International Journal Of Geriatric Psychiatry[JOURNAL]
Sun
200 papers
Development and Cross-Sectional Validation of the Quality of Life and Function Five-Domain Scale (QFS-5) in Dementia-Free Community-Dwelling Older Adults.
Ismail Z, Warring I, Guan DX … +8 more , Chue P, Bardell A, Ballard C, Creese B, Corbett A, Pickering E, Roach P, Smith EE
Int J Geriatr Psychiatry · 2026 Apr · PMID 42024650 · Full text
INTRODUCTION: Quality of life (QoL) captures objective life conditions, subjective wellbeing, and personal aspirations. Interest is growing in ability-based, patient-centered instruments, not confounded by health outcome...
INTRODUCTION: Quality of life (QoL) captures objective life conditions, subjective wellbeing, and personal aspirations. Interest is growing in ability-based, patient-centered instruments, not confounded by health outcomes. The Quality of Life and Function Five Domain Scale (QFS-5) uses a multi-dimensional approach to measure QoL emphasizing abilities and life engagement. We describe the development and validation of the QFS-5 in a large sample of community-dwelling older adults. METHODS: The validation sample comprised 1610 participants aged ≥ 50 from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN-PROTECT). Internal consistency was assessed using Cronbach's alpha and item-total correlations. Confirmatory factor analysis (CFA) evaluated domain structure. Criterion validity was tested through Pearson's correlation with the EuroQol-5D (EQ-5D). Convergent and discriminant validity were evaluated from associations with cognitive, mental health, and functional measures. Floor and ceiling effects were investigated. RESULTS: The QFS-5 demonstrated excellent internal consistency (α = 0.92); CFA supported the proposed domain structure with strong item loadings. Criterion validity was confirmed with correlation of -0.61 against the EQ-5D; higher symptom burden on related scales were associated with lower QFS-5 scores. Floor effects were minimal, while modest ceiling effects were observed in some domains. No significant floor or ceiling effects were found in participants with frailty. CONCLUSION: Validity and reliability are established for this ability-based QoL scale, within a sample of mostly cognitively unimpaired, community-dwelling older adults. The QFS-5 aligns with EQ-5D, demonstrating potential clinical and research utility to measure relevant patient-reported QoL outcomes.
Resilience Shields and Grit Intensifies Subjective Cognitive Decline in Middle-To-Older Aged Black Americans.
Folorunsho S, Clark M, Odo O … +3 more , Jackson YL, Nwakasi C, Esiaka DK
Int J Geriatr Psychiatry · 2026 Apr · PMID 41999666 · Full text
BACKGROUND: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differe...
BACKGROUND: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap. METHODS: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to explore if the associations differed by sex. RESULTS: Analysis showed that grit (β = 0.386, p < 0.001) was positively associated with SCD, but the effect size was larger in Black men (β = 0.527, p < 0.001) than women (β = 0.285, p < 0.001). Also, resilience (β = -0.220, p < 0.001) was negatively associated with SCD and the effect size was larger in Black men (β = -0.266, p < 0.001) than women (β = -0.187, p < 0.01). CONCLUSION: Our findings suggest that while higher levels of resilience may be a protective factor against SCD, higher grit may be associated with greater likelihood of SCD. Future studies should assess whether these associations persist when using objective measures of cognitive decline and further examine these factors as potential targets for cognitive health interventions.
N-Acetylcysteine and Dementia Risk in Elderly Patients.
Sun M, Lu Z, Chen WM … +7 more , Lv S, Fu N, Yang Y, Wang Y, Miao M, Wu SY, Zhang J
Int J Geriatr Psychiatry · 2026 Apr · PMID 41989985 · Publisher ↗
OBJECTIVE: This study aimed to investigate the association between N-acetylcysteine (NAC) use and dementia risk in elderly individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD). METHODS: Utilizing Taiwa...
