited. We conducted a systematic review and meta-analysis to describe the longitudinal progression and heterogeneity of NPS across Alzheimer's disease (AD), Lewy body dementia (LBD), and frontotemporal dementia (FTD).

Methods

We systematically reviewed observational longitudinal studies published between 2000 and 2024 assessing the prevalence or severity of NPS at ≥ 2 time points using validated instruments. Random-effects meta-analyses were performed to pool changes in prevalence (risk difference) and severity (standardized mean difference [SMD]) at short-term (< 12 months), mid-term (12 to < 24 months), and long-term (≥ 24 months) follow-up. Heterogeneity and publication bias were also assessed. Subgroup analyses were conducted by type of neurocognitive disorder.

Results

We included 26 studies comprising 5509 participants. Apathy was the most prevalent NPS at baseline (45%), followed by irritability (35%) and depression (35%). Over time, most NPS demonstrated progressive increases in prevalence, with agitation (+16%) and apathy (+15%) emerging most frequently at long-term follow-up. Severity of most NPS remained stable, except for apathy and aberrant motor behavior, which increased significantly, and sleep disturbances, which improved. Global NPS burden increased significantly at long-term (SMD +2.04). Heterogeneity of trajectories was notably high and varied across symptoms and disorders. Subgroup analyses in AD confirmed increases in apathy, delusions, and hallucinations over time.

Conclusions

NPS exhibit distinct and heterogeneous longitudinal patterns in neurocognitive disorders. Greater understanding of these trajectories may inform clinical management, prognostication, and the timing of interventions.

目的：神经精神症状（NPS）是神经认知障碍的常见和繁重的表现，但其随时间自然演变的特征是有限的。我们进行了一项系统回顾和荟萃分析，以描述阿尔茨海默病（AD）、路易体痴呆（LBD）和额颞叶痴呆（FTD）中NPS的纵向进展和异质性。方法：我们系统地回顾了2000年至2024年间发表的观察性纵向研究，使用经过验证的仪器在≥2个时间点评估NPS的患病率或严重程度。进行随机效应荟萃分析，汇总短期患病率（风险差异）和严重程度（标准化平均差异[SMD]）的变化（结果：我们纳入了26项研究，包括5509名参与者）。在基线时，冷漠是最普遍的NPS(45%)，其次是易怒（35%）和抑郁（35%）。随着时间的推移，大多数NPS表现出逐渐增加的患病率，在长期随访中最常出现躁动（+16%）和冷漠（+15%）。大多数NPS的严重程度保持稳定，但冷漠和异常运动行为显著增加，睡眠障碍有所改善。长期来看，全球NPS负担显著增加（SMD +2.04）。轨迹的异质性非常高，并且在症状和障碍之间存在差异。阿尔茨海默病的亚组分析证实，随着时间的推移，冷漠、妄想和幻觉增加。结论：NPS在神经认知障碍中表现出不同且异质性的纵向模式。更好地了解这些轨迹可以为临床管理、预测和干预时机提供信息。

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引用次数: 0

Awareness, Perceptions, Stigma, Attitudes, and Help-Seeking Behavior Regarding Alzheimer's Disease Among Older Adults in Nigeria: A Community-Based Cross-Sectional Study 尼日利亚老年人对阿尔茨海默病的认识、认知、污名、态度和求助行为：一项基于社区的横断面研究

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-20 DOI: 10.1002/gps.70170

Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

Objective

To assess awareness, perceptions, stigma, attitudes, and help-seeking behavior related to Alzheimer's disease (AD) among older adults in Nigeria.

Methods

This 12-month community-based cross-sectional study (May 2024–April 2025) was conducted across 12 purposively selected urban and rural communities, representing Nigeria's six geopolitical zones. A total of 744 older adults (≥ 60 years; mean age = 70.3) were recruited using a multistage sampling technique. Data were collected using the Alzheimer's Disease Assessment Questionnaire (ADAQ), a validated instrument covering sociodemographic characteristics, AD awareness, perceptions, stigma, attitudes, help-seeking behavior, and diagnostic care barriers. Descriptive statistics and chi-square (χ²) tests were conducted using SPSS v22.0, with significance set at p ≤ 0.05.

