International Journal of Geriatric Psychiatry最新文献_第6页

Stigma Beliefs and Attitudes Against Dementia and Help-Seeking Intentions in Hypothetical Early Signs of Dementia: An Observational Cross-Sectional Study of Middle-Aged and Older Adults in Japan 在假设的痴呆早期症状中，对痴呆的污名化信念、态度和寻求帮助的意向：一项对日本中老年人的观察性横断面研究

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-08-11 DOI: 10.1002/gps.70141

Taiji Noguchi, Erhua Shang, Takahiro Hayashi

Objectives

People's stigma toward dementia may hinder support and care in early dementia. We explored the association of stigma beliefs and attitudes toward dementia with help-seeking intentions among middle-aged and older adults in hypothetical early signs of dementia.

Methods

This cross-sectional study involved individuals aged 40 years and above without dementia, recruited from public facility visitors in Aichi, Japan, between July and August 2024. Dementia stigma was assessed using a short form of the Phillipson Dementia Stigma Assessment, comprising four domains: personal avoidance (avoiding contact and interaction with people with dementia), fear of labeling (fear and anxiety regarding dementia diagnosis), person-centeredness (respect and positive attitudes toward people with dementia), and fear of discrimination (fear of ostracism because of dementia). The participants were asked about their help-seeking intentions from family members, other relatives, healthcare professionals, public facilities, and the phone helpline during the hypothetical early signs of dementia.

Results

Data from 380 individuals were analyzed (mean age 75.0 years; 76.1% women), of whom 90.4% had help-seeking intentions from a partner, 85.9% from children, and 85.8% from healthcare professionals. Multivariable regression analysis revealed that higher dementia stigma was associated with a lower likelihood of help-seeking intentions from a partner, children, and healthcare professionals. Of the subdomains, fear of discrimination was negatively related to help-seeking intentions.

Conclusions

This study indicated that people's stigma beliefs and attitudes may pose barriers to help-seeking in the early stage of dementia. Our findings highlight the need to strengthen support for individuals with early dementia, while reducing people's fear of discrimination and prejudice against dementia in the long term.

人们对痴呆症的耻辱感可能会阻碍早期痴呆症的支持和护理。我们探讨了在假设的老年痴呆症早期症状中，对痴呆症的耻辱感、信念和态度与寻求帮助的意图之间的联系。方法本横断面研究纳入了2024年7月至8月期间从日本爱知市公共设施访客中招募的40岁及以上无痴呆的个体。痴呆症耻辱感的评估采用Phillipson痴呆症耻辱感评估的简短形式，包括四个领域：个人回避（避免与痴呆症患者接触和互动），对标签的恐惧（对痴呆症诊断的恐惧和焦虑），以人为中心（对痴呆症患者的尊重和积极态度），以及对歧视的恐惧（害怕因痴呆症而被排斥）。参与者被问及他们的家庭成员、其他亲属、医疗保健专业人员、公共设施和电话求助热线在假设的早期痴呆症症状期间寻求帮助的意图。结果分析了380例个体资料(平均年龄75.0岁；76.1%的女性)，其中90.4%的人有伴侣的求助意向，85.9%的人有孩子的求助意向，85.8%的人有医疗保健专业人员的求助意向。多变量回归分析显示，较高的痴呆症耻辱感与伴侣、儿童和医疗保健专业人员寻求帮助的可能性较低有关。在子域中，对歧视的恐惧与求助意图呈负相关。结论在痴呆早期，人们的耻辱感、信念和态度可能成为寻求帮助的障碍。我们的研究结果强调需要加强对早期痴呆症患者的支持，同时减少人们对长期歧视和偏见痴呆症的恐惧。

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引用次数: 0

Meaningful Moments of Connection: How People Affected by Dementia and Their Carers Living at Home Understand, Interpret and Experience Everyday Aesthetics 有意义的联系时刻：痴呆症患者和他们的家庭护理人员如何理解、解释和体验日常美学

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-08-03 DOI: 10.1002/gps.70136

Sarah Fox, James Thompson, John Keady

Objectives

This study considers how people affected by dementia living in their own homes understand and interpret everyday aesthetics and what relevance this holds in their everyday lives.