OBJECTIVE: This study aimed to investigate the association between N-acetylcysteine (NAC) use and dementia risk in elderly individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD). METHODS: Utilizing Taiwan's National Health Insurance Research Database (NHIRD), we conducted a population-based cohort study of 105,144 elderly COPD patients to investigate the association between NAC use and dementia risk. Propensity score matching (PSM) ensured balanced covariates between NAC users and nonusers. Cox regression analysis and Poisson Regression analysis were employed to assess dementia risk, considering NAC dosage, treatment duration, and comorbidities. Competing risk analysis and Kaplan-Meier method were used to account for mortality risk and estimate dementia incidence, respectively. RESULTS: Elderly NAC users demonstrated a significant association with a lower dementia risk (adjusted hazard ratio [aHR]: 0.76, 95% confidence interval [CI]: 0.74-0.78). Higher daily NAC intake was associated with a dose-dependent decline in dementia risk, with optimal benefits observed at an average daily dose of 1.61 defined daily doses (DDD). Stratification by cumulative defined daily doses (cDDD) of NAC revealed a consistent dose-response relationship, with progressively diminished dementia risk across quartiles of cDDD. Notably, NAC use was associated with a lower risk of Alzheimer's dementia (aHR: 0.68, 95% CI: 0.66-0.70) compared to non-NAC antimucolytic users. CONCLUSIONS: NAC use is associated with a dose-dependent reduction in dementia risk among elderly COPD patients, particularly for Alzheimer's dementia. Our findings underscore the potential of NAC as a potential protective factor against dementia in this vulnerable population, warranting further investigation and consideration in clinical practice.
Mortality of People With Alzheimer's Disease and Psychiatric Morbidity: A Nationwide Finnish Cohort Study.
Alastalo A, Haapea M, Nordström T … +5 more , Tolppanen AM, Miettunen J, Nietola M, Hartikainen S, Jääskeläinen E
Int J Geriatr Psychiatry · 2026 Apr · PMID 41960639 · Full text
OBJECTIVES: Psychiatric comorbidities are common in Alzheimer's disease (AD), and they have a negative impact on quality of life, but their impact on mortality remains unclear. This study examined mortality among persons...
OBJECTIVES: Psychiatric comorbidities are common in Alzheimer's disease (AD), and they have a negative impact on quality of life, but their impact on mortality remains unclear. This study examined mortality among persons with AD and psychiatric morbidity compared to persons with AD without psychiatric morbidity. This is the first study to analyze Alzheimer's disease mortality based on the timing of earlier psychiatric morbidity. METHODS: We utilized the nationwide register-based MEDALZ cohort, including 70,718 Finnish individuals diagnosed with AD between 2005 and 2011. Individuals were categorized into four groups based on the occurrence of their hospital-treated psychiatric diagnosis before the diagnosis of AD. Mortality was assessed over an 8-year follow-up. Chi-square test was used to compare the differences between the four groups in terms of causes of death and annual cumulative mortality. We determined cumulative mortality curves and hazard ratios, stratified by age, gender, cardiovascular disease, and the year of AD diagnosis. RESULTS: During the 8-year follow-up, 70.4% of the AD cohort had died. Persons with earlier psychiatric morbidity had an AD diagnosis 1.4-4.3 years earlier and died 1.4-4.1 years younger. Mortality risk was slightly higher among those with psychiatric morbidity compared to those without (adjusted HRs 1.03-1.41), with the effect decreasing over the years of follow-up. Mortality risk was not affected by the timing of psychiatric morbidity. CONCLUSION: Psychiatric comorbidity is associated with earlier AD onset and reduced lifespan; however, post-diagnosis survival appears to be largely determined by AD progression itself.
Ten Years of Actor and Cross-Partner Influence on Cognitive Function: Between- and Within-Couple Analysis.
Zhang Z, Yu JJ, Meng X
Int J Geriatr Psychiatry · 2026 Apr · PMID 41903220 · Publisher ↗
OBJECTIVES: Although cognitive interdependence among spouses is recognized, there remains a paucity of research that disentangles these reciprocal associations at the between- and within-couple levels, particularly withi...
OBJECTIVES: Although cognitive interdependence among spouses is recognized, there remains a paucity of research that disentangles these reciprocal associations at the between- and within-couple levels, particularly within non-Western populations. This study addresses these gaps by examining longitudinal dyadic interactions in cognitive functioning among middle-aged and older Chinese couples. METHOD: Five-wave data collected over a decade were derived from the China Health and Retirement Longitudinal Study (CHARLS), encompassing 6089 heterosexual couples. At baseline, the mean age was 54.99 years (SD = 9.51) for husbands and 52.83 years (SD = 9.13) for wives. Cross-Lagged Panel Model (CLPM) and Random Intercept (RI)-CLPM were utilized to distinguish between between-couple and within-couple mutual effects. Age and education level were investigated as potential moderators of these associations. RESULTS: The between-couple findings revealed significant mutual effects among couples. Conversely, evidence for within-couple cognitive contagion was limited. Neither age nor education level moderated these reciprocal effects. Lower-educated wives tended to exhibit greater stability in cognitive functioning than their higher-educated counterparts. CONCLUSION: The between-couple findings support the similarity-attraction theory and highlight gender-specific role transitions that influence cognitive aging, while the absence of within-couple cognitive concordance may be due to the length of assessment intervals or individual differences. These findings emphasize the need for future research with more frequent assessments and better control of trait-like characteristics to clarify these dynamics and support targeted cognitive health interventions for middle-aged and older couples.
