International Journal Of Geriatric Psychiatry[JOURNAL]
Sun
200 papers
Psychometric Validation of the Bedford Alzheimer Nursing-Severity Scale in Community-Dwelling Persons With Severe Dementia.
Cheong CY, Yap P, Ng TP … +2 more , Tan BY, Malhotra C
Int J Geriatr Psychiatry · 2026 Jan · PMID 41508538 · Publisher ↗
OBJECTIVES: Measuring disease severity in persons with severe dementia is essential for clinical care and research. Most instruments encounter issues, for example floor effects in characterising persons with severe demen...
OBJECTIVES: Measuring disease severity in persons with severe dementia is essential for clinical care and research. Most instruments encounter issues, for example floor effects in characterising persons with severe dementia. We aimed to evaluate the psychometric properties of the Bedford Alzheimer Nursing-Severity Scale (BANS) and its short version, BANS-6, in community-dwelling persons with severe dementia. METHODS: We used baseline data from a multi-centre prospective longitudinal study. 215 caregivers of community-dwelling persons with severe dementia (≥ FAST stage 6c) were recruited (mean age 83.6 ± 8.2). We evaluated BANS' construct validity with exploratory factor analysis, correlation with other established measures, and predictive validity. RESULTS: Factor analysis revealed a two-factor solution (variance 58.35%) with item-2 (sleep-wake cycle) not loading onto any factor. Dropping item-2 (BANS-6) revealed a single-factor solution (variance 49.26%) and Cronbach's α improved from 0.701 to 0.782. FAST did not correlate with the Cohen-Mansfield Agitation Inventory and Quality of Life in Late-Stage Dementia Scale, but both BANS and BANS-6 did. For predictive validity, after adjusting for age, sex and comorbidities, BANS-6 remained significantly associated with key clinical complications of severe dementia: pneumonia (β = 2.09, 95% CI = 0.13-4.05), fever episodes (β = 1.24, 95% CI = 0.10-2.40) and oral antibiotic use (β = 1.33, 95%CI = 0.11-2.55), tube feeding (β = 4.42, 95% CI = 2.62-6.22), pressure sores (β = 2.51, 95% CI = 0.85-4.18), eating problems (β = 3.27, 95%CI = 2.20-4.34), and malnutrition (β = 1.63, 95% CI = 0.24-3.02) in the last 4 months. BANS was not significantly associated with pneumonia, oral antibiotics, and pressure sores, and FAST was not significantly associated with any outcome. CONCLUSIONS: BANS and its short version, BANS-6, are valid, reliable, and clinically relevant tools for assessing dementia severity in community-dwelling persons with severe dementia, warranting further exploration in diverse population settings. The findings suggest that BANS-6 has better psychometrics and clinical utility than BANS.
Preliminary Serological Evidence of Toxocara canis and Toxoplasma gondii Exposure Among Very Elderly Neuropsychiatric Patients in Taiwan.
Weng HW, Hung CS, Ou TY … +2 more , Chou CM, Fan CK
Int J Geriatr Psychiatry · 2026 Jan · PMID 41503888 · Publisher ↗
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Cognitive Reserve and Its Relationship With Memory Changes: An Analysis of the Survey of Health, Aging, and Retirement in Europe (SHARE).
Melendez JC, Venegas LC, de la Fuente CP
Int J Geriatr Psychiatry · 2026 Jan · PMID 41496475 · Full text
OBJECTIVES: To examine the longitudinal association between cognitive reserve (CR)-related proxies and episodic memory in older adults, and to explore the role of sociodemographic and clinical risk factors. METHODS: Data...
OBJECTIVES: To examine the longitudinal association between cognitive reserve (CR)-related proxies and episodic memory in older adults, and to explore the role of sociodemographic and clinical risk factors. METHODS: Data were drawn from 2279 participants of the Survey of Health, Aging and Retirement in Europe (SHARE), with baseline in wave 5 (2013) and follow-up in wave 9 (2021-2022). A CR-proxy score was constructed using education, occupation, physical activity, social engagement, and loneliness. Logistic regression models were used to predict immediate and delayed recall performance at follow-up, adjusting for age, sex, depression, vascular risk factors, and sensory impairments. RESULTS: Higher levels of CR-related proxies significantly reduced the odds of impairment in both immediate recall (OR = 0.55, p < 0.001) and delayed recall (OR = 0.46, p < 0.001). Age was associated with poorer memory outcomes, while women showed better performance in delayed recall being female predicted lower odds of preserved delayed recall. Depression was significantly related to poorer immediate recall, but other health conditions and sensory factors were not significant predictors. CONCLUSIONS: CR-related proxies were strong predictors of memory performance over the 9-year period, particularly for delayed recall. These findings reflect sociobehavioural influences associated with CR development, rather than direct evidence of CR as a neurofunctional mechanism. Promoting cognitively, socially and physically enriching activities, together with addressing depression, may help preserve memory function in aging populations.
