American Journal of Geriatric Psychiatry最新文献

英文中文

The Ratio of Triglycerides to HDL-C As a Modifiable Risk Factor for Age-Related Cognitive Impairment 甘油三酯与HDL-C的比值是与年龄相关的认知障碍的可改变危险因素。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-27 DOI: 10.1016/j.jagp.2025.09.015

Jovian C. Lam Ph.D., Jennifer Kaci Fairchild Ph.D.

引用次数: 0

Relationship Between SSRI Exposure During Later Life and Clinical and Neuropathological Correlates of Dementia 老年生活中SSRI暴露与痴呆临床和神经病理学相关性的关系

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-25 DOI: 10.1016/j.jagp.2025.09.020

Jacob S. Shaw B.S. , Michael J.C. Bray M.D., M.Sc. , Courtney K. Harrington B.A. , Paul B. Rosenberg M.D. , Constantine G. Lyketsos M.D. , Matthew E. Peters M.D.

Objectives

While depression is a risk factor for dementia, few studies examining the association between selective serotonin reuptake inhibitors (SSRIs) and dementia risk have controlled for confounding major depression and none to our knowledge have examined neuropathological outcomes. We examined the association between continuation of SSRIs in older adults with a lifetime history of depression and progression of cognitive and functional impairment, depression, and neuropathologic correlates of dementia.

Design

This retrospective cohort study analyzed data from the National Alzheimer’s Coordinating Center.

Participants

Participants aged 55 years or older were required to have clinician documented lifetime history of depression (n = 688). 463 (67.3%) reported continued SSRI use at every study visit prior to death.

Measurements

Primary clinical outcomes included the Clinical Dementia Rating-Sum of Boxes (CDR-SB), Functional Activities Questionnaire (FAQ), and the 15-item Geriatric Depression Scale (GDS-15). Neuropathological outcomes included assessments of Alzheimer’s Disease (AD) pathology and cerebrovascular changes relevant to Vascular dementia (VaD).

Results

Continued SSRI use during later life was associated with a significantly slower increase on the CDR-SB compared to discontinuation of SSRIs. Rates of change on the FAQ and GDS-15 did not differ significantly between groups. While rates of AD pathology did not differ significantly between groups, continued SSRI use was associated with significantly lower rates of lacunes/infarcts on autopsy after controlling for smoking years and hypertension.

Conclusions

Persistent use of SSRIs prior to death was associated with decreased progression of cognitive impairment and a nearly 50% reduction of lacunes/infarcts on autopsy. Our study is the first of our knowledge to identify associations between SSRI exposure in later life and neuropathological changes relevant to VaD on autopsy, which is considered the gold standard of diagnosis.

虽然抑郁症是痴呆的一个危险因素，但很少有研究检查选择性5 -羟色胺再摄取抑制剂（SSRIs）与痴呆风险之间的关系，并且据我们所知，没有研究检查神经病理结果。我们研究了终身有抑郁症病史的老年人继续服用SSRIs与认知和功能障碍、抑郁症和痴呆相关神经病理进展之间的关系。这项回顾性队列研究分析了来自国家阿尔茨海默病协调中心的数据。年龄在55岁或以上的参与者被要求有临床医生记录的终生抑郁症史（n = 688）。463（67.3%）报告在死亡前的每次研究访问中继续使用SSRI。主要临床结果包括临床痴呆评分盒和（CDR-SB）、功能活动问卷（FAQ）和15项老年抑郁量表（GDS-15）。神经病理学结果包括阿尔茨海默病（AD）病理评估和与血管性痴呆（VaD）相关的脑血管变化。结果：与停用SSRIs相比，在晚年继续使用SSRI与CDR-SB的显著缓慢增加相关。FAQ和GDS-15的变化率在两组之间没有显著差异。虽然AD病理发生率在两组之间没有显著差异，但在控制吸烟年限和高血压后，继续使用SSRI可显著降低尸检时的腔隙/梗死发生率。结论：死亡前持续使用ssri类药物可降低认知功能障碍的进展，并可使尸检时发现的腔隙/梗死减少近50%。我们的研究是我们所知的第一个确定晚年暴露于SSRI与尸检时VaD相关的神经病理变化之间关系的研究，这被认为是诊断的金标准。

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引用次数: 0

Posttraumatic Stress Symptoms, Functioning, and Suicidal Ideation in Older U.S. Veterans: A Network Analysis 美国老年退伍军人的创伤后应激症状、功能和自杀意念：网络分析。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-25 DOI: 10.1016/j.jagp.2025.09.018

Robert H. Pietrzak Ph.D., M.P.H. , Ian C. Fischer Ph.D. , Peter J. Na M.D., M.P.H. , Joan M. Cook Ph.D. , Tobias R. Spiller M.D.