Results

Overall, 64.9% of respondents were aware of AD, although 66.8% held negative perceptions. High perceived stigma (62.1%) and undesirable attitudes (71.4%) were common. Only 26.2% reported appropriate help-seeking behavior. Key barriers to AD diagnostic care included lack of specialists (85.8%), high costs (84.3%), and limited access to services (80.9%). Significant associations were found between AD awareness and age (χ² = 6.432, p = 0.011), gender (χ² = 3.833, p = 0.020), marital status (χ² = 2.319, p = 0.032), living arrangement (χ² = 1.377, p = 0.010), and income (χ² = 2.363, p = 0.031), but not with education (χ² = 1.765, p = 0.163) or religion (χ² = 3.832, p = 0.521).

Conclusion

Despite moderate awareness, perceptions and attitudes toward AD among older Nigerian adults remain largely unfavorable. Stigma and structural barriers continue to impede timely diagnosis and care. Community-targeted interventions are essential to improve AD literacy and health-seeking behaviors in this population.

目的：评估尼日利亚老年人对阿尔茨海默病（AD）的认识、认知、耻辱感、态度和求助行为。方法：这项为期12个月的社区横断面研究（2024年5月至2025年4月）在12个有目的地选择的城市和农村社区进行，代表尼日利亚的六个地缘政治区域。采用多阶段抽样技术，共招募744名老年人（≥60岁，平均年龄= 70.3）。使用阿尔茨海默病评估问卷（ADAQ）收集数据，这是一种经过验证的工具，涵盖社会人口学特征、阿尔茨海默病意识、认知、污名、态度、寻求帮助行为和诊断护理障碍。采用SPSS v22.0进行描述性统计和χ2检验，p≤0.05为显著性。结果：总体而言，64.9%的受访者知道AD，尽管66.8%的受访者持负面看法。较高的污名感（62.1%）和不良态度（71.4%）较为常见。只有26.2%的人有适当的求助行为。阿尔茨海默病诊断护理的主要障碍包括缺乏专家（85.8%）、费用高（84.3%）和获得服务有限（80.9%）。AD知知度与年龄（χ2 = 6.432, p = 0.011）、性别（χ2 = 3.833, p = 0.020）、婚姻状况（χ2 = 2.319, p = 0.032）、生活方式（χ2 = 1.377, p = 0.010）、收入（χ2 = 2.363, p = 0.031）有显著相关性，与教育程度（χ2 = 1.765, p = 0.163）、宗教信仰（χ2 = 3.832, p = 0.521）无显著相关性。结论：尽管意识适度，但尼日利亚老年人对阿尔茨海默病的看法和态度在很大程度上仍不乐观。耻辱感和结构性障碍继续阻碍及时诊断和护理。以社区为目标的干预措施对于提高这一人群的阿尔茨海默病知识和寻求健康行为至关重要。

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引用次数: 0

Prevalence and Associated Factors of Chronic Depression Among Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression 老年人慢性抑郁症患病率及相关因素：系统综述、meta分析和meta回归。

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-18 DOI: 10.1002/gps.70160

M. W. Stratmann, H.-H. König, A. Hajek

Objectives

Although late-life depression is common, there has previously not been a comprehensive review of chronic depression (CD) in older adults. This systematic review summarizes prevalence rates, potential risk factors, and consequences of CD in later life.

Methods

This preregistered review (PROSPERO: CRD42025649324) searched MEDLINE, Web of Science, CINAHL and PsycINFO from inception to February 2025. Observational studies reporting the prevalence of CD in older adults (mean age 60+) were included. Study quality was assessed using the Joanna Briggs Institutes Critical Appraisal Tool. Random-effects models were used to estimate pooled prevalence across subgroups and meta-regression analyses were used to explore sources of heterogeneity.

Results

A total of 39 articles (38 studies) met the inclusion criteria; 20 articles (27 data points) were included in meta-analysis for point prevalence. Overall point prevalence was 4.02% [2.88%–5.35%], with estimates varying by assessment method: 2.30% [1.47%–3.31%] using DSM-IV/DSM-III-R, 7.12% [2.31%–14.22%] using DSM-III/ICD-10% and 5.52% [3.80%–7.54%] using rating scales. Prevalence varied also by region and was higher for women. Consistent risk factors included less physical activity and higher impairment in daily life. Evidence on consequences was sparse.

