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

Objective: This study aimed to evaluate the nutritional status, perceived health, and adaptation to aging of older adults and to examine the relationships among these variables.

Methods: This descriptive, cross-sectional study included 386 older adults receiving care at the outpatient clinics of a public hospital in northeastern Turkey. Data were collected using a sociodemographic questionnaire, the Standardised Mini-Mental State Examination, the Mini Nutritional Assessment-Short Form (MNA-SF), the Perception of Health Scale, and the Assessment Scale of Adaptation Difficulty for the Elderly. Statistical analyses included independent samples t-tests, one-way ANOVA, Pearson correlation analysis, and path analysis.

Results: The mean MNA-SF score was 11.52 ± 1.96; the mean health perception score was 48.07 ± 5.53; and the mean adaptation difficulty score was 0.99 ± 0.04. Health perception significantly predicted adaptation difficulty in older adults. MNA-SF scores varied significantly by age, body mass index (BMI), marital status, place of residence, and regular medication use (p < 0.01). Similarly, health perception scores differed significantly based on age, BMI, place of residence, educational level, income status, and the presence of chronic disease (p < 0.05). Adaptation difficulty scores also showed significant variation by age (p < 0.001).

Conclusion: The findings revealed that 38.6% of participants were at risk of malnutrition, while 3.9% were malnourished. Although participants' overall health perception was moderate, their adaptation to aging was generally high. A more positive health perception was associated with better adaptation to aging. Targeted health and nutrition programs are recommended for high-risk groups, particularly older adults with lower socioeconomic status or those residing in rural areas.

Background: Increasing life expectancy will lead to more people living with dementia (PLwD) and, consequently, more caregivers experiencing burden. Caregivers burden is influenced by characteristics of both PLwD and caregivers themselves, as well as healthcare services organisation. The COVID-19 pandemic and lockdown measures implemented in Italy worsened PLwD and their caregivers' well-being. Recognising the importance of understanding the profiles and care needs of PLwD and their caregivers, a national survey was conducted within the Italian Fund for Alzheimer's and Dementias to investigate the sociodemographic characteristics of PLwD caregivers and their care recipients in Italy. This study aimed to describe the characteristics of Italian caregivers of PLwD, their use of services, and satisfaction with the latter.

Methods: A cross-sectional national survey was conducted. A self-administered questionnaire was developed consisting mainly of multiple-choice questions.

Results: A total of 2369 caregivers participated in the survey. Most of them resided in Northern Italy (60.1%), were females (73.4%) and care recipients' children (74.1%). Median diagnostic delay ranged from 7 to 36 months. Diagnosis was formulated mainly by a physician from a Centre for Cognitive Disorders and Dementia. Caregiver training was poorly reported (34.1%). PLwD clinical condition worsened during the pandemic. The mean degree of satisfaction with services dedicated to dementia was "acceptable". Negative/very negative degree of satisfaction was associated with not living in the North, increased caregiver's age, not having received training, severe degree of disease, having received the diagnosis suspicion from a private doctor, and not having used day care centres or Centres for Cognitive Disorders and Dementia.

Conclusions: Differences in the sociodemographic profile of caregivers and disparity in services across Italy emerged. The establishment of a comprehensive, accessible, and well-integrated network of services across all stages of the disease progression is needed.

Aim: Multiple comorbidities are common amongst the elderly due to shared underlying factors. We used latent class analysis (LCA) to explore the of multimorbidities amongst the elderly and their association with self-rating of health, life satisfaction, limitations in daily activities and depressive symptoms.

Methods: We utilised a subset of nationally representative survey data from the Longitudinal Aging Survey of India 2017-2018 covering elderly >= 60 years of age. LCA was used to examine patterns of 11 chronic morbidities. Classes were compared across socio-demographic and behavioural characteristics. Various model fit statistics (Akaike, Bayesian and sample size adjusted Bayesian information criteria, likelihood ratio tests and entropy) and the meaningfulness of the classes were used to select the number of latent classes.

Results: Four distinct latent classes were identified: 'Hypertension/Lung/Bone/Others', 'Cardio-metabolic', 'Hypertension-Diabetes' and the 'Healthy class'. There were significant differences between classes on socio-demographics (age, sex, residence, education, wealth quintile) and behaviours (tobacco, alcohol, physical activity, yoga). 'Hypertension/Lung/Bone/Others' class was significantly associated with limitations in ADLs, limitations in IADLs and depressive symptoms compared to the 'healthy class'. 'Cardio-metabolic' class had significantly higher rates of hospital admission in the last 12 months.

Conclusions: Elderly could be grouped into four distinct classes based on their multimorbidity status. The single-disease paradigm does not fit the approach for caring for patients with multimorbid conditions. Care of multimorbid elderly individuals needs an integrated and continuity of care approach.