Objectives

To identify posttraumatic stress disorder (PTSD) symptoms most central to the disorder and examine associations with functioning and suicidal ideation (SI) among older U.S. military veterans with full or subthreshold PTSD.

Methods

Data were analyzed from 233 veterans aged ≥60 years (mean = 70.5) with full or subthreshold PTSD who participated in the National Health and Resilience in Veterans Study. Network analyses estimated symptom centrality (i.e., symptoms most strongly connected to others) and examined associations between PTSD symptoms, functioning, and SI.

Results

Negative beliefs about the self or world and trauma-related emotional and physiological reactivity were the most central PTSD symptoms. Difficulty concentrating and anhedonic symptoms were most consistently associated with functional difficulties and SI.

Conclusions

A dual-focus approach that addresses PTSD symptoms highly interconnected within the disorder and those most strongly linked to functional difficulties and suicide risk may help promote recovery among older veterans with full or subthreshold PTSD.

目的：确定创伤后应激障碍（PTSD）最核心的症状，并检查患有完全或阈下创伤后应激障碍的美国老年退伍军人的功能和自杀意念（SI）的关系。方法：对233名年龄≥60岁（平均70.5岁）患有完全或阈下创伤后应激障碍（PTSD）的退伍军人进行数据分析。网络分析估计了症状中心性（即与其他症状联系最紧密的症状），并检查了PTSD症状、功能和SI之间的关联。结果：对自我或世界的消极信念和创伤相关的情绪和生理反应是创伤后应激障碍最主要的症状。注意力集中困难和快感缺乏症状最一致地与功能困难和SI相关。结论：双焦点方法解决PTSD内部高度关联的症状和那些与功能困难和自杀风险最密切相关的症状，可能有助于促进患有完全或阈下PTSD的老年退伍军人的康复。

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引用次数: 0

Maintenance of Technology-Based Functional Skills Training Gains in Older Participants With and Without Mild Cognitive Impairment: The Role of Booster Training 在有或无轻度认知障碍的老年参与者中，基于技术的功能技能训练收益的维持：强化训练的作用。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-24 DOI: 10.1016/j.jagp.2025.09.019

Xin Yao Lin Ph.D. , Philip D. Harvey Ph.D. , Peter Kallestrup M.S. , Sara J. Czaja Ph.D.

Objective

Prior research has demonstrated that the technology-based Functional Skills Assessment and Training program (FUNSAT™) improves functional skills among older adults with and without Mild Cognitive Impairment (MCI). The current study examined maintenance of training gains and the role of booster sessions on sustaining training gains.

Design

Randomized clinical trial with post-training follow-ups.

Setting

14 Community centers in New York City and Miami.

Participants

Older adults with normal cognition (n = 74) or MCI (n = 90), ranging in age from 60 to 90 years.

Intervention

Computerized cognitive and skills trainings delivered at home 2x weekly for 12 weeks or until mastery.

Measurements

The FUNSAT™ program includes financial, medication management, and transportation skills. Completion time and errors were assessed pretraining (T1), post-training (T2), one-month post-training (T3) and 3-months post-training (T4). Participants whose T2 training gains were not sustained at T3 (according to predetermined criteria) received booster training.

Results

The percentage of participants needing a booster was low (13% to 34% across tasks); need for booster training was greater for more complex tasks (e.g., internet banking). Participants who did not need a booster improved in performance from T2 to T3. Booster training was efficacious as those receiving booster training subsequently regained training gains and their performance did not differ from the no-booster group at T4.

Conclusions

The findings further support the efficacy of the FUNSAT™ training program; most participants maintained or increased their training gains over time. Booster training was beneficial in terms of sustaining gains, indicating that booster sessions play a critical role in skills training.

