Pub Date : 2025-05-01Epub Date: 2024-10-22DOI: 10.1177/08919887241295730
Yun Fan, Yun Ling, Xibin Zhou, Kai Li, Chunxiang Zhou
BackgroundEndoplasmic reticulum (ER) stress-induced neurodegeneration has been considered an underlying cause of Alzheimer disease (AD). Here, we investigated the beneficial effects of licochalcone A (Lico A), a valuable flavonoid of the root of the Glycyrrhiza species, against cognitive impairment in AD by regulating ER stress.MethodsThe triple transgenic mouse AD models were used and were administrated 5 or 15 mg/kg Lico A. Cognitive deficits, Aβ deposition, ER stress, and neuronal apoptosis were determined using Morris Water Maze test, probe trial, immunofluorescence staining, western blotting, and TUNEL staining. To investigate the mechanisms of how Lico A exerts anti-AD effects, primary hippocampal neurons were isolated from the AD model mice and treated with Lico A, salubrinal, an eIF2α phosphatase inhibitor, ML385, a Nrf2 inhibitor, or LY294002, an inhibitor of PI3K. Pharmacokinetics and toxicity of Lico A (15 mg/kg) in AD mice were evaluated.ResultsWe found that Lico A improved cognitive impairment, decreased Aβ plaques, inhibited ER stress, and reduced neuronal apoptosis in the hippocampus and cortex of AD mice. Treatment with Lico A in primary hippocampal neurons exerted the same effects as it did in vivo. Additionally, cotreatment with ML385 or LY294002 significantly impeded the effects of Lico A against ER stress. Moreover, 15 mg/kg Lico A had a good bioavailability and low toxicity in AD mice.ConclusionOur results demonstrated that Lico A ameliorates ER stress-induced neuronal apoptosis by inhibiting PERK/eIF2α/ATF4/CHOP signaling, suggesting the therapeutic potential of Lico A in AD treatment.
背景:内质网(ER)应激诱导的神经退行性变一直被认为是阿尔茨海默病(AD)的根本原因。在此,我们研究了甘草根中一种珍贵的黄酮类化合物甘草查耳酮 A(Lico A)通过调节内质网应激对阿兹海默病认知障碍的有益作用:通过莫里斯水迷宫试验、探针试验、免疫荧光染色、Western印迹和TUNEL染色测定认知障碍、Aβ沉积、ER应激和神经细胞凋亡。为了研究 Lico A 如何发挥抗 AD 作用的机制,研究人员从 AD 模型小鼠体内分离出原代海马神经元,并用 Lico A、eIF2α 磷酸酶抑制剂 salubrinal、Nrf2 抑制剂 ML385 或 PI3K 抑制剂 LY294002 处理。我们评估了 Lico A(15 毫克/千克)在 AD 小鼠体内的药代动力学和毒性:结果:我们发现 Lico A 可改善 AD 小鼠的认知障碍、减少 Aβ 斑块、抑制 ER 应激并减少海马和皮层中神经元的凋亡。在原发性海马神经元中使用 Lico A 可产生与在体内相同的效果。此外,与 ML385 或 LY294002 共用可显著抑制 Lico A 对抗 ER 应激的作用。此外,15 毫克/千克的 Lico A 在 AD 小鼠体内具有良好的生物利用度和低毒性:我们的研究结果表明,Lico A可通过抑制PERK/eIF2α/ATF4/CHOP信号转导来改善ER应激诱导的神经细胞凋亡,这表明Lico A具有治疗AD的潜力。
{"title":"Licochalcone A Ameliorates Cognitive Dysfunction in an Alzheimer's Disease Model by Inhibiting Endoplasmic Reticulum Stress-Mediated Apoptosis.","authors":"Yun Fan, Yun Ling, Xibin Zhou, Kai Li, Chunxiang Zhou","doi":"10.1177/08919887241295730","DOIUrl":"10.1177/08919887241295730","url":null,"abstract":"<p><p>BackgroundEndoplasmic reticulum (ER) stress-induced neurodegeneration has been considered an underlying cause of Alzheimer disease (AD). Here, we investigated the beneficial effects of licochalcone A (Lico A), a valuable flavonoid of the root of the Glycyrrhiza species, against cognitive impairment in AD by regulating ER stress.MethodsThe triple transgenic mouse AD models were used and were administrated 5 or 15 mg/kg Lico A. Cognitive deficits, Aβ deposition, ER stress, and neuronal apoptosis were determined using Morris Water Maze test, probe trial, immunofluorescence staining, western blotting, and TUNEL staining. To investigate the mechanisms of how Lico A exerts anti-AD effects, primary hippocampal neurons were isolated from the AD model mice and treated with Lico A, salubrinal, an eIF2α phosphatase inhibitor, ML385, a Nrf2 inhibitor, or LY294002, an inhibitor of PI3K. Pharmacokinetics and toxicity of Lico A (15 mg/kg) in AD mice were evaluated.ResultsWe found that Lico A improved cognitive impairment, decreased Aβ plaques, inhibited ER stress, and reduced neuronal apoptosis in the hippocampus and cortex of AD mice. Treatment with Lico A in primary hippocampal neurons exerted the same effects as it did <i>in vivo</i>. Additionally, cotreatment with ML385 or LY294002 significantly impeded the effects of Lico A against ER stress. Moreover, 15 mg/kg Lico A had a good bioavailability and low toxicity in AD mice.ConclusionOur results demonstrated that Lico A ameliorates ER stress-induced neuronal apoptosis by inhibiting PERK/eIF2α/ATF4/CHOP signaling, suggesting the therapeutic potential of Lico A in AD treatment.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"201-213"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-10-01DOI: 10.1177/08919887241289533
Anderson Chen, Eran Metzger, Soyoung Lee, David Osser
