American Journal of Geriatric Psychiatry最新文献

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Reply to the Letter on “Life Fatigue: A Critical Analysis” 回复关于 "生命疲劳：批判性分析

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.10.001

Margarita Bofarull M.D., M.A., Montse Esquerda M.D., Ph.D., David Lorenzo Ph.D.

引用次数: 0

Posttraumatic Stress Disorder in Older Veterans admitted to VA Community Living Centers: Prevalence and Risk Correlates 退伍军人事务部社区生活中心收治的老年退伍军人中的创伤后应激障碍：患病率与风险相关性。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.07.014

Kelly O'Malley Ph.D. , Jennifer Moye Ph.D. , Jianwei Leng M.Stat , Zachary Burningham Ph.D.

Objectives

To examine prevalence and risk correlates for post-traumatic stress disorder (PTSD) occurring during or after admission to a Veterans Administration (VA) skilled nursing facility.

Design

Retrospective cohort analysis of electronic health record information extracted from the VA Corporate Data Warehouse.

Setting

United States VA skilled nursing facility.

Participants

57,414 Veterans age 60+ with an admission during five fiscal years, 2018–2022, excluding those who died within six months of admission or were still admitted.

Measurements

The dependent variable was PTSD diagnosis during or six-months following the admission. Risk correlates examined were: age, gender, race, rurality, clinical complexity, prior dementia diagnosis, length of stay, and facility size; odds ratios (OR) and confidence intervals (CI) are provided for each correlate.

Results

19.1% of Veterans had a diagnosis of PTSD, associated with younger age (age 60–69 compared to age 80+; OR: 2.92, 95% CI: 2.70–3.14; age 70–79 compared to age 80+ OR: 4.51, 95% CI: 4.20–4.84); female gender (OR: 1.65, 95% CI: 1.50–1.82); minoritized race (OR: 1.17, 95% CI: 1.12–1.23); higher clinical complexity (OR:1.22, 95% CI: 1.17–1.28). As compared to Veterans who had a prior PTSD diagnosis, Veterans with newly diagnosed PTSD were more likely to be older (age 60 group OR= 0.59, 95% CI:0.51–0.70; age 70 group OR= 0.54, 95% CI:0.46–0.62,), rural (OR=1.14, 95% CI:1.04–1.24) and admitted to a larger facility (OR=1.22, 95% CI:1.12–1.33).

Conclusions

PTSD is a significant concern for older Veterans admitted to VA skilled nursing facilities, supporting the need for trauma-informed care, particularly for those most at risk.

目的：研究在退伍军人管理局（VA）专业护理机构住院期间或之后发生的创伤后应激障碍（PTSD）的患病率和风险相关性：研究在退伍军人管理局（VA）专业护理机构住院期间或之后发生的创伤后应激障碍（PTSD）的患病率和风险相关性：设计：对退伍军人管理局企业数据仓库中提取的电子健康记录信息进行回顾性队列分析：美国退伍军人管理局专业护理机构：57414名年龄在60岁以上的退伍军人，在2018-2022年的5个财政年度期间入院，不包括入院后6个月内死亡或仍在住院的退伍军人：因变量为入院期间或入院后六个月内的创伤后应激障碍诊断。研究的风险相关因素包括：年龄、性别、种族、乡村、临床复杂性、之前的痴呆诊断、住院时间和设施规模；提供了每个相关因素的几率比（OR）和置信区间（CI）：19.1%的退伍军人被诊断出患有创伤后应激障碍，这与他们的年龄较小（60-69 岁与 80 岁以上相比，OR：2.92，95% CI：2.70-3.14；70-79 岁与 80 岁以上相比，OR：4.51，95% CI：4.51）有关：4.51，95% CI：4.20-4.84）；女性（OR：1.65，95% CI：1.50-1.82）；少数民族（OR：1.17，95% CI：1.12-1.23）；临床复杂性更高（OR：1.22，95% CI：1.17-1.28）。与之前诊断出创伤后应激障碍的退伍军人相比，新诊断出创伤后应激障碍的退伍军人更有可能年龄较大（60 岁组 OR=0.59，95% CI：0.51-0.70；70 岁组 OR=0.54，95% CI：0.46-0.62，）、住在农村（OR=1.14，95% CI：1.04-1.24）和住在较大的机构（OR=1.22，95% CI：1.12-1.33）：创伤后应激障碍是退伍军人事务部专业护理机构收治的老年退伍军人的一个重要问题，这说明有必要提供创伤知情护理，尤其是对那些风险最高的退伍军人。