目的：先前的研究已经证明，基于技术的功能技能评估和培训计划（FUNSAT™）可以改善有或无轻度认知障碍（MCI）的老年人的功能技能。目前的研究调查了训练收益的维持和强化课程对维持训练收益的作用。设计：随机临床试验，训练后随访。环境：纽约和迈阿密的14个社区中心。参与者：认知正常的老年人（n = 74）或轻度认知障碍的老年人（n = 90），年龄从60岁到90岁不等。干预：每周在家进行2次计算机化的认知和技能培训，持续12周或直到掌握为止。测量：FUNSAT™项目包括财务、药物管理和运输技能。评估训练前（T1）、训练后（T2）、训练后1个月（T3）和训练后3个月（T4）的完成时间和误差。T2训练收益不能维持到T3（根据预定标准）的参与者接受强化训练。结果：需要助推器的参与者百分比很低（13%至34%的任务）；对于更复杂的任务（例如，网上银行），需要更多的加强培训。不需要助推器的参与者从T2到T3的表现有所改善。强化训练是有效的，因为那些接受强化训练的人随后恢复了训练收益，他们的表现在T4时与没有强化训练的组没有区别。结论：研究结果进一步支持FUNSAT™培训计划的有效性；随着时间的推移，大多数参与者保持或增加了他们的训练收益。强化训练在持续收益方面是有益的，这表明强化训练在技能训练中起着至关重要的作用。

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引用次数: 0

Invited Perspective on “Daily Associations Between Caregiving Time and Spousal Caregivers' Well-Being: The Moderating Roles of Daily Marital Interactions.” (Yang et al. 2025) “照顾时间与配偶照顾者幸福感之间的日常关联：日常婚姻互动的调节作用”之邀请观点。（Yang et al. 2025）。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-23 DOI: 10.1016/j.jagp.2025.09.009

Rose Lin Ph.D., Maria M. Quiñones-Cordero Ph.D.

引用次数: 0

Unraveling Personality Heterogeneity in Late-Life Suicide Attempters: Methodological Considerations and Clinical Implications 揭示晚年自杀企图者的人格异质性：方法学考虑和临床意义。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-21 DOI: 10.1016/j.jagp.2025.09.007

Jinchao Zhao M.D., Le Xiong M.D., Weiliang Cao M.D.

引用次数: 0

Feasibility and Tolerability of Novel Deep Repetitive Transcranial Magnetic Stimulation for Depression in Older Adults: DIVINE Pilot Study 新的深度重复经颅磁刺激治疗老年人抑郁症的可行性和耐受性：DIVINE试点研究

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-20 DOI: 10.1016/j.jagp.2025.09.016

Dante Duarte M.D., Ph.D. , Anne-Marie Di Passa M.Sc. , Carly McIntyre-Wood M.Sc. , Emily MacKillop Ph.D. , Shelby Prokop-Millar B.Sc. , Horodjei Yaya M.Sc. , Allan Fein M.Sc. , Emily Vandehei M.Sc. , Jane De Jesus B.Sc., B.A. , Benicio N. Frey M.D., Ph.D. , James MacKillop Ph.D.

Objectives

Major depressive disorder (MDD) is a leading cause of global disability and is notably prevalent in older adults. Deep transcranial magnetic stimulation (dTMS), specifically the H1-coil targeting the lateral prefrontal cortex, is approved for adults with treatment-resistant MDD and has shown promise in seniors. However, substantive proportions do not respond to the H1-coil and other H-coils, targeting different brain regions implicated in MDD, may also offer therapeutic benefits. The current study examined the feasibility and tolerability of the H4-coil and H7-coil designs in seniors with MDD for the first time.

Materials and Methods

Participants were 21 older adults with moderate-to-severe treatment-resistant MDD randomized to 20 sessions of H4-coil or H7-coil dTMS for four weeks. Primary outcomes were feasibility (protocol completion) and tolerability (frequency of adverse events). Secondary outcomes were depression, anxiety, cognition, sleep, and somatic complaints, and coil differences.

Results

Intention-to-treat protocol completion rates were 86.8% for the H4-coil and 98% for the H7-coil. Both treatments were generally well-tolerated with low rates of AEs and no evidence of negative cognitive effects. There was a significant reduction in depression (F_(4,68) = 46.54, p < 0.0000001, η² = 0.73), but no significant coil differences. Both treatments also led to significant reductions in anxiety and somatic complaints.