The Hidden Arc of Caregiver Decline: Trajectory, Reserve, and Systemic Implications.
Thanchonnang C, Rattanapitoon SK, La N … +1 more , Rattanapitoon NK
Int J Geriatr Psychiatry · 2026 Jan · PMID 41495878 · Publisher ↗
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Music, Leisure and Dementia Risk: Clarifying What is Really Being Measured.
Sada RM
Int J Geriatr Psychiatry · 2026 Jan · PMID 41492125 · Publisher ↗
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Factors Associated With Physical Restraint Use in Older Adults With Dementia in Geriatric Care Facilities During the COVID-19 Pandemic in Japan.
Jung H, Akishita M, Iwamoto Y … +3 more , Tanabe J, Hirohama K, Ishii S
Int J Geriatr Psychiatry · 2025 Dec · PMID 41405017 · Full text
OBJECTIVES: We aimed to identify factors associated with the use of physical restraints in geriatric care facilities housing older adults with dementia during the COVID-19 pandemic in Japan. METHODS: A cross-sectional an...
OBJECTIVES: We aimed to identify factors associated with the use of physical restraints in geriatric care facilities housing older adults with dementia during the COVID-19 pandemic in Japan. METHODS: A cross-sectional anonymous online survey was conducted from January to February 2023 in special nursing homes (SNHs) for older adults with moderate to severe dementia and group homes (GHs) for those with mild to moderate dementia. The survey gathered information on facility characteristics, the presence of residents with dementia infected during COVID-19 clusters, and the use of physical restraints. Additional items addressed challenges encountered during a cluster outbreak, difficulties in managing residents with dementia infected with COVID-19, measures implemented for these residents, and considerations when residents were unable to isolate in their rooms owing to wandering. Multiple logistic regression analysis was used to identify factors associated with physical restraint use. RESULTS: Data from 286 SNHs and 151 GHs were analyzed, all of which housed residents with dementia infected during COVID-19 clusters. Among them, 49 SNHs (17.1%) and 14 GHs (9.3%) reported using physical restraints. In SNHs, multiple logistic regression analysis identified wandering, worsening dementia symptoms, and ongoing infections as significant factors associated with restraint use. In GHs, difficulty communicating the situation to other residents and families was notably associated with restraint implementation. CONCLUSIONS: The use of physical restraints in facilities caring for older adults with moderate to severe dementia may be associated with worsening dementia symptoms during the COVID-19 pandemic in Japan. These findings underscore the need for improved staff training and the development of care strategies aimed at minimizing restraint use during infectious disease outbreaks.
Persistence and Determinants of Late-Life Depression: Results of the Nationally Representative Longitudinal German Aging Survey 2008 to 2023.
Stratmann MW, König HH, Hajek A
Int J Geriatr Psychiatry · 2025 Dec · PMID 41405014 · Full text
OBJECTIVES: Late-life depression is the most common mental disorder in older adults. As symptom progression and risk factors are not well understood, this study focuses on longitudinal symptom progression and time-varyin...
OBJECTIVES: Late-life depression is the most common mental disorder in older adults. As symptom progression and risk factors are not well understood, this study focuses on longitudinal symptom progression and time-varying risk factors. METHODS: Longitudinal data of adults aged 60+ were drawn from six waves (2008-2023) of the German Aging Survey (DEAS), with the largest analytic sample in 2014 (n = 6515). At each wave participants were classified as having "no" (0-9), "minor" (10-17) or "major" (18-45) depressive symptoms (DS) based on the German Center for Epidemiologic Studies Depression Scale (CES-D). Persistent DS were defined as PDS (at least minor DS) or majorPDS (major DS) across two consecutive waves. Weighted transition probabilities between DS stages were calculated across all person-years. Linear fixed effects regression with cluster-robust standard errors was used to identify time-varying determinants of DS. RESULTS: In 2014, the prevalence rate was 17.4% [16.6%-18.1%] for minor DS, 7.2% [6.6%-7.8%] for major DS, 12.2% [11.3%-13.1%] for PDS and 2.5% [2.0%-3.1%] for majorPDS. Estimates were similar across all six waves. Minor DS frequently persisted (37.3% [34.1%-40.6%]) or progressed to major DS (11.7% [9.6%-14.2%]). Major DS persisted in 38.6% [31.1%-46.7%] and remitted to minor DS in 31.8% [25.9%-38.3%] of cases. Transition to widowhood (β = 0.67, p < 0.05), worsening of physical functioning (β = -0.06, p < 0.01), increasing loneliness (β = 1.02, p < 0.01), worsening of sleep quality (β = 0.78-4.40, p < 0.01) and decreasing BMI (β = -0.08, p < 0.01) were associated with increases in DS. CONCLUSIONS: DS are common in later life and are frequently persistent. Minor DS often persist or worsen, underscoring their role as a key risk factor. Major DS frequently remits only partly. Early, targeted interventions could be informed by modifiable determinants that may also help to allocate scarce mental health resources effectively.