Methods

Nine households, comprising ten family carers and seven people living with dementia, shared their self-identified meaningful moments of connection reflective of their personal understanding and interpretation of everyday aesthetics. Data collection involved a range of creative and self-initiated approaches, including scrapbooking, photography, and elicitation interviews. Data were analysed using reflective thematic analysis.

Results

Six discrete but interlinked themes were identified, namely: (1) Connection with others; (2) Connection with materiality; (3) Connection with self-image; (4) Connection with pride and societal value; (5) Connection with enjoyable activities; and (6) Connection with the lived environment, that revealed how people affected by dementia self-identify everyday aesthetic experiences in their daily lives.

Discussion

Our findings show these self-identified experiences span multiple physical and psychological domains of everyday life, each of which acts to support the personhood and identity of the person living with dementia. We suggest that development of a new model of care based on everyday aesthetic needs and informed by people affected by dementia, might bridge the gap between theory and practice in person-centred care. Going forward, developing care practices and support systems which focus on identifying and fulfilling the aesthetic needs of people living with dementia may offer a novel way to enhancing independence and personal well-being.

本研究考虑了生活在自己家中的痴呆症患者如何理解和解释日常美学，以及这在他们日常生活中的相关性。方法9个家庭，包括10名家庭护理人员和7名痴呆症患者，分享了他们自我认定的有意义的联系时刻，反映了他们对日常美学的个人理解和解释。数据收集涉及一系列创造性和自发的方法，包括剪贴簿、摄影和启发式访谈。数据分析采用反思性专题分析。结果确定了六个独立但相互关联的主题，即：(1)与他人的联系；(2)与重要性的联系；(3)与自我形象的联系；(4)与自尊和社会价值的联系；(5)与愉快的活动相联系；(6)与生活环境的联系，揭示了痴呆症患者如何在日常生活中自我识别日常审美体验。我们的研究结果表明，这些自我认同的经历跨越了日常生活的多个生理和心理领域，每一个领域都支持痴呆症患者的人格和身份。我们建议，开发一种基于日常审美需求的新型护理模式，并由痴呆症患者提供信息，可能会弥合以人为本的护理理论与实践之间的差距。展望未来，发展注重识别和满足痴呆症患者审美需求的护理实践和支持系统，可能为增强独立性和个人福祉提供一种新途径。

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引用次数: 0

Inequalities in Dementia Care and Research. 痴呆症护理和研究中的不平等现象。

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-08-01 DOI: 10.1002/gps.70143

Pinar Soysal, Andrea Slachevski, Yaohua Chen

引用次数: 0

Correction to “The Influence of a Dementia Diagnosis on Clinical Decision-Making in Dysphagia Management” 更正“痴呆诊断对吞咽困难治疗临床决策的影响”

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-08-01 DOI: 10.1002/gps.70133

Table 3 should have the following labels for the columns and rows:

We apologize for this error.

表3中的列和行应该有以下标签：我们为这个错误道歉。

引用次数: 0

The Association Between Health Literacy and Depressive Symptoms With the Mediation Role of Family Health and Perceived Social Support in Older Adults: A Nationwide Cross-Sectional Study in China. 健康素养与老年人抑郁症状的关系及家庭健康和感知社会支持的中介作用：一项中国全国性横断面研究

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-08-01 DOI: 10.1002/gps.70134

Shiying Cai, Zijie Zhuang, Weiming Lu, Yifei Wang, Zhiyuan Tian, Jie Ren, Jue Li, Jiaxin Chen, Guangbo Luo, Bin Lin, Xiali Yang

Objectives: There was a lack of in-depth understanding of the relationship between health literacy and depressive symptoms, and it was also unclear whether family health and perceived social support mediated this relationship and were negatively associated with the presence of depressive symptoms in older adults. This study aimed to explore the relationship between health literacy and depressive symptoms among older adults, while assessing the mediating roles of family health and perceived social support.

Methods: A cross-sectional study was conducted in China in 2021, involving 1147 participants aged 60 and older recruited using a nationwide multistage random sampling method. Ordered logistic regression and generalized additive models were employed to examine the association between health literacy and depressive symptoms, and the mediating effects of family health and perceived social support were assessed using mediation analysis with non-parametric bootstrapping. The Karlson-Holm-Breen (KHB) method was used to evaluate combined indirect associations, and subgroup mediation analyses were performed for "young-old" (65-74 years) and "old-old" (≥ 75 years) participants.