Conclusions

Approximately 4% of adults aged 60+ meet criteria for CD. Estimates vary substantially by method and region, and potential risk factors and outcomes remain poorly understood. Future studies should target underrepresented subgroups - such as the oldest old, the institutionalized and physically and cognitively impaired individuals—using both dimensional and categorical assessment. CD in late life appears often unrecognized, untreated and underresearched.

目的：尽管晚年抑郁症很常见，但以前没有对老年人慢性抑郁症（CD）进行全面的回顾。本系统综述总结了乳糜泻的患病率、潜在危险因素和晚年生活的后果。方法：本预注册综述（PROSPERO: CRD42025649324）检索MEDLINE、Web of Science、CINAHL和PsycINFO，检索时间为建站至2025年2月。观察性研究报告了老年人（平均年龄60岁以上）的乳糜泻患病率。使用乔安娜布里格斯研究所关键评估工具评估研究质量。随机效应模型用于估计跨亚组的合并患病率，并使用元回归分析来探索异质性的来源。结果：共有39篇文章（38项研究）符合纳入标准；20篇文章（27个数据点）被纳入点患病率的荟萃分析。总体点患病率为4.02%[2.88% ~ 5.35%]，不同评估方法的估计值不同：使用DSM-IV/DSM-III- r的估计值为2.30%[1.47% ~ 3.31%]，使用DSM-III/ICD-10%的估计值为7.12%[2.31% ~ 14.22%]，使用评定量表的估计值为5.52%[3.80% ~ 7.54%]。患病率也因地区而异，女性较高。一致的风险因素包括较少的体育活动和日常生活中较高的损害。关于后果的证据很少。结论：大约4%的60岁以上的成年人符合CD的标准。不同的方法和地区的估计值差异很大，潜在的危险因素和结果仍然知之甚少。未来的研究应该针对未被充分代表的亚群体——比如最年长的老人、被机构照料的人、身体和认知受损的人——使用维度和分类评估。老年乳糜泻往往未被发现，未得到治疗，研究不足。

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引用次数: 0

Critical Appraisal of Sex Differences in White Matter Burden and Neuropsychiatric Symptoms in Older Adults 老年人白质负担和神经精神症状性别差异的批判性评价

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-18 DOI: 10.1002/gps.70166

Brijesh Sathian, Javed Iqbal, Hanadi Al Hamad

引用次数: 0

Unmet Needs in Dementia Care: The Predictive Role of Caregiver Challenges 痴呆护理中未满足的需求：照顾者挑战的预测作用。

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-16 DOI: 10.1002/gps.70164

Laiss Bertola, Fabiana da Mata, Ari Alex Ramos, Carolina Godoy, Fernanda Menezes de Faria, Rosa Lucchetta, Haliton Alves de Oliveira Junior, Cleusa Pinheiro Ferri

Background and Objectives

In low- and middle-income countries (LMICs), family caregivers provide most of the support for people with dementia (PWD), yet little is known about how caregiver needs relate to unmet needs of PWD ^– especially in Latin America. This study explored that relationship in Brazilian caregiver-PWD dyads.

Methods

140 Brazilian dyads underwent in-home interviews, with assessments including a comprehensive needs of care instrument, caregiver burden, mental health, and caregiving experience, as well as PWD symptoms and demographics.

Results

All dyads had at least one unmet need. A combined model incorporating predictors from both PWD and caregivers indicated that PLWD having lower education, being male, and exhibiting more neuropsychiatric symptoms are associated with more unmet needs. Additionally, caregiver-related factors such as being male, having fewer years of caregiving experience, and having more unmet needs of their own were also linked to greater unmet needs in PWD.

Discussion and Implications

Caregiver well-being significantly affects the quality of dementia care. Caregivers' unmet needs likely reflect both their personal limitations and broader care challenges. Addressing both caregiver and PWD needs through targeted support strategies is essential for improving dementia care in LMICs, and especially in culturally and economically diverse settings.