A Pilot Historical-Control Study of Nudge-Based Semi-Supervised Resistance Exercise in Older Adults With Mild Cognitive Impairment.
Zhao X, Lan Y, Li Y … +2 more , Yan X, Wan Q
Int J Geriatr Psychiatry · 2025 Dec · PMID 41389150 · Publisher ↗
AIMS: To evaluate the feasibility and preliminary effects of the nudges-based semi-supervised resistance exercise program in older adults with mild cognitive impairment (MCI). DESIGN: A Pilot Historical-Control Study. ME...
AIMS: To evaluate the feasibility and preliminary effects of the nudges-based semi-supervised resistance exercise program in older adults with mild cognitive impairment (MCI). DESIGN: A Pilot Historical-Control Study. METHODS: Participants in the intervention group received a 12-week semi-supervised resistance exercise with nudges. The historical control group consisted of participants from a prior study by our team who received fully-supervised resistance training. Propensity score matching was performed to generate matched pairs. The primary outcome was the feasibility, including recruitment rate, retention rate, adherence, labor resource costs and participants' perceptions regarding nudges' usefulness. The secondary outcomes were cognitive function and physical function. RESULTS: A total of 30 participants in the intervention group and 33 participants in the historical control group completed the program. The recruitment rate for the intervention group was 47.22%, and the retention rate was 88.24%. In the historical control group, the recruitment rate was 59.02%, and the retention rate was 91.67%. Following 1:1 propensity score matching, the adherence rates for the intervention and control groups were 96.59% and 91.85%, respectively, with no significant difference observed (Z = 1.309, p = 0.191). The intervention group required 15.25 healthcare professional labor hours (344.65 RMB), lower than the control group (24 h; 542.4 RMB). Most nudges were assessed as beneficial; however, certain ones were deemed ineffective, and some that initially showed promise diminished impacts over time. Both groups exhibited significant improvements in cognitive and physical functions from pre-to post-intervention, with no significant differences between the groups (p > 0.05). CONCLUSION: The semi-supervised resistance exercise program with nudges is a viable alternative compared to fully-supervised mode. Large-scale randomized controlled trials should be conducted to validate these findings.
The Relationship Between Brain Structure and Neuropsychiatric Symptoms in Patients With Mild Cognitive Impairment and Alzheimer's Dementia.
Hsu CC, Chang CC, Lee JF … +3 more , Chiou JY, Wang SI, Gloria Yang FP
Int J Geriatr Psychiatry · 2025 Dec · PMID 41367056 · Publisher ↗
INTRODUCTION: Neuropsychiatric symptoms (NPS) are highly prevalent from mild cognitive impairment (MCI) to Alzheimer's dementia (AD). Understanding the link between NPS and regional brain changes can provide insight into...
INTRODUCTION: Neuropsychiatric symptoms (NPS) are highly prevalent from mild cognitive impairment (MCI) to Alzheimer's dementia (AD). Understanding the link between NPS and regional brain changes can provide insight into neural correlates of disease progression. METHODS: This cross-sectional study analyzed 1536 older adults from the National Alzheimer's Coordinating Center comprising 860 healthy controls, 389 patients with MCI, and 287 patients with AD. The NPSs were evaluated with the Neuropsychiatric Inventory (NPI), which measures severity in four domains: mood, psychosis, frontal, and total symptoms. Magnetic resonance imaging quantified regional gray matter volumes (GM), cerebrospinal fluid volume (CSF), and white matter hyperintensity (WMH) volumes to see their correlations with NPS. RESULTS: All volumes showed the smallest in dementia, the intermediate in MCI, and the largest in healthy controls. Higher total NPI scores were significantly associated with smaller volumes of hippocampal and gray matter volumes and larger cerebrospinal fluid volume, with the strongest correlations in the dementia group. By domain, NPI-mood symptoms were correlated with reduced hippocampal, temporal, and frontal volumes. NPI-psychosis symptoms also correlated with frontotemporal regions, but less extensively. Mood symptoms were most strongly linked to temporolimbic atrophy. CONCLUSION: The study supports associations between emerging neuropsychiatric manifestations and accumulating structural brain damage along the pathological cascade.