Results: Higher health literacy was associated with a lower likelihood of depressive symptoms (OR = 0.98, 95% CI: 0.97-0.99). Mediation analysis showed that the total indirect effect was thus estimated at -0.01, and the total effect of health literacy on depressive symptoms was approximately -0.03. The negative association between health literacy and depressive symptoms, as well as the mediating role of family health, remained significant in both the 65-74 and ≥ 75 age groups. However, the mediating effect of perceived social support was significant only in the 65-74 age group.

Conclusions: Health literacy is negatively associated with depressive symptoms in Chinese older adults and could be considered as a focus for intervention strategies. Enhancing health literacy may improve family health and perceived social support, and potentially lower depressive symptoms.

目的：对健康素养与抑郁症状之间的关系缺乏深入的了解，也不清楚家庭健康和感知到的社会支持是否介导了这种关系，并与老年人抑郁症状的存在负相关。本研究旨在探讨健康素养与老年人抑郁症状的关系，同时评估家庭健康和感知社会支持的中介作用。方法：于2021年在中国进行横断面研究，采用全国多阶段随机抽样方法招募60岁及以上的1147名参与者。采用有序逻辑回归和广义加性模型检验健康素养与抑郁症状之间的关系，采用非参数自助中介分析评估家庭健康和感知社会支持的中介作用。采用Karlson-Holm-Breen （KHB）方法评估联合间接关联，并对“young-old”（65-74岁）和“old-old”（≥75岁）参与者进行亚组中介分析。结果：较高的健康素养与较低的抑郁症状可能性相关（OR = 0.98, 95% CI: 0.97-0.99）。中介分析显示，间接影响的总效应估计为-0.01，健康素养对抑郁症状的总影响约为-0.03。健康素养与抑郁症状之间的负相关，以及家庭健康的中介作用，在65-74岁和≥75岁年龄组中仍然显著。然而，感知社会支持的中介作用仅在65-74岁年龄组中显著。结论：健康素养与中国老年人抑郁症状呈负相关，可作为干预策略的重点。提高健康素养可以改善家庭健康和感知到的社会支持，并可能减轻抑郁症状。

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引用次数: 0

Dose-Response Association of Handgrip Strength With Alzheimer's Disease: A Longitudinal Study Involving 85,979 Adults 握力与阿尔茨海默病的剂量-反应关联：一项涉及85,979名成年人的纵向研究

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-07-30 DOI: 10.1002/gps.70137

Rodrigo Núñez-Cortés, Joaquín Calatayud, Sergio Calonge-Pascual, Lars Louis Andersen, Rúni Bláfoss, José Francisco López-Gil, Rubén López-Bueno

Objective

To investigate the dose-response relationship between handgrip strength and incidence of Alzheimer's disease (AD) in middle-aged and older adults.

Design

Longitudinal study.

Patients and Methods

A longitudinal study was conducted in people over 50 years old in 27 European countries and Israel. Data were collected from waves 1, 2, 4, 5, 6, 7 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) between February 2004 and January 2021. Handgrip strength was measured with a hand dynamometer. AD was self-reported based on previous diagnosis. Dose-response associations were assessed by restricted cubic splines.

Results

A total of 85,979 (55.8% female) participants were followed for a median of 9.3 years. Over this time, 3324 (3.9%) developed AD. In the adjusted model, for participants < 65 years, those in the middle third of handgrip strength showed a lower risk of AD compared to the lower third (HR = 0.63, 95% CI: 0.47–0.84), as well as participants in the upper third (HR = 0.63, 95% CI: 0.47–0.85). The spline model determined that the minimum and optimal doses of handgrip strength for a significant reduction in the risk of AD for those aged < 65 years were 54 kg (HR = 0.99; 95% CI: 0.08–0.99) and 56 kg (HR = 0.27; 95% CI: 0.08–0.91), respectively. Among those aged ≥ 65 years, the minimum and optimal doses were 31 kg (HR = 0.69; 95% CI: 0.48–0.99) and 49 kg (HR = 0.57; 95% CI: 0.43–0.76), respectively.

Conclusion

Higher levels of handgrip strength showed a lower risk of developing AD, among adults aged 50 years and over. However, the dose-response relationship is limited to specific ranges according to age group. We identified a range between 54 and 56 kg years and a range between 31 and 49 kg as suitable to prevent AD in adults aged 50–64 and ≥ 65 years, respectively. Routine assessment of hand grip strength can help healthcare professionals identify people at increased risk of AD. Strength-based interventions could provide a practical strategy to support cognitive health and reduce the risk of dementia in clinical practice.

