Int J Geriatr Psychiatry
· 2025 Oct · PMID 41116682
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OBJECTIVE: To assess awareness, perceptions, stigma, attitudes, and help-seeking behavior related to Alzheimer's disease (AD) among older adults in Nigeria. METHODS: This 12-month community-based cross-sectional study (M...OBJECTIVE: To assess awareness, perceptions, stigma, attitudes, and help-seeking behavior related to Alzheimer's disease (AD) among older adults in Nigeria. METHODS: This 12-month community-based cross-sectional study (May 2024-April 2025) was conducted across 12 purposively selected urban and rural communities, representing Nigeria's six geopolitical zones. A total of 744 older adults (≥ 60 years; mean age = 70.3) were recruited using a multistage sampling technique. Data were collected using the Alzheimer's Disease Assessment Questionnaire (ADAQ), a validated instrument covering sociodemographic characteristics, AD awareness, perceptions, stigma, attitudes, help-seeking behavior, and diagnostic care barriers. Descriptive statistics and chi-square (χ) tests were conducted using SPSS v22.0, with significance set at p ≤ 0.05. RESULTS: Overall, 64.9% of respondents were aware of AD, although 66.8% held negative perceptions. High perceived stigma (62.1%) and undesirable attitudes (71.4%) were common. Only 26.2% reported appropriate help-seeking behavior. Key barriers to AD diagnostic care included lack of specialists (85.8%), high costs (84.3%), and limited access to services (80.9%). Significant associations were found between AD awareness and age (χ = 6.432, p = 0.011), gender (χ = 3.833, p = 0.020), marital status (χ = 2.319, p = 0.032), living arrangement (χ = 1.377, p = 0.010), and income (χ = 2.363, p = 0.031), but not with education (χ = 1.765, p = 0.163) or religion (χ = 3.832, p = 0.521). CONCLUSION: Despite moderate awareness, perceptions and attitudes toward AD among older Nigerian adults remain largely unfavorable. Stigma and structural barriers continue to impede timely diagnosis and care. Community-targeted interventions are essential to improve AD literacy and health-seeking behaviors in this population.
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41108601
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OBJECTIVES: Although late-life depression is common, there has previously not been a comprehensive review of chronic depression (CD) in older adults. This systematic review summarizes prevalence rates, potential risk fac...OBJECTIVES: Although late-life depression is common, there has previously not been a comprehensive review of chronic depression (CD) in older adults. This systematic review summarizes prevalence rates, potential risk factors, and consequences of CD in later life. METHODS: This preregistered review (PROSPERO: CRD42025649324) searched MEDLINE, Web of Science, CINAHL and PsycINFO from inception to February 2025. Observational studies reporting the prevalence of CD in older adults (mean age 60+) were included. Study quality was assessed using the Joanna Briggs Institutes Critical Appraisal Tool. Random-effects models were used to estimate pooled prevalence across subgroups and meta-regression analyses were used to explore sources of heterogeneity. RESULTS: A total of 39 articles (38 studies) met the inclusion criteria; 20 articles (27 data points) were included in meta-analysis for point prevalence. Overall point prevalence was 4.02% [2.88%-5.35%], with estimates varying by assessment method: 2.30% [1.47%-3.31%] using DSM-IV/DSM-III-R, 7.12% [2.31%-14.22%] using DSM-III/ICD-10% and 5.52% [3.80%-7.54%] using rating scales. Prevalence varied also by region and was higher for women. Consistent risk factors included less physical activity and higher impairment in daily life. Evidence on consequences was sparse. CONCLUSIONS: Approximately 4% of adults aged 60+ meet criteria for CD. Estimates vary substantially by method and region, and potential risk factors and outcomes remain poorly understood. Future studies should target underrepresented subgroups - such as the oldest old, the institutionalized and physically and cognitively impaired individuals-using both dimensional and categorical assessment. CD in late life appears often unrecognized, untreated and underresearched.