Potentially Harmful Behaviors in Dementia Informal Caregivers: Family Interaction Pattern as the Missing Link.
Cheng ST
Int J Geriatr Psychiatry · 2026 Apr · PMID 41903219 · Full text
Potentially harmful behaviors (PHB) by dementia caregivers may stem from preexisting family conflict patterns, through processes such as behavior contagion, emotional displacement, and aggravation of caregiving stress. O...
Potentially harmful behaviors (PHB) by dementia caregivers may stem from preexisting family conflict patterns, through processes such as behavior contagion, emotional displacement, and aggravation of caregiving stress. Over time, these behaviors may be normalized and instinctively used under caregiving strain. Addressing the family environment in interventions, such as by promoting constructive communication and conflict resolution, may be crucial to break the transmission of harmful interactions and reduce PHB.
Elder Abuse in South Africa: A Community-Based Study of Its Prevalence, Perpetrators, and Predictors.
Jacobs R, Farina N, Schneider M
Int J Geriatr Psychiatry · 2026 Mar · PMID 41863421 · Publisher ↗
BACKGROUND: Elder abuse is under-researched in low-and middle-income countries (LMICs) where culture and context shape detection and reporting. This study estimated the prevalence, perpetrators and predictors of self-rep...
BACKGROUND: Elder abuse is under-researched in low-and middle-income countries (LMICs) where culture and context shape detection and reporting. This study estimated the prevalence, perpetrators and predictors of self-reported elder abuse in South Africa. METHODS: Data were collected in 2021 from 490 households in the STRIDE community-based survey across the Western Cape and Limpopo provinces. Each household included an older adult (≥ 65 years) and an informant (≥ 18 years). The adapted EAST assessed physical, emotional, sexual and financial abuse and neglect. Other measures included functional impairment (WHODAS 2.0), dementia caseness (10/66 algorithm), dementia severity (DSRS), neuropsychiatric symptoms (NPI-Q), social engagement (LSNS-6), and a novel insight into memory impairment variable comparing informant and self-ratings of memory. Logistic regression models examined demographic and health-related predictors of self-reported elder abuse. RESULTS: One in ten (10.4%) older adults screened positive for abuse, with most perpetrators being either a non-family member where there is a personal relationship, or family member. Financial (78%) and emotional (50%) abuse were dominant, while neglect, physical and sexual abuse were less frequent (< 6%). Functional impairment was associated with elder abuse (OR = 1.05, p < 0.01). Recall ability was not associated with reporting abuse, highlighting that cognitive limitations within the present sample did not influence disclosure. CONCLUSION: Elder abuse in South Africa is prevalent and closely linked to functional dependence and financial exploitation. This is one of the first studies to examine the relationship between dementia, functional impairment and elder abuse at community level, providing critical evidence to inform prevention and support strategies in LMICs.
Synuclein Disorder-Related Genetic Determinants of Mild Behavioural Impairment in a Pre-Clinical Community Cohort.
Sander-Long M, Creese B, Corbett A … +3 more , Rosenzweig I, Cummings J, Ballard C
Int J Geriatr Psychiatry · 2026 Mar · PMID 41855104 · Full text
BACKGROUND: The GBA variant confers increased risk of synuclein disorders but it is unclear what impact it has in pre-clinical groups. This study aimed to identify early psychiatric and cognitive manifestations amongst p...
BACKGROUND: The GBA variant confers increased risk of synuclein disorders but it is unclear what impact it has in pre-clinical groups. This study aimed to identify early psychiatric and cognitive manifestations amongst pre-clinical GBA carriers in a community cohort. METHOD: This study used data from the PROTECT-UK cohort to compare 388 GBA carriers (N370S, E326K and T369M) without Parkinson's disease to age-matched controls. Neuropsychiatric symptoms (NPS) were measured with the Mild Behaviour Impairment Checklist, and cognition was measured using computerised neuropsychology. RESULTS: Results: GBA carriers over 70 had significantly increased NPS compared with controls (z = 2.13, p = 0.03). There was no difference between carriers and non-carriers in younger individuals but a sub-group comparison in the overall cohort showed that NPS were more severe in quartile four (Q4) of carriers compared to Q4 of controls (z = 2.39, p = 0.017), indicating an increase in NPS in this sub-group across a broader age range. No differences in cognition were seen. DISCUSSION: These findings suggest that NPS may be an early clinical manifestation of emerging synucleinopathy amongst individuals prior to diagnosis.
