International Journal of Geriatric Psychiatry最新文献_第8页

Understanding Interactions Between Life Satisfaction and Genetic Predisposition on Risk of Alzheimer's Disease up to 14 Years Later: Findings From the UK Biobank 了解生活满意度和遗传倾向对14年后阿尔茨海默病风险的相互作用：来自英国生物银行的发现

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-29 DOI: 10.1002/gps.70120

Amber John, Roopal Desai, David Bartres-Faz, Dorina Cadar, Darya Gaysina, Aida Suarez Gonzalez, Natalie L. Marchant, Emily Willroth, Marcus Richards, Rob Saunders, Joshua Stott

Objectives

Previous research investigating associations between life satisfaction and risk of Alzheimer's disease (AD) has been mixed. This association may differ depending on genetic risk for AD. The aim of this study was to test interactions between life satisfaction and genetic predisposition on the future incidence of AD diagnosis.

Methods

Data were used from 66,668 participants aged 60+ from the UK Biobank. Participants attended an assessment centre at baseline, and data were linked to hospital admissions data and death records up to 14 years later. Cox proportional hazards models were used to test interactions between life satisfaction and a polygenic risk score (PRS) for AD on incident AD diagnosis. Models were also run stratified by genetic risk for AD.

Results

Models adjusted for age, sex, ethnicity, deprivation, education, and depression showed main effects of both life satisfaction (OR = 0.78, 95% CI = 0.68–0.90, p = 0.001) and the AD PRS (OR = 2.26, 95% CI = 2.12–2.40, p < 0.001) on incident AD. There was a significant interaction between the two (OR = 1.21, 95% CI = 1.09–1.35, p < 0.001). Stratified models showed that life satisfaction was associated with lower incident AD in the low, but not in the high genetic risk group (low: OR = 0.56, 95% CI = 0.42–0.75, p < 0.001; high: OR = 0.88, 95% CI = 0.75–1.04, p = 0.13).

Conclusions

Results show that genetic risk for AD modified the relationship between life satisfaction and the risk of AD. This suggests that genetic risk may weaken associations between life satisfaction and AD risk. The findings clarify the mixed results of previous research on this topic and may contribute to more tailored approaches to the prevention of AD in the future.

目的以往调查生活满意度与阿尔茨海默病（AD）风险之间关系的研究结果不一。这种关联可能因阿尔茨海默病的遗传风险而异。本研究的目的是测试生活满意度和遗传易感性对未来AD诊断发病率的相互作用。方法数据来自英国生物银行（UK Biobank）的66,668名60岁以上的参与者。参与者在基线时参加了一个评估中心，数据与14年后的住院数据和死亡记录相关联。使用Cox比例风险模型来检验生活满意度与AD多基因风险评分（PRS）在AD偶发诊断中的相互作用。模型也按照AD的遗传风险分层运行。结果调整了年龄、性别、种族、贫困、教育程度和抑郁的模型显示，生活满意度（OR = 0.78, 95% CI = 0.68-0.90, p = 0.001）和AD PRS (OR = 2.26, 95% CI = 2.12-2.40, p <；0.001)。两者之间存在显著的交互作用(OR = 1.21, 95% CI = 1.09-1.35, p <；0.001)。分层模型显示，生活满意度与低遗传风险组的低AD发生率相关，但与高遗传风险组无关(低：OR = 0.56, 95% CI = 0.42-0.75, p <；0.001;高：OR = 0.88, 95% CI = 0.75-1.04, p = 0.13)。结论AD的遗传风险改变了生活满意度与AD风险之间的关系。这表明遗传风险可能会削弱生活满意度和AD风险之间的联系。这些发现澄清了之前关于这一主题的研究结果，并可能有助于未来更有针对性地预防阿尔茨海默病。

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引用次数: 0

Real-World Effectiveness and Tolerability of Prolonged Intermittent Theta Burst Stimulation in Older Adults With Treatment-Resistant Depression 延长间歇性θ波爆发刺激在老年难治性抑郁症患者中的实际疗效和耐受性

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-12 DOI: 10.1002/gps.70111

Chih-Ming Cheng, Jia-Shyun Jeng, Mu-Hong Chen, Wen-Han Chang, Mu-N Liu, Wei-Chen Lin, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su, Cheng-Ta Li

Background

Older treatment-resistant depression (TRD) patients with transportation concerns may struggle to complete 30–36 repetitive transcranial magnetic stimulation (rTMS) sessions. Uninsured rTMS medical costs may be another issue in certain nations. 2-Week prolonged intermittent theta-burst stimulation (iTBS1800) to the left-sided dorsolateral prefrontal cortex (DLPFC) demonstrated similar antidepressant efficacy to standard rTMS or iTBS in adults with TRD. However, no study has yet confirmed the antidepressant effect of iTBS1800 in geriatric TRD patients.

