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

Background: Depression has a significant global impact. Previous studies have suggested a link between depression and prostate diseases. However, these studies are often observational and may be influenced by confounding factors and reverse causality. This research aimed to explore the potential causal relationship between depression and prostate diseases using Mendelian randomisation (MR) and to assess the mediating role of immune cell phenotypes.

Methods: We utilised MR methods with genome-wide association studies (GWAS) data. The analysis was conducted in two phases: (a) a two-sample MR to investigate the impact of depression on prostate diseases; and (b) a two-step MR to evaluate the mediating effect of 731 immune cell phenotypes. Depression data were obtained from an extensive GWAS involving 480 359 participants across multiple European cohorts. Prostate disease data, including prostatitis, prostate cancer, and benign prostatic hyperplasia, were obtained from European-based GWAS. Independent single nucleotide polymorphisms related to depression were selected based on genome-wide significance criteria. Various MR methods, including inverse variance weighting, weighted median, MR-Egger, MR-PRESSO, MR-Robust, and MR-RAPS, were employed to ensure robust causal inference.

Results: The MR analysis revealed a potential causal relationship between depression and an increased risk of prostatitis (odds ratio = 1.606, P = 8.35E-04). Sensitivity analysis confirmed the robustness of these findings. Additionally, a two-step MR analysis identified CD24+ CD27+ %lymphocytes as a potential mediator, with a mediation effect of 0.108 (P = 0.03), accounting for 22.78% of the total effect.

Conclusions: This study offers novel genetic evidence for the causal relationship between depression and prostatitis, with immune cells identified as potential mediators in this process. These findings highlight the importance of psychological factors in developing prostatitis and suggest that immune cells could be novel therapeutic targets.

Objective: The objectives of this study were to examine the factors associated with suicidal ideation in a community-dwelling older adult population in Korea. Specifically, the study focuses on the role of emotional abuse and depression, and investigates the mediating effect of depression in the relationship between emotional abuse and suicidal ideation.

Methods: This study utilised data from 10 097 individuals aged 65 and older, based on a 2020 survey conducted by the Korea Institute for Health and Social Affairs.

Results: In our study, 1.9% of older adults reported suicidal ideation, 4.4% reported experiencing emotional abuse, and 12.8% reported having depression (defined as a score of ≥8 on the short version of the Geriatric Depression Scale). Our results revealed that younger-older adults, older adults living without a spouse, poor social support, subjective health status, emotional abuse (odds ratio (OR) = 2.929), and depression (OR = 5.152) were found to be significantly associated with suicidal ideation after controlling for all confounding factors. Furthermore, the mediation analysis revealed that the OR for emotional abuse decreased from 3.284 to 2.929 after accounting for depression, suggesting that depression partially mediates the relationship between emotional abuse and suicidal ideation.

Conclusion: Emotional abuse and depression were found to be associated with suicidal ideation in community-dwelling Korean older adults. Notably, depression was found to buffer the relationship between emotional abuse and suicidal ideation, indicating a mediating effect.

An 87-year-old woman with a history of multiple cardiovascular conditions, diabetes mellitus, and chronic renal failure developed insomnia and restless leg syndrome (RLS) with periodic limb movements during hospitalization for superior mesenteric artery ischaemia, which was successfully treated by mechanical embolectomy. She was found to be anaemic, with a haemoglobin at 10.5 g/dL (reference range: 11.8 15 g/dL) and serum ferritin at 13μg/L (reference range: 30 400μg/L). Given the severity of her symptoms and iron deficiency, we opted against oral iron supplementation, as its absorption is slower and less efficient. Instead, we administered intravenous iron sucrose as a first-line treatment, resulting in a corrected ferritin level of 90μg/L. Her RLS symptoms regressed within two days after intravenous iron supplementation. This case highlights the importance of considering RLS in patients presenting with insomnia, as effective treatments are available to improve patient outcomes.

Background: The aim of this study is to examine the effect of a 12-week creative handcraft programme, consisting of three different activities, on blood pressure, stress and depression in elderly patients with essential hypertension.

Method: This pretest-posttest quasi-experimental research was conducted with the participation of elderly individuals living in a nursing home. Data were collected using the Patient Information Form, Standardised Mini-Mental State Examination for the Uneducated (MMSE-E), Perceived Stress Scale (PSS), Geriatric Depression Scale (GDS) and Blood Pressure Follow-up Form. Data were collected using the Patient Information Form, MMSE-E, PSS, GDS and Blood Pressure Follow-up Form.