背景和目标：在低收入和中等收入国家，家庭照顾者为痴呆症患者提供了大部分支持，但人们对照顾者需求与未满足的痴呆症患者需求之间的关系知之甚少，尤其是在拉丁美洲。本研究探讨了巴西护理人员与残疾人的关系。方法：对140名巴西夫妇进行了家庭访谈，评估包括护理工具的综合需求、照顾者负担、心理健康和照顾经验，以及PWD症状和人口统计学。结果：所有夫妇至少有一个未满足的需求。结合来自PWD和护理者的预测因子的组合模型表明，受教育程度较低、为男性、表现出更多神经精神症状的PLWD与更多未满足的需求相关。此外，与护理人员相关的因素，如男性、护理经验较少、自己有更多未满足的需求，也与PWD中更多未满足的需求有关。讨论和启示：照顾者的幸福感显著影响痴呆症护理的质量。护理人员未满足的需求可能反映了他们个人的局限性和更广泛的护理挑战。通过有针对性的支持战略解决护理人员和残疾人的需求，对于改善中低收入国家，特别是在文化和经济多样化的环境中，痴呆症护理至关重要。

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引用次数: 0

Intrinsic Capacity Predictors of Dementia and Mortality in the Sydney Memory and Ageing Study 悉尼记忆与衰老研究中痴呆和死亡率的内在能力预测因子。

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-10-14 DOI: 10.1002/gps.70156

Katya Numbers, Suraj Samtani, Katja Hanewald, Jared Cheung, Perminder S. Sachdev, Henry Brodaty

Background

Intrinsic Capacity (IC) is a developing concept focussed on promoting healthy ageing by maintaining functional abilities. It has been proposed as a better predictor of outcomes like dementia and mortality, compared to traditional frailty measures that focus on deficits. This study aims to replicate the five-factor structure of IC among older adults in Australia and to evaluate its effectiveness in predicting long-term health outcomes, in comparison with existing frailty measures.

Methods

IC scores were computed for 400 older adults aged 70 to 90 participating in the Sydney Memory and Ageing Study (MAS). Structural equation modelling, including second-order confirmatory analysis, was used to compute the five IC domains. Cox proportional hazard models were used to compare the predictive value of the second-order IC factor with the Frailty Phenotype and Frailty Index for dementia over 10 years and mortality over 12 years.

Results

Factor loadings for the IC structure yielded five subgroups (cognitive function, psychological health, locomotive ability, sensory function, vital function) with one global factor. The structure had good fit (SRMR = 0.054, GFI = 0.966). IC was associated with lower hazard (risk) of dementia (HR = 0.567, p < 0.001) over 10-year and lower hazard of mortality (HR = 0.649, p < 0.001) over 12-year, controlling for age, sex, and education. Finally, IC explained additional variance beyond the Frailty Phenotype when predicting both incident dementia and mortality risk. Compared with the Frailty Index, IC contributed additional variance for dementia risk but not for mortality.

Conclusion

Evaluation of a person's IC at baseline explains additional variance compared to traditional frailty measures when predicting the risk of future negative health outcomes such as dementia incidence and mortality.

背景：内在能力（IC）是一个发展中的概念，其重点是通过维持功能能力来促进健康老龄化。与关注缺陷的传统虚弱指标相比，它被认为可以更好地预测痴呆症和死亡率等结果。本研究旨在在澳大利亚老年人中复制IC的五因素结构，并评估其在预测长期健康结果方面的有效性，并与现有的虚弱指标进行比较。方法：对参加悉尼记忆与衰老研究（MAS）的400名70 ~ 90岁老年人的IC评分进行计算。结构方程模型，包括二阶验证性分析，被用来计算五个IC域。采用Cox比例风险模型比较二级IC因子与脆弱表型和脆弱指数对10年以上痴呆和12年以上死亡率的预测价值。结果：IC结构的因子负荷分为认知功能、心理健康、运动能力、感觉功能和生命功能5个亚组，具有1个全局因子。结构拟合良好（SRMR = 0.054, GFI = 0.966）。IC与10年内较低的痴呆风险（HR = 0.567, p < 0.001）和较低的死亡率风险（HR = 0.649, p）相关。结论：在预测未来痴呆发病率和死亡率等负面健康结果的风险时，与传统的虚弱指标相比，基线时的IC评估解释了额外的方差。

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引用次数: 0