Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society最新文献

Background: Knee osteoarthritis (OA) is a chronic, long-term disease with both physical and psychosocial consequences. In determining the treatment programs of patients diagnosed with knee OA and ensuring compliance with treatment, it is important to understand the emotional attitudes and experiences of patients regarding the physical and psychosocial effects of the disease. This study aimed to create a scale for evaluating the emotional attitudes of patients with knee OA as they manage and cope with the condition.

Methods: The research was a validity and reliability study designed using methodological methods. Study data were collected from the Department of Physical Therapy and Rehabilitation at a university hospital in Turkey between November and December 2024. The study sample included 90 patients diagnosed with knee OA. To establish the validity of the scale, content validity and construct validity were assessed. Internal consistency was determined using Cronbach's alpha reliability coefficient, item-total score correlations, and the Hotelling T² test. The test-retest method was applied to determine the scale's stability over time.

Results: The content validity index (CVI) values for the draft form of the scale ranged between 0.91 and 1.00. The exploratory factor analysis indicated that the scale consisted of a single factor, which explained 41.62% of the total variance. The scale demonstrated strong reliability, with a Cronbach's alpha coefficient of 0.86, item-total correlations ranging from 0.36 to 0.73, and a significant Hotelling T² value (P < 0.001). Test-retest analysis indicated a positive and highly significant correlation for the overall scale (r = 0.964, P < 0.001).

Conclusion: The knee osteoarthritis emotional meaning scale (KOEMS) was demonstrated to be a valid and reliable instrument for this patient sample.

Background: The purpose of this study was to reveal inter- and intra-rater reliability of the detailed evaluation of cognitive function by assistive robot for older adults.

Methods: We investigated the inter-rater and test-retest reliability. Neurobehavioral Cognitive Status Examination was conducted twice for each participant using an assistive robot and the examiner respectively (Experiment 1). The order of these two tests was randomly selected and the interval between them was 1 week. In Experiment 2, we investigated the test-retest reliability of the first robot test and this additional robot test was conducted approximately 6 weeks after Experiment 1.

Results: Fifty-one (13 men and 38 women, mean age: 80.5 ± 5.6 years) participants went through Experiment 1 and 29 of those (eight men and 21 women, mean age: 80.4 ± 4.8 years) completed Experiment 2. In Experiment 1, the interclass coefficient (ICC) in orientation was in the high range and its Cronbach's α was 0.919, rated as excellent internal consistency. On the other hand, other items did not show positive results. In Experiment 2, the ICCs in orientation, attention, and repetition were in the adequate range, while other items showed marginal or low range.

Conclusions: Orientation was supposed to be utilised for figuring out initial symptoms of dementia. In the future, as robot functions become more high-tech, a partner robot might be able to measure the symptoms and severity of dementia.

Objective: To explore the influence of education level on scores in the Mandarin Chinese version of the Rowland Universal Dementia Assessment Scale (RUDAS) among stroke patients and to provide guidance regarding the application and optimisation of the RUDAS.

Methods: A total of 235 stroke patients were census sampled for an evaluation of cognitive function using the Mandarin Chinese version of the RUDAS. A test was carried out to analyze the differences in RUDAS scores between sexes, and one-way analysis of variance and the Scheffe multiple comparison test were used to analyze the differences in RUDAS scores between age groups and between education levels. SPSS 22.0 software was used for statistical analysis. Differential item functioning (DIF) analysis was performed using logistic regression. If P < 0.05, then an item was considered to exhibit DIF.

Results: The overall education levels of the stroke patients were moderate. There was no significant difference in RUDAS scores based on education level or sex, but there was a difference between age groups. There were three items that exhibited DIF: square, internal line and external line.

Conclusion: RUDAS scores were not strongly influenced by education level, and most items were suitable for screening among stroke patients with different education levels. However, when drawing a cube, differences in education level should be taken into consideration.

Background: Stressful life events greatly increase the risk of depression, which affects about 22% of older persons in northeast Malaysia. But how emotional distress manifests itself in reaction to these stressful events differs from person to person. Therefore, this study aims to delve into the nuances of emotional expression among older adults with depression symptoms in northeast Malaysia, alongside their help-seeking behaviours and utilisation of professional support.

Methods: Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research.

Results: None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.'

Conclusion: The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.

Background: Alzheimer's disease (AD) is associated with impairments in not only memory but also visuospatial cognitive function. Despite its adverse effects on the quality of life, patients with early-stage AD are often neglected. Emerging evidence suggests that patients with AD exhibit increased vulnerability of myelin, a crucial component for neuronal conduction and survival. To test our hypothesis that myelin damage was associated with cognitive deficits in AD, we examined correlations of myelin integrity, quantified by T1-weighted/T2-weighted (T1w/T2w) ratios, with visuospatial cognitive abilities and compared them between patients with AD and cognitively normal (CN) individuals.

Methods: Fifty-seven patients with AD and 22 CN subjects were enrolled in this study. To assess subjects' visuo-constructive abilities, we employed the Rey-Osterrieth Complex Figure Copy Test (ROCFT-c) paired with analysis of T1- and T2-weighted magnetic resonance imaging brain images. Voxel-based associations between T1w/T2w ratios and ROCFT-c scores in the AD group were assessed, controlling for age and handedness (voxel threshold uncorrected P < 0.001, cluster threshold uncorrected P < 0.05). Additionally, we compared the T1w/T2w ratios of these identified brain regions between the AD and CN groups.