Duration and Quality of Sleep as Risk Factors for Cognitive Impairment: An Umbrella Review of Systematic Reviews.
Harbishettar V, Ramachandra P, Tenagi S … +6 more , Srivastava S, Pn R, Rajkumar RP, Leroi I, Ks S, Gupta R
Int J Geriatr Psychiatry · 2026 Mar · PMID 41854212 · Publisher ↗
BACKGROUND: The 2020 Lancet Commission report on dementia prevention, intervention, and care, as well as its 2024 update, did not include sleep duration or sleep quality among the identified modifiable risk factors for d...
BACKGROUND: The 2020 Lancet Commission report on dementia prevention, intervention, and care, as well as its 2024 update, did not include sleep duration or sleep quality among the identified modifiable risk factors for dementia. Emerging evidence, however, supports a renewed, systematic reappraisal of the relationship between sleep parameters and cognitive impairment. METHODS: An umbrella review was conducted to comprehensively evaluate the associations between sleep duration, sleep quality, and cognitive decline. This review was registered with PROSPERO (CRD420250655199) and adhered to PRISMA guidelines, as reported in the PRIOR checklist. Major electronic databases, including PubMed, Ovid MEDLINE, PsycINFO, and Google Scholar, were systematically searched for peer-reviewed systematic reviews and meta-analyses up to the end of February 2025. Eligible reviews included observational studies (cohort, cross-sectional, or case-control) examining sleep duration or sleep quality as exposures and irreversible cognitive decline or dementia as outcomes. Quality was assessed using the CASP tool. Reviews primarily focusing on parasomnias or sleep apnea were excluded. RESULTS: Of 786 records identified, 13 systematic reviews met the inclusion criteria, including 11 with meta-analyses. Five reviews reported associations with long sleep duration, six with short sleep duration, and three reported no significant association with short sleep duration. Among five cohort-based reviews, three consistently supported an association between sleep duration and cognitive decline. Two of three low-bias reviews also supported this association. No low-risk or cohort-only reviews specifically examined sleep quality. Two reviews assessing both duration and quality of sleep reported increased dementia risk. Overall, pooled evidence from cohort-only and low-bias reviews supported a U-shaped association between sleep duration and cognitive impairment, with longitudinal data suggesting temporal directionality. CONCLUSION: As most evidence was rated low certainty by GRADE, these findings should be considered supplementary to the 2024 Lancet Commission report. As the first rigorously conducted umbrella review, this review consolidates existing evidence and highlights the need for well-designed prospective research to clarify the independent effects of sleep duration and quality on cognition.
Symptoms of Mood Disturbance and Depression Diagnosis Among South Asian Home Care Clients in Ontario, Canada: Evidence of Under-Detection of Mental Health Needs.
Behera P, Gill N, Sultan H … +2 more , Heckman GAW, Hirdes JP
Int J Geriatr Psychiatry · 2026 Mar · PMID 41841339 · Full text
BACKGROUND: Depression poses a significant global health burden yet remains widely undiagnosed and untreated, especially among South Asian populations. Despite higher prevalence rates, depression among South Asian immigr...
BACKGROUND: Depression poses a significant global health burden yet remains widely undiagnosed and untreated, especially among South Asian populations. Despite higher prevalence rates, depression among South Asian immigrants in countries like Canada is often under-recognized due to cultural nuances. This study aims to examine patterns of mood disturbance and risk factors for depression diagnosis among South Asian and general home care clients in Ontario, Canada. METHODS: Using data from the interRAI Home Care (HC) assessments conducted between 2018 and 2022, demographic and clinical characteristics of South Asian home care clients were compared against the general home care population. Depression diagnosis and mood disturbance severity were assessed using standardized measures. Multivariate logistic regression models were employed to examine risk factors for depression diagnosis. RESULTS: While mood disturbance prevalence was comparable, the percentages with depression diagnosis were significantly lower 0.50 (95% CI 0.47-0.54) among South Asian home care clients compared to the general home care population. Multivariate analyses confirmed this difference even after accounting for demographic and clinical factors. DISCUSSION: The under-detection of depression among South Asian home care clients suggests potential issues related to cultural competence among health care providers and stigma. Systematic assessment tools like the interRAI HC can aid in identifying mental health needs. Efforts are needed to increase awareness, reduce stigma, and provide culturally appropriate mental health services for South Asian populations. CONCLUSION: Depression is under-recognized among South Asian home care clients in Ontario, Canada, despite a similar prevalence of mood disturbance. Addressing cultural competence and stigma is crucial for improving the detection and treatment of depression in this population.
