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

Background: To know the level of health locus of control (HLC) and investigate the factors associated with HLC among community-dwelling older adults.

Method: A total of 470 older adults completed the Multidimensional Health Locus of Control Scale, the Activities of Daily Living Scale, the Geriatric Depression Scale, and the Lubben Social Network Scale. Hierarchical multiple regression was used to explore the factors associated with HLC.

Results: Gender, marital status, income and the number of chronic diseases were associated with internal HLC; age, educational level, income, activities of daily living and social networks were associated with powerful others HLC; social networks were associated with chance HLC (P < 0.05).

Conclusion: As modifiable factors, physical function and social support are essential for improving HLC in older adults and interventional programs aiming at changing them could help older adults maintain acceptable levels of HLC.

Background: Enhancing post-stroke cognitive impairment (PSCI) is a key aspect of prognosis for stroke patients. Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) is currently a widely utilised method for treating PSCI. With the increasing promotion of traditional Chinese medicine, Xingnao Kaiqiao (XNKQ) acupuncture has been progressively incorporated into clinical treatment. This paper observes the effect of LF-rTMS with XNKQ acupuncture on patients with PSCI.

Methods: Totally, 192 patients with PSCI were consecutively recruited and treated either with LF-rTMS and XNKQ acupuncture (observation group) or LF-rTMS only (control group) for 4 weeks. The pre- and post-treatment Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, P300 latency and amplitude, inflammatory factor levels were compared and clinical efficacy was assessed.

Results: Both groups exhibited increased MMSE/MoCA scores, and P300 amplitude, and shortened P300 latency, and the observation group had higher scores and P300 amplitude, and shorter P300 latency than the control group. Both groups displayed decreased inflammatory factor levels (Tumour necrosis factor-α, interleukin (IL)-6, IL-10, IL-1β) after treatment, which were lower in the observation group than the control group. Inflammatory factor levels in PSCI patients were negatively interrelated with MMSE, MoCA score and P300 amplitude, and positively with P300 latency. The observation group showed an increased number of patients showing cured and significantly effective results, a decreased number of patients showing effective and invalid results, and an observably elevated total effective rate.

Conclusion: LF-rTMS with XNKQ acupuncture can improve cognitive function and reduce inflammatory immune response, and has better clinical efficacy in PSCI patients.

Background: Cognitive decline seen in old age manifests itself as a decrease in reasoning ability that is not related to intelligence. This situation, together with many other problems, can affect the psychological well-being of the elderly. Especially the elderly living in institutional care constitute a special group that needs to be protected. It is important that the psychotherapy interventions to be carried out with this group are determined according to the characteristics of the group. The aim of this study is to determine the effect of art therapy on cognitive status and psychological well-being in the elderly living in institutional care.

Methods: This single-blind randomised controlled study was conducted with 42 elderly individuals living in three nursing homes in Türkiye. In the study, the sample group was assigned to the experimental (n = 21) and control (n = 21) groups by simple randomisation. Art therapy intervention was applied to the elderly individuals in the experimental group, and no special intervention was applied to the control group. The sociodemographic information form, standardised mini mental test (MMT) and Psychological Well-being Scale for the Elderly (PWBS) were used as data collection tools in the study.

Results: It was found that there was a statistically significant difference between the pre-test and post-test total scores of the PWBS and MMT in favour of the post-test (P < 0.001). In the study, the effect of the art therapy intervention applied to the elderly individuals in the experimental group was evaluated and it was determined that the difference between the PWBS ( ${\eta }^2$  = 0.75) and MMT ( ${\eta }^2$  = 0.52) scores had a medium effect level.

Conclusions: The results showed that art therapy has a positive effect on the psychological well-being and cognitive status of the elderly in institutional care and can be used as a moderate developmental intervention.