Methods

We analyzed chart data from May 2018 to September 2022 to identify TRD patients aged ≥ 50 years who received self-pay TMS treatments at a single medical center in Taiwan. All patients had major depressive disorder and had failed at least one prior antidepressant treatment. The Hamilton Depression Rating Scale (HDRS-17) was evaluated before and after TMS stimulation.

Results

97 older patients with TRD (mean ± SD, age, 62.81 ± 7.89; 69.1%% female) was identified. Approximately 70% of patients reported anxious depression and prior antidepressant failures (≥ 3). The average number of self-pay TMS sessions was 11.71 ± 3.15) (range:10–30). Patients receiving iTBS1800 demonstrated a greatly higher remission rate than those receiving 10 Hz rTMS (29.5% vs 13.2%, respectively, p = 0.048), particularly in patients with mild and moderate depression. Age was not a clinically significant determinant of remission following TMS therapy.

Conclusion

Left-sided DLPFC iTBS1800 may be a feasible option for treating older patients with TRD due to its favorable effect and shorter treatment period, which may be ideal for patients with transportation, budgetary and vacation restrictions. More study is needed to compare the antidepressant efficacy of iTBS1800 to other TMS protocols in older patients with TRD.

有交通问题的老年难治性抑郁症（TRD）患者可能难以完成30-36个重复经颅磁刺激（rTMS）疗程。在某些国家，未投保的rTMS医疗费用可能是另一个问题。在成人TRD患者中，对左侧背外侧前额叶皮层（DLPFC）进行2周延长的间歇性theta-burst刺激（iTBS1800）显示出与标准rTMS或iTBS相似的抗抑郁效果。然而，尚无研究证实iTBS1800对老年TRD患者的抗抑郁作用。方法分析2018年5月至2022年9月的图表数据，以确定在台湾单一医疗中心接受自费经颅磁刺激治疗的年龄≥50岁的TRD患者。所有患者均患有重度抑郁症，且既往至少有一次抗抑郁药物治疗失败。在经颅磁刺激前后分别评估汉密尔顿抑郁评定量表（HDRS-17）。结果老年TRD患者97例(平均±SD，年龄62.81±7.89；69.1%为女性)。大约70%的患者报告焦虑性抑郁和既往抗抑郁失败（≥3）。平均自费TMS次数为11.71±3.15次（范围：10 ~ 30次）。接受iTBS1800治疗的患者的缓解率大大高于接受10 Hz rTMS治疗的患者（分别为29.5% vs 13.2%, p = 0.048），特别是在轻度和中度抑郁症患者中。年龄不是经颅磁刺激治疗后缓解的临床显著决定因素。结论左侧DLPFC iTBS1800治疗老年TRD效果好，治疗时间短，适合交通、预算、假期受限的患者，是治疗老年TRD的可行选择。iTBS1800与其他经颅磁刺激方案在老年TRD患者中的抗抑郁疗效比较需要更多的研究。

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引用次数: 0

Neuropsychiatric Symptoms and White Matter Hyperintensities in Older Cognitively Unimpaired Men Versus Women 老年认知功能未受损男性与女性的神经精神症状和白质高信号

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-10 DOI: 10.1002/gps.70107

Ioannis Liampas, Daniil Tsirelis, Silvia Demiri, Vasileios Siokas, Antonia Tsika, Elli Zoupa, Polyxeni Stamati, Lambros Messinis, Grigorios Nasios, Efthimios Dardiotis

Objectives

We aimed to examine association patterns of white matter hyperintensities (WMH) with neuropsychiatric symptoms (NPS) in men versus women.

Methods

We performed a cross-sectional analysis of data acquired from the National Alzheimer's Coordinating Center database. Cognitively unimpaired participants aged ≥ 50 years with data on WMH severity were studied. Using Cardiovascular Health Study scores, WMH were coded as no to mild (score: 0–4), moderate (score: 5–6) or extensive (score: 7–8). NPS were quantified on the Neuropsychiatric Inventory Questionnaire. For the purposes of the main analysis, participants were dichotomized for presence of each NPS (0: absent; 1: present). Adjusted binary logistic regression models estimated the odds of having each of 12 NPS by sex-WMH status. To confirm the validity of our findings, the correlations between NPS severity and WMH burden were also separately explored in men and women.

Results

Among 4617 participants with normal cognition, there were 1502 men and 2685 women with no to mild WMH changes, 102 men and 274 women with moderate WMH changes and 19 men and 35 women with extensive WMH changes. Greater WMH burden (especially extensive changes) was related to increased odds of lability symptoms (agitation, disinhibition, irritability) and apathy in men but not women. Elation and appetite disorders followed the same trend but failed to achieve statistical significance. The exploratory analysis revealed positive correlations between these symptoms' severity with WMH burden in men but not in women.

Conclusions

WMH burden was differentially associated with NPS in older men versus women with normal cognition.

