Pub Date : 2025-02-07DOI: 10.1016/S1064-7481(25)00005-3
{"title":"Information for Subscribers","authors":"","doi":"10.1016/S1064-7481(25)00005-3","DOIUrl":"10.1016/S1064-7481(25)00005-3","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 3","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.jagp.2025.01.013
Dan Blazer
{"title":"Loneliness and Solitude: The Yin and Yang of Social Disconnection.","authors":"Dan Blazer","doi":"10.1016/j.jagp.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.01.013","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.jagp.2025.01.009
Chenguang Du, Zhibo Shen, Marrium Mansoor, Qiong Chen, Benjamin Katz
Background and objectives: Although recent research has consistently shown that psychological resilience is positively associated with cognitive function among older adults, the underlying mechanisms are still largely unclear. In this study, we assessed the potential mediating role of physical activity between psychological resilience and cognition using a longitudinal, population dataset of US older adults.
Research design and methods: Data were derived from three time points (2010-2012, 2014-2016, and 2018-2020) of the Health and Retirement Study (HRS), with 8,296 older adults at baseline included (aged 65 or above). Cognitive function was measured by 35-point Telephone Interview Cognitive Screen (TICS). psychological resilience was measured using a previously established simplified resilience score.
Results: Psychological resilience at baseline was positively associated with physical activity at T2, 4 years later (β=0.08,SE=0.01,p<0.001). In addition, physical activity predicted an increase in cognitive function from T2 to T3 (4 years to 8 years later) (β=0.05,SE=0.07,p<0.001). Finally, a significant indirect effect of psychological resilience (T1) on cognitive function (T3) through physical activity from (T2) was observed (β = 0.01, 95% CI [0.01, 0.02], p <0.001).
Discussion and implications: Physical activity may function as a protective factor for the cognitive functioning of older adults. This association is partially mediated by enhanced physical activity.
{"title":"Psychological Resilience, Cognitive Function, and Physical Activity: A Longitudinal Mediation Study.","authors":"Chenguang Du, Zhibo Shen, Marrium Mansoor, Qiong Chen, Benjamin Katz","doi":"10.1016/j.jagp.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.01.009","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although recent research has consistently shown that psychological resilience is positively associated with cognitive function among older adults, the underlying mechanisms are still largely unclear. In this study, we assessed the potential mediating role of physical activity between psychological resilience and cognition using a longitudinal, population dataset of US older adults.</p><p><strong>Research design and methods: </strong>Data were derived from three time points (2010-2012, 2014-2016, and 2018-2020) of the Health and Retirement Study (HRS), with 8,296 older adults at baseline included (aged 65 or above). Cognitive function was measured by 35-point Telephone Interview Cognitive Screen (TICS). psychological resilience was measured using a previously established simplified resilience score.</p><p><strong>Results: </strong>Psychological resilience at baseline was positively associated with physical activity at T2, 4 years later (β=0.08,SE=0.01,p<0.001). In addition, physical activity predicted an increase in cognitive function from T2 to T3 (4 years to 8 years later) (β=0.05,SE=0.07,p<0.001). Finally, a significant indirect effect of psychological resilience (T1) on cognitive function (T3) through physical activity from (T2) was observed (β = 0.01, 95% CI [0.01, 0.02], p <0.001).</p><p><strong>Discussion and implications: </strong>Physical activity may function as a protective factor for the cognitive functioning of older adults. This association is partially mediated by enhanced physical activity.</p>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.jagp.2025.01.008
Yasmeen Zahra
{"title":"Mapping the Political Geography of Dementia.","authors":"Yasmeen Zahra","doi":"10.1016/j.jagp.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.jagp.2025.01.008","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/S1064-7481(24)00554-2
{"title":"Information for Subscribers","authors":"","doi":"10.1016/S1064-7481(24)00554-2","DOIUrl":"10.1016/S1064-7481(24)00554-2","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 2","pages":"Page A1"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143269971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The association between specific types of malignancies and the subsequent risk of dementia remains unknown.
Design
A retrospective population-based cohort study based on data from Taiwan National Health Insurance Research Database.
Setting and participants
We recruited 32,250 patients who survived malignancies and 322,500 controls between 1998 and 2011 and followed them up until the end of 2013.