Bertola L, da Mata F, Ramos AA
… +5 more, Godoy C, de Faria FM, Lucchetta R, de Oliveira Junior HA, Ferri CP
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41099422
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BACKGROUND AND OBJECTIVES: In low- and middle-income countries (LMICs), family caregivers provide most of the support for people with dementia (PWD), yet little is known about how caregiver needs relate to unmet needs of...BACKGROUND AND OBJECTIVES: In low- and middle-income countries (LMICs), family caregivers provide most of the support for people with dementia (PWD), yet little is known about how caregiver needs relate to unmet needs of PWD especially in Latin America. This study explored that relationship in Brazilian caregiver-PWD dyads. METHODS: 140 Brazilian dyads underwent in-home interviews, with assessments including a comprehensive needs of care instrument, caregiver burden, mental health, and caregiving experience, as well as PWD symptoms and demographics. RESULTS: All dyads had at least one unmet need. A combined model incorporating predictors from both PWD and caregivers indicated that PLWD having lower education, being male, and exhibiting more neuropsychiatric symptoms are associated with more unmet needs. Additionally, caregiver-related factors such as being male, having fewer years of caregiving experience, and having more unmet needs of their own were also linked to greater unmet needs in PWD. DISCUSSION AND IMPLICATIONS: Caregiver well-being significantly affects the quality of dementia care. Caregivers' unmet needs likely reflect both their personal limitations and broader care challenges. Addressing both caregiver and PWD needs through targeted support strategies is essential for improving dementia care in LMICs, and especially in culturally and economically diverse settings.
Jaffa E, Wu Z, Owen A
… +7 more, Phyo AAZ, Woods RL, Orchard SG, T-J Chong T, Shah RC, Murray A, Ryan J
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41088732
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OBJECTIVES: To determine whether engagement in music-related leisure activities is associated with a reduced risk of dementia and cognitive impairment no dementia (CIND), as well as better cognitive wellbeing in initiall...OBJECTIVES: To determine whether engagement in music-related leisure activities is associated with a reduced risk of dementia and cognitive impairment no dementia (CIND), as well as better cognitive wellbeing in initially cognitively healthy older adults. Here, cognitive wellbeing includes maintaining good cognitive function as well as quality of life. Potential effect modification by education was also investigated. METHODS: This study used secondary data from the ASPirin in Reducing Events in the Elderly (ASPREE) study, and the ASPREE Longitudinal Study of Older Persons (ALSOP) sub-study. Included were 10,893 community-dwelling Australian adults who were 70 years and older, without dementia diagnosis at recruitment to the study. Cox proportional hazard regression models were used to determine the association between level of music engagement (listening to music, playing an instrument, and a combination of both) and dementia risk from year 3 onwards. Linear mixed models were used to investigate the association with cognitive wellbeing. Analyses adjusted for age, gender and level of education completed. RESULTS: Always listening to music, compared with never/rarely/sometimes, was associated with a 39% decreased risk of dementia (95% CI = 0.45,0.82, p = 0.001), and a 17% decreased risk of CIND (95% CI = 0.74, 0.92, p = 0.001). Playing an instrument (often/always) was associated with a 35% decreased dementia risk only (95% CI = 0.42,0.99, p = 0.047). Participants who both listened to and played music had a 33% decreased dementia risk (95% CI = 0.51,0.89, p = 0.006) and a 22% decreased CIND risk (95% CI = 0.65,0.92, p = 0.004). Always listening to music was associated with better global cognition and memory over time (p < 0.001, p = 0.004, respectively), but not the other cognitive domains. Engagement in music-related activities was not associated with changes in subjective cognitive wellbeing. In general, findings were stronger in individuals with over 16 years of education. CONCLUSION: These results highlight music as a potential promising, accessible strategy to help reduce cognitive impairment and delay the onset of dementia in later life.