目的探讨握力与中老年人阿尔茨海默病（AD）发病率的量效关系。设计纵向研究。患者和方法一项纵向研究在27个欧洲国家和以色列的50岁以上人群中进行。数据收集自2004年2月至2021年1月期间欧洲健康、老龄化和退休调查（SHARE）的第1、2、4、5、6、7和8轮。用手测力仪测量握力。AD是基于先前诊断的自我报告。剂量-反应关联通过受限三次样条进行评估。结果共有85,979名参与者（女性55.8%）被随访，中位时间为9.3年。在此期间，3324例（3.9%）患AD。在调整后的模型中，对于参与者<；65岁时，握力在中间三分之一的人患AD的风险低于握力在中间三分之一的人（HR = 0.63, 95% CI: 0.47-0.84），握力在中间三分之一的人患AD的风险低于握力在中间三分之一的人（HR = 0.63, 95% CI: 0.47-0.85）。样条模型确定了可显著降低老年人AD风险的最小和最佳握力剂量。65岁54 kg (HR = 0.99；95% CI: 0.08-0.99)和56 kg (HR = 0.27；95% CI: 0.08-0.91)。在年龄≥65岁的人群中，最小和最佳剂量为31 kg (HR = 0.69；95% CI: 0.48-0.99)和49 kg (HR = 0.57；95% CI: 0.43-0.76)。结论在50岁及以上的成年人中，握力水平越高，患AD的风险越低。然而，剂量-反应关系根据年龄组限制在特定范围内。我们确定54 - 56 kg /年和31 - 49 kg /年的范围分别适用于50-64岁和≥65岁的成年人预防AD。对手部握力的常规评估可以帮助医疗保健专业人员识别AD风险增加的人群。在临床实践中，以力量为基础的干预措施可以提供一种实用的策略，以支持认知健康并降低痴呆症的风险。

{"title":"Dose-Response Association of Handgrip Strength With Alzheimer's Disease: A Longitudinal Study Involving 85,979 Adults","authors":"Rodrigo Núñez-Cortés, Joaquín Calatayud, Sergio Calonge-Pascual, Lars Louis Andersen, Rúni Bláfoss, José Francisco López-Gil, Rubén López-Bueno","doi":"10.1002/gps.70137","DOIUrl":"https://doi.org/10.1002/gps.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the dose-response relationship between handgrip strength and incidence of Alzheimer's disease (AD) in middle-aged and older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Longitudinal study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A longitudinal study was conducted in people over 50 years old in 27 European countries and Israel. Data were collected from waves 1, 2, 4, 5, 6, 7 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) between February 2004 and January 2021. Handgrip strength was measured with a hand dynamometer. AD was self-reported based on previous diagnosis. Dose-response associations were assessed by restricted cubic splines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 85,979 (55.8% female) participants were followed for a median of 9.3 years. Over this time, 3324 (3.9%) developed AD. In the adjusted model, for participants < 65 years, those in the middle third of handgrip strength showed a lower risk of AD compared to the lower third (HR = 0.63, 95% CI: 0.47–0.84), as well as participants in the upper third (HR = 0.63, 95% CI: 0.47–0.85). The spline model determined that the minimum and optimal doses of handgrip strength for a significant reduction in the risk of AD for those aged < 65 years were 54 kg (HR = 0.99; 95% CI: 0.08–0.99) and 56 kg (HR = 0.27; 95% CI: 0.08–0.91), respectively. Among those aged ≥ 65 years, the minimum and optimal doses were 31 kg (HR = 0.69; 95% CI: 0.48–0.99) and 49 kg (HR = 0.57; 95% CI: 0.43–0.76), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher levels of handgrip strength showed a lower risk of developing AD, among adults aged 50 years and over. However, the dose-response relationship is limited to specific ranges according to age group. We identified a range between 54 and 56 kg years and a range between 31 and 49 kg as suitable to prevent AD in adults aged 50–64 and ≥ 65 years, respectively. Routine assessment of hand grip strength can help healthcare professionals identify people at increased risk of AD. Strength-based interventions could provide a practical strategy to support cognitive health and reduce the risk of dementia in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740274","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}