Measurements
Diagnoses of dementia (including Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia) was made during the follow-up period. Cox regression analyses were performed after adjusting for potential confounders. A sensitivity analysis was conducted to exclude patients with prodromal dementia.
Results
Cancer survivors were more likely to develop AD (hazard ratio [HR]: 1.68, 95% confidence interval [CI]: 1.38–2.06), unspecified dementia (HR: 1.19, 95% CI: 1.07–1.32), and any dementia (HR: 1.26, 95% CI: 1.16–1.37) compared with controls after adjusting for potential confounders. Importantly, cancers of the digestive and genitourinary organs seem to be associated with AD, unspecified dementia, and any dementia, whereas only malignant neoplasms of the brain are more likely to develop into VaD. Sensitivity analyses after exclusion of the first three or five years of observation and after exclusion of case enrollment before 2009 or 2007 showed consistent findings.
Conclusion
Cancer survivors are at higher risk of subsequent dementia. Different types of cancer survivors may contribute to variable risks of specific dementias. Further studies are necessary to investigate the underlying mechanisms in cancer survivors and patients with dementia.
{"title":"Risk of Dementia in Different Types of Cancer Survivors: A Nationwide Cohort Study","authors":"Che-Sheng Chu M.D. , Shu-Li Cheng M.D., Ph.D. , Ya-Mei Bai M.D., Ph.D. , Tung-Ping Su M.D. , Shih-Jen Tsai M.D. , Tzeng-Ji Chen M.D., Ph.D. , Fu-Chi Yang M.D., Ph.D. , Mu-Hong Chen M.D., Ph.D. , Chih-Sung Liang M.D.","doi":"10.1016/j.jagp.2024.07.013","DOIUrl":"10.1016/j.jagp.2024.07.013","url":null,"abstract":"<div><h3>Objectives</h3><div>The association between specific types of malignancies and the subsequent risk of dementia remains unknown.</div></div><div><h3>Design</h3><div>A retrospective population-based cohort study based on data from Taiwan National Health Insurance Research Database.</div></div><div><h3>Setting and participants</h3><div>We recruited 32,250 patients who survived malignancies and 322,500 controls between 1998 and 2011 and followed them up until the end of 2013.</div></div><div><h3>Measurements</h3><div>Diagnoses of dementia (including Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia) was made during the follow-up period. Cox regression analyses were performed after adjusting for potential confounders. A sensitivity analysis was conducted to exclude patients with prodromal dementia.</div></div><div><h3>Results</h3><div>Cancer survivors were more likely to develop AD (hazard ratio [HR]: 1.68, 95% confidence interval [CI]: 1.38–2.06), unspecified dementia (HR: 1.19, 95% CI: 1.07–1.32), and any dementia (HR: 1.26, 95% CI: 1.16–1.37) compared with controls after adjusting for potential confounders. Importantly, cancers of the digestive and genitourinary organs seem to be associated with AD, unspecified dementia, and any dementia, whereas only malignant neoplasms of the brain are more likely to develop into VaD. Sensitivity analyses after exclusion of the first three or five years of observation and after exclusion of case enrollment before 2009 or 2007 showed consistent findings.</div></div><div><h3>Conclusion</h3><div>Cancer survivors are at higher risk of subsequent dementia. Different types of cancer survivors may contribute to variable risks of specific dementias. Further studies are necessary to investigate the underlying mechanisms in cancer survivors and patients with dementia.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 2","pages":"Pages 156-166"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jagp.2024.08.003
Lena Rupp Dipl.Psych. (Germany)
{"title":"Invited Perspective on “Caregiving experiences as mediators Between Caregiving Stressors and anticipatory Grief in Severe Dementia: Findings From Longitudinal Path Analysis”","authors":"Lena Rupp Dipl.Psych. (Germany)","doi":"10.1016/j.jagp.2024.08.003","DOIUrl":"10.1016/j.jagp.2024.08.003","url":null,"abstract":"","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 2","pages":"Pages 153-155"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The rising prevalence of Alzheimer's disease (AD) and related dementia worldwide underscores the urgent need for effective interventions, particularly for managing neuropsychiatric symptoms (NPS) such as sleep disturbance. This review explores the emerging role of Dual Orexin Receptor Antagonists (DORA) in addressing sleep disturbance in patients with Alzheimer's disease dementia.