BackgroundThis is a new algorithm from the Psychopharmacology Algorithm Project at the Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed.ResultsSelective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with a preference for sertraline or escitalopram. If avoiding sexual side effects is a priority, buspirone is an option for the relatively healthy older adult. If response is inadequate, the second recommended trial is with a different SSRI or one of the serotonin-norepinephrine update inhibitors (SNRIs), venlafaxine or duloxetine. For a third medication trial, additional alternatives added to the previous options now include pregabalin/gabapentin, lavender oil, and agomelatine. If there is an unsatisfactory response to the third option chosen, quetiapine may be considered. We recommend caution with the following for acute treatment in this population: benzodiazepines and hydroxyzine. Other agents given low priority but having some supportive evidence were vilazodone, vortioxetine, mirtazapine, and cannabidiol. Acknowledging that the median age of onset of GAD is in early adulthood, many patients with GAD will have been started on benzodiazepines (or other medications that require caution in the elderly) for GAD at a younger age. These medications may be continued with regular observation to see if the potential harms are starting to exceed the benefits and a switch to other recommended agents may be justified.
{"title":"A Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient.","authors":"Anderson Chen, Eran Metzger, Soyoung Lee, David Osser","doi":"10.1177/08919887241289533","DOIUrl":"10.1177/08919887241289533","url":null,"abstract":"<p><p>BackgroundThis is a new algorithm from the Psychopharmacology Algorithm Project at the Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed.ResultsSelective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with a preference for sertraline or escitalopram. If avoiding sexual side effects is a priority, buspirone is an option for the relatively healthy older adult. If response is inadequate, the second recommended trial is with a different SSRI or one of the serotonin-norepinephrine update inhibitors (SNRIs), venlafaxine or duloxetine. For a third medication trial, additional alternatives added to the previous options now include pregabalin/gabapentin, lavender oil, and agomelatine. If there is an unsatisfactory response to the third option chosen, quetiapine may be considered. We recommend caution with the following for acute treatment in this population: benzodiazepines and hydroxyzine. Other agents given low priority but having some supportive evidence were vilazodone, vortioxetine, mirtazapine, and cannabidiol. Acknowledging that the median age of onset of GAD is in early adulthood, many patients with GAD will have been started on benzodiazepines (or other medications that require caution in the elderly) for GAD at a younger age. These medications may be continued with regular observation to see if the potential harms are starting to exceed the benefits and a switch to other recommended agents may be justified.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"155-171"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-09-27DOI: 10.1177/08919887241285558
Malvina O Pietrzykowski, Colleen E Jackson, Charles E Gaudet
ObjectivesRates of post-traumatic stress disorder (PTSD) among older adults range from 0.4%-4.5%. Research examining PTSD in adults has demonstrated numerous associations between physical and mental health conditions; however, these are less well characterized in older adults. The current study aimed to identify base rates of such conditions among older adults with and without a history of PTSD.MethodIn a case control design using the National Alzheimer's Coordinating Center Uniform Data Set, adults 65 years or older from the United States who endorsed either the presence or absence of PTSD were matched by age to assess between-group differences (N = 472; 236 pairs). We examined differences across self-reported sociodemographics and physical health, mental health, and substance use histories.ResultsMore participants with a history of PTSD identified as Hispanic, non-white, non-married, and functionally independent. Compared to individuals without a history of PTSD, significantly more individuals with a history of PTSD had histories of depression, anxiety, substance abuse, Parkinson's disease, seizures, insomnia, and TBI. Among participants without PTSD history, only 14.7% reported a history of TBI, compared to 41.1% of individuals with PTSD history.ConclusionsFindings showed expected trends toward worse physical and mental health among older adults with self-reported PTSD. There was a striking difference in the frequency of TBI history between participants with and without PTSD. These findings underscore a need to assess for PTSD among older adults, particularly those reporting a history of TBI.