{"title":"Posttraumatic Stress Disorder in Older Veterans admitted to VA Community Living Centers: Prevalence and Risk Correlates","authors":"Kelly O'Malley Ph.D. , Jennifer Moye Ph.D. , Jianwei Leng M.Stat , Zachary Burningham Ph.D.","doi":"10.1016/j.jagp.2024.07.014","DOIUrl":"10.1016/j.jagp.2024.07.014","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine prevalence and risk correlates for post-traumatic stress disorder (PTSD) occurring during or after admission to a Veterans Administration (VA) skilled nursing facility.</div></div><div><h3>Design</h3><div>Retrospective cohort analysis of electronic health record information extracted from the VA Corporate Data Warehouse.</div></div><div><h3>Setting</h3><div>United States VA skilled nursing facility.</div></div><div><h3>Participants</h3><div>57,414 Veterans age 60+ with an admission during five fiscal years, 2018–2022, excluding those who died within six months of admission or were still admitted.</div></div><div><h3>Measurements</h3><div>The dependent variable was PTSD diagnosis during or six-months following the admission. Risk correlates examined were: age, gender, race, rurality, clinical complexity, prior dementia diagnosis, length of stay, and facility size; odds ratios (OR) and confidence intervals (CI) are provided for each correlate.</div></div><div><h3>Results</h3><div>19.1% of Veterans had a diagnosis of PTSD, associated with younger age (age 60–69 compared to age 80+; OR: 2.92, 95% CI: 2.70–3.14; age 70–79 compared to age 80+ OR: 4.51, 95% CI: 4.20–4.84); female gender (OR: 1.65, 95% CI: 1.50–1.82); minoritized race (OR: 1.17, 95% CI: 1.12–1.23); higher clinical complexity (OR:1.22, 95% CI: 1.17–1.28). As compared to Veterans who had a prior PTSD diagnosis, Veterans with newly diagnosed PTSD were more likely to be older (age 60 group OR= 0.59, 95% CI:0.51–0.70; age 70 group OR= 0.54, 95% CI:0.46–0.62,), rural (OR=1.14, 95% CI:1.04–1.24) and admitted to a larger facility (OR=1.22, 95% CI:1.12–1.33).</div></div><div><h3>Conclusions</h3><div>PTSD is a significant concern for older Veterans admitted to VA skilled nursing facilities, supporting the need for trauma-informed care, particularly for those most at risk.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 1","pages":"Pages 34-43"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037810","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}

引用次数: 0

Sleep Capital: Linking Brain Health to Wellbeing and Economic Productivity Across the Lifespan 睡眠资本。将大脑健康与整个生命周期的福祉和经济生产力联系起来

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.07.011

Diego A. Golombek Ph.D. , Harris Eyre MD, Ph.D. , Ignacio Spiousas Ph.D. , Leandro P. Casiraghi Ph.D. , Kaisa M. Hartikainen M.D., Ph.D. , Timo Partonen M.D., Ph.D. , Mika Pyykkö M.Sc. , Charles F. Reynolds 3rd M.D. , William M. Hynes Ph.D. , Claudio L.A. Bassetti M.D., Ph.D. , Michael Berk M.D., Ph.D. , Kun Hu Ph.D. , Agustín Ibañez Ph.D.