Results: The voxel-based analysis demonstrated positive correlations between T1w/T2w ratios and ROCFT-c scores in the right middle temporal gyrus and right praecuneus in patients with AD who exhibited significantly lower T1w/T2w ratios in the right middle temporal gyrus (P = 0.038) and a trend toward lower T1w/T2w ratios in the right praecuneus (P = 0.055).

Conclusions: Our results demonstrated a strong association between reduced myelin integrity in the right middle temporal gyrus and right praecuneus and visuospatial cognitive dysfunction in patients with AD. These findings are believed to shed light on the neural basis of visuospatial processing in patients with AD, underlining the necessity for developing objective biomarkers for assessing patients' visuospatial cognitive function.

Background: Postoperative cognitive dysfunction (POCD) is a postoperative complication of the central nervous system, especially in elderly patients. Growing evidence shows a close relationship between the kidney and cognition. This study aimed to evaluate the relationship between the subsequent risk of POCD and indicators related to the kidney.

Methods: A total of 93 eligible patients (≥65 years old) undergoing elective total hip replacement were enrolled. Before and 1 day after surgery, blood samples were collected from enrolled patients. Mini-Mental State Examination and Montreal Cognitive Assessment were conducted 1 day before surgery and 1 week after surgery or at discharge. The receiver operating characteristic curve was used to examine the predictive value of the estimated glomerular filtration rate (eGFR) for POCD. Univariate and multiple logistic regression models were used to analyze the risk factors of POCD.

Results: Thirty patients (32.26%) were assessed for POCD 1 week after surgery. The preoperative eGFR level in the POCD group was significantly lower than in the non-POCD group (P < 0.001). The area under the curve of eGFR was 0.739 (95% CI, 0.630-0.848; P < 0.001). The multivariable logistic regression analysis results showed that preoperative eGFR was independently associated with POCD (odds ratio = 0.965, 95% CI = 0.935-0.996, P = 0.028) after adjustment for mixed factors.

Conclusion: Low eGFR is associated with an increased risk of POCD in patients undergoing elective total hip replacement surgery. Low eGFR is an effective predictor of incident POCD.

Background: Chronic pain may be an important factor influencing cognitive impairment; however, there is limited research on that link in older adults with disabilities. We aimed to determine the association between chronic pain and cognitive impairment in older adults with disabilities.

Methods: This 24-month prospective cohort study involved 143 Japanese older adults (≥65 years of age) with long-term care insurance. Chronic pain was defined as pain persisting for ≥3 months, and cognitive impairment was defined as a Mini-Mental State Examination score ≤ 23. We employed logistic regression analysis with chronic pain as the independent variable and cognitive impairment as the dependent variable after propensity score matching (PSM).

Results: Sixty-six participants were selected using PSM, and logistic regression analysis showed that chronic pain was significantly associated with cognitive impairment (odds ratio: 4.103, 95% confidence interval: 1.455-11.567, P = 0.008).

Conclusion: To prevent cognitive impairment in older adults with disabilities, the management of chronic pain should be considered, as they are related.

Background: In addressing elderly healthcare issues, cognitive impairment can cause significant disruptions in daily life and may potentially develop into dementia. Thus, finding ways to delay the progression of cognitive impairment is a critical issue.

Methods: This study aims to develop an adaptive artificial intelligence (AI) mechanism that creates enjoyable and beneficial content to help delay cognitive impairment in the elderly. Utilising virtual reality (VR) and a fishing game, the design enhances reaction time and attention through interactive fishing activities. The AI personalises content based on individual performance to improve cognitive function.

Results: Experimental results showed that adaptive AI increased participant satisfaction from 86.84 to 91.05 points and future willingness from 75.26 to 85.68 points. The number of fish caught rose from 98 to 120, with the average per participant increasing from 2.64 to 2.85.

Conclusions: This is undoubtedly the trend of the future. VR allows the elderly to have a more impactful and memorable first experience, while AI dynamically adjusts the game's difficulty based on the elderly's performance, addressing the issue of reduced willingness to continue due to inappropriate game difficulty. The VR game developed in this study is designed to be relaxing and incorporates mechanisms to promote the elderly's health. It is not restricted by location or time and, more importantly, meets the health promotion needs of the elderly.

Background: Malignancy is a critical factor affecting death anxiety and psychological well-being. This study examined the impact of malignancy on death anxiety and psychological well-being in middle-aged and older adult patients undergoing abdominal surgery and projected it along with sociodemographic profiles.

Methods: This study is quasi-experimental in design. It was conducted with patients undergoing abdominal surgery at a university hospital due to suspected malignancy. A total of 93 patients participated in the study: 57 patients diagnosed with malignancy were included in the experimental group, while 36 patients without a malignancy diagnosis were included in the control group. Data were collected using a questionnaire developed by the researchers based on the literature, the 'Turkish Death Anxiety Scale', and the 'Psychological Well-being Scale'. The analyses revealed that the data were normally distributed, and parametric tests were used to analyze differences between demographic variables and groups. Cohen's d and r values were examined to assess the effect size in the tests.

Results: The study found a significant difference in death anxiety between the experimental and control groups (P < 0.05), with higher mean scores in the experimental group. Malignancy had a large effect on death anxiety (d = 1.42). Additionally, the control group had significantly higher mean psychological well-being scores compared to the experimental group (P < 0.05).

Conclusions: The study found that malignancy significantly affects death anxiety and psychological well-being. Increased death anxiety in patients with malignancy was associated with reduced psychological well-being. Thus, assessing death anxiety and providing targeted nursing care are essential for supporting the psychological well-being of these patients.