目的:老年人患创伤后应激障碍(PTSD)的比例为 0.4%-4.5%。对成年人创伤后应激障碍的研究表明,身体和精神健康状况之间存在许多关联;然而,这些关联在老年人中的表现却不尽人意。本研究旨在确定有创伤后应激障碍病史和无创伤后应激障碍病史的老年人中此类病症的基本比率:方法:使用国家阿尔茨海默氏症协调中心统一数据集(National Alzheimer's Coordinating Center Uniform Data Set)进行病例对照设计,将美国 65 岁或以上、认可存在或不存在创伤后应激障碍的成年人按年龄进行配对,以评估组间差异(N = 472;236 对)。我们研究了自我报告的社会人口统计学、身体健康、心理健康和药物使用史之间的差异:结果:有创伤后应激障碍病史的参与者中,更多的人认为自己是西班牙裔、非白人、未婚且功能独立。与没有创伤后应激障碍病史的人相比,有创伤后应激障碍病史的人中有抑郁、焦虑、药物滥用、帕金森病、癫痫发作、失眠和创伤性脑损伤病史的人要多得多。在没有创伤后应激障碍病史的参与者中,只有 14.7% 的人报告有创伤后应激障碍病史,而在有创伤后应激障碍病史的人中,有创伤后应激障碍病史的人占 41.1%:研究结果表明,在自述患有创伤后应激障碍的老年人中,身体和精神健康状况呈现出预期的恶化趋势。在有创伤后应激障碍和没有创伤后应激障碍的参与者中,有创伤后应激障碍病史的频率有显著差异。这些发现强调了在老年人中评估创伤后应激障碍的必要性,尤其是那些报告有创伤后应激障碍病史的老年人。
{"title":"Co-Occurring Mental and Physical Health Conditions Among Older Adults With and Without Post-traumatic Stress Disorder: A Case Control Study.","authors":"Malvina O Pietrzykowski, Colleen E Jackson, Charles E Gaudet","doi":"10.1177/08919887241285558","DOIUrl":"10.1177/08919887241285558","url":null,"abstract":"<p><p>ObjectivesRates of post-traumatic stress disorder (PTSD) among older adults range from 0.4%-4.5%. Research examining PTSD in adults has demonstrated numerous associations between physical and mental health conditions; however, these are less well characterized in older adults. The current study aimed to identify base rates of such conditions among older adults with and without a history of PTSD.MethodIn a case control design using the National Alzheimer's Coordinating Center Uniform Data Set, adults 65 years or older from the United States who endorsed either the presence or absence of PTSD were matched by age to assess between-group differences (N = 472; 236 pairs). We examined differences across self-reported sociodemographics and physical health, mental health, and substance use histories.ResultsMore participants with a history of PTSD identified as Hispanic, non-white, non-married, and functionally independent. Compared to individuals without a history of PTSD, significantly more individuals with a history of PTSD had histories of depression, anxiety, substance abuse, Parkinson's disease, seizures, insomnia, and TBI. Among participants without PTSD history, only 14.7% reported a history of TBI, compared to 41.1% of individuals with PTSD history.ConclusionsFindings showed expected trends toward worse physical and mental health among older adults with self-reported PTSD. There was a striking difference in the frequency of TBI history between participants with and without PTSD. These findings underscore a need to assess for PTSD among older adults, particularly those reporting a history of TBI.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"191-200"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-11-21DOI: 10.1177/08919887241302107
Jingkai Wei, Kun Li, Youngran Kim, Rahul Ghosal, Donglan Zhang, Anwar T Merchant, Casey Crump
Background and ObjectivesHearing aids may reduce the risk of dementia among individuals with hearing loss. However, no evidence is available from randomized controlled trials (RCTs) on the effectiveness of hearing aids use in reducing incident dementia. Using target trial emulation, we leveraged an existing longitudinal cohort study to estimate the association between hearing aids initiation and risk of dementia.Research Design and MethodsThe Health and Retirement Study was used to emulate target trials among non-institutionalized participants aged ≥50 years with self-reported hearing loss, without dementia at baseline, and without use of hearing aids in the previous 2 years. Intention-to-treat analysis was conducted to estimate the risk of dementia associated with hearing aids initiation vs controls who did not initiate hearing aids. Pooled logistic regression models with inverse-probability of treatment and censoring weights were applied to estimate risk ratios, and 95% confidence intervals were calculated using 1000 sets of bootstrapping.ResultsAmong 2314 participants (328 in the intervention group and 1986 in the control group; average age: 72.3 ± 9.7 years, 49% women, and 81% White), after 8 years of follow-up, risk of dementia was significantly lower among individuals who initiated hearing aids (risk difference (RD): -0.05, 95% confidence interval (CI): -0.08, -0.01). A lower risk was observed particularly among adults aged 50-74 years, men, and individuals with cardiovascular disease.Discussion and ImplicationsHearing aids use was associated with a significant reduction of incident dementia. Future interventional studies are needed to further assess the effectiveness of hearing aids in preventing dementia.