Introduction and framework

Sleep capital contributes to individual and societal wellbeing, productivity, and economic outcomes and involves a novel aspect of brain capital. It encompasses the quality and quantity of sleep as integral components that influence cognitive abilities, mental and brain health, and physical health, affecting workplace productivity, learning, decision-making, and overall economic performance. Here, we bring a framework to understand the complex relationship between sleep quality, health, wellbeing, and economic productivity. Then we outline the multilevel impact of sleep on cognitive abilities, mental/brain health, and economic indicators, providing evidence for the substantial returns on investment in sleep health initiatives. Moreover, sleep capital is a key factor when considering brain health across the lifespan, especially for the aging population.

Discussion

We propose specific elements and main variables to develop specific indexes of sleep capital to address its impacts on health, wellbeing and productivity.

Conclusion

Finally, we suggest policy recommendations, workplace interventions, and individual strategies to promote sleep health and brain capital. Investing in sleep capital is essential for fostering a healthier, happier, fairer and more productive society.

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引用次数: 0

Transition

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.10.003

Nancy R. Davison

引用次数: 0

Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention 声波刺激改善阿尔茨海默氏症患者的慢波睡眠：多晚居家干预措施

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.07.002

Laura Van den Bulcke M.D. , Hannah Davidoff M.Sc. , Elisabeth Heremans M.Sc. , Yasmin Potts B.A. (Hons) , Kristof Vansteelandt Ph.D. , Maarten De Vos Ph.D. , Daan Christiaens Ph.D. , Louise Emsell Ph.D. , Laura H. Jacobson Ph.D. , Daniël Hoyer Ph.D., D.Sc. , Bertien Buyse M.D., Ph.D. , Mathieu Vandenbulcke M.D., Ph.D. , Dries Testelmans M.D., Ph.D. , Maarten Van Den Bossche M.D., Ph.D.

Objectives

To investigate the efficacy of closed-loop acoustic stimulation (CLAS) during slow-wave sleep (SWS) to enhance slow-wave activity (SWA) and SWS in patients with Alzheimer's disease (AD) across multiple nights and to explore associations between stimulation, participant characteristics, and individuals’ SWS response.

Design

A 2-week, open-label at-home intervention study utilizing the DREEM2 headband to record sleep data and administer CLAS during SWS.

Setting and participants

Fifteen older patients with AD (6 women, mean age: 76.27 [SD = 6.06], mean MOCA-score: 16.07 [SD = 6.94]), living at home with their partner, completed the trial.

Intervention

Patients first wore the device for two baseline nights, followed by 14 nights during which the device was programmed to randomly either deliver acoustic stimulations of 50 ms pink noise (± 40 dB) targeted to the slow-wave up-phase during SWS or only mark the wave (sham).

Results

On a group level, stimulation significantly enhanced SWA and SWS with consistent SWS enhancement throughout the intervention. However, substantial variability existed in individual responses to stimulation. Individuals received more stimulations on nights with increased SWS compared to baseline than on nights with no change or a decrease. In individuals, having lower baseline SWS correlated with receiving fewer stimulations on average during the intervention.

Conclusion

CLAS during SWS is a promising nonpharmacological method to enhance SWA and SWS in AD. However, patients with lower baseline SWS received fewer stimulations during the intervention, possibly resulting in less SWS enhancement. Individual variability in response to stimulation underscores the need to address personalized stimulation parameters in future research and therapy development.