目的：我们旨在研究男性和女性白质高信号（WMH）与神经精神症状（NPS）的关联模式。方法我们对从国家阿尔茨海默病协调中心数据库获得的数据进行了横断面分析。研究年龄≥50岁的认知未受损的WMH严重程度数据。使用心血管健康研究评分，WMH被编码为无到轻度（得分：0-4）、中度（得分：5-6）或广泛（得分：7-8）。用神经精神量表对NPS进行量化。为了主要分析的目的，参与者被二分类为每个NPS的存在(0：不存在；1:存在)。调整后的二元逻辑回归模型估计了按性别- wmh状态分列的12个NPS中的每一个的几率。为了证实我们研究结果的有效性，我们还在男性和女性中分别探讨了NPS严重程度与WMH负担之间的相关性。结果4617名认知正常的受试者中，无至轻度WMH改变的男性1502人，女性2685人，中度WMH改变的男性102人，女性274人，重度WMH改变的男性19人，女性35人。更大的WMH负担（尤其是广泛的变化）与男性易受影响症状（躁动、抑制解除、易怒）和冷漠的几率增加有关，但与女性无关。兴高采烈和食欲障碍也有相同的趋势，但没有达到统计学意义。探索性分析显示，这些症状的严重程度与男性的WMH负担呈正相关，而与女性无关。结论老年男性与认知正常女性的WMH负担与NPS的相关性存在差异。

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引用次数: 0

Prevalence and Associated Factors of Depressive Symptoms and Major Depressive Disorder Among the Oldest-Old in India 印度老年人抑郁症状和重度抑郁症的患病率及相关因素

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-09 DOI: 10.1002/gps.70112

Supa Pengpid, Karl Peltzer, André Hajek, Razak M. Gyasi

Objectives

Few studies have assessed the prevalence and correlates of major depressive disorder (MDD) and depressive symptoms among the oldest-old (≥ 80 years) in low- and middle-income countries. Using national data from India, the study's objective was to determine the prevalence of MDD and depressive symptoms, as well as the characteristics that are related to them, among people aged 80 and beyond.

Methods

Data from the nationally representative cross-sectional 2017-2018 Longitudinal Aging Study in India (LASI) were analyzed. The analytical sample consisted of 3163 community-dwelling people aged 80 and older (proxy interviews were excluded). MDD and depressive symptoms were evaluated using established measures. Multiple logistic regressions were used (with demographic, health, and social-related explanatory factors).

Results

The prevalence of depressive symptoms was 34.8% and MDD 10.3%. Regressions found that higher food insecurity (Adjusted Odds Ratio-AOR: 1.22, 95% Confidence Interval-CI: 1.03–1.44), lower subjective economic status (AOR: 0.90, 95% CI: 0.82–0.98), lower self-rated health status (AOR: 0.78, 95% CI: 0.66–0.93), lower life satisfaction (AOR: 0.66, 95% CI: 0.56–0.78), higher functional disability (AOR: 1.18, 95% CI: 1.06–1.32), physical inactivity (AOR: 1.57, 95% CI: 1.09–2.28), and higher perceived discrimination (AOR: 1.49, 95% CI: 1.35–1.64) increased the odds of depressive symptoms, and higher food insecurity (AOR: 1.31, CI: 1.02–1.68), lower self-rated health status (AOR: 0.65, 95% CI: 0.50–0.85), higher functional disability (AOR: 1.23, 95% CI: 1.08–1.40), and higher perceived discrimination (AOR: 1.23, 95% CI: 1.06–1.42) increased the odds of MDD.

Conclusions

Depression was prevalent among the oldest-old in India. Appropriate intervention strategies should be applied to prevent MMD among the oldest-old in India.

很少有研究评估中低收入国家老年人（≥80岁）中重度抑郁症（MDD）和抑郁症状的患病率及其相关因素。利用印度的国家数据，该研究的目的是确定80岁及以上人群中重度抑郁症和抑郁症状的患病率，以及与之相关的特征。方法分析2017-2018年印度纵向老龄化研究（LASI）的全国代表性横断面数据。分析样本包括3163名80岁及以上的社区居民（排除代理访谈）。使用既定的测量方法评估重度抑郁症和抑郁症状。采用多元逻辑回归（人口统计学、健康和社会相关解释因素）。结果抑郁症患病率为34.8%，重度抑郁症患病率为10.3%。回归发现，食物不安全程度较高（调整优势比-AOR: 1.22, 95%可信区间-CI: 1.03-1.44），主观经济状况较低（AOR: 0.90, 95% CI: 0.82-0.98），自我评价健康状况较低（AOR: 0.78, 95% CI: 0.66 - 0.93），生活满意度较低（AOR: 0.66, 95% CI: 0.56-0.78），功能残疾程度较高（AOR: 1.18, 95% CI: 1.06-1.32），缺乏运动（AOR: 1.57, 95% CI: 1.09-2.28），感知歧视程度较高（AOR: 1.49, 95% CI: 1.49）。1.35-1.64)增加了抑郁症状的几率，较高的食物不安全（AOR: 1.31, CI: 1.02-1.68）、较低的自评健康状况（AOR: 0.65, 95% CI: 0.50-0.85）、较高的功能残疾（AOR: 1.23, 95% CI: 1.08-1.40）和较高的感知歧视（AOR: 1.23, 95% CI: 1.06-1.42）增加了MDD的几率。结论抑郁症在印度老年人中普遍存在。应该采用适当的干预策略来预防印度老年人的烟雾病。