To examine whether cognitive frailty serves as a predictor of hospitalisation in older adults. PubMed, Web of Science, Embase, Scopus and Cochrane Library databases were systematically searched from inception to February 6, 2024. The reviewers independently selected studies, extracted data and evaluated the quality of studies. Stata 15.1 Software was used to perform the meta-analysis. A total of 13 articles were included in this study, including 34 230 participants. The results suggested that cognitive frailty was associated with hospitalisation in older adults (odds ratio (OR) = 1.79, 95% CI: 1.33-2.42, P < 0.001). The risk of hospitalisation for patients with cognitive frailty was 1.76 times higher than that for patients without cognitive frailty (relative risk = 1.76, 95% CI: 1.48-2.08, P < 0.001). According to different models of cognitive frailty, the results of subgroup analysis showed that the frail + cognitive impairment group had the highest risk of hospitalisation (OR = 2.22, 95% CI: 1.51-3.26, P < 0.001). Subgroup analysis based on study design showed that the incidence of hospitalisation was lowest in the cohort study group (OR = 1.51, 95% CI: 1.14-2.00, P = 0.004). This study suggested that cognitive frailty was an important predictor of hospitalisation in older adults. Future studies are needed to investigate the impact of cognitive frailty on hospitalisation in older adults, as this may help reduce hospitalisation rates and improve patients' quality of life.

Background: On 6 February, 2023, Turkey experienced a disaster resulting from two major earthquakes. The elderly population stands out as one of the most vulnerable and least adaptable. This study aims to identify the quality of life (QOL) and post-traumatic stress disorder (PTSD) symptoms among elderly earthquake survivors in Turkey.

Methods: This research was conducted between 1 October, 2023 and 15 December, 2023 as a cross-sectional design. During the data collection process, survey questions prepared by the researchers (29 questions) and the Elderly Quality of Life Scale (OPQOL-Bref) and the Impact of Events Scale (IES-R) were used.

Results: Three hundred and eighty-four elderly people participated in the study. PTSD was more common in those diagnosed with chronic diseases after the earthquake, in those who had a drug-free period after the earthquake, in those who smoked and quit smoking, and in those who started psychiatric medication after the earthquake. Post-traumatic stress was seen more frequently in those with low QOL scores and in those who had a longer period of not using medication after the earthquake. It was observed that QOL was better in married people, high school graduates, those with average income levels, those who did not have chronic diseases before and after the earthquake, those who did not have a drug-free period after the earthquake, those who were physically active, and those who did not use psychiatric medication after the earthquake.

Conclusion: Chronic disease diagnosis post-earthquake, drug-free periods, smoking habits, and psychiatric medication usage were identified as influential factors in PTSD occurrence. Additionally, the study shed light on the profound effect of earthquake-related experiences, such as house damage, injuries, deaths in first-degree relatives, displacement, and changes in living conditions, on PTSD prevalence.

Background: Behavioural and psychological symptoms of dementia (BPSD) negatively impact the quality of life of patients with dementia and their surrounding caregivers. Therefore, identifying modifiable factors to prevent BPSD is crucial. This cross-sectional study investigated the association between hearing impairment (HI), social relationships, and BPSD.

Methods: A survey involving 179 patients who attended a memory clinic was conducted between July 2023 and March 2024. Pure-tone audiometry and questionnaire interviews were conducted, while medical records were reviewed. HI was defined as an average hearing level ≥ 40 dB, measured by pure-tone audiometry using the better-hearing ear. BPSD presence and severity were assessed using the BPSD25Q-based questionnaire. Multiple regression analysis was used for calculating partial regression coefficients to assess the association between HI, social relationship indicators, and BPSD presence and severity, adjusting for confounders.

Results: Among the 144 participants included in the analysis, the mean age was 82.7 years, and 96 (66.7%) were female individuals. Using multiple regression analysis, individuals with HI, whether living with others (β = 1.49, P = 0.038) or living alone (β = 2.23, P = 0.044) had a higher presence of BPSD, compared with those without HI who live with others. Additionally, those with HI who regularly engaged in conversations (β = 1.51, P = 0.027) or did not participate in social interactions (β = 2.02, P = 0.020) also had a higher presence of BPSD, compared with individuals without HI in similar circumstances. Similarly, those with HI and living alone (β = 4.54, P = 0.033) and lacking social interaction (β = 3.89, P = 0.020) experienced increased BPSD severity.

Conclusion: Our findings indicated that living alone and lacking social interaction with having HI were linked to both the presence and severity of BPSD. Additionally, increased verbal communication through conversations with cohabiting family members and others in patients with HI was associated with a higher presence of BPSD. Reducing communication stress and maintaining social connections are essential for managing these challenges.