背景和目的:助听器可降低听力损失患者患痴呆症的风险。然而,目前还没有随机对照试验(RCT)的证据表明使用助听器对减少痴呆症的发生具有效果。通过目标试验仿真,我们利用现有的纵向队列研究来估计助听器的使用与痴呆症风险之间的关系:研究设计与方法:我们利用健康与退休研究(Health and Retirement Study)对年龄≥50 岁、自述有听力损失、基线时未患痴呆症且在过去两年中未使用助听器的非住院参与者进行了目标试验模拟。我们进行了意向治疗分析,以估算开始使用助听器与未开始使用助听器的对照组相比患痴呆症的风险。采用带有反向治疗概率和删减权重的汇总逻辑回归模型来估算风险比,并使用1000组引导法计算95%置信区间:在2314名参与者中(干预组328人,对照组1986人;平均年龄:72.3 ± 9.7岁,49%为女性,81%为白人),经过8年的随访,开始使用助听器的人患痴呆症的风险显著降低(风险差异(RD):-0.05,95%置信区间(CI):-0.08,-0.01)。特别是在 50-74 岁的成年人、男性和患有心血管疾病的人中观察到了较低的风险:助听器的使用与痴呆症发病率的显著降低有关。未来需要进行干预性研究,以进一步评估助听器在预防痴呆症方面的效果。
{"title":"Initiation of Hearing Aids Use and Incident Dementia Among Mid-to-late Life Adults: The Health and Retirement Study 2010-2018.","authors":"Jingkai Wei, Kun Li, Youngran Kim, Rahul Ghosal, Donglan Zhang, Anwar T Merchant, Casey Crump","doi":"10.1177/08919887241302107","DOIUrl":"10.1177/08919887241302107","url":null,"abstract":"<p><p>Background and ObjectivesHearing aids may reduce the risk of dementia among individuals with hearing loss. However, no evidence is available from randomized controlled trials (RCTs) on the effectiveness of hearing aids use in reducing incident dementia. Using target trial emulation, we leveraged an existing longitudinal cohort study to estimate the association between hearing aids initiation and risk of dementia.Research Design and MethodsThe Health and Retirement Study was used to emulate target trials among non-institutionalized participants aged ≥50 years with self-reported hearing loss, without dementia at baseline, and without use of hearing aids in the previous 2 years. Intention-to-treat analysis was conducted to estimate the risk of dementia associated with hearing aids initiation vs controls who did not initiate hearing aids. Pooled logistic regression models with inverse-probability of treatment and censoring weights were applied to estimate risk ratios, and 95% confidence intervals were calculated using 1000 sets of bootstrapping.ResultsAmong 2314 participants (328 in the intervention group and 1986 in the control group; average age: 72.3 ± 9.7 years, 49% women, and 81% White), after 8 years of follow-up, risk of dementia was significantly lower among individuals who initiated hearing aids (risk difference (RD): -0.05, 95% confidence interval (CI): -0.08, -0.01). A lower risk was observed particularly among adults aged 50-74 years, men, and individuals with cardiovascular disease.Discussion and ImplicationsHearing aids use was associated with a significant reduction of incident dementia. Future interventional studies are needed to further assess the effectiveness of hearing aids in preventing dementia.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"172-179"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-09-03DOI: 10.1177/08919887241281066
Xiaofeng Zhu, Ming Wei, Lijun Wang, Qiang Tong, Xiu Yang, Qiu Han
ObjectiveThe study aimed to evaluate the impact of Botulinum toxin A (BoNT/A) on neuropsychiatric symptoms in Parkinson's disease (PD) patients.MethodsA total of 125 PD patients and an equal number of age- and gender-matched healthy controls were involved. Mental health status was assessed using the Cornell Medical Index (CMI) self-assessment questionnaire. Sixty-four PD patients exhibiting neuropsychiatric symptoms were selected for the controlled study and randomly grouped into treatment and control groups. The treatment group received BoNT/A injections, while the control group received a placebo. The primary outcome measures included depression scores from the CMI and the proportion of patients displaying improvement in neuropsychiatric symptoms at 8 weeks post-treatment. The secondary outcome was other CMI scores at 4, 8, and 12 weeks post-treatment.ResultsThe outcomes revealed that PD patients had significantly higher scores in various neuropsychiatric factors compared to healthy controls. At 4 weeks post-treatment, the treatment group displayed improvements in depression and tension. At 8 weeks post-treatment, they exhibited significant reductions in depression, anxiety, sensitivity, and tension compared to the control group. Moreover, a notably higher percentage of patients in the treatment group showed improvement in neuropsychiatric symptoms compared to the control group. At 12 weeks post-treatment, the treatment group exhibited significant improvements in somatization, depression, sensitivity, and tension.ConclusionPD patients commonly experience multiple neuropsychiatric symptoms, and BoNT/A has demonstrated efficacy in alleviating these symptoms. Specifically, BoNT/A was found to effectively alleviate somatization, tension, anxiety, depression, and sensitivity in PD patients.