The Social Dimension of Religious Attendance and Well-Being in Older Adults: Beyond Online Services in the COVID-19 Era.
Woo BKP, Chung S, Chung JOP
Int J Geriatr Psychiatry · 2026 Mar · PMID 41782444 · Publisher ↗
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Unmet Diagnostic Needs for Dementia as a Marker of Unmet Needs Clustering.
Okamura T, Ura C, Inagaki H … +1 more , Awata S
Int J Geriatr Psychiatry · 2026 Mar · PMID 41782398 · Publisher ↗
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Association of Unilateral and Bilateral Speech-In-Noise Hearing Status With Dementia.
Lang H, Ye Z, Wang X … +4 more , Peng B, Chen X, Fang Y, Xin J
Int J Geriatr Psychiatry · 2026 Mar · PMID 41761898 · Publisher ↗
OBJECTIVES: Although hearing loss is a well-established risk factor for dementia, previous studies predominantly focused on peripheral hearing sensitivity, overlooking deficits in central auditory processing as measured...
OBJECTIVES: Although hearing loss is a well-established risk factor for dementia, previous studies predominantly focused on peripheral hearing sensitivity, overlooking deficits in central auditory processing as measured by speech-in-noise (SIN) testing. This study aims to investigate the association between bilateral SIN hearing loss and the risk of all-cause dementia, and to examine how cognitive reserve (CR) modifies this association. METHODS: We conducted a prospective cohort study utilizing data from the UK Biobank, a large, population-based cohort. Participants were recruited between 2006 and 2010, with follow-up lasting until October 2023. The primary outcome was all-cause dementia, and secondary outcomes included some brain regions of interest. Cox proportional-hazards models were employed to estimate dementia risk and differences in brain volume associated with bilateral SIN hearing status, as well as the interaction between SIN hearing and CR. RESULTS: Of the 72,004 participants, both bilateral hearing loss (HR = 1.507, 95% CI: 1.349, 1.685) and unilateral hearing loss (HR = 1.181, 95% CI: 1.068, 1.305) were associated with higher dementia risk. Bilateral hearing loss was significantly associated with volume in brain regions supporting auditory, including subcortical volumes, regional gray matter volumes, accumbens, hippocampus, central opercular cortex, and heschl's gyrus. Right ear dominance was observed in unilateral mild hearing loss, whereas unilateral severe hearing loss demonstrated left ear dominance. Although dementia risk showed a dose-response relationship according to the level of SIN hearing and CR, there was no evidence that CR significantly moderated the association between SIN hearing and dementia risk. CONCLUSIONS: Our study highlights significant disparities in dementia risk and brain volume based on bilateral hearing status, and hearing conservation strategies should consider hearing status laterality and severity to enhance prevention precision.
Finding Solutions to Addressing Inequalities in Dementia Diagnosis and Care: Recommendations From a Country-Wide Consultation.
Giebel C, Poole M, Talbot C … +14 more , Chadborn N, Brookes N, Samsi K, Clarkson P, Cannon J, Gabbay M, Hanna K, Komuravelli A, Rozansky D, Tetlow H, Walpert M, Whittington R, Williams E, Robinson L
Int J Geriatr Psychiatry · 2026 Mar · PMID 41744366 · Full text
BACKGROUND: Accessing a diagnosis and receiving adequate care and support for dementia can often be subject to various inequalities. Personal-, community-, and infrastructure-level factors can contribute to and often int...
BACKGROUND: Accessing a diagnosis and receiving adequate care and support for dementia can often be subject to various inequalities. Personal-, community-, and infrastructure-level factors can contribute to and often intersect in causing unequal health and care outcomes. With a paucity of evidence to inform solutions for dementia inequalities, the aim of this public consultation exercise was to explore potential solutions to inequalities in dementia diagnosis and care with different dementia stakeholders. METHODS: Utilising a future workshop approach, we conducted 11 in-person and remote consultation workshops to discuss experienced barriers of accessing diagnosis and care; discuss an ideal-world scenario where no barriers exist; and solutions to reach more equitable dementia diagnosis and care with people with dementia, unpaid carers, health and social care professionals, and third sector representatives. Discussions were synthesised by the research team and one public consultation group and mapped against the Dementia Inequalities model. RESULTS: A total of 131 different stakeholders in dementia attended 11 workshops across England. Solutions were identified across three layers of inequalities, with the majority of solutions proposed on a community and infrastructure level. Examples included link workers, a social care career pathway, Community Champions, adequate home equipment, and digital training. Some solutions require Governmental input, such as creating career pathways in the social care workforce, similar to the NHS, to train and maintain good paid carers, as well as a cross-UK national dementia strategy raising the priority of dementia and required changes. CONCLUSIONS: Dementia inequalities could be addressed via diverse and holistic approaches. With limited evidence to date on the impact of some of the proposed solutions, future research needs to build on these recommendations and design and test suitable interventions.