引用次数: 0

Associations of Plasma p-tau181 With Age, Adjusted for Kidney Function and Sociodemographic Factors 血浆p-tau181与年龄、肾功能和社会人口因素的关系

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-07-29 DOI: 10.1002/gps.70138

Jemma Hazan, Kathy Y. Liu, Henrik Zetterberg, Nick Fox, Robert Howard, with ADNI

Introduction

Plasma phosphorylated tau (p-tau) levels, such as p-tau181, are elevated in Alzheimer's disease compared to cognitively unimpaired individuals. They represent potential candidate blood biomarkers for use in memory services where CSF examinations are not available. However, the effect of age on plasma p-tau levels remains undetermined. Limited studies have investigated the association between age and plasma p-tau thus far, and fewer still have differentiated levels by brain amyloid pathology. Characterising these associations and determining if this is influenced by sociodemographic factors or medical comorbidities is important for establishing blood biomarker reference ranges.

Methods

Using ADNI data, we analysed 860 observations (581 participants; age range: 55–95 years; 56.0% male; 93.6% White). Linear mixed models (LMMs) estimated fixed effects of age, creatinine, baseline BMI, sex, ethnicity, and group (Control vs. AD) on plasma p-tau181 concentration, with a random intercept for participant ID. Separate LMMs assessed covariate effects and interactions with group status.

Results

Analysis of ADNI data revealed a significant positive association between p-tau181 levels, group status, and creatinine in the fully adjusted LLM. Group status may have obscured the total effect of age on p-tau181, as its removal from the model resulted in a significant age effect. Single-variable models showed the positive association between either age, or creatinine and p-tau181 levels did not differ between control and AD groups. There was a significant negative association between BMI and plasma p-tau, which was stronger in AD versus control groups.

Conclusions

This study provides insights into the factors that may influence plasma p-tau181 levels. These findings underscore the need to account for clinical and demographic factors when interpreting p-tau181. Future research should validate these associations in diverse populations and explore underlying mechanisms.

与认知功能未受损的个体相比，阿尔茨海默病患者血浆磷酸化tau （p-tau）水平（如p-tau181）升高。它们代表了在没有脑脊液检查的记忆服务中使用的潜在候选血液生物标志物。然而，年龄对血浆p-tau水平的影响仍未确定。迄今为止，研究年龄与血浆p-tau之间关系的研究有限，通过脑淀粉样蛋白病理区分p-tau水平的研究仍然较少。描述这些关联并确定其是否受到社会人口因素或医学合并症的影响，对于建立血液生物标志物参考范围非常重要。方法利用ADNI数据分析860例观察结果(581名受试者；年龄范围：55-95岁；男性56.0%;93.6%的白人)。线性混合模型（lmm）估计年龄、肌酐、基线BMI、性别、种族和组（对照与AD）对血浆p-tau181浓度的固定影响，参与者ID随机截距。单独的lmm评估协变量效应和与组状态的相互作用。结果ADNI数据分析显示，在完全调整后的LLM中，p-tau181水平、组状态和肌酐之间存在显著正相关。群体状态可能掩盖了年龄对p-tau181的总体影响，因为从模型中去除p-tau181会导致显著的年龄效应。单变量模型显示年龄、肌酐和p-tau181水平之间的正相关在对照组和AD组之间没有差异。BMI和血浆p-tau之间存在显著的负相关，在AD组中比对照组更强。结论：本研究提供了可能影响血浆p-tau181水平的因素。这些发现强调了在解释p-tau181时需要考虑临床和人口因素。未来的研究应该在不同的人群中验证这些关联，并探索潜在的机制。

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引用次数: 0

Time to Diagnosis in Dementia: A Systematic Review With Meta-Analysis 痴呆的诊断时间：荟萃分析的系统回顾

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-07-27 DOI: 10.1002/gps.70129

Olubunmi Kusoro, Moïse Roche, Rafael Del-Pino-Casado, Phuong Leung, Vasiliki Orgeta