Stress, Social Isolation Profiles, and Depressive Symptoms Among Older Adults in a Low-Income Community in Singapore.
Sung P, Koh VJW, Chan A
Int J Geriatr Psychiatry · 2025 Dec · PMID 41366782 · Publisher ↗
OBJECTIVES: To identify distinct social isolation profiles and their associations, both direct and stress-moderating, with depressive symptoms using objective and subjective indicators of social isolation among older adu...
OBJECTIVES: To identify distinct social isolation profiles and their associations, both direct and stress-moderating, with depressive symptoms using objective and subjective indicators of social isolation among older adults in a low-income community. METHODS: Latent class analysis and multivariable regression were conducted with data from 881 individuals aged 60 years or above residing in public rental housing in the Chin Swee area of Singapore. RESULTS: Four profiles emerged: "well-connected and less lonely" (27.9%), "structurally isolated but less lonely" (56.4%), "somewhat isolated and moderately lonely" (11.3%), and "severely isolated and highly lonely" (4.4%). The latter two profiles demonstrated significantly greater depressive symptoms than the former two. Additionally, the "somewhat isolated and moderately lonely" profile showed heightened vulnerability to stressors, exhibiting stronger associations between life stressors and depressive symptoms compared with the "well-connected and less lonely" profile. CONCLUSIONS: Subjective loneliness, more so than objective structural isolation, is pivotal in shaping older adults' mental health and stress vulnerability within low-income settings. Interventions should consider decoupling loneliness from social isolation, tailoring support to the specific needs associated with different social isolation profiles.
Associations of Household Solid Fuel Use, Loneliness and Social Isolation With Mild Cognitive Impairment Among Community-Dwelling Older Adults: A Nationally Representative Study.
Liu Q, Huang Y, Wang B … +1 more , Wang C
Int J Geriatr Psychiatry · 2025 Dec · PMID 41355161 · Publisher ↗
OBJECTIVES: Indoor air pollution related to household solid fuel use for heating and cooking and social disconnection including loneliness and social isolation are reported to increase the risk of mild cognitive impairme...
OBJECTIVES: Indoor air pollution related to household solid fuel use for heating and cooking and social disconnection including loneliness and social isolation are reported to increase the risk of mild cognitive impairment (MCI), but their joint associations have not yet been examined. This study aimed to explore their joint associations with MCI. METHODS: Data were from five waves (2011-2020) of the China Health and Retirement Longitudinal Study (CHARLS) among 5314 cognitively intact participants aged ≥ 60 years at baseline. Cox proportional hazards models were applied to explore the associations of household solid fuel use and social disconnection with MCI. RESULTS: During the 9-year follow-up, 644 (12.5%) participants experienced MCI. Participants exposed to both solid fuel use and social disconnection (HR = 1.417, 95% CI = 1.149-1.747) had higher risk of MCI than those exposed to one factor alone (HR = 1.195-1.218, 95% CI = 0.944-1.572). There were significant additive interaction (RERI = 0.274, 95% CI = 0.065-0.482) and multiplicative interaction (p for interaction = 0.017) between household fuel types for heating and loneliness. The association of loneliness with higher risk of MCI was not significant in both subgroups, but the values of HR in the solid fuel use subgroup (HR = 1.142, 95% CI = 0.997-1.307, p = 0.055) were higher than that in the clean fuel use subgroup (HR = 0.853, 95% CI = 0.695-1.046, p = 0.126). CONCLUSION: Household solid fuel use and social disconnection may be independently and jointly associated with MCI. These findings implicate that social and health strategies should address the reduction of solid fuel use and improvement of social connections to maintain cognitive function among older adults.
Apathy in Cerebral Small Vessel Disease Stroke Is a Predictor of Quality of Life, Mood and Distress in Both Patients and Carers.