An 85-year-old woman with late-onset depression subsequently developed persistent oral cenesthopathy. As antidepressant augmentation, low-dose aripiprazole improved both mood and oral symptoms, but oversedation and parkinsonism necessitated tapering and discontinuation. After discontinuation, oral cenesthopathy recurred without clear depressive worsening. Dopamine transporter single-photon emission computed tomography showed reduced bilateral striatal uptake and ¹²³I-metaiodobenzylguanidine cardiac scintigraphy showed decreased uptake, with preserved cognition. In light of the clinical and imaging findings suggestive of dopaminergic dysfunction, and after an informed discussion of off-label use, pramipexole 0.25 mg daily was initiated. Oral discomfort lessened within 1 week and oral intake normalised by 2 weeks, without adverse effects; remission of oral symptoms and mood persisted for 6 months. Overall, the presentation was conceptually compatible with the psychiatric-onset phenotype described in the prodromal Lewy body disease research framework, but this remains an interpretive consideration rather than a diagnosis. Assessing possible dopaminergic involvement in similar cases of oral cenesthopathy may aid individualised management; however, the therapeutic role of dopamine agonists requires confirmation in prospective studies.

Objective: This study aimed to examine changes in the quality of life (QoL) of novice family caregivers from low- to middle-income households after receiving 6 months of home nursing care support. Additionally, it sought to identify factors influencing their QoL.

Methods: A longitudinal design using structured questionnaires was adopted. Participants were novice family caregivers for individuals with severe disabilities in central Taiwan and qualified for low- to middle-income subsidies. Assessments occurred at baseline, 3 and 6 months. The questionnaire covered demographics and the World Health Organization Quality of Life-BREF. Data were analysed using descriptive statistics, repeated-measures ANOVA and mixed-effects models.

Results: A total of 50 participants (31 females; mean age = 53.72 years) were enrolled. Participants' QoL scores significantly improved after 6 months of home nursing care. Closer relationships with the care recipients were significantly associated with higher QoL in the psychological, social relationships and environmental domains. Having access to stress relief channels or activities was linked to better physical health. Longer daily caregiving hours were associated with better QoL in physical health and environmental domains, while more caregiving days per week were positively related to better physical and psychological QoL.

Conclusion: The QoL among low- to middle-income family caregivers significantly improved after 6 months of home nursing care. Key factors affecting QoL included the closeness of the caregiver-care recipient relationship, availability of stress relief activities, daily caregiving hours and weekly caregiving frequency.

Background: Cognitive frailty (CF), characterised by the co-occurrence of physical frailty and mild cognitive impairment, poses significant risks for adverse health outcomes in community-dwelling older adults, yet effective prediction tools remain limited.

Objective: This study aimed to develop and validate a nomogram model for predicting CF risk in community-dwelling older adults based on multidimensional mental and physical functional markers.

Methods: A cross-sectional analysis included 481 participants (mean age 69.2 ± 7.3 years; 60.3% female) from Shanghai communities. Assessments encompassed cognitive function (MoCA), physical frailty (EFS), mental health (GDS-15, PSQI), nutritional status (MNA-SF), and physical performance (grip strength, TUG test, standing on one leg with eyes closed/open tests). Univariate and multivariate logistic regression identified predictors, followed by nomogram construction and internal validation via bootstrapping (500 resamples).

Results: CF prevalence was 41.4% (199/481). Six independent predictors were identified: chronic disease status (OR = 2.587), malnutrition (OR = 0.852), depressive symptoms (OR = 1.062), poor sleep quality (OR = 1.245), impaired mobility (TUG time: OR = 1.100), and balance deficits (Time to stand on one leg with eyes closed time: OR = 0.935). The nomogram demonstrated moderate discrimination (C-index = 0.761, 95% CI = 0.718-0.804) and excellent calibration (Hosmer-Lemeshow p = 0.19). Internal validation confirmed robustness (corrected C-index = 0.761).

Conclusion: This nomogram integrates easily accessible mental and physical functional markers, offering a practical tool for early CF risk stratification in community settings. Its application may guide personalised interventions to mitigate cognitive and functional decline in ageing populations.

Background: Although several studies have been conducted on dementia disclosure, research on the factors influencing the desire for disclosure remains limited. This study aimed to identify the factors that determine whether patients and caregivers wish to disclose a dementia diagnosis.

Methods: We conducted a retrospective survey of 804 patients who visited the Dementia Disease Medical Center at the Kyoto Prefectural University of Medicine Hospital. A total of 201 patients were included in this study. We compared survey responses between two groups: those in which the patient wanted the dementia diagnosis disclosed versus those who did not, and those in which the caregiver wanted the diagnosis disclosed versus those who did not. Statistical analyses included the chi-squared test, Fisher's exact test and Mann-Whitney U test.

Results: A total of 188 patients (93.5%) wanted to be disclosed about dementia diagnosis, while 151 caregivers (75.1%) wished for the patient's diagnosis to be disclosed. There was a significant difference in hallucinations (as measured by the Neuropsychiatric Inventory 12-item version) between patients who wanted the diagnosis disclosed and those who did not (p < 0.001). Additionally, caregivers who wanted the patient to be informed reported milder symptoms of agitation (p = 0.014) and apathy (p = 0.005) in the patients than did those who did not want the information disclosed. Furthermore, when patients requested a medical examination, caregivers requested that the diagnosis be disclosed to them (p = 0.037).