Estimating the Future Health and Social Care Costs of Alzheimer's Disease Dementia in the UK: Impact of Disease Modifying Therapy Efficacy, Uptake, and Care Model - A Scenario Modelling Study.
Evans M, Ritchie C, Trepel D … +8 more , Hahn-Pedersen JH, Kettle J, Chan MS, Bray BD, Clark A, Ivkovic M, Wichmann CA, Edwards S
Int J Geriatr Psychiatry · 2026 Feb · PMID 41693328 · Full text
BACKGROUND: To model scenarios exploring potential impacts of disease-modifying therapies (DMTs) for Alzheimer's disease (AD) dementia on future health and social care costs in the United Kingdom. METHODS: A cohort Marko...
BACKGROUND: To model scenarios exploring potential impacts of disease-modifying therapies (DMTs) for Alzheimer's disease (AD) dementia on future health and social care costs in the United Kingdom. METHODS: A cohort Markov model was developed using population projections and published AD epidemiological data. Stage-specific transition rates (mild cognitive impairment due to AD and mild, moderate, severe AD dementia) and health and social care cost data were applied to estimate cost outcomes over 2020-2040. Potential proportion of eligible population receiving treatment (uptake) and follow-up care models (primary vs. specialist care) were elicited from expert opinion. Scenarios combined ranges of DMT efficacy estimates, uptake, and care model. DMT price was excluded due to no UK precedent. RESULTS: Without DMT access, 1,038,405 people (1.5%) were projected to have AD dementia by 2040. Under the various DMT treatment scenarios, the prevalence of AD dementia by 2040 was projected to be 34,000-98,000 cases lower. Associated cumulative cost offsets were higher, £4.4-12.9billion over 2020-2040, in scenarios where most individuals received primary care follow-up, compared with majority specialist care follow-up (-£2.3billion to +£3.2billion). Assuming DMT efficacy of 25%, 58% uptake and majority primary care follow-up cumulative cost offsets increased from £4.4billion to £10.1billion by 2040 but the UK Health Service would need to diagnose and provide DMT for over a million individuals by 2030 and two million by 2040 to achieve this. CONCLUSIONS: Potential cost offset from DMT are large but highly dependent on the model of healthcare delivery and the ability of healthcare systems to scale up diagnosis and treatment services.
Increased Risk of Transition to Institutional Care Among Community-Dwelling Older Adults With Cognitive Frailty: A Competing Risks Survival Analysis.
Bian J, Chen Z, Fong DYT … +2 more , Choi EPH, Chau PH
Int J Geriatr Psychiatry · 2026 Feb · PMID 41635203 · Full text
BACKGROUND: Cognitive frailty (CF) is the coexistence of physical frailty and cognitive impairment. Transition to institutional care (TIC) refers to the move from home to a long-term care institution and represents a maj...
BACKGROUND: Cognitive frailty (CF) is the coexistence of physical frailty and cognitive impairment. Transition to institutional care (TIC) refers to the move from home to a long-term care institution and represents a major change in living arrangement and care needs among older adults. Both CF and TIC are pressing challenges in ageing populations; however, evidence on their association remains limited. OBJECTIVES: This study aimed to explore the longitudinal relationship between CF and TIC among community-dwelling older adults, using the Chinese population as an example. METHODS: This retrospective cohort study utilised data from four waves (2008-2018) of the Chinese Longitudinal Healthy Longevity Survey. Community-dwelling participants aged between 65 and 100 years at baseline were included. CF was defined based on the modified Fried criteria and the Chinese version Mini-Mental State Examination. The Fine-Grey subdistribution regression models were used, treating mortality and lost to follow-up as competing risks and controlling for gender, age, living area, marital status, living arrangement, multimorbidity, household income, and preference for institutional care. RESULTS: The baseline prevalence of CF was 2.3% (95% CI: 2.0%-2.6%). During follow-up, 1.2% (95% CI: 1.0%-1.4%) transitioned to institutional care, 47.1% (95% CI: 46.1%-48.2%) died before TIC and 32.1% (95% CI: 31.1%-33.0%) were lost to follow-up. Incidence rate of TIC was 2.3 (95% CI: 1.9-2.8) per 1000 person-years. Individuals with CF had a higher risk of TIC (SHR 3.51, 95% CI: 1.49 to 8.28; p = 0.004) compared to those without physical frailty and cognitive impairment. CONCLUSION: Our findings demonstrated the positive association between CF and TIC, highlighting the need for appropriate and timely management of CF and personalised interventions for this vulnerable group to delay premature institutionalisation.