{"title":"Treatment of Neuropsychiatric Symptoms in Parkinson's Disease With Botulinum Toxin A: A 12 week Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Xiaofeng Zhu, Ming Wei, Lijun Wang, Qiang Tong, Xiu Yang, Qiu Han","doi":"10.1177/08919887241281066","DOIUrl":"10.1177/08919887241281066","url":null,"abstract":"<p><p>ObjectiveThe study aimed to evaluate the impact of Botulinum toxin A (BoNT/A) on neuropsychiatric symptoms in Parkinson's disease (PD) patients.MethodsA total of 125 PD patients and an equal number of age- and gender-matched healthy controls were involved. Mental health status was assessed using the Cornell Medical Index (CMI) self-assessment questionnaire. Sixty-four PD patients exhibiting neuropsychiatric symptoms were selected for the controlled study and randomly grouped into treatment and control groups. The treatment group received BoNT/A injections, while the control group received a placebo. The primary outcome measures included depression scores from the CMI and the proportion of patients displaying improvement in neuropsychiatric symptoms at 8 weeks post-treatment. The secondary outcome was other CMI scores at 4, 8, and 12 weeks post-treatment.ResultsThe outcomes revealed that PD patients had significantly higher scores in various neuropsychiatric factors compared to healthy controls. At 4 weeks post-treatment, the treatment group displayed improvements in depression and tension. At 8 weeks post-treatment, they exhibited significant reductions in depression, anxiety, sensitivity, and tension compared to the control group. Moreover, a notably higher percentage of patients in the treatment group showed improvement in neuropsychiatric symptoms compared to the control group. At 12 weeks post-treatment, the treatment group exhibited significant improvements in somatization, depression, sensitivity, and tension.ConclusionPD patients commonly experience multiple neuropsychiatric symptoms, and BoNT/A has demonstrated efficacy in alleviating these symptoms. Specifically, BoNT/A was found to effectively alleviate somatization, tension, anxiety, depression, and sensitivity in PD patients.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"223-231"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2024-10-01DOI: 10.1177/08919887241289532
Kirti Veeramachaneni, Yuzhi Wang, George Grossberg, Joanne Salas, Jeffrey F Scherrer
ObjectiveTo determine the association between antipsychotic prescriptions and incident dementia in patients with schizophrenia or schizoaffective disorder.MethodsIn this retrospective cohort study, Cox Proportional hazard models estimated the association between antipsychotic prescriptions and incident dementia in participants ≥50 years of age with a schizophrenia/schizoaffective disorder diagnosis over 12 years. Confounding was controlled by E-balance.ResultsCumulative dementia incidence was significantly greater among those with an antipsychotic prescription compared to those without (7.9% vs 5.5%, P < 0.0001). After controlling for confounding, antipsychotic prescriptions were associated with a 92% increased risk for dementia (HR = 1.92; 95% CI:1.13-3.27). This association was not significant among those aged ≥65 years. Antipsychotic prescription type (eg, first generation, yes or no) did not affect dementia risk but prescription number did.ConclusionAntipsychotic prescriptions were associated with almost twice the incidence of dementia compared to patients without in those with schizophrenia/schizoaffective disorder.