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引用次数: 0

Autism, Diagnostics, and Dementia: A Consensus Report From the 2nd International Summit on Intellectual Disabilities and Dementia 自闭症、诊断和痴呆：第二届智障和痴呆国际峰会的共识报告

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-06 DOI: 10.1002/gps.70110

Matthew P. Janicki, Philip McCallion, Nancy Jokinen, Frode Kibsgaard Larsen, Kathyrn P. Service, Dawna T. Mughal, Karen Watchman, Tiziano Gomiero, Seth M. Keller

Objectives

The second International Summit on Intellectual Disability and Dementia, held in 2023, highlighted the unique challenges of diagnosing dementia in older autistic adults, particularly those with intellectual disabilities, due to the complex interplay of cognitive, communicative, and behavioral factors. This article addresses key diagnostic issues and post-diagnostic considerations for this population.

Method

A consensus report was developed by the Summit's Autism/Dementia Working Group through background reviews, expert discussions at the Summit, and iterative draft revisions, incorporating feedback from internal and external stakeholders. Key issues were extracted from the report and abridged for this manuscript.

Results

Diagnostic challenges stem from overlapping symptoms of co-occurring neurodevelopmental and psychiatric conditions, rendering standard dementia tools insufficient. Comprehensive evaluations tailored to autism-related traits, sensory sensitivities, and alternative communication methods are essential. Building diagnostic capacity among clinicians and fostering multidisciplinary collaboration are critical. Longitudinal assessments, initiated before dementia symptoms appear, facilitate early detection of subtle changes. Emerging biomarkers and neuroimaging techniques show promise and should be incorporated where feasible. Accommodations, such as virtual assessments in familiar settings, can enhance diagnostic accuracy by reducing anxiety. Creating transition processes from diagnostics to post-diagnostic supports will aid in mitigating challenges and enhance life quality when dementia is a factor.

Conclusions

Research and clinician education are urgently needed to improve diagnostic approaches and streamline the transition from diagnosis to tailored post-diagnostic support. An integrated framework of comprehensive efforts is vital for our better understanding of age-associated neuropathological diagnostics and enabling long-term well-being of older autistic adults with dementia.

在2023年举行的第二届智力残疾和痴呆症国际峰会上，强调了由于认知、交流和行为因素的复杂相互作用，诊断老年自闭症患者（特别是智力残疾患者）痴呆症的独特挑战。本文讨论了该人群的关键诊断问题和诊断后注意事项。方法峰会自闭症/痴呆症工作组通过背景审查、峰会专家讨论和反复修订草案，结合内部和外部利益相关者的反馈，制定了一份共识报告。关键问题已从报告中摘录，并为本手稿作了删节。结果诊断挑战源于神经发育和精神疾病共同发生的重叠症状，使得标准的痴呆工具不足。针对自闭症相关特征、感官敏感性和替代沟通方法的综合评估是必不可少的。建立临床医生的诊断能力和促进多学科合作至关重要。在痴呆症状出现之前就开始进行纵向评估，有助于早期发现细微的变化。新兴的生物标记物和神经成像技术显示出希望，在可行的地方应该加以结合。在熟悉的环境中进行虚拟评估，可以通过减少焦虑来提高诊断的准确性。创建从诊断到诊断后支持的过渡过程将有助于减轻挑战，并在痴呆症是一个因素时提高生活质量。结论迫切需要研究和临床医生教育来改进诊断方法，并简化从诊断到量身定制的诊断后支持的过渡。综合努力的综合框架对于我们更好地理解与年龄相关的神经病理学诊断和使老年自闭症痴呆症患者长期健康至关重要。

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引用次数: 0

Cognitive Stimulation Therapy—Spain (CST-ES): Cultural Adaptation Process and Pilot Study 西班牙认知刺激疗法（CST-ES）：文化适应过程和试点研究

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-05 DOI: 10.1002/gps.70109

Enrique Pérez-Sáez, Elisa Aguirre Sánchez, Mireia Tofiño García, Teresa Rodríguez del Rey, Beatriz Peláez Hernández

Objectives

To assess the validity and acceptability of an adapted version of Cognitive Stimulation Therapy (CST) for the Spanish population and culturally adapt the original UK manuals.