Results: It was determined that the 12-week creative handicraft programme was effective in reducing stress and depression in elderly individuals with essential hypertension and was also found to be beneficial in regulating blood pressure (p < 0.001).

Conclusions: The results suggest that nurses should incorporate creative handcraft activities in the management of essential hypertension, stress and depression in elderly individuals.

Background: This study aimed to compare depressive symptoms and cognitive function between older adults who accepted cataract surgery and those who declined it.

Methods: This cross-sectional observational study was conducted at the Department of Ophthalmology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey. The study included 108 patients aged 60 years or older with bilateral cataracts. The surgery-accepting group consisted of 54 participants, while the surgery-refusing group included 54 participants, matched on a 1:1 basis by age (±2 years), gender and systemic health conditions such as diabetes and hypertension. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15), and cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Exclusion criteria included patients with unilateral cataracts, prior cataract surgery, major neurological disorders (e.g., dementia, Parkinson's disease) or severe psychiatric disorders.

Results: The mean GDS-15 score was 7.33 ± 2.5 in the surgery-refusing group and 5.26 ± 1.47 in the surgery-accepting group (p < 0.001). A significant positive correlation was found between the severity of visual impairment and higher depressive symptoms (p < 0.001), indicating that worse vision is associated with more depressive symptoms. However, no significant difference was observed in MMSE scores between the two groups (23.57 ± 1.34 vs. 23.67 ± 1.33, p = 0.95), suggesting that the refusal of cataract surgery is not directly related to cognitive function.

Conclusions: Refusal of cataract surgery is significantly associated with more depressive symptoms but does not appear to be linked to cognitive function. These findings highlight the importance of addressing psychological factors when discussing surgical options with older adults and emphasise the need for a multidisciplinary approach to improve both visual and mental health outcomes.

Background: This study aimed to examine the association between depressive tendencies and bathing or hot spring bathing habits in community-dwelling individuals aged ≥ 40 years.

Methods: This cross-sectional study included 542 participants from the Tarumizu Study 2021, in which the participants underwent health checks. The frequencies of bathing and hot spring bathing were assessed using a questionnaire. The frequency of bathing was classified into '< 7 times/week' and '7 times/week', whereas the frequency of hot spring bathing was classified into '< 1 time/week' and '≥ 1 time/week'. Depressive tendencies were assessed using the 15-item Geriatric Depression Scale, with a score of ≥ 5 considered depressive tendencies.

Results: Among the participants, 487 (89.9%) bathed 7 times/week, and 124 (22.9%) bathed in hot springs ≥ 1 time/week. The depressive tendency group included 95 (17.5%) participants. The proportion of participants who bathed in hot springs ≥ 1 time/week was significantly lower in the depressive tendency group (14.7%) than in the normal group (24.6%) (p = 0.038). Multivariable logistic regression analysis adjusted for age, sex, income-generating job, outing frequency, mobility problems, smoking history and alcohol intake demonstrated that the odds ratio for depressive tendency was significantly lower for hot spring bathing ≥ 1 time/week than for < 1 time/week (adjusted odds ratio: 0.51, 95% confidence interval: 0.27-0.95, p = 0.033). In contrast, no association was observed between depressive tendencies and bathing frequency.

Conclusions: Hot spring bathing frequency of ≥ 1 time/week was significantly associated with depressive tendencies in community-dwelling middle-aged and older adults. However, depressive tendencies were not associated with bathing frequency. Further longitudinal studies are needed to examine the preventive effects of hot spring bathing on depressive tendencies.

Objective: This study aims to investigate the role of long non-coding RNA (lncRNA) PRR34 antisense RNA 1 (PRR34-AS1) and microRNA (miR)-29c-3p in Alzheimer's disease (AD) and to explore their mechanisms.

Methods: The study included 35 AD patients and 35 healthy controls. In vitro experiments were conducted using microglial cell lines HMC3 and BV2, which were treated with Aβ25-35, and gene knockout or overexpression experiments were performed to verify the function of the target genes. PRR34-AS1 and miR-29c-3p levels in serum and cells were detected using RT-qPCR. Dual luciferase reporter assay and RNA pull-down assay were conducted to validate the interaction between PRR34-AS1 and miR-29c-3p. The CCK-8 assay and flow cytometry were used to assess cell viability and apoptosis.

Results: The findings showed that PRR34-AS1 levels were elevated in the serum of AD patients, while miR-29c-3p levels were significantly decreased, with a negative correlation observed between them. Silencing PRR34-AS1 alleviated the decline in cell viability and increase in apoptosis induced by Aβ25-35 in microglial cells and inhibited the release of pro-inflammatory factors. Additionally, a direct interaction between PRR34-AS1 and miR-29c-3p was confirmed. Silencing miR-29c-3p counteracted the anti-inflammatory effects of PRR34-AS1.