Conclusions: The findings indicate a gap in the awareness of dementia information disclosure between patients and caregivers in Japan. Furthermore, the factors influencing the desire for disclosure appear to differ between patients and caregivers.

Semantic dementia (SD) is a type of dementia characterized by a loss of semantic memory, typically presenting with left-predominant temporal lobe atrophy and a frontotemporal lobar degeneration with TDP-43 (FTLD-TDP) type C pathology. However, atypical variants, such as those with a late-onset or right-predominant atrophy, exhibit considerable pathological diversity. We report an 81-year-old woman with atypical SD who presented with impaired naming, mild word comprehension deficits, and prosopagnosia. Brain MRI revealed right-predominant atrophy in the amygdala, hippocampus, and anterior temporal lobes. Cerebrospinal fluid analysis showed a normal Aβ level, suggesting a non-Alzheimer's disease pathology. Tau PET imaging demonstrated a high signal in the right anterior temporal lobe, consistent with primary tauopathy. The patient's clinical presentation and imaging findings, particularly the atrophy in the amygdala and hippocampus, as well as the preserved communication ability, raised the possibility of argyrophilic grain disease (AGD) as the underlying pathology. This case highlights the importance of molecular imaging in diagnosing atypical SD. It suggests that AGD should be considered a possible underlying pathology for atypical SD cases, particularly those with late onset and right-sided predominance. A longer follow-up and eventual autopsy would be necessary to confirm the pathological diagnosis.

Background: Olfactory training (OT) has been proposed as a non-pharmacological intervention to improve cognitive functions and depressive symptomatology, but evidence remains fragmented.

Methods: In this study, we conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing OT versus control in middle-aged and elderly adults. Four databases (PubMed, Cochrane Library, Web of Science, Embase) were systematically searched from database inception through June 2025. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using fixed- or random-effects models as appropriate. Risk of bias was assessed with the Cochrane tool; sensitivity analyses and funnel plots evaluated robustness and small-study bias.

Results: Six RCTs with a total of 302 participants were included. The OT did not significantly improve global cognition (SMD = 0.65; 95% CI -0.37 to 1.67) or verbal fluency (SMD = 0.06; 95% CI -0.22 to 0.34). However, OT produced a modest benefit in memory (SMD = 0.38; 95% CI 0.06-0.70) and depressive symptoms (SMD = -0.35; 95% CI -0.62 to -0.07). Risk of bias was generally low to unclear, with performance and allocation concealment most frequently at high or unclear risk. Leave-one-out analyses showed that memory and depressive symptomatology effects were sensitive to the inclusion of individual studies, whereas global cognition and fluency findings remained stable. Funnel plots suggested possible publication bias for global cognition but not for other domains.

Conclusions: OT may have potential benefit to memory and depressive symptomatology in middle-aged and elderly adults, while it still needs further high-quality, large-scale investigations to confirm the effects.

Background: Behavioural and psychological symptoms of dementia (BPSD), encompassing disturbances in perception, thought, mood and behaviour, are prevalent among individuals with dementia and can substantially affect their quality of life. Although prior research has suggested that hearing impairment (HI) may exacerbate BPSD due to communication difficulties and diminished social engagement, the relationship between HI and specific BPSD manifestations remains insufficiently explored. This study aims to examine the association between HI and distinct BPSD in individuals with cognitive decline attending a memory clinic.

Methods: This study included 179 individuals with cognitive decline and their accompanying persons who visited a memory clinic between July 2023 and March 2024. Pure-tone audiometry and a questionnaire survey were conducted. HI was defined as an average hearing level of 40 dB or higher. BPSD was assessed using a questionnaire derived from the BPSD25Q, a 25-item questionnaire designed to evaluate BPSD. The association between HI and BPSD was analyzed using modified Poisson regression, with adjusted risk ratios (aRR) and 95% confidence intervals (CI) calculated.

Results: A total of 144 individuals were included in the analysis, with a mean age of 82.7 years, approximately 70% of whom were female. The aRR (95% CI) for the presence of specific BPSD among individuals with HI were as follows: anxiety, 2.08 (1.09-3.99); irritability, 1.73 (1.05-2.86); verbally aggressive behaviour, 3.41 (1.24-9.40); physically aggressive behaviour, 5.54 (1.31-23.40); leaving home unannounced, 4.22 (1.25-14.16); hoarding behaviour, 1.83 (1.06-3.16); resistance to care, 2.12 (1.02-4.40); and carelessness with fire, 4.46 (1.12-17.83). No significant association was observed between HI and other BPSD.

Conclusions: These findings suggest that HI may contribute to the presence of specific BPSD. Tailored interventions incorporating communication strategies and environmental modifications may help mitigate BPSD in individuals with cognitive decline and HI.