Marguet OE, Pallucca C, Morris R … +1 more , Markus HS
Int J Geriatr Psychiatry · 2025 Dec · PMID 41340429 · Full text
OBJECTIVE: Apathy occurs in one-third of patients after stroke and is particularly common in small vessel disease (SVD) stroke. Apathy is known to be associated with reduced ability to engage in everyday life activities,...
OBJECTIVE: Apathy occurs in one-third of patients after stroke and is particularly common in small vessel disease (SVD) stroke. Apathy is known to be associated with reduced ability to engage in everyday life activities, including neurorehabilitation. Apathy has been associated with increased caregiver burden and distress in other neurological diseases, but there is little data on stroke. We aimed to evaluate whether distress is higher and quality of life (QoL) lower in apathetic stroke patients and their caregivers. METHODS: We conducted a cohort study on patients with symptomatic SVD and their caregivers. We recruited 40 patient-caregiver pairs (20 with apathy and 20 without) and assessed apathy, patient disability, QoL, cognition and depression. We assessed apathy-related caregivers' distress, caregiver burden, mood and quality of life. Statistical tests were performed to compare the apathetic and control groups. Univariate correlations and multiple linear regressions were used to assess relationships between apathy and measures of quality of life, burden, distress and mood. RESULTS: Apathy was a strong predictor of caregiver distress (β = 0.11, p < 0.001), burden (β = 0.7, p < 0.001) and depression (β = 0.12, p < 0.001). In contrast, physical disability was not an independent predictor of caregiver burden. Apathy was also a strong predictor of patient QoL (β = -0.67, p < 0.001) and depression (β = 0.49, p < 0.001). CONCLUSION: Apathy is a major independent predictor of caregiver burden. Caregivers of apathic patients experience increased distress, burden and lower mood. Patients with apathy also experience lower mood and worse QoL. The major effect of apathy on caregivers suggests targeting them should be an important component of the treatment of apathy in patients with stroke.
A National Survey of Day Care Centers Hosting People With Dementia in Italy.
Matascioli F, Lorenzini P, Giaquinto F … +8 more , Vaccaro R, Salvi E, Carnevale G, Locuratolo N, Vanacore N, Bacigalupo I, Permanent Table of the National Dementia Plan Study Group, DCCs Study Group
Int J Geriatr Psychiatry · 2025 Nov · PMID 41287243 · Full text
OBJECTIVES: A national survey was conducted in the Italian Day Care Centers hosting people with dementia (DCCs). This national survey aimed to describe the characteristics, the organizational structure and the opening pe...
OBJECTIVES: A national survey was conducted in the Italian Day Care Centers hosting people with dementia (DCCs). This national survey aimed to describe the characteristics, the organizational structure and the opening period during the COVID-19 pandemic of the DCCs. METHODS: A list of all national DCCs was provided by representatives from each Italian region. The online questionnaire consisted of two main parts: a profile section (location, access) and a data collection form (organization, services, treatments, activities, and any discontinuation of the services due to the COVID-19 outbreak). RESULTS: A total of 1084 DCCs were included in the study after verifying their actual capacity to accommodate persons with dementia. Overall, 443 facilities (41%) completed the profile section and 300 (27,7%) also completed the data collection form. Most of the DCCs participating in the survey were privately owned facilities affiliated with the Regional Health Service (88.5% vs. 11.5% of public facilities). The imbalance in favor of private facilities was present in all three Italian macro-areas, particularly in the North, where almost all facilities were private (private vs. public, North 97.1% vs. 2.9%, Center 65.5% vs. 34.5%; Southern and Islands 75.5% vs. 24.5%). Only one-fifth of the facilities exclusively admitted people with dementia. As regards the pandemic period, only 6% of facilities remained always open in 2020, in 2021 the percentage increased, with 48% of the facilities reported as open. CONCLUSIONS: This paper presents an overview of the current situation of DCCs in Italy, showing still considerable heterogeneity based on geographic location. The survey finally highlights how the COVID-19 pandemic emergency has impacted the activities of these types of facilities.
How is the Beginning and End of Frequent Laughter Associated With Changes in Loneliness Amongst Older People in Japan? A JAGES Longitudinal Study.
Hajek A, Kondo N, König HH
Int J Geriatr Psychiatry · 2025 Nov · PMID 41266953 · Full text
OBJECTIVE: Little is known about the association between frequency of laughter and loneliness-in particular based on longitudinal data. Therefore, our aim was to examine how the onset and the end of frequent laughter is...