Conclusion

This study provides evidence supporting the feasibility and tolerability of the H4-coil and H7-coil in seniors with MDD, with promising evidence of therapeutic benefits. The findings support future sham-controlled designs to formally evaluate clinical efficacy.

Clinical Trial Registration

The Clinicaltrials.gov registration number for the study is NCT05855850.

重度抑郁症（MDD）是全球致残的主要原因之一，在老年人中尤为普遍。深经颅磁刺激（dTMS），特别是针对外侧前额皮质的h1线圈，已被批准用于治疗难治性重度抑郁症的成人，并在老年人中显示出前景。然而，实质性比例对h1线圈和其他h线圈没有反应，针对与重度抑郁症有关的不同大脑区域，也可能提供治疗益处。本研究首次探讨了h4 -线圈和h7 -线圈设计在老年MDD患者中的可行性和耐受性。材料和方法研究对象为21名中重度难治性重度抑郁症老年人，随机分为20组h4线圈或h7线圈dTMS，疗程4周。主要结局是可行性（方案完成情况）和耐受性（不良事件发生频率）。次要结局是抑郁、焦虑、认知、睡眠、躯体疾患和线圈差异。结果h4盘管的意向治疗方案完成率为86.8%，h7盘管的完成率为98%。两种治疗通常耐受性良好，不良反应发生率低，无证据表明对认知有负面影响。抑郁显著降低（F(4,68) = 46.54, p < 0.0000001, η2 = 0.73），但无显著差异。这两种治疗方法也显著减少了焦虑和身体不适。结论本研究为H4-coil和H7-coil治疗老年重度抑郁症的可行性和耐受性提供了证据，证明其治疗效果良好。研究结果支持未来的假对照设计来正式评估临床疗效。临床试验注册该研究的Clinicaltrials.gov注册号为NCT05855850。

{"title":"Feasibility and Tolerability of Novel Deep Repetitive Transcranial Magnetic Stimulation for Depression in Older Adults: DIVINE Pilot Study","authors":"Dante Duarte M.D., Ph.D. , Anne-Marie Di Passa M.Sc. , Carly McIntyre-Wood M.Sc. , Emily MacKillop Ph.D. , Shelby Prokop-Millar B.Sc. , Horodjei Yaya M.Sc. , Allan Fein M.Sc. , Emily Vandehei M.Sc. , Jane De Jesus B.Sc., B.A. , Benicio N. Frey M.D., Ph.D. , James MacKillop Ph.D.","doi":"10.1016/j.jagp.2025.09.016","DOIUrl":"10.1016/j.jagp.2025.09.016","url":null,"abstract":"<div><h3>Objectives</h3><div>Major depressive disorder (MDD) is a leading cause of global disability and is notably prevalent in older adults. Deep transcranial magnetic stimulation (dTMS), specifically the H1-coil targeting the lateral prefrontal cortex, is approved for adults with treatment-resistant MDD and has shown promise in seniors. However, substantive proportions do not respond to the H1-coil and other H-coils, targeting different brain regions implicated in MDD, may also offer therapeutic benefits. The current study examined the feasibility and tolerability of the H4-coil and H7-coil designs in seniors with MDD for the first time.</div></div><div><h3>Materials and Methods</h3><div>Participants were 21 older adults with moderate-to-severe treatment-resistant MDD randomized to 20 sessions of H4-coil or H7-coil dTMS for four weeks. Primary outcomes were feasibility (protocol completion) and tolerability (frequency of adverse events). Secondary outcomes were depression, anxiety, cognition, sleep, and somatic complaints, and coil differences.</div></div><div><h3>Results</h3><div>Intention-to-treat protocol completion rates were 86.8% for the H4-coil and 98% for the H7-coil. Both treatments were generally well-tolerated with low rates of AEs and no evidence of negative cognitive effects. There was a significant reduction in depression (F<sub>(4,68)</sub> = 46.54, p < 0.0000001, η<sup>2</sup> = 0.73), but no significant coil differences. Both treatments also led to significant reductions in anxiety and somatic complaints.</div></div><div><h3>Conclusion</h3><div>This study provides evidence supporting the feasibility and tolerability of the H4-coil and H7-coil in seniors with MDD, with promising evidence of therapeutic benefits. The findings support future sham-controlled designs to formally evaluate clinical efficacy.</div></div><div><h3>Clinical Trial Registration</h3><div>The <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> registration number for the study is NCT05855850.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"34 1","pages":"Pages 41-56"},"PeriodicalIF":3.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594863","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