Timely dementia diagnosis is a global priority, reflected in most national and regional policies and plans. Nevertheless, there are currently no robust estimates of the average time to diagnosis (TTD) and factors influencing diagnostic intervals. This article presents the first systematic review of quantitative studies on TTD in dementia and the factors associated with its duration. We systematically searched EMBASE, Psych INFO, MEDLINE, and CINAHL databases for relevant studies published up to December 2024. We defined TTD as the interval between symptom onset (rated by family carers or patients using interviews or medical records) to final diagnosis. Risk of bias was assessed using the Reporting studies on time to diagnosis tool. We included 13 studies reporting data on 30,257 participants, with age at onset ranging between 54 and 93 years. Meta-analysis pooling 10 studies showed that average mean TTD across all types of dementia was 3.5 years [confidence interval (CI): 2.7–4.3; moderate quality evidence]. Analyses of six studies showed that TTD in young onset dementia was 4.1 years (CI: 3.4–4.9; moderate quality evidence). Although the factors influencing TTD were inconsistent, a younger age at onset and having frontotemporal dementia were consistently associated with a longer interval to diagnosis. TTD in dementia remains long, and specific healthcare strategies are urgently needed to improve it. Increasing the evidence base and developing interventions to reduce TTD should be a future research priority. Specialist services are likely to be key in improving TTD in young-onset dementia.

及时诊断痴呆症是一项全球优先事项，反映在大多数国家和区域政策和计划中。然而，目前还没有对平均诊断时间（TTD）和影响诊断间隔的因素的可靠估计。本文首次系统回顾了TTD在痴呆中的定量研究及其持续时间的相关因素。我们系统地检索了EMBASE、Psych INFO、MEDLINE和CINAHL数据库，检索了截止到2024年12月发表的相关研究。我们将TTD定义为症状发作（由家庭护理人员或患者通过访谈或医疗记录评定）到最终诊断之间的时间间隔。偏倚风险采用报告研究的诊断时间工具进行评估。我们纳入了13项研究，报告了30,257名参与者的数据，他们的发病年龄在54至93岁之间。汇总10项研究的荟萃分析显示，所有类型痴呆的平均平均TTD为3.5年[置信区间（CI）： 2.7-4.3；中等质量证据]。对6项研究的分析显示，年轻痴呆患者的TTD为4.1年(CI: 3.4-4.9；中等质量证据)。虽然影响TTD的因素不一致，但发病年龄较年轻和患有额颞叶痴呆始终与较长的诊断间隔相关。痴呆症的TTD仍然很长，迫切需要具体的医疗保健策略来改善它。增加证据基础和制定减少TTD的干预措施应该是未来研究的重点。专家服务可能是改善年轻痴呆患者TTD的关键。

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引用次数: 0

The Moderating Role of Dementia-Related Fear in the Relationship Between Perceived Cognitive Decline and Motivation for Dementia Risk Reduction Behaviors in Community-Dwelling Middle-Aged and Older Adults 社区居住中老年人认知能力下降与痴呆风险降低行为动机的关系中，痴呆相关恐惧的调节作用

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-07-25 DOI: 10.1002/gps.70130

Rose Lin, Sara Laureen Bartels, Ladislav Batalik, Jing Jing Su

Objective

With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing effective policy strategies for dementia risk reduction. This study explores the moderating role of dementia-related fear on the relationship between perceived cognitive decline and engagement in dementia risk reduction behaviors.

Methods

A cross-sectional study was conducted among 200 Chinese community-dwelling middle-aged and older adults. Hierarchical regression and simple slope analysis were used to assess the moderating effect of dementia-related fear on the relationship between perceived cognitive decline and motivation to engage in dementia risk reduction behaviors.

Results

A significant correlation was found between perceived cognitive decline and increased motivation to engage in dementia risk reduction behaviors (r = 0.44). Dementia-related fear acted as a significant moderator; motivation was positively associated with low to moderate levels of fear, whereas this association diminished and became non-significant at higher levels of fear.

Conclusions

The findings suggest that while lower levels of dementia-related fear may be linked to increased motivation for engaging in risk reduction behaviors, elevated levels of fear do not appear to support such engagement. Rather than emphasizing the negative impacts of dementia, public health strategies should empower individuals with actionable messages to engage in dementia risk reduction behaviors.