OBJECTIVE: Little is known about the association between frequency of laughter and loneliness-in particular based on longitudinal data. Therefore, our aim was to examine how the onset and the end of frequent laughter is associated with changes in loneliness amongst older people in Japan. METHODS/DESIGN: Longitudinal data were taken from the Japan Gerontological Evaluation Study (JAGES, waves 6 and 7 with n = 5262 observations, mean age was 74.4 years, SD: 5.8 years). The widely used and psychometrically sound UCLA-3 was used to quantify loneliness. Frequency of laughing served as key independent variable. Asymmetric linear fixed effects regressions were used, adjusting for several time-varying covariates. RESULTS: After adjusting for several sociodemographic, lifestyle-related and health-related time-varying factors, there was a significant association between the onset of frequent laughing and decreases in loneliness (β = -0.18, p < 0.05). Age and sex did not moderate this association. In contrast, the cessation of frequent laughter was not significantly associated with changes in loneliness. CONCLUSIONS: Starting frequent laughter may help to avoid negative consequences such as loneliness among older adults in Japan. This may emphasize the importance of finding ways to start laughing frequently. Efforts to reduce loneliness are important because it is in turn associated with outcomes such as morbidity and mortality.
Assessment of Long-Term Mild and Major Neurocognitive Disorders 48 Months After Cardiac Surgery.
Florido-Santiago M, Pérez-Belmonte LM, Lara JP … +7 more , Millán-Gómez M, Pérez-Velasco MA, Osuna-Sánchez J, García-Casares N, Gómez-Huelgas R, Blanco-Reina E, Barbancho MA
Int J Geriatr Psychiatry · 2025 Nov · PMID 41251654 · Full text
OBJECTIVES: To assess the incidence of both Mild and Major Neurocognitive Disorders (NCD), according to the DSM-5 criteria, after cardiac surgery (off-pump an on-pump procedures) and to propose some risk associated facto...
OBJECTIVES: To assess the incidence of both Mild and Major Neurocognitive Disorders (NCD), according to the DSM-5 criteria, after cardiac surgery (off-pump an on-pump procedures) and to propose some risk associated factors. METHODS: Prospective and sequential study. Patients (n = 70, 65.9 years old, mean age) were evaluated for cognitive function (Neuronorma Battery) and daily life activities (Barthel Index and Bayer-Activities of Daily Living Scale) before surgery and at 1, 6, 12, and 48 months postoperatively. Off-pump (n = 36) and on-pump (n = 34) patients groups were compared. DSM-5 criteria for Mild NCD and Major NCD were applied. Independent associated risk factors were described. RESULTS: A 40.8% (off-pump) and 39.3% (on-pump) of patients met DSM-5 criteria for Mild NCD 48 months after cardiac surgery and a further 7.1% (on-pump) of them, for Major NCD. Clinical factors were associated with Mild NCD and both clinical and surgical factors, were associated with Major NCD. CONCLUSION: A relevant incidence of long-term Mild NCD and Major NCD has been described 48 months after cardiac surgery, more intense in the on-pump group of patients. Assessment (identifying those with higher risk), prevention and treatment strategies for these patients should be provided. The DSM-5 criteria to classify NCD could be applied to characterize any cognitive decline due to any disease or surgical procedure.
Association of Caregiver Types With General and Health-Related Indicators of Subjective Well-Being in a Longitudinal Cohort of Middle-Aged and Older Adults in China.
Su Q, Cheng C
Int J Geriatr Psychiatry · 2025 Nov · PMID 41236134 · Publisher ↗
OBJECTIVES: With the increased demand for care services, understanding how the association between caregiving and subjective well-being varies at different ages becomes a crucial policy concern. This study examined the l...
OBJECTIVES: With the increased demand for care services, understanding how the association between caregiving and subjective well-being varies at different ages becomes a crucial policy concern. This study examined the longitudinal associations between informal caregiving (and different caregiver types) and selected subjective well-being outcomes. Furthermore, gender and household wealth heterogeneity were explored. METHODS: Based on the China Health and Retirement Longitudinal Study data, we used growth curve models to examine how the association between informal caregiving and subjective well-being varies across age. RESULTS: Overall, caregivers reported higher life satisfaction at age 60 compared to non-caregivers, although the positive association between caregiving and life satisfaction becomes weaker and even turns negative as people age. In contrast, caregivers consistently had lower health-related quality of life (HRQoL) than non-caregivers. When examining different caregiving types, grandparent caregivers initially had higher life satisfaction at age 60 than non-caregivers, but this advantage became less evident with age. Adult child caregivers generally showed higher life satisfaction than non-caregivers, whereas spousal caregivers consistently reported lower life satisfaction. Regarding HRQoL, there were no significant differences between adult child caregivers, grandparent caregivers, and non-caregivers, but spousal caregivers had significantly lower HRQoL than their non-caregiving counterparts. Furthermore, the relationship between caregiving and subjective well-being was influenced by both gender and household wealth. CONCLUSIONS: The relationship between informal caregiving and subjective well-being is dynamic, and different types of caregivers display distinct age-related patterns. These findings can provide practical policy recommendations for policymakers to structure and improve sustainable informal care systems.