{"title":"Association Between Antipsychotic Medication Use and Dementia Risk in Patients With Schizophrenia or Schizoaffective Disorder.","authors":"Kirti Veeramachaneni, Yuzhi Wang, George Grossberg, Joanne Salas, Jeffrey F Scherrer","doi":"10.1177/08919887241289532","DOIUrl":"10.1177/08919887241289532","url":null,"abstract":"<p><p>ObjectiveTo determine the association between antipsychotic prescriptions and incident dementia in patients with schizophrenia or schizoaffective disorder.MethodsIn this retrospective cohort study, Cox Proportional hazard models estimated the association between antipsychotic prescriptions and incident dementia in participants ≥50 years of age with a schizophrenia/schizoaffective disorder diagnosis over 12 years. Confounding was controlled by E-balance.ResultsCumulative dementia incidence was significantly greater among those with an antipsychotic prescription compared to those without (7.9% vs 5.5%, <i>P</i> < 0.0001). After controlling for confounding, antipsychotic prescriptions were associated with a 92% increased risk for dementia (HR = 1.92; 95% CI:1.13-3.27). This association was not significant among those aged ≥65 years. Antipsychotic prescription type (eg, first generation, yes or no) did not affect dementia risk but prescription number did.ConclusionAntipsychotic prescriptions were associated with almost twice the incidence of dementia compared to patients without in those with schizophrenia/schizoaffective disorder.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"180-190"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1177/08919887251330311
Xiaohang Zhao, Skylar Biyang Sun
ObjectiveThis study aims to examine educational heterogeneity in the relationship between internet use and episodic memory among older adults in China, within the context of advancing Chinese modernization.MethodsData from the 2018 and 2020 waves of China Health and Retirement Longitudinal Study (CHARLS) were used for analysis. By employing a longitudinal study design with lagged predictors and the inverse probability of treatment weighting (IPTW) approach alongside its extension-the marginal structural model (MSM) for sufficient cause interactions-this study mitigated potential reverse causality and self-selection biases related to internet use and educational attainment.ResultsThe findings indicate a significant positive longitudinal association between internet use and delayed word recall in older women, incorporating delayed and immediate recall scores at baseline as covariates for predicting propensity scores of internet use. Additionally, the preservation of delayed word recall linked to internet use was more pronounced among older women with less than an elementary school education. Doubly robust estimation results further confirmed the reliability of the core findings. Furthermore, we investigated the longitudinal associations between specific online activities and episodic memory. The results show that posting on social media and engaging in online chatting positively correlated with episodic memory in older women, whereas browsing news online was positively associated with episodic memory in older men.ConclusionThese findings support the cognitive enrichment hypothesis, which asserts that internet use serves as a mentally stimulating activity that may help delay cognitive aging, especially among individuals with limited cognitive stimuli.
{"title":"Educational Heterogeneity in the Relationship Between Internet Use and Episodic Memory Among Older Adults.","authors":"Xiaohang Zhao, Skylar Biyang Sun","doi":"10.1177/08919887251330311","DOIUrl":"https://doi.org/10.1177/08919887251330311","url":null,"abstract":"<p><p>ObjectiveThis study aims to examine educational heterogeneity in the relationship between internet use and episodic memory among older adults in China, within the context of advancing Chinese modernization.MethodsData from the 2018 and 2020 waves of China Health and Retirement Longitudinal Study (CHARLS) were used for analysis. By employing a longitudinal study design with lagged predictors and the inverse probability of treatment weighting (IPTW) approach alongside its extension-the marginal structural model (MSM) for sufficient cause interactions-this study mitigated potential reverse causality and self-selection biases related to internet use and educational attainment.ResultsThe findings indicate a significant positive longitudinal association between internet use and delayed word recall in older women, incorporating delayed and immediate recall scores at baseline as covariates for predicting propensity scores of internet use. Additionally, the preservation of delayed word recall linked to internet use was more pronounced among older women with less than an elementary school education. Doubly robust estimation results further confirmed the reliability of the core findings. Furthermore, we investigated the longitudinal associations between specific online activities and episodic memory. The results show that posting on social media and engaging in online chatting positively correlated with episodic memory in older women, whereas browsing news online was positively associated with episodic memory in older men.ConclusionThese findings support the cognitive enrichment hypothesis, which asserts that internet use serves as a mentally stimulating activity that may help delay cognitive aging, especially among individuals with limited cognitive stimuli.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251330311"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-24DOI: 10.1177/08919887241313225