Social Cognition in Community Dwelling Persons With Dementia; Is Facial Emotion Recognition Related to Proxy Rated Empathy and Aggression?
Ter Horst AT, Gerritsen MJJ, Spikman JM
Int J Geriatr Psychiatry · 2026 Feb · PMID 41607131 · Full text
OBJECTIVES: Aggressive behaviour and decreased empathy occur in many dementia syndromes. This may be related to lowered overall cognitive functioning which is a common feature of dementia. However, to date, the role of s...
OBJECTIVES: Aggressive behaviour and decreased empathy occur in many dementia syndromes. This may be related to lowered overall cognitive functioning which is a common feature of dementia. However, to date, the role of social cognitive impairments such as facial emotion recognition (FER) deficits in dementias other than behavioural variant frontotemporal dementia (bvFTD) remains largely elusive. This study focusses on people who were recently diagnosed with dementia in the memory clinic of a regional hospital, excluding bvFTD. The first question was whether FER was impaired in this group. Next the relation between FER, cognitive functioning and proxy-rated levels of empathic and aggressive behaviour was examined. METHODS: 80 persons with non-bvFTD dementia were included. FER, overall cognitive functioning, mental speed and executive functioning (mental flexibility, working memory), were measured with respectively The Ekman 60 faces Test, the Mini Mental State Examination (MMSE), the Oral version of the Letter Digit Substitution Test, the Controlled Word Association Test, and the Digit Span test. Empathic and aggressive behaviour were measured using proxy ratings on the Empathic Concern scale of the Interpersonal Reactivity Index, and the Aggression Questionnaire, respectively. RESULTS: Persons with non-bvFTD dementia were significantly impaired in FER compared to healthy controls, but impaired FER was not significantly related to proxy ratings of aggressive or unempathic behaviour. Neither were cognitive impairments in mental speed and executive functions significantly related to these behaviours. However, we did find a significant association between lower MMSE-scores with higher proxy ratings of unempathic behaviour. CONCLUSIONS: Levels of emphatic behaviour in persons with non-bvFTD dementia as indicated by proxies might be primarily related to disease severity and not directly to impairments in FER as a measure of social cognition.
Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia.
Zuliani G, Boscolo Bragadin F, Romagnoli T … +5 more , Polastri M, Cervellati C, Dario FDP, Brombo G, Zuin M
Int J Geriatr Psychiatry · 2026 Jan · PMID 41569242 · Full text
OBJECTIVE: Behavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based firs...
OBJECTIVE: Behavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based first on a non-pharmacological and subsequently on a pharmacological approach. We explored the potential effect of long-term treatment with acetylcholinesterase inhibitors (AChEI) on BPSD severity over time. METHODS: The initial sample included 4032 older patients with mild-moderate dementia (Alzhemier's disease - AD, Lewy body dementia - LBD, or vascular dementias - VaD) from the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS). After propensity score matching, a cohort of 1408 patients (704 treated with AChEI = AChEI+ and 704 not treated = AChEI-) was generated. The mean age was 73.2 years (females: 50.4%). The mean follow-up duration was 4.3 ± 1.6 years (range: 2.2-8.3 years). Patients were evaluated at baseline, T1 (2 years), T2 (4 years), T3 (6.2 years), and T4 (8.1 years). BPSD severity was assessed by Neuropsychiatric Inventory (NPI-Q). RESULTS: The baseline mean NPI-Q severity score was 1.33. At T4, the score increased to 1.41 in AChEI- patients (+6% from baseline), while it decreased to 1.26 in AChEI+ (-6%) (all p < 0.01 from T1 to T4). As regards the NPI-Q sub-items, six of them (hallucinations, agitation/aggression, depression/dysphoria, anxiety, disinhibition and irritability/lability) exhibited significant differences over time (all p < 0.01) in favor of the AChEI + group (stabilization or improvement). Similar trends were observed when LOAD, LBD and VaD were considered separately. In contrast, for five domains (delusions, elation/euphoria, motor disturbances, night-time behaviors, and appetite/eating changes) no differences were observed. CONCLUSIONS: Our study supports the potential role for AChEI in BPSD management, demonstrating a trend toward symptoms stabilization or improvement in patients with mild-moderate dementia. Although the effects were not uniform across all NPI-Q domains, and the limitations of the study, our results reinforces the relevance of AChEI in the comprehensive treatment of dementia.