Methods

The process followed the Formative Method for Adapting Psychotherapy (FMAP). Two focus groups were conducted with healthcare professionals specialized in the care of people with dementia, a pilot study with a small sample size (n = 6), and individual interviews with participants, family caregivers, and group facilitators. The study was conducted at the National Reference Center for Alzheimer's and Dementia Care (CREA), a specialized dementia care center in Spain. The participants included eight healthcare professionals for the focus groups, six persons with dementia from CREA outpatient programs for the pilot study, their family caregivers, and two group facilitators. Assessments for the pilot study included the Mini-Mental State Examination (MMSE), Cambridge Cognitive Assessment Revised (CAMCOG-R), Geriatric Depression Scale (GDS-15), Quality of Life in Alzheimer's Disease Scale (QoL-AD), Barthel Index (BI), and the Lawton and Brody Scale for Instrumental Activities of Daily Living (IADL).

Results

The adapted CST principles and structure were deemed suitable for the Spanish context, with necessary linguistic and cultural adjustments. The pilot study reported no implementation issues, with positive feedback from participants, caregivers, and facilitators, alongside significant cognitive and quality of life improvements.

Discussion

The culturally adapted Cognitive Stimulation Therapy—Spain (CST-ES) is a valid and appropriate intervention for the Spanish population, providing a valuable addition to non-pharmacological therapies for dementia in Spain.

目的评估西班牙人群认知刺激疗法（CST）改编版本的有效性和可接受性，并对英国原版手册进行文化改编。方法采用适应心理治疗形成法（FMAP）。两个焦点小组由专门照顾痴呆症患者的医疗保健专业人员组成，进行了一项小样本量的试点研究（n = 6），并对参与者、家庭照顾者和小组促进者进行了个人访谈。这项研究是在国家阿尔茨海默病和痴呆症护理参考中心（CREA）进行的，这是西班牙一家专门的痴呆症护理中心。参与者包括焦点小组的8名医疗保健专业人员，试点研究中CREA门诊项目的6名痴呆症患者，他们的家庭照顾者和2名小组协调员。试点研究的评估包括简易精神状态检查（MMSE）、剑桥认知评估修订版（CAMCOG-R）、老年抑郁量表（GDS-15）、阿尔茨海默病生活质量量表（QoL-AD）、Barthel指数（BI）和日常生活工具性活动劳顿和布罗迪量表（IADL）。结果调整后的CST原则和结构被认为适合西班牙语语境，并进行了必要的语言和文化调整。试点研究报告没有实施问题，参与者、护理人员和促进者的积极反馈，以及显著的认知和生活质量改善。文化适应性认知刺激疗法-西班牙（CST-ES）是西班牙人群有效和适当的干预措施，为西班牙痴呆症的非药物治疗提供了有价值的补充。

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引用次数: 0

Depressive Symptoms Before and During the COVID-19 Pandemic in Veteran Nursing Home Residents 老年疗养院居民在COVID-19大流行之前和期间的抑郁症状

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-06-01 DOI: 10.1002/gps.70108

Madeline B. Benz, James L. Rudolph, Frank DeVone, Thomas A. Bayer, Alexander Garbin, Mriganka Singh, Stefan Gravenstein, Scotte Hartronft, Rhonda Toms, Brandon A. Gaudiano, Jane Metrik, Julia Browne

Objectives

Infection control measures in the Department of Veterans Affairs Community Living Centers (CLCs), analogous to nursing homes, during the COVID-19 pandemic may have impacted residents' mental health. The purpose of this study was to examine changes in depressive symptoms before and during the COVID-19 pandemic in CLC residents.

Methods

This cross-sectional national cohort study evaluated depressive symptoms in Veteran CLC residents from geographically diverse CLCs across four 9-month periods of the COVID-19 pandemic: pre (before COVID-19), early (before vaccine), mid (before booster), and late (after booster). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9), a standardized depression assessment, which is a required measure in the Minimum Data Set (MDS). We computed change in PHQ-9 scores from the initial to the last PHQ-9 assessment for each pandemic period. We also performed a focused analysis of residents with a past year depression diagnosis.

Results

The overall sample comprised 47,755 Veteran CLC residents, 43% percent (n = 20,554) of whom had a depression diagnosis. The overall cohort mean PHQ-9 scores were similar across pandemic periods (pre = 2.64, early = 2.48, mid = 2.61, late = 2.45). There was intra-resident decline in PHQ-9 during each period which was statistically, but not clinically significant (pre = −0.54, early = −0.47, mid = −0.55, late = −0.49). Residents with a depression diagnosis followed a similar pattern for scores and decline in the periods compared with the full sample. PHQ-9 average scores indicated minimal depression even among those with a depression diagnosis, limiting ability to detect changes over time.

Conclusions

For CLC residents during the COVID-19 pandemic, PHQ-9 scores were not meaningfully different between time periods. Characteristics of the study (e.g., sample/setting) or of older adults generally (e.g., resilience) may explain the low rates of depression.