Jonathan Fan, Nathan Churchill, Ayad Fadhel, Luis R Fornazzari, Vincenzo De Luca, Zahinoor Ismail, David G Munoz, Tom A Schweizer, Corinne E Fischer
BackgroundPsychosis occurs in approximately 41% of patients living with Alzheimer's disease. Previous findings from our group based on analyses of a neuropathological cohort suggest that among AD patients with Lewy Body pathology, female APOE4 homozygotes are at significantly greater risk of psychosis. This study aims to replicate this finding in a clinical cohort using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset.MethodsOur group used data from a sample of patients with AD in the ADNI database from the ADNI1, ADNI2, ADNI3, and ADNIGO studies. We defined psychosis status as experiencing hallucinations or delusions at one time point based on the Neuropsychiatric Inventory. We then used forward binary logistic regression to determine if sex and APOE4 status are predictors of AD + P.ResultsIn total there were 204 participants who met the inclusion criteria, 133 of which were male, and 71 of which were female. Fifty-six patients were APOE4 non-carriers, 109 patients were APOE4 heterozygote carriers, and 39 were APOE4 homozygote carriers. In total, there were 59 patients with psychosis. When adjusting for mini mental state examination score, adjusted hippocampal volume, and age, we demonstrate that female APOE4 homozygotes have a significantly increased risk of psychosis compared to other groups (P = 0.0264, OR = 19.50).DiscussionThe results of our study demonstrate a significant association between psychosis risk and female APOE4 homozygotes, thus corroborating findings from a neuropathological cohort. The effects of APOE ε4 on psychosis risk are significant only in females, and not in males.
{"title":"Determining the Role of Sex and APOE4 status on Psychosis in Alzheimer's Disease.","authors":"Jonathan Fan, Nathan Churchill, Ayad Fadhel, Luis R Fornazzari, Vincenzo De Luca, Zahinoor Ismail, David G Munoz, Tom A Schweizer, Corinne E Fischer","doi":"10.1177/08919887241313225","DOIUrl":"https://doi.org/10.1177/08919887241313225","url":null,"abstract":"<p><p>BackgroundPsychosis occurs in approximately 41% of patients living with Alzheimer's disease. Previous findings from our group based on analyses of a neuropathological cohort suggest that among AD patients with Lewy Body pathology, female APOE4 homozygotes are at significantly greater risk of psychosis. This study aims to replicate this finding in a clinical cohort using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset.MethodsOur group used data from a sample of patients with AD in the ADNI database from the ADNI1, ADNI2, ADNI3, and ADNIGO studies. We defined psychosis status as experiencing hallucinations or delusions at one time point based on the Neuropsychiatric Inventory. We then used forward binary logistic regression to determine if sex and APOE4 status are predictors of AD + P.ResultsIn total there were 204 participants who met the inclusion criteria, 133 of which were male, and 71 of which were female. Fifty-six patients were <i>APOE4</i> non-carriers, 109 patients were <i>APOE4</i> heterozygote carriers, and 39 were <i>APOE4</i> homozygote carriers. In total, there were 59 patients with psychosis. When adjusting for mini mental state examination score, adjusted hippocampal volume, and age, we demonstrate that female APOE4 homozygotes have a significantly increased risk of psychosis compared to other groups (<i>P</i> = 0.0264, OR = 19.50).DiscussionThe results of our study demonstrate a significant association between psychosis risk and female APOE4 homozygotes, thus corroborating findings from a neuropathological cohort. The effects of <i>APOE</i> ε4 on psychosis risk are significant only in females, and not in males.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887241313225"},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-21DOI: 10.1177/08919887251329957
Sarah Horn, Yunfeng Dai, Samuel S Wu, Nabila Dahodwala
BackgroundWomen with Parkinson's disease (PD) are less likely to have a caregiver.ObjectiveTo determine factors contributing to gender disparities in PD caregiving.MethodsWe conducted a cross-sectional survey of people with PD and caregivers participating in the Parkinson's Foundation Parkinson's Outcomes Project and compared patient and caregiver characteristics by gender.ResultsAmong PD patients, 20.7% of 1663 women and 14.2% of 3005 men had no caregiver (P < 0.001). Women without caregivers were older (69.1 vs 66.3, P < 0.001), less likely to be married (30.4% vs 54.7%, P < 0.001), and more likely to be taking an antidepressant (41.8% vs 30.9%, P = 0.002) than men. Using stepwise logistic regression models, gender differences in access to caregiving were explained by marital status. Among caregivers, women reported more strain (P < 0.001) and had less time for other family members (P < 0.001).ConclusionFewer women with PD have caregivers because they are less likely to have a spouse.