{"title":"Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention","authors":"Laura Van den Bulcke M.D. , Hannah Davidoff M.Sc. , Elisabeth Heremans M.Sc. , Yasmin Potts B.A. (Hons) , Kristof Vansteelandt Ph.D. , Maarten De Vos Ph.D. , Daan Christiaens Ph.D. , Louise Emsell Ph.D. , Laura H. Jacobson Ph.D. , Daniël Hoyer Ph.D., D.Sc. , Bertien Buyse M.D., Ph.D. , Mathieu Vandenbulcke M.D., Ph.D. , Dries Testelmans M.D., Ph.D. , Maarten Van Den Bossche M.D., Ph.D.","doi":"10.1016/j.jagp.2024.07.002","DOIUrl":"10.1016/j.jagp.2024.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the efficacy of closed-loop acoustic stimulation (CLAS) during slow-wave sleep (SWS) to enhance slow-wave activity (SWA) and SWS in patients with Alzheimer's disease (AD) across multiple nights and to explore associations between stimulation, participant characteristics, and individuals’ SWS response.</div></div><div><h3>Design</h3><div>A 2-week, open-label at-home intervention study utilizing the DREEM2 headband to record sleep data and administer CLAS during SWS.</div></div><div><h3>Setting and participants</h3><div>Fifteen older patients with AD (6 women, mean age: 76.27 [SD = 6.06], mean MOCA-score: 16.07 [SD = 6.94]), living at home with their partner, completed the trial.</div></div><div><h3>Intervention</h3><div>Patients first wore the device for two baseline nights, followed by 14 nights during which the device was programmed to randomly either deliver acoustic stimulations of 50 ms pink noise (± 40 dB) targeted to the slow-wave up-phase during SWS or only mark the wave (sham).</div></div><div><h3>Results</h3><div>On a group level, stimulation significantly enhanced SWA and SWS with consistent SWS enhancement throughout the intervention. However, substantial variability existed in individual responses to stimulation. Individuals received more stimulations on nights with increased SWS compared to baseline than on nights with no change or a decrease. In individuals, having lower baseline SWS correlated with receiving fewer stimulations on average during the intervention.</div></div><div><h3>Conclusion</h3><div>CLAS during SWS is a promising nonpharmacological method to enhance SWA and SWS in AD. However, patients with lower baseline SWS received fewer stimulations during the intervention, possibly resulting in less SWS enhancement. Individual variability in response to stimulation underscores the need to address personalized stimulation parameters in future research and therapy development.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 1","pages":"Pages 73-84"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708417","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}

引用次数: 0

Keeping Clinically-Rooted Interventions at the Heart of Hospital Workplace Safety 将临床干预作为医院工作场所安全的核心。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.07.015

Carmen Black M.D., M.H.S. , Noah Sobel B.A. , Jordyn Williams B.A.

引用次数: 0

Memoirs of a Healthcare Worker During the Pandemic 大流行病期间的医护人员回忆录》。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.09.002

Deanna C. Fernandes Pharm.D.

引用次数: 0

A Case of Gerotranscendence: Lived Experience of a Neurodegenerative Disorder and a Spiritual Awakening to Nondual Awareness 一个老年超越的案例：神经退行性疾病的生命体验与非二元意识的精神觉醒。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.09.006

Helen Lavretsky M.D., M.S. , Neil Schuitevoerder Ph.D.

引用次数: 0

Reply to Letter to the Editor: “Psychedelics in Older Adults: Difficulties of a Clear Therapeutic Evidence” 回复致编辑的信："老年人服用迷幻药：明确治疗证据的困难"。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.09.009

Hannes Kettner M.S. , Leor Roseman Ph.D. , Adam Gazzaley M.D., Ph.D. , Robin L. Carhart-Harris Ph.D. , Lorenzo Pasquini Ph.D.

引用次数: 0

Poor Sleep is Common in Treatment-Resistant Late-life Depression and Associated With Poorer Antidepressant Response: Findings From the OPTIMUM Clinical Trial 晚期抑郁症患者普遍存在睡眠质量差的问题，这与抗抑郁药反应较差有关：OPTIMUM临床试验的结果。

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.jagp.2024.07.020

Michael S.B. Mak M.D. , Marie Anne Gebara M.D. , Eric J. Lenze M.D. , Daniel M. Blumberger M.D. , Patrick J. Brown Ph.D. , Pilar Cristancho M.D. , Alastair J. Flint M.B , Jordan F. Karp M.D. , Helen Lavretsky M.D. , J. Philip Miller A.B. , Charles F. Reynolds III M.D. , Steven P. Roose M.D. , Benoit H. Mulsant M.D. , Sarah T. Stahl Ph.D.