目的随着痴呆症发病率的增加，生活方式干预是降低长期风险的关键。了解影响生活方式改变动机的心理因素对于制定减少痴呆症风险的有效政策策略至关重要。本研究探讨了痴呆症相关恐惧在认知能力下降和参与痴呆症风险降低行为之间的关系中的调节作用。方法对200名居住在社区的中国中老年进行横断面研究。采用层次回归和简单斜率分析来评估痴呆相关恐惧对认知能力下降与参与痴呆风险降低行为动机之间关系的调节作用。结果发现认知能力下降与参与痴呆症风险降低行为的动机增加之间存在显著相关性（r = 0.44）。与痴呆症相关的恐惧起到了重要的调节作用；动机与低至中等水平的恐惧呈正相关，而这种关联在较高水平的恐惧中减弱并变得不显著。研究结果表明，虽然与痴呆症相关的恐惧水平较低可能与参与降低风险行为的动机增加有关，但恐惧水平升高似乎并不支持这种参与。公共卫生战略不应强调痴呆症的负面影响，而应向个人提供可操作的信息，使其参与减少痴呆症风险的行为。

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引用次数: 0

The Cost-Effectiveness of an Intervention to Preserve Independence in People With Dementia (Vs. No Intervention): A Decision-Analytic (Markov) Model Analysis 干预维持痴呆患者独立性的成本效益（与不干预相比）：决策分析（马尔可夫）模型分析

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-07-23 DOI: 10.1002/gps.70132

Luke Paterson, Rachel A. Elliott, Fofi Constantinidou, Renaud David, Piers Dawes, Eric Frison, Mark Hann, Hannah Hussain, Iracema Leroi, Antonis M. Politis, Chryssoula Thodi, Elizabeth M. Camacho, SENSE-Cog Study Team

Objectives

Interventions that enable people with dementia to retain some independence in activities of daily living (ADL) may delay transitions into residential care and offset sharp reductions in quality of life (QoL). The aim of this study was to estimate how effective a hypothetical intervention needs to be at preserving independence in home-dwelling people with dementia, to be cost-effective.

Methods

A decision-analytic model was constructed to compare costs and outcomes of a cohort of people with dementia in the United Kingdom and European Union over a 10-year period. At model entry, the cohort was distributed across low, moderate, or high levels of dependence. The impact of a hypothetical intervention that preserves independence was evaluated by reducing the proportion of people entering the model with moderate and high dependence. The model included costs for the intervention and health and social care resource use. Secondary analysis included estimated costs of informal care. Health benefit was measured as quality-adjusted life-years (QALYs).

Results

The cost of the intervention was £570/person. At this cost, an intervention that resulted in 7.5% of the sample entering the model in a lower level of dependence (compared with no intervention) was likely to be cost-effective (£8690/QALY). An intervention costing £250/person would only need a 2.5% effect and one costing £1000/person would need to have a 10% effect to be potentially cost-effective. Including informal care costs increased the size of the effect required for the intervention to be cost-effective because more of the care provided at lower levels of dependence is informal.

Conclusions

Preserving independence in people with dementia may be a cost-effective way to help them live well for longer. Our results provide a guide on costs and required effects for those developing interventions to preserve independence in people with dementia.

使痴呆症患者在日常生活活动（ADL）中保持一定独立性的干预措施可能会延迟向住宿护理的过渡，并抵消生活质量（QoL）的急剧下降。本研究的目的是估计一种假设的干预措施在保持老年痴呆症患者的独立性方面需要多大的效果，才能具有成本效益。方法构建决策分析模型，比较英国和欧盟10年间痴呆患者队列的成本和结果。在模型进入时，队列分布在低、中、高依赖水平。通过减少中等和高度依赖的人进入模型的比例来评估保持独立性的假设干预的影响。该模型包括干预和保健及社会护理资源使用的成本。二次分析包括非正式护理的估计费用。健康效益以质量调整生命年（QALYs）衡量。结果干预费用为570英镑/人。在这个成本下，导致7.5%的样本以较低的依赖程度进入模型的干预（与不干预相比）可能是具有成本效益的（8690英镑/QALY）。花费250英镑/人的干预只需要2.5%的效果，花费1000英镑/人的干预需要10%的效果才能具有潜在的成本效益。包括非正式护理费用增加了干预措施具有成本效益所需效果的大小，因为在较低依赖水平上提供的护理更多是非正式的。结论：保持痴呆患者的独立性可能是一种经济有效的方法，可以帮助他们活得更久。我们的结果为那些开发干预措施以保持痴呆症患者独立性的人提供了成本和所需效果的指导。

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