A Walk With Grief: A Personal Narrative of Coping With the Death of a Same Sex Partner in Late Life 与悲伤同行：晚年应对同性伴侣死亡的个人叙述。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-20 DOI: 10.1016/j.jagp.2025.09.012

Sarah T. Stahl Ph.D., Joelle Kincman Ph.D., Katalin Szanto M.D.

Grief is a complex and multifaceted process. While there is no reason to think that the grieving process would be dissimilar if an LGBTQ+ individual loses a partner than the grief of a heterosexual individual, they often receive and perceive less practical and emotional support, empathy and are treated unequally legally post loss. To date no studies have investigated whether this experience (disenfranchised loss) more likely leads to prolonged grief disorder or other mental health sequelae. This article describes aspects of disenfranchised grief, loneliness, and artificial intelligence for emotional support based on the personal experience of an older gay widower who was moderately depressed and lonely at the time of enrollment in a clinical trial for late-life bereavement and suicide risk.

悲伤是一个复杂而多方面的过程。虽然没有理由认为LGBTQ+个体失去伴侣的悲伤过程会与异性恋个体的悲伤不同，但他们通常会得到和感受到更少的实际和情感支持、同情，并且在失去伴侣后受到不平等的法律对待。到目前为止，还没有研究调查这种经历（被剥夺公民权的丧失）是否更有可能导致长期的悲伤障碍或其他精神健康后遗症。这篇文章描述了被剥夺的悲伤、孤独和人工智能情感支持的各个方面，这是基于一位老年同性恋鳏夫的个人经历，他在参加一项针对晚年丧亲和自杀风险的临床试验时，患有中度抑郁和孤独。

引用次数: 0

Effects of Comorbid Anxiety on Treatment Outcomes After Accelerated Theta Burst Stimulation for Late-Life Depression 共病焦虑对加速θ波爆发刺激治疗晚期抑郁症疗效的影响。

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-20 DOI: 10.1016/j.jagp.2025.09.017

Jeanette Hui M.Sc., M.D. , Alisson P. Trevizol M.D., Ph.D. , Hyewon H. Lee M.D. , Reza Zomorrodi Ph.D. , Christoph Zrenner M.D. , Benoit H. Mulsant M.D., M.S. , Daniel M. Blumberger M.D., M.Sc.

Objectives

Accelerated theta burst stimulation (TBS) offers a time-efficient alternative to conventional repetitive transcranial magnetic stimulation and has recently been explored in late-life depression (LLD). Anxiety symptoms frequently occur in depressed older adults and are known to reduce the effectiveness of first-line therapeutic options. The impact of anxiety symptoms on treatment outcomes from accelerated TBS is unknown.

Methods

Secondary analyses were performed on data from an open-label pilot trial where 78 outpatients with LLD received a 5-day course of accelerated sequential bilateral TBS (NCT05119699).

Results

Participants with a comorbid anxiety disorder had more severe depressive symptoms before and after treatment and lower remission rates at the 4-week follow-up, but not immediately at treatment end. Baseline anxiety symptoms did not significantly affect rates of remission from suicidal ideation at either follow-up time points.

Conclusions

Comorbid anxiety symptoms may reduce the effectiveness of accelerated TBS for treating depressive symptoms in older adults.

目的：加速θ波爆发刺激（TBS）为传统的重复经颅磁刺激提供了一种时间效率高的替代方案，最近在老年抑郁症（LLD）中得到了探索。焦虑症状经常出现在抑郁的老年人中，并且已知会降低一线治疗方案的有效性。焦虑症状对加速TBS治疗结果的影响尚不清楚。方法：对一项开放标签试点试验的数据进行二次分析，该试验中78名LLD门诊患者接受了5天的加速顺序双侧TBS疗程（NCT05119699）。结果：患有共病焦虑症的参与者在治疗前后有更严重的抑郁症状，在4周的随访中缓解率更低，但在治疗结束时不是立即。在任何随访时间点，基线焦虑症状对自杀意念缓解率均无显著影响。结论：共病性焦虑症状可能会降低加速TBS治疗老年人抑郁症状的有效性。