目的新型冠状病毒肺炎大流行期间，退伍军人事务部社区生活中心（CLCs）的感染控制措施可能会影响居民的心理健康。本研究的目的是研究CLC患者在COVID-19大流行之前和期间抑郁症状的变化。方法本横断面国家队列研究评估了在COVID-19大流行的4个9个月期间，来自不同地理位置的CLC退伍军人的抑郁症状：前（在COVID-19之前）、早期（在接种疫苗之前）、中期（在加强疫苗之前）和晚期（在加强疫苗之后）。采用患者健康问卷（PHQ-9）对抑郁症状进行评估，这是一种标准化的抑郁评估，是最小数据集（MDS）的要求。我们计算了每个大流行时期PHQ-9评分从最初到最后一次PHQ-9评估的变化。我们还对过去一年被诊断为抑郁症的居民进行了重点分析。结果共纳入47,755名CLC退伍军人，其中43% （n = 20,554）被诊断为抑郁症。整个队列平均PHQ-9评分在大流行期间相似（前期= 2.64，早期= 2.48，中期= 2.61，晚期= 2.45）。住院期间PHQ-9均有下降，差异有统计学意义，但临床差异无统计学意义（术前= - 0.54，早期= - 0.47，中期= - 0.55，晚期= - 0.49）。与完整的样本相比，被诊断为抑郁症的居民的得分和下降也遵循了类似的模式。PHQ-9平均得分表明，即使在被诊断为抑郁症的人群中，抑郁程度也很低，这限制了他们检测变化的能力。结论在COVID-19大流行期间，CLC居民的PHQ-9评分在不同时间段之间没有显著差异。研究的特征（例如，样本/环境）或老年人的一般特征（例如，恢复力）可能解释抑郁症的低发病率。

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引用次数: 0

Does Frailty Predict Cognitive and Functional Deficits After Nine Years? 虚弱是否预示着九年后的认知和功能缺陷？

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-05-30 DOI: 10.1002/gps.70104

Beatriz Raz Franco de Santana, Daniela de Assumpção, Flávia Silva Arbex Borim, Ivan Aprahamian, Ligiana Pires Corona, Samila Sathler Tavares Batistoni, Deusivania Vieira da Silva Falcão, Meire Cachioni, Ruth Caldeira de Melo, Anita Liberalesso Neri, Monica Sanches Yassuda

Objectives

To identify the variables at baseline, including physical frailty, that might predict cognitive and functional deficits in a 9-year follow-up.

Methods

This investigation included participants from the FIBRA study in Campinas city and Ermelino Matarazzo, subdistrict of São Paulo city, with complete data collected at baseline and follow-up for the variables sex, age, education, frailty phenotype, number of chronic diseases, and tobacco and alcohol use. Of the initial 1284 participants at baseline, 98 that exhibited cognitive impairment were excluded. At follow-up, 451 participants were located and reinterviewed and 85 scored below the cut-off on the Mini-Mental State Exam (MMSE), of which 45 also presented functional deficit.

Results

The follow-up subsample comprised predominantly participants that were female (68.1%), aged 65–74 years (71.6%), and had low education (0–4 years of education, 75.6%). At baseline, 35.5% were non-frail, 57.0% pre-frail and 7.5% frail, whereas at follow-up, 29.4% were non-frail, 62.3% pre-frail and 8.3% frail. Logistic regression showed that age and education but not frailty at baseline were associated with cognitive and functional deficits at follow-up.

Conclusions

Higher age and lower education at baseline were predictors of cognitive and functional deficits after 9 years, whereas frailty was not. Further longitudinal studies should be conducted to elucidate the factors predicting cognitive and functional decline in low-and middle-income countries.

目的确定基线变量，包括身体虚弱，在9年随访中可能预测认知和功能缺陷。方法本研究纳入了来自圣保罗市Campinas市和Ermelino Matarazzo街道的FIBRA研究的参与者，在基线和随访时收集了性别、年龄、教育程度、脆弱表型、慢性病数量和烟酒使用等变量的完整数据。在最初的1284名基线参与者中，98名表现出认知障碍的参与者被排除在外。在随访中，451名参与者被定位并重新访谈，其中85人在迷你精神状态测试（MMSE）中得分低于临界值，其中45人也表现出功能缺陷。结果随访子样本主要为女性（68.1%），年龄在65-74岁（71.6%），受教育程度低（0-4年，75.6%）。基线时，35.5%为非虚弱，57.0%为虚弱前期，7.5%为虚弱，而随访时，29.4%为非虚弱，62.3%为虚弱前期，8.3%为虚弱。逻辑回归显示，年龄和教育程度与随访时的认知和功能缺陷有关，而基线时的虚弱程度与随访时的认知和功能缺陷无关。结论：较高的年龄和较低的基线教育水平是9年后认知和功能缺陷的预测因素，而虚弱不是预测因素。应该进行进一步的纵向研究，以阐明预测中低收入国家认知和功能衰退的因素。