Global Temporal Trends and Projections of Anxiety Disorders Prevalence Among the Older Adults: An Age-Period-Cohort Analysis Based on the GBD 2021.
Wang J, Yang D, Pan P … +5 more , Ping L, Huang Y, Shan Q, Wang Y, Xia K
Int J Geriatr Psychiatry · 2026 Jan · PMID 41566647 · Publisher ↗
BACKGROUND: Anxiety disorders in older adults impose a markedly greater disease burden than in younger individuals. This study provides an overview and analysis of temporal trends in the prevalence of anxiety disorders i...
BACKGROUND: Anxiety disorders in older adults impose a markedly greater disease burden than in younger individuals. This study provides an overview and analysis of temporal trends in the prevalence of anxiety disorders in older adults over the past 30 years, examining global, regional, and national patterns with a particular focus on age, period, and birth cohort effects. METHODS: Estimates and 95% uncertainty intervals (UI) of anxiety disorder prevalence in older adults from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed. Age-period-cohort (APC) models were used to estimate the overall annual percentage change in prevalence (net drift), the annual percentage change within each age group (local drift), and longitudinal age-specific ratios adjusted for stage bias (age effect) and period/cohort relative risk (period/cohort effect) from 1992 to 2021 at global, regional, and national levels. Nordpred APC model was utilized for forecasting future epidemiological trajectories. RESULTS: From 1992 to 2021, the global prevalence of anxiety disorders in older adults increased markedly, with prevalence among women approximately double that among men. Age-standardized prevalence rates (ASPR) rose globally, particularly in low-middle socio-demographic index (SDI) regions, while high SDI regions saw smaller or even negative changes. In age groups, prevalence decreased in those aged 65-69 to 85-89, with little change in the 90+ group. High SDI regions exhibited stable or declining prevalence in younger age groups, whereas low SDI regions saw increased prevalence in older age groups. Gender differences were observed, with women showing higher and more consistent prevalence trends, while men exhibited rising rates in low SDI regions. Projections suggest that global cases of anxiety disorders among older adults will rise to 73.24 million by 2045, characterized by a higher prevalence in females and an increasing ASPR. CONCLUSION: This study highlights the complex epidemiology of anxiety disorders in older adults, with global prevalence and ASPR projected to rise, demonstrating regional and national heterogeneity. Anxiety disorders will remain a concern for older adults through 2045. Gender differences, especially the increasing prevalence among men, should be considered in intervention strategies.
Predictors and Correlates of Loneliness and Social Isolation in People With Dementia: Longitudinal Findings From the IDEAL Programme.
Rippon I, Victor CR, Gamble LD … +5 more , Martyr A, Quinn C, Matthews FE, Clare L, IDEAL programme team
Int J Geriatr Psychiatry · 2026 Jan · PMID 41549508 · Full text
OBJECTIVE: To identify predictors of loneliness and social isolation experienced by people with dementia at baseline and over time. METHODS: Using data from the Improving the experience of Dementia and Enhancing Active L...
OBJECTIVE: To identify predictors of loneliness and social isolation experienced by people with dementia at baseline and over time. METHODS: Using data from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (2014-2018), we examined the prevalence and predictors of loneliness and social isolation in 1547 people with mild-to-moderate dementia over 24 months. Loneliness was measured using the six-item De Jong Gierveld Scale at baseline and 24 months and social isolation by the six-item Lubben Social Network Scale at baseline, 12 and 24 months. Generalised linear mixed effects models examined possible predictors of loneliness and social isolation including individual characteristics, depression, cognition, cultural participation, and neighbourhood characteristics. RESULTS: At baseline 35.4% of people with dementia were categorised as being lonely and 28.8% as socially isolated, increasing to 39.3% and 32.0% 2 years later. Over the 24-month follow-up none of these predictors were associated with changes in social isolation scores. Only perceived neighbourhood trust was associated with change in loneliness longitudinally. At baseline, depressive symptoms, living alone, smaller social networks and lower neighbourhood trust were associated with greater loneliness. Cross-sectionally, loneliness and lower cognitive ability were associated with greater social isolation, and greater cultural participation, more green and blue spaces nearby and higher neighbourhood trust were associated with lower social isolation scores. CONCLUSIONS: The findings highlight the importance of the local environment and cultural participation for people with dementia. Enhancing interactions with the local neighbourhood through initiatives such as dementia friendly communities may help to reduce loneliness and social isolation.
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