Methods
A comprehensive literature search identified four relevant publications between 2014 and 2024, detailing the use of DORA medications, including suvorexant and lemborexant, in patients with Alzheimer's disease.
Results
Findings suggest that suvorexant may improve total sleep time (TST), wakefulness after sleep onset (WASO), and sleep efficiency (SE) in Alzheimer's patients with insomnia. Lemborexant demonstrated potential in improving circadian rhythm parameters, particularly in patients with irregular sleep-wake rhythm disorder (ISWRD). Safety profiles of DORA medications appeared favorable, with mild to moderate adverse events reported. However, concerns over potential adverse events, such as falls, underscore the need for careful monitoring.
Conclusion
While the evidence suggests promise for DORA medications in addressing sleep disturbance in Alzheimer's disease, limitations in study populations and duration highlight the need for further investigation. Future clinical trials should aim for broader inclusion criteria, encompassing diverse dementia subtypes and severity levels, to enhance generalizability. Additionally, longer-term trials are essential to assess the sustained efficacy and safety of DORA interventions in this vulnerable population.
导言:阿尔茨海默病(AD)及相关痴呆症在全球的发病率不断上升,这凸显了对有效干预措施的迫切需求,尤其是在控制睡眠障碍等神经精神症状(NPS)方面。本综述探讨了双奥列克辛受体拮抗剂(DORA)在解决阿尔茨海默病痴呆症患者睡眠障碍方面的新作用:通过全面的文献检索,我们找到了2014年至2024年间的四篇相关文献,这些文献详细介绍了阿尔茨海默病患者使用DORA药物(包括suvorexant和lemborexant)的情况:研究结果表明,舒伐雷司坦可改善阿尔茨海默病患者的总睡眠时间(TST)、睡眠开始后的觉醒(WASO)和睡眠效率(SE)。伦博雷沙坦具有改善昼夜节律参数的潜力,特别是在睡眠-觉醒节律失调(ISWRD)患者中。DORA 药物的安全性似乎良好,报告的不良事件为轻度至中度。然而,对潜在不良事件(如跌倒)的担忧强调了仔细监测的必要性:虽然有证据表明 DORA 药物有望解决阿尔茨海默病患者的睡眠障碍问题,但研究人群和持续时间的局限性凸显了进一步研究的必要性。未来的临床试验应采用更广泛的纳入标准,包括不同的痴呆亚型和严重程度,以提高普适性。此外,还必须进行更长期的试验,以评估 DORA 干预措施对这一弱势群体的持续疗效和安全性。
{"title":"Efficacy And Safety of Dual Orexin Receptor Antagonist (DORA) For Sleep Disturbance in Patients With Alzheimer's Disease Dementia. A Review Article","authors":"Abdulrahman Alshiban M.B.B.S. , Tuna Hasoglu M.D. , Joel Oster M.D.","doi":"10.1016/j.jagp.2024.09.016","DOIUrl":"10.1016/j.jagp.2024.09.016","url":null,"abstract":"<div><h3>Introduction</h3><div>The rising prevalence of Alzheimer's disease (AD) and related dementia worldwide underscores the urgent need for effective interventions, particularly for managing neuropsychiatric symptoms (NPS) such as sleep disturbance. This review explores the emerging role of Dual Orexin Receptor Antagonists (DORA) in addressing sleep disturbance in patients with Alzheimer's disease dementia.</div></div><div><h3>Methods</h3><div>A comprehensive literature search identified four relevant publications between 2014 and 2024, detailing the use of DORA medications, including suvorexant and lemborexant, in patients with Alzheimer's disease.</div></div><div><h3>Results</h3><div>Findings suggest that suvorexant may improve total sleep time (TST), wakefulness after sleep onset (WASO), and sleep efficiency (SE) in Alzheimer's patients with insomnia. Lemborexant demonstrated potential in improving circadian rhythm parameters, particularly in patients with irregular sleep-wake rhythm disorder (ISWRD). Safety profiles of DORA medications appeared favorable, with mild to moderate adverse events reported. However, concerns over potential adverse events, such as falls, underscore the need for careful monitoring.</div></div><div><h3>Conclusion</h3><div>While the evidence suggests promise for DORA medications in addressing sleep disturbance in Alzheimer's disease, limitations in study populations and duration highlight the need for further investigation. Future clinical trials should aim for broader inclusion criteria, encompassing diverse dementia subtypes and severity levels, to enhance generalizability. Additionally, longer-term trials are essential to assess the sustained efficacy and safety of DORA interventions in this vulnerable population.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 2","pages":"Pages 209-218"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Family caregivers of older adults with severe dementia often experience anticipatory grief. We aimed to investigate the temporal association of caregiving stressors (older adults’ behavioral symptoms, and caregiver-older adult co-residence and emotional closeness) and caregivers’ anticipatory grief, and its mediation by positive and negative caregiving experiences.