Background

Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep.

Methods

Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the beginning (week-0) and end (week-10) of treatment. The analyses examined whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep during depression treatment.

Results

About half (51%, n = 323) of participants reported insufficient sleep at baseline. Both persistent insufficient sleep (25%, n = 158) and worsened sleep (10%, n = 62) during treatment were associated with antidepressant nonresponse. Participants who maintained sufficient sleep (26%, n = 164) or who improved their sleep (n = 25%, n = 158) were three times more likely to experience a depression response than those with persistent insufficient sleep or worsened sleep.

Conclusion

Insufficient sleep is common in TRLLD and it is associated with poorer treatment response to antidepressants.

背景：成人晚期抗药性抑郁症（TRLLD）患者的睡眠问题发生率很高；然而，人们对TRLLD药物治疗期间睡眠问题的发生和变化知之甚少。本分析研究了：（1）TRLLD 成年人睡眠不足的发生情况；（2）药物治疗期间睡眠的变化情况；以及（3）持续睡眠不足、睡眠恶化、睡眠改善或持续睡眠充足的参与者之间的治疗结果是否存在差异：对OPTIMUM治疗TRLLD临床试验中634名60岁以上参与者的数据进行二次分析。在治疗开始（第0周）和结束（第10周）时，使用蒙哥马利-阿斯伯格抑郁评分量表中的睡眠项目对睡眠进行评估。分析研究了抑郁症治疗期间睡眠持续不足、睡眠恶化、睡眠改善或睡眠持续充足的参与者的治疗结果是否存在差异：约半数参与者（51%，n = 323）在基线时报告睡眠不足。治疗期间持续睡眠不足（25%，n = 158）和睡眠恶化（10%，n = 62）都与抗抑郁药无反应有关。保持充足睡眠（26%，n = 164）或睡眠改善（n = 25%，n = 158）的参与者出现抑郁反应的几率是持续睡眠不足或睡眠恶化者的三倍：结论：睡眠不足在TRLLD中很常见，而且与抗抑郁药物治疗反应较差有关。

{"title":"Poor Sleep is Common in Treatment-Resistant Late-life Depression and Associated With Poorer Antidepressant Response: Findings From the OPTIMUM Clinical Trial","authors":"Michael S.B. Mak M.D. , Marie Anne Gebara M.D. , Eric J. Lenze M.D. , Daniel M. Blumberger M.D. , Patrick J. Brown Ph.D. , Pilar Cristancho M.D. , Alastair J. Flint M.B , Jordan F. Karp M.D. , Helen Lavretsky M.D. , J. Philip Miller A.B. , Charles F. Reynolds III M.D. , Steven P. Roose M.D. , Benoit H. Mulsant M.D. , Sarah T. Stahl Ph.D.","doi":"10.1016/j.jagp.2024.07.020","DOIUrl":"10.1016/j.jagp.2024.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep.</div></div><div><h3>Methods</h3><div>Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the beginning (week-0) and end (week-10) of treatment. The analyses examined whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep during depression treatment.</div></div><div><h3>Results</h3><div>About half (51%, n = 323) of participants reported insufficient sleep at baseline. Both persistent insufficient sleep (25%, n = 158) and worsened sleep (10%, n = 62) during treatment were associated with antidepressant nonresponse. Participants who maintained sufficient sleep (26%, n = 164) or who improved their sleep (n = 25%, n = 158) were three times more likely to experience a depression response than those with persistent insufficient sleep or worsened sleep.</div></div><div><h3>Conclusion</h3><div>Insufficient sleep is common in TRLLD and it is associated with poorer treatment response to antidepressants.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 1","pages":"Pages 63-72"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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