Conclusion: This study discovered that the PRR34-AS1/miR-29c-3p axis played a crucial role in the Aβ25-35-induced AD cell model. The inhibition of PRR34-AS1 can alleviate neuroinflammation and apoptosis in microglial cells, with miR-29c-3p serving as a significant mediator in this process.

Background: To delay or prevent the development of MCI, identifying a potential target is essential. Olfactory dysfunction has been linked to MCI. However, it remains unclear to what extent odour-specific identification impairment affects domain-specific cognition. Therefore, we aimed to investigate the association of olfactory dysfunction and odour-specific identification impairment with cognitive domains in older adults.

Methods: In 1084 community-dwelling older adults from the Chinese Multi-Provincial Cohort Study, olfactory function was assessed using the modified Sniffin' Sticks identification test, and impaired odour identification was defined as an incorrect identification of one odour. Olfactory dysfunction was defined as three or more odours. Cognition was assessed using MOCA, comprised of six cognitive domains. MCI was defined as an education-modified MOCA score of < 26.

Results: Overall, 35.6% of participants had olfactory dysfunction, and 60.1% had MCI. Participants with olfactory dysfunction had a higher risk of MCI and exhibited lower global cognitive function than those without olfactory dysfunction. Notably, impaired odour identification of fish (OR = 1.48, 95% CI: 1.03-2.13) and leather (OR = 1.45, 95% CI: 1.09-1.92) was significantly associated with the risk of MCI. Furthermore, impaired odour identification of all odours except rose was significantly associated with global cognitive function. Participants with impaired odour identification of fish and leather had significantly poorer memory than unimpaired participants.

Conclusions: Our findings demonstrated that impaired identification of specific odours increased the risk of MCI and domain-specific cognitive dysfunction, suggesting that odour identification impairment may thus be a potential target for future MCI/dementia intervention studies.

This study aimed to compare the efficacy and safety of different active agent treatments for depression associated with sleep disorders in the elderly population. The major international databases, including Medline (via PubMed), Cochrane Library, Scopus and Embase, WHO International Clinical Trials Registry Platform, ClinicalTrials, were searched using a predesigned search strategy. Randomised controlled trials (RCTs) that had compared the pharmacological treatments or placebo therapy interventions were included. The mean difference with a 95% confidence interval was used to summarise the effect size in the network meta-analysis. The frequentist approach was used for data analysis. In total, 12 RCTs out of 8673 retrieved references met the inclusion criteria in this review (3070 participants). All types of intervention were effective in decreased Insomnia Severity Index (ISI) and depression score, and sertraline had the highest probability of being the most effective intervention in decreasing the ISI (standard mean difference (SMD) = -2.17, 95% confidence interval (95% CI): -2.60, -1.75), Hamilton Depression Scale (HAM-D: SMD = -3.10, 95% CI: -3.60, -2.61) in elderly patients with depression and insomnia. Safety assessments included treatment-emergent adverse events and serious adverse events. In terms of the number of patients reporting escitalopram and zuranolone, zolpidem, seltorexant and eszopiclone had higher risks of serious adverse events than placebo or other treatments. In conclusion, sertraline had the highest probability of being the optimal intervention for decreased ISI and HAM-D in elderly patients with depressive and insomnia. Escitalopram, zuranolone, and seltorexant did not show overall material benefits in reducing ISI. These results should serve evidence-based clinical practice.

Background: We prospectively examined the prevalence, co-existence, and change of geriatric giant syndromes in older people over 2 years.

Methods: Two hundred and five older subjects were examined before and after 2 years. Ten geriatric giants were assessed at both time points: cognitive impairment, depression, orthostatic hypotension, polypharmacy, sarcopenia, dynapenia, falls, chronic pain, faecal and urinary incontinence.

Results: Chronic pain, cognitive impairment, and urinary incontinence were three of the most commonly occurring geriatric giants at baseline (57%, 46%, and 40%). The presence of faecal incontinence, urinary incontinence, falls, depression, cognitive impairment, orthostatic hypotension, and polypharmacy was most strongly related to the number of geriatric giants in total at baseline (P < 0.05). A higher intake of dietary antioxidants by one point was related to fewer geriatric giants after 2 years (by 0.04, after adjusting for confounding factors (P = 0.03)).

Conclusions: Geriatric giant syndromes tend to co-exist and change with high variability over 2 years. Higher intake of antioxidants with diet could be related to fewer geriatric giants over time.