Physical Versus Cognitive Impairment in Stroke-Free Older Adults Living in Rural Settings: Relative Contributions to Decreased Functionality.
Del Brutto OH, Mera RM, Sedler MJ … +4 more , Rumbea DA, Arias EE, Gutierrez J, Del Brutto VJ
Int J Geriatr Psychiatry · 2025 Nov · PMID 41169011 · Publisher ↗
OBJECTIVES: Both physical and cognitive impairments contribute to disability. However, their relative impact on functional decline among older adults in low-resource settings has not been adequately studied. This study a...
OBJECTIVES: Both physical and cognitive impairments contribute to disability. However, their relative impact on functional decline among older adults in low-resource settings has not been adequately studied. This study aims to explore the role of these factors on functionality. METHODS: Following a population-based, cross-sectional design, older adults living in rural Ecuador underwent a handgrip strength (HGS) test for physical performance, the Montreal Cognitive Assessment (MoCA) to evaluate cognitive performance, and a Functional Assessment Questionnaire (FAQ) assessed functionality. A generalized structural equation modeling (GSEM) approach was utilized to evaluate a predefined set of causal assumptions and integrate hypothesized latent constructs, providing a comprehensive explanation of the relationships among multiple interconnected variables and their association with dysfunctionality. RESULTS: We included 603 individuals (mean age: 67.5 ± 7 years; 54% women). According to the GSEM approach, a 10% rise in HGS (2.4 kg) was associated with a 3.68% improvement in functionality (p < 0.001), whereas a 10% increase in MoCA scores resulted in a 2.06% improvement in functionality (p < 0.001). One standard deviation (SD) in HGS comprised 18% of the distribution, which yielded a 6.5% shift in functionality. Similarly, one SD difference in MoCA scores accounted for 19% of the distribution, and a 3.91% change in functionality. CONCLUSIONS: Both physical and cognitive impairments significantly contribute to decreased functionality. However, physical performance exerts a greater influence on functional independence than cognitive performance. These findings highlight the importance of a holistic approach to interventions aimed at enhancing quality of life in older adults residing in low-resource rural settings.
Religious Attendance, Psychological Well-Being, and Mental Health Issues Among Older Adults: A Seven-Year Longitudinal Study in the United States.
Hua Z
Int J Geriatr Psychiatry · 2025 Nov · PMID 41157924 · Publisher ↗
OBJECTIVES: Although studies have reported an association between attending religious services and diminished mental health issues, the underlying mechanisms have not been thoroughly explored. Additionally, longitudinal...
OBJECTIVES: Although studies have reported an association between attending religious services and diminished mental health issues, the underlying mechanisms have not been thoroughly explored. Additionally, longitudinal evidence supporting this association is limited. This study aimed to examine whether psychological well-being mediates the longitudinal association between religious attendance and mental health issues. METHODS: A total of 2767 older adults (baseline mean age = 75.02 years, 57.9% female) from the National Health and Aging Trends Study (NHATS) were included in the analysis. Respondents' religious attendance, psychological well-being, and depressive and anxiety symptoms were measured annually across 7 years. Based on descriptive statistics, a longitudinal mediation analysis within a Bayesian framework was conducted. RESULTS: Results indicated that, controlling for sociodemographic variables and autoregressive effects, attending religious services was significantly and longitudinally associated with improved psychological well-being (β = 0.13, 95% CI: [0.10, 0.17]), which, in turn, significantly predicted subsequent reductions in depressive and anxiety symptoms (β = -0.30, 95% CI: [-0.33, -0.28]). On average, psychological well-being accounted for 26.7% of the total effect of religious attendance on mental health issues. CONCLUSIONS: Hence, supporting older adults who wish to attend religious services may be linked to better psychological well-being and mental health.
Development of the Clinical Insight Questionnaire: A Novel Clinical Tool for the Assessment of Insight Into Cognitive Symptoms and Everyday Functioning in People With Neurodegeneration.