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引用次数: 0

Differentiating Treatment-Resistant Depression With and Without Parkinsonism in the Elderly From a Psychiatric Perspective by 99mTc-TRODAT-1 SPECT Imaging 99mTc-TRODAT-1 SPECT成像从精神病学角度鉴别老年难治性抑郁症伴与不伴帕金森病

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-05-30 DOI: 10.1002/gps.70102

Tung-Ping Su, Chiu-Jung Huang, Wei-Chung Mao, Yu-Hsien Chiu, Ren-Shyan Liu, Li-Fen Chen

<div> <section> <h3> Objectives</h3> <p>Late-life depression often overlaps with neurodegenerative diseases leading to diagnostic and treatment challenges for neuropsychiatrists. This study aimed to differentiate elderly treatment-resistant depression (TRD) comorbid with parkinsonism from elderly TRD without Parkinsonism as well as elderly healthy controls using striatum dopamine transporter (DAT) imaging by <sup>99m</sup>Tc TRODAT-1 SPECT.</p> </section> <section> <h3> Methods</h3> <p>Three groups were enrolled, including patients with TRD, patients with TRD comorbid with parkinsonism, and healthy controls. To obtain the DAT availability, the specific uptake ratios of the bilateral striatum were evaluated. Linear regression analyses were performed to evaluate the relationship between age and DAT level in the subregions of the striatum. Machine learning was applied to categorize the three groups with 10-fold cross-validation.</p> </section> <section> <h3> Results</h3> <p>The study enrolled 32 patients with TRD (<span></span><math> <semantics> <mrow> <mn>66.15</mn> <mo>±</mo> <mn>6.82</mn> </mrow> <annotation> $66.15pm 6.82$</annotation> </semantics></math>), 36 TRD patients with parkinsonism (<span></span><math> <semantics> <mrow> <mn>70.27</mn> <mo>±</mo> <mn>5.63</mn> </mrow> <annotation> $70.27pm 5.63$</annotation> </semantics></math>), and 74 healthy elderly (<span></span><math> <semantics> <mrow> <mn>66.95</mn> <mo>±</mo> <mn>10.59</mn> </mrow> <annotation> $66.95pm 10.59$</annotation> </semantics></math>). A normative DAT concentration by age was established, providing a reference for clinical use. DAT levels differed among groups (all pairwise <i>p</i> < 0.01), with healthy controls exhibiting the highest levels, followed by patients with TRD, and then TRD patients with parkinsonism. Further, the Fine k-NN classifier emerged as the top performer to achieve 85.7% accuracy.</p> </section> <section> <h3> Conclusions</h3> <p>Besides clinical assessment, dopaminergic as

目的老年抑郁症常与神经退行性疾病重叠，给神经精神病学家的诊断和治疗带来挑战。本研究旨在利用99mTc TRODAT-1 SPECT纹状体多巴胺转运体（DAT）成像技术，区分老年帕金森病伴发的难治性抑郁症（TRD）与非帕金森病的老年抑郁症（TRD）以及老年健康对照。方法将TRD患者、TRD合并帕金森病患者和健康对照组分为3组。为了获得数据的有效性，评估了双侧纹状体的特定摄取比率。采用线性回归分析来评估纹状体亚区年龄与DAT水平之间的关系。应用机器学习对三组进行10倍交叉验证分类。结果32例TRD患者（66.15±6.82美元66.15pm 6.82美元），TRD帕金森患者36例（70.27±5.63美元70.27pm 5.63美元）；健康老年人74例（66.95±10.59$ 66.95pm 10.59$）。建立了按年龄划分的标准DAT浓度，为临床使用提供参考。各组间DAT水平存在差异(p <；0.01)，健康对照最高，TRD患者次之，TRD合并帕金森患者次之。此外，Fine k-NN分类器表现最佳，准确率达到85.7%。结论除临床评价外，多巴胺能评价可作为老年帕金森与TRD的鉴别指标。TRD中较低的DAT可用性表明TRD可能是帕金森病的前驱症状。精神科医生应考虑老年人、抑郁症患者的共病性神经退行性疾病，并使用临床评估、神经学检查和脑成像进行早期帕金森病筛查。

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引用次数: 0

The Relationship Between Caregiver Burden With Insomnia and Malnutrition in Caregivers of Older Hospitalized Patients 老年住院患者照顾者失眠负担与营养不良的关系

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry

Pub Date : 2025-05-28 DOI: 10.1002/gps.70106

Nisa Ozen Aydin, Irem Tanriverdi, Ozge Pasin, Betul Sumbul Sekerci, Lee Smith, André Hajek, Pinar Soysal

Objectives

The aim of this study was to investigate among caregivers of older hospitalized patients, the relationship between caregiver burden, caregivers' nutrition, and the two most common sleep disorders—excessive daytime sleepiness and insomnia—as well as the interplay between these factors.