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引用次数: 0

Living Alone, Early Tau Pathology, and Loneliness in Cognitively Unimpaired Older Adults During the COVID-19 Pandemic 在COVID-19大流行期间，独居、早期Tau病理学和认知功能受损老年人的孤独感

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry

Pub Date : 2025-09-20 DOI: 10.1016/j.jagp.2025.09.014

Benjamin S. Zide M.St , Geoffroy Gagliardi Ph.D. , Heidi I.L. Jacobs Ph.D. , Jennifer R. Gatchel M.D., Ph.D. , Yakeel T. Quiroz Ph.D. , Gad A. Marshall M.D. , Dorene M. Rentz Psy.D. , Keith A. Johnson M.D. , Reisa A. Sperling M.D. , Patrizia Vannini Ph.D. , Nancy J. Donovan M.D. , Harvard Aging Brain Study

Background

Social restrictions during the COVID-19 pandemic heightened concerns about the negative health impacts of loneliness on older adults, particularly among those living alone. This study evaluated whether Alzheimer’s disease (AD) pathology might be an underlying factor contributing to increased loneliness in cognitively unimpaired (CU) older adults living alone or with others during the pandemic.

Methods

One hundred-two CU participants from the Harvard Aging Brain Study completed pre-pandemic assessments of loneliness, cognition, cortical amyloid burden (PiB-PET), and tau pathology in inferior temporal (IT) and entorhinal cortical (EC) regions (FTP-PET). In May 2020, participants completed online surveys assessing living arrangements (alone versus with others) and current loneliness. Linear regressions estimated the interactive effects of living alone and either PiB, EC or IT FTP binding, or cognition on changes in loneliness, adjusting for age, sex, time since the pre-pandemic imaging, and pre-pandemic levels of depression, anxiety, and loneliness.

Results

Participants living alone during the pandemic reported greater increases in loneliness compared to those living with others (β = 1.22, p = 0.024). Higher right EC and right IT FTP binding interacted with living alone to amplify this association (for the right EC FTP interaction, β = 4.14, p = 0.043, R² = 0.21; for the right IT FTP interaction, β = 7.16, p = 0.017, R² = 0.23). Other interactions of living alone with PiB-PET or cognition were not associated with change in loneliness.

Conclusion

Greater tau pathology amplified the association between living alone and increased loneliness among CU older adults during the COVID-19 pandemic. AD pathological brain changes may play an unrecognized role in late-life loneliness.

背景：2019冠状病毒病大流行期间的社会限制加剧了人们对孤独对老年人，特别是独居老年人健康负面影响的担忧。本研究评估了阿尔茨海默病（AD）病理是否可能是导致大流行期间独居或与他人一起生活的认知未受损（CU）老年人孤独感增加的潜在因素。方法：来自哈佛大学老化脑研究的102名CU参与者完成了孤独感、认知、皮质淀粉样蛋白负担（PiB-PET）和下颞叶（IT）和内嗅皮质（EC）区域（FTP-PET）的tau病理学的大流行前评估。2020年5月，参与者完成了在线调查，评估生活安排（独自一人与他人）和当前的孤独感。线性回归估计了独居与PiB、EC或IT FTP绑定或认知对孤独感变化的交互影响，调整了年龄、性别、自大流行前成像以来的时间以及大流行前的抑郁、焦虑和孤独感水平。结果：与与他人同住的参与者相比，大流行期间独居的参与者报告的孤独感增加更大（β = 1.22, p = 0.024）。较高的右EC和右IT FTP绑定与独居相互作用，以扩大这种关联（对于右EC FTP交互，β = 4.14, p = 0.043, R2 = 0.21；对于右IT FTP交互，β = 7.16, p = 0.017, R2 = 0.23）。单独生活与PiB-PET或认知的其他相互作用与孤独感的变化无关。结论：在COVID-19大流行期间，更大的tau病理放大了独居与CU老年人孤独感增加之间的关联。阿尔茨海默病病理性大脑变化可能在晚年孤独中起着未被认识到的作用。

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引用次数: 0

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