Design
Prospective cohort.
Setting
Singapore.
Participants
About 169 family caregivers of older adults with severe dementia were surveyed every 4 months for 4 years (up to 13 surveys).
Measurements
We measured anticipatory grief using the Marwit Meuser Caregiver Grief Inventory-Short Form, negative caregiving experiences using the Caregiver Reaction Assessment scale, positive caregiving experiences using Gain in Alzheimer Care Instrument and behavioral symptoms using the Cohen-Mansfield Agitation Inventory. We implemented a cross-lagged panel model to test mediation, a form of longitudinal path analysis.
Results
About 35% of the caregivers reported high anticipatory grief at least once during the study period. Older adults’ behavioral symptoms had a significant direct effect (Standardized coefficient [95% confidence interval]: 0.12 [0.04, 0.21]) on caregivers’ anticipatory grief. Negative experiences mediated the significant indirect effect of older adults’ behavioral symptoms (0.16 [0.06, 0.25]) and coresidence (0.16 [0.07, 0.25]) on caregivers’ anticipatory grief. Positive caregiving experiences did not mediate any path.
Conclusions
Findings indicate a temporal association between caregiving stressors and anticipatory grief, mediated by negative caregiving experiences. Routine screening for anticipatory grief, and interventions to address caregiver stressors and negative caregiving experiences may alleviate caregivers’ grief.
{"title":"Caregiving Experiences as Mediators Between Caregiving Stressors and Anticipatory Grief in Severe Dementia: Findings From Longitudinal Path Analysis","authors":"Isha Chaudhry M.Sc. , Louisa Poco Ph.D. , Ishwarya Balasubramanian Ph.D. , Ellie Bostwick Andres DrPH , Chetna Malhotra M.D., M.P.H.","doi":"10.1016/j.jagp.2024.07.017","DOIUrl":"10.1016/j.jagp.2024.07.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Family caregivers of older adults with severe dementia often experience anticipatory grief. We aimed to investigate the temporal association of caregiving stressors (older adults’ behavioral symptoms, and caregiver-older adult co-residence and emotional closeness) and caregivers’ anticipatory grief, and its mediation by positive and negative caregiving experiences.</div></div><div><h3>Design</h3><div>Prospective cohort.</div></div><div><h3>Setting</h3><div>Singapore.</div></div><div><h3>Participants</h3><div>About 169 family caregivers of older adults with severe dementia were surveyed every 4 months for 4 years (up to 13 surveys).</div></div><div><h3>Measurements</h3><div>We measured anticipatory grief using the Marwit Meuser Caregiver Grief Inventory-Short Form, negative caregiving experiences using the Caregiver Reaction Assessment scale, positive caregiving experiences using Gain in Alzheimer Care Instrument and behavioral symptoms using the Cohen-Mansfield Agitation Inventory. We implemented a cross-lagged panel model to test mediation, a form of longitudinal path analysis.</div></div><div><h3>Results</h3><div>About 35% of the caregivers reported high anticipatory grief at least once during the study period. Older adults’ behavioral symptoms had a significant direct effect (Standardized coefficient [95% confidence interval]: 0.12 [0.04, 0.21]) on caregivers’ anticipatory grief. Negative experiences mediated the significant indirect effect of older adults’ behavioral symptoms (0.16 [0.06, 0.25]) and coresidence (0.16 [0.07, 0.25]) on caregivers’ anticipatory grief. Positive caregiving experiences did not mediate any path.</div></div><div><h3>Conclusions</h3><div>Findings indicate a temporal association between caregiving stressors and anticipatory grief, mediated by negative caregiving experiences. Routine screening for anticipatory grief, and interventions to address caregiver stressors and negative caregiving experiences may alleviate caregivers’ grief.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 2","pages":"Pages 143-152"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}