{"title":"Contributors to Gender Disparities in Parkinson's Disease Caregiving.","authors":"Sarah Horn, Yunfeng Dai, Samuel S Wu, Nabila Dahodwala","doi":"10.1177/08919887251329957","DOIUrl":"https://doi.org/10.1177/08919887251329957","url":null,"abstract":"<p><p>BackgroundWomen with Parkinson's disease (PD) are less likely to have a caregiver.ObjectiveTo determine factors contributing to gender disparities in PD caregiving.MethodsWe conducted a cross-sectional survey of people with PD and caregivers participating in the Parkinson's Foundation Parkinson's Outcomes Project and compared patient and caregiver characteristics by gender.ResultsAmong PD patients, 20.7% of 1663 women and 14.2% of 3005 men had no caregiver (<i>P</i> < 0.001). Women without caregivers were older (69.1 vs 66.3, <i>P</i> < 0.001), less likely to be married (30.4% vs 54.7%, <i>P</i> < 0.001), and more likely to be taking an antidepressant (41.8% vs 30.9%, <i>P</i> = 0.002) than men. Using stepwise logistic regression models, gender differences in access to caregiving were explained by marital status. Among caregivers, women reported more strain (<i>P</i> < 0.001) and had less time for other family members (<i>P</i> < 0.001).ConclusionFewer women with PD have caregivers because they are less likely to have a spouse.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251329957"},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundHearing loss has been related to impaired cognition among older adults. The cost effectiveness of existing hearing support tools is controversial. Other potential modifying strategies that could effectively intervene in this prevalent and far-reaching association between hearing loss and cognitive decline remain unclear. This study aimed to narratively and quantitatively synthesize the mediators and moderators involved in the link between hearing loss and cognitive impairment from a psycho-social and physical point of view.MethodWe searched 6 databases for articles exploring mediating or moderating associations of hearing loss-cognition association from inception to March, 2024. Data were synthesized narratively and quantitatively by meta-analytic approaches.ResultsThe search yielded 63 included studies. Social (social engagement, social support, age, sex, ethnicity, cognitive reserve)-psycho (depression, anxiety, loneliness, resilience)-physical (cardiovascular diseases and risk factors, perceived health, disability, APOE carrier, vision impairment, gait speed) variables mediated or moderated the relationship between hearing loss and cognitive impairment to varying degrees. Subgroup analyses identified susceptible populations at greater risk for cognitive decline, including women, younger elders with hearing loss, and older adults with dual sensory loss.ConclusionCombined interventions targeting these modifiable variables across psycho-social and physical dimensions may be more cost-effective for intervening in the ensemble of hearing loss-cognitive impairment in older adults.
{"title":"How to Break Stubborn Association Between Hearing Loss and Cognitive Impairment: A Systematic Review and Meta-Analysis of Moderators and Mediators.","authors":"Zeyi Zhang, Tingting Wang, Heng Cao, Longshan Yang, Xue Chen, Yu Han","doi":"10.1177/08919887251328880","DOIUrl":"https://doi.org/10.1177/08919887251328880","url":null,"abstract":"<p><p>BackgroundHearing loss has been related to impaired cognition among older adults. The cost effectiveness of existing hearing support tools is controversial. Other potential modifying strategies that could effectively intervene in this prevalent and far-reaching association between hearing loss and cognitive decline remain unclear. This study aimed to narratively and quantitatively synthesize the mediators and moderators involved in the link between hearing loss and cognitive impairment from a psycho-social and physical point of view.MethodWe searched 6 databases for articles exploring mediating or moderating associations of hearing loss-cognition association from inception to March, 2024. Data were synthesized narratively and quantitatively by meta-analytic approaches.ResultsThe search yielded 63 included studies. Social (social engagement, social support, age, sex, ethnicity, cognitive reserve)-psycho (depression, anxiety, loneliness, resilience)-physical (cardiovascular diseases and risk factors, perceived health, disability, APOE carrier, vision impairment, gait speed) variables mediated or moderated the relationship between hearing loss and cognitive impairment to varying degrees. Subgroup analyses identified susceptible populations at greater risk for cognitive decline, including women, younger elders with hearing loss, and older adults with dual sensory loss.ConclusionCombined interventions targeting these modifiable variables across psycho-social and physical dimensions may be more cost-effective for intervening in the ensemble of hearing loss-cognitive impairment in older adults.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251328880"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}