Numbers K, Samtani S, Hanewald K
… +3 more, Cheung J, Sachdev PS, Brodaty H
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41086232
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BACKGROUND: Intrinsic Capacity (IC) is a developing concept focussed on promoting healthy ageing by maintaining functional abilities. It has been proposed as a better predictor of outcomes like dementia and mortality, co...BACKGROUND: Intrinsic Capacity (IC) is a developing concept focussed on promoting healthy ageing by maintaining functional abilities. It has been proposed as a better predictor of outcomes like dementia and mortality, compared to traditional frailty measures that focus on deficits. This study aims to replicate the five-factor structure of IC among older adults in Australia and to evaluate its effectiveness in predicting long-term health outcomes, in comparison with existing frailty measures. METHODS: IC scores were computed for 400 older adults aged 70 to 90 participating in the Sydney Memory and Ageing Study (MAS). Structural equation modelling, including second-order confirmatory analysis, was used to compute the five IC domains. Cox proportional hazard models were used to compare the predictive value of the second-order IC factor with the Frailty Phenotype and Frailty Index for dementia over 10 years and mortality over 12 years. RESULTS: Factor loadings for the IC structure yielded five subgroups (cognitive function, psychological health, locomotive ability, sensory function, vital function) with one global factor. The structure had good fit (SRMR = 0.054, GFI = 0.966). IC was associated with lower hazard (risk) of dementia (HR = 0.567, p < 0.001) over 10-year and lower hazard of mortality (HR = 0.649, p < 0.001) over 12-year, controlling for age, sex, and education. Finally, IC explained additional variance beyond the Frailty Phenotype when predicting both incident dementia and mortality risk. Compared with the Frailty Index, IC contributed additional variance for dementia risk but not for mortality. CONCLUSION: Evaluation of a person's IC at baseline explains additional variance compared to traditional frailty measures when predicting the risk of future negative health outcomes such as dementia incidence and mortality.
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41084242
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BACKGROUND: Cognitive decline commonly co-occurs with dynamic physical and mental health changes in older adults. While early-life adversity has been linked to various later-life health outcomes, its relationship with co...BACKGROUND: Cognitive decline commonly co-occurs with dynamic physical and mental health changes in older adults. While early-life adversity has been linked to various later-life health outcomes, its relationship with cognitive function considering different health trajectories remains unclear. OBJECTIVES: To identify distinct clusters of physical-mental-cognitive health trajectories among Chinese older adults and to examine the association between childhood adversities and cognitive function across these trajectories. METHODS: Using data from the China Health and Retirement Longitudinal Study (2011-2020), we included 6178 adults aged ≥ 60 years. Latent Class Growth Modeling was used to identify trajectory patterns of functional limitations, depressive symptoms, and cognitive function. Mixed linear models examined associations between childhood adversities and cognitive function overall and across different identified trajectory patterns. RESULTS: Four distinct trajectory classes were identified: healthy individuals (59.8%), rapid cognitive decline with gradual physical-mental decline (16.5%), mild cognitive decline with physical-mental improvement (14.4%), and moderate cognitive decline with rapid physical and moderate mental decline (9.4%). Experience of multiple childhood adversities was significantly associated with lower cognitive function (β = -0.36, 95% CI [-0.58, -0.14]), independent of adulthood factors and consistent across various trajectory patterns. Among individuals showing rapid cognitive decline with gradual physical-mental deterioration, experiencing two childhood adversities predicted lower cognitive function (β = -0.88, 95% CI [-1.62, -0.14]). CONCLUSION: Childhood adversities are associated with cognitive impairment regardless of physical-mental-cognitive health trajectories in older Chinese adults. These findings highlight the long-term impact of early-life experiences on cognitive health in later life.