Method

The study universe consisted of informal caregivers of older inpatients at an university hospital in Turkiye. The sample included 100 caregivers selected through purposive sampling between March 2024-/January 2025. Data were collected on personal information, caregiver burden (assessed using the Multidimensional Caregiver Burden Inventory [MCBI]), nutritional status (evaluated using the Mini Nutritional Assessment Test [MNA] and the Healthy Eating Attitude Scale), sleep status (assessed using the Epworth Sleepiness Scale and the Insomnia Severity Index [ISI]), and muscle strength (measured by a handgrip dynamometer).

Result

A total of 100 caregivers (79% female, with a mean age of 50.5 years). Females comprised 61% of the patient population, and the mean age was 78.5 years. A significant positive correlation was found between the MCBI score and caregiving duration, ISI score, and patient age (p < 0.005). In contrast, the MCBI score showed a significant negative correlation with the MNA score and muscle strength (p ≤ 0.005). The adjusted linear regression analysis revealed that the MNA score had a significant negative effect on MCBI, while the ISI score had a significant positive effect.

Conclusion

In the present study caregiver burden was associated with poor nutrition and sleep disturbances. Thus, reducing caregiver burden may improve insomnia and malnutrition. Moreover, addressing sleep and nutrition problems in caregivers suffering from insomnia or malnutrition may contribute to a reduction in overall caregiver burden.

目的探讨老年住院患者护理人员负担、营养状况与两种最常见的睡眠障碍日间过度嗜睡和失眠症之间的关系及其相互作用。方法研究对象为土耳其某大学医院老年住院患者的非正式护理人员。样本包括2024年3月至2025年1月期间通过有目的抽样选择的100名护理人员。收集的数据包括个人信息、照顾者负担（使用多维照顾者负担量表[MCBI]评估）、营养状况（使用迷你营养评估测试[MNA]和健康饮食态度量表评估）、睡眠状况（使用爱普沃斯嗜睡量表和失眠严重程度指数[ISI]评估）和肌肉力量（通过握力计测量）。结果共100名护理人员，女性79%，平均年龄50.5岁。女性占患者总数的61%，平均年龄为78.5岁。MCBI评分与护理时间、ISI评分和患者年龄呈显著正相关(p <；0.005)。MCBI评分与MNA评分和肌力呈显著负相关（p≤0.005）。调整后的线性回归分析显示，MNA评分对MCBI有显著的负向影响，而ISI评分对MCBI有显著的正向影响。结论在本研究中，照顾者负担与营养不良和睡眠障碍有关。因此，减轻照顾者负担可能改善失眠和营养不良。此外，解决患有失眠或营养不良的照顾者的睡眠和营养问题可能有助于减轻照顾者的总体负担。

{"title":"The Relationship Between Caregiver Burden With Insomnia and Malnutrition in Caregivers of Older Hospitalized Patients","authors":"Nisa Ozen Aydin, Irem Tanriverdi, Ozge Pasin, Betul Sumbul Sekerci, Lee Smith, André Hajek, Pinar Soysal","doi":"10.1002/gps.70106","DOIUrl":"https://doi.org/10.1002/gps.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to investigate among caregivers of older hospitalized patients, the relationship between caregiver burden, caregivers' nutrition, and the two most common sleep disorders—excessive daytime sleepiness and insomnia—as well as the interplay between these factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study universe consisted of informal caregivers of older inpatients at an university hospital in Turkiye. The sample included 100 caregivers selected through purposive sampling between March 2024-/January 2025. Data were collected on personal information, caregiver burden (assessed using the Multidimensional Caregiver Burden Inventory [MCBI]), nutritional status (evaluated using the Mini Nutritional Assessment Test [MNA] and the Healthy Eating Attitude Scale), sleep status (assessed using the Epworth Sleepiness Scale and the Insomnia Severity Index [ISI]), and muscle strength (measured by a handgrip dynamometer).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A total of 100 caregivers (79% female, with a mean age of 50.5 years). Females comprised 61% of the patient population, and the mean age was 78.5 years. A significant positive correlation was found between the MCBI score and caregiving duration, ISI score, and patient age (<i>p</i> < 0.005). In contrast, the MCBI score showed a significant negative correlation with the MNA score and muscle strength (<i>p</i> ≤ 0.005). The adjusted linear regression analysis revealed that the MNA score had a significant negative effect on MCBI, while the ISI score had a significant positive effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the present study caregiver burden was associated with poor nutrition and sleep disturbances. Thus, reducing caregiver burden may improve insomnia and malnutrition. Moreover, addressing sleep and nutrition problems in caregivers suffering from insomnia or malnutrition may contribute to a reduction in overall caregiver burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 6","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171401","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}

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