Pennington C, Ball H, Connelly P … +9 more , Coulthard E, Duncan G, Ivenso C, Langheinrich T, Pattan V, Quinn T, Ritchie K, Ritchie C, Russ T
Int J Geriatr Psychiatry · 2025 Nov · PMID 41157909 · Full text
OBJECTIVES: Altered insight into cognitive symptoms and diagnosis is a common feature of neurodegeneration, and can adversely impact on quality of life and ability to access medical care. Affected individuals can lose aw...
OBJECTIVES: Altered insight into cognitive symptoms and diagnosis is a common feature of neurodegeneration, and can adversely impact on quality of life and ability to access medical care. Affected individuals can lose awareness of their symptoms and therefore decline to engage with medical assessment and treatment. Assessing insight is difficult, and there is a lack of short, easily administered clinical assessment tools. The aim of this study was to develop and evaluate the feasibility of a novel insight assessment questionnaire (The Clinical Insight Questionnaire, CLIQ) which can be independently completed by adults with a range of cognitive abilities. METHODS: A discrepancy score approach was used to evaluate insight. A novel questionnaire targeting the domains of memory, personality and social behaviour, executive function, language, and activities of daily living was devised using the Delphi approach and public feedback. Participant and informant mirror versions of each item were written. The discrepancy between participant and informant scores provides an overall insight score. 12 UK based experts in cognitive disorder diagnosis and assessment were invited to review potential questionnaire items, as was a PPI group. A feasibility study was conducted where people with mild memory or thinking symptoms and an informant completed the questionnaire and the Montreal Cognitive Assessment. RESULTS: Following an iterative process using the expert Delphi group and public feedback, 20 final questionnaire items were selected from an initial pool of 30 items. 21 people with mild cognitive symptoms but no formally diagnosed cognitive disorder (median MoCA score 24.5) participated in feasibility testing. The mean discrepancy score was 1.14, close to the ideal score of zero. No participants found the assessment upsetting or too long, and 81% rated the questions as easy to understand. CONCLUSIONS: The Clinical Insight Questionnaire (CLIQ) is a novel clinical tool for the assessment of insight in people with mild to moderate neurodegeneration. In feasibility testing it was quick and easy for people with mild cognitive symptoms and informants to self-complete. Initial feasibility testing showed very promising findings for usability and acceptability, and a full validation study is now in progress.
Natural Evolution and Heterogeneity of Neuropsychiatric Symptoms Across Neurocognitive Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.
Skoda O, Conant M, Couture V … +4 more , Bruneau MA, Forget MF, Nguyen QD, Desmarais P
Int J Geriatr Psychiatry · 2025 Oct · PMID 41117129 · Publisher ↗
OBJECTIVES: Neuropsychiatric symptoms (NPS) are common and burdensome manifestations of neurocognitive disorders but the characterization of their natural evolution over time is limited. We conducted a systematic review...
OBJECTIVES: Neuropsychiatric symptoms (NPS) are common and burdensome manifestations of neurocognitive disorders but the characterization of their natural evolution over time is limited. We conducted a systematic review and meta-analysis to describe the longitudinal progression and heterogeneity of NPS across Alzheimer's disease (AD), Lewy body dementia (LBD), and frontotemporal dementia (FTD). METHODS: We systematically reviewed observational longitudinal studies published between 2000 and 2024 assessing the prevalence or severity of NPS at ≥ 2 time points using validated instruments. Random-effects meta-analyses were performed to pool changes in prevalence (risk difference) and severity (standardized mean difference [SMD]) at short-term (< 12 months), mid-term (12 to < 24 months), and long-term (≥ 24 months) follow-up. Heterogeneity and publication bias were also assessed. Subgroup analyses were conducted by type of neurocognitive disorder. RESULTS: We included 26 studies comprising 5509 participants. Apathy was the most prevalent NPS at baseline (45%), followed by irritability (35%) and depression (35%). Over time, most NPS demonstrated progressive increases in prevalence, with agitation (+16%) and apathy (+15%) emerging most frequently at long-term follow-up. Severity of most NPS remained stable, except for apathy and aberrant motor behavior, which increased significantly, and sleep disturbances, which improved. Global NPS burden increased significantly at long-term (SMD +2.04). Heterogeneity of trajectories was notably high and varied across symptoms and disorders. Subgroup analyses in AD confirmed increases in apathy, delusions, and hallucinations over time. CONCLUSIONS: NPS exhibit distinct and heterogeneous longitudinal patterns in neurocognitive disorders. Greater understanding of these trajectories may inform clinical management, prognostication, and the timing of interventions.
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