Su Z, Yang X, Zhang R
… +8 more, Kaburu FM, Tong C, McDonnell D, Bentley BL, Zou X, Nie JB, Veiga CPD, Xiang YT
Int J Geriatr Psychiatry
· 2025 Oct · PMID 41078286
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OBJECTIVES: Nanny-induced elder abuse is a persistent issue in China. Unlike certified nurses and care workers who undergo extensive evaluation processes, elder-care nannies or "bao mu" often have little to no profession...OBJECTIVES: Nanny-induced elder abuse is a persistent issue in China. Unlike certified nurses and care workers who undergo extensive evaluation processes, elder-care nannies or "bao mu" often have little to no professional training. Background screening procedures are also highly variable and selective, depending on the specific labour agencies involved. This paper aims to discuss technologies with the potential to detect, prevent, and reduce nanny-induced elder abuse. METHODS: This study reviews existing literature and case reports to explore how digital technologies-such as surveillance cameras and smart wearables-have been used to uncover and monitor elder abuse in home care settings. It also examines policy gaps and technological interventions relevant to the Chinese context. RESULTS: Recent discoveries of elder abuse in China-including verbal, physical, psychological, financial, and sexual abuse-have primarily come to light through the use of digital surveillance. Smart technologies, from home-care robots to network monitoring systems, have all demonstrated potential in alerting families and caregivers to abnormal and abusive behaviors by hired care professionals like nannies. However, while surveillance technologies can play an important role in detecting and documenting elder abuse by nannies, they are regarded as limited technical aids rather than comprehensive solutions. Overreliance on monitoring devices may generate a series of ethical and social concerns. CONCLUSIONS: While systemic reforms like mandatory training and evaluation procedures may take time to implement, technological solutions such as surveillance and wearable monitoring offer relatively cost-effective, immediate tools to address elder abuse. However, ethical considerations-particularly regarding privacy and data security-must be rigorously upheld to protect older people's digital health rights.
Int J Geriatr Psychiatry
· 2025 Oct · PMID 40999725
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OBJECTIVES: This study aimed to investigate the age-dependent association between new cognitive classification and chronic diseases among middle-aged and older adults using Poisson regression analysis. METHODS: We includ...OBJECTIVES: This study aimed to investigate the age-dependent association between new cognitive classification and chronic diseases among middle-aged and older adults using Poisson regression analysis. METHODS: We included 6940 people from the 2018 Korean Longitudinal Study of Aging. Cognitive status was classified as normal, moderate, and severe based on the participants' Korean Mini-Mental State Examination scores and instrumental activities of daily living. Poisson regression analysis was performed to predict the number of chronic diseases in middle-aged and older adults with grade three cognitive status. The number of predicted events at each cognitive level was calculated according to age. RESULTS: In the normal cognitive group, most of the participants were females 2515 (54.03), and the average age was 66.50 (SD = 8.62). Compared to the normal cognitive group (n = 4665), the incidence of chronic disease in the moderate cognitive impairment group (n = 1316) was 0.07 times that of the normal group, whereas, in the severe cognitive impairment group (n = 420), it was 0.21 times that of the normal group. CONCLUSIONS: Higher levels of cognitive impairment and older age were associated with a higher probability of having multiple chronic conditions. The study findings highlight the importance of integrative care with cognitive function and age in managing multiple chronic conditions.
Wiesner T, Grammatikos P, van Gils V
… +1 more, Bauermeister S
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40990184
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OBJECTIVES: Emerging evidence demonstrates that multimorbidity, defined as the co-occurrence of at least two chronic conditions, may elevate the risk of dementia especially when certain conditions co-occur. Therefore, we...OBJECTIVES: Emerging evidence demonstrates that multimorbidity, defined as the co-occurrence of at least two chronic conditions, may elevate the risk of dementia especially when certain conditions co-occur. Therefore, we investigated the available evidence on the relationship between clusters of multimorbidity and dementia risk in adults. METHODS: Embase, PsycINFO, and Ovid MEDLINE were searched until the ninth of February 2025. Included studies reported dementia risk or incidence in adult populations in relation to different clusters of multimorbidity. A narrative synthesis was structured according to the identified clusters across studies, their associations with dementia risk, and any moderation or stratification analyses for APOE ε4 allele carriership and C-reactive protein (CRP), among others. The Quality In Prognosis Studies (QUIPS) tool was used for quality assessment. RESULTS: Of the 870 abstracts screened, 7 were included in the final synthesis. Significant relationships between clusters of multimorbidity and an elevated risk of dementia were identified in all studies. The most consistent findings related to cardiometabolic and mental health/neuropsychiatric clusters evidencing the highest dementia risk. Other multimorbidity clusters were less well studied and results regarding dementia risk varied across studies. Moderation and stratification analyses for APOE ε4 and CRP, where available, yielded inconsistent findings. CONCLUSION: This systematic review highlights the importance of understanding multimorbidity clusters for early identification of dementia risk and targeted treatment approaches. Further research is required to explore relationships between multimorbidity clusters and dementia risk across different ethnic groups as well as the potential moderating role of lifestyle factors.
Quinn C, Young H, Stamou V
… +3 more, Gridley K, Mason C, Oyebode J
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40974198
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OBJECTIVES: Access to appropriate social care post-diagnosis is crucial for people with young onset dementia (YOD) and their families. Yet care is hugely variable, frequently lacking, and poorly coordinated. We aimed to...OBJECTIVES: Access to appropriate social care post-diagnosis is crucial for people with young onset dementia (YOD) and their families. Yet care is hugely variable, frequently lacking, and poorly coordinated. We aimed to establish levels of awareness, knowledge, and practice among professionals regarding social care provision for people with YOD. METHODS: A short survey (24 items) was developed based on previous research and through consultation with experts by experience and the project steering group. The aim was to establish awareness, knowledge, and practice among professionals regarding social care needs, care planning, and provision for people YOD. The survey was available online. RESULTS: There were 139 responses from health and social care professionals. A wide range of situations triggered referrals to social care, illustrating the holistic impact of YOD. However, most referrals were triggered by crises rather than a proactive approach and were in response to carers' needs rather than those of the person with YOD. Referrals for advice and guidance around financial impacts were common. Most respondents reported there was no agreed care pathway and no YOD-specific guidelines in their service. Areas of good practice in social care provision included: person-centred and reablement based approaches; multi-disciplinary and multi-agency working; support from peers and the third sector; seamless care pathways and dedicated YOD services; support for carers; and personal budgets. CONCLUSIONS: Staff need accurate knowledge and awareness of specific YOD-related issues to provide effective social care for those with YOD and their families. The current system tends to be reactive at point of crisis, whereas proactive planning and provision could pre-empt crises and provide more effective support. YOD-specific care pathways and guidance are needed to improve social care for this population.
Alexander CM, Earle H, Martyr A
… +1 more, Clare L
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40922519
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OBJECTIVES: Awareness of difficulties varies in people with dementia. Low awareness, also termed anosognosia, has been implicated in carer stress and safety concerns, and can be a barrier to effective clinical communicat...OBJECTIVES: Awareness of difficulties varies in people with dementia. Low awareness, also termed anosognosia, has been implicated in carer stress and safety concerns, and can be a barrier to effective clinical communication. Little is known about how to manage situations arising from low awareness. This review looked for evidence of existing interventions to enhance care in situations regarding low awareness, and considered their utility, feasibility and acceptability when delivering personalised care. METHODS: We used systematic review methodology, adapted for a rapid timeline, searching five databases and grey literature sources. The review built on an earlier scoping review about measuring awareness in dementia. The protocol was registered on PROSPERO (CRD42024626367). Interventions were included if targeted at people with any dementia type in any setting, or dyads or informal carers, or clinicians. Interventions of any type were eligible where awareness had been measured and addressed, and quantitative outcome data were available. Risk of bias of included articles was assessed. The review is reported as a narrative synthesis. RESULTS: From the database search, 6042 articles were screened, with additional findings from grey literature. Seven articles were included, describing heterogenous interventions. Two interventions aimed to enhance awareness as the primary goal. No intervention was aimed at informal carers or clinicians, and none addressed specific everyday concerns arising from low awareness. Five non-pharmacological interventions used methods involving music, a garden, a cognitive programme, interview-based psychosocial approaches or staff training. These appeared generally acceptable to care recipients, with some feasibility of use, but with limited efficacy. Intervention goals regarding awareness were poorly defined. Outcomes on awareness were mixed in comparison with control groups, with slowing of decline at best. Some improvement in mood, quality of life and coping was observed. Two drug interventions showed a reduction in neuropsychiatric symptoms but limited utility regarding awareness. Available public guidance about awareness issues is relevant but lacks a clear evidence-base. CONCLUSIONS: The review identified evidence gaps for suitable interventions for managing low awareness in dementia. Existing interventions have limited efficacy and application regarding awareness. There is scope for further intervention development in this area.
Redondo R, Pinazo-Clapés C, Checa I
… +2 more, Pinazo-Hernandis S, Sales A
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40910417
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INTRODUCTION: Suicide among older adults living in care homes is a major public health challenge. This study analyses the perceptions and attitudes of professionals working in care homes towards suicidal ideation and sui...INTRODUCTION: Suicide among older adults living in care homes is a major public health challenge. This study analyses the perceptions and attitudes of professionals working in care homes towards suicidal ideation and suicide attempts in this population. METHOD: A total of 338 nursing home professionals from Spain participated in the study. A vignette-based methodology was used, in which cases of suicidal ideation or suicide attempts were described, varying the gender of the actor. Responses to a questionnaire assessed perceived frequency, attention-seeking behaviour, ageism, experienced anxiety, perceived risk and likelihood of future suicide. RESULTS: Professionals perceived suicidal ideation to be more common and normative in older adults, particularly women. However, they attributed a higher risk and likelihood of suicide to cases involving suicide attempts, which also elicited more anxiety. No significant differences were found in the perception of these situations as 'attention-seeking behaviour'. DISCUSSION: Acceptance of suicidal ideation as normal behaviour of suicidal ideation in older adults may reduce the perceived urgency to intervene, highlighting the need for specialised training to help identify risk signals and act promptly. This study highlights the importance of addressing age and gender bias in suicide prevention in care homes and advocates the development of evidence-based strategies.
Nishida H, Bun S, Shikimoto R
… +7 more, Kida H, Suzuki K, Takamiya A, Hirano J, Niimura H, Uchida H, Mimura M
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40903988
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OBJECTIVES: Pareidolic illusions involve perceiving meaningful objects in ambiguous or visually complex stimuli. Although seen in dementia, their presence and associated neuroanatomical basis in older adults without deme...OBJECTIVES: Pareidolic illusions involve perceiving meaningful objects in ambiguous or visually complex stimuli. Although seen in dementia, their presence and associated neuroanatomical basis in older adults without dementia remain unclear. Investigating these illusions in this population may reveal early neurodegenerative changes preceding overt dementia. Such insights could support the use of pareidolic illusions as potential early markers for diagnosis and intervention. This study therefore aimed to examine the prevalence and associated neuroanatomical characteristics of pareidolic illusions in community-dwelling older adults without dementia, as assessed by the Noise Pareidolia Test (NPT). METHODS: We investigated the prevalence of pareidolic illusions in older adults aged 65-84 residing in Tokyo, Japan with suspected cognitive decline but without dementia. Participants were classified as cognitively normal or having mild cognitive impairment (MCI) based on standard criteria. Participants underwent NPT, and those who exhibited one or more pareidolic illusions were classified as pareidolia-positive. Additionally, a whole-brain voxel-based morphometry (VBM) of structural magnetic resonance imaging data was performed to assess gray matter volume differences associated with pareidolic illusions. RESULTS: Pareidolic illusions were present in 35.1% (155/441) of participants. These individuals were significantly older, had shorter years of education, and more likely to be diagnosed with MCI. VBM revealed significantly lower gray matter volume in bilateral temporal clusters-areas associated with face-related visuoperceptual processing-among pareidolia-positive individuals. CONCLUSIONS: Pareidolic illusions were relatively common in community-dwelling older adults without dementia. These illusions may be an early marker of neurodegenerative changes affecting visuoperceptual pathways, and may be detectable using NPT.
Kimura N, Chadani Y, Kawai R
… +9 more, Fujito R, Kanemoto H, Takahashi R, Kashibayashi T, Shinagawa S, Tagai K, Ishii K, Ikeda M, Kazui H
Int J Geriatr Psychiatry
· 2025 Sep · PMID 40899733
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OBJECTIVE: The association between core clinical features and anxiety and the neural basis of anxiety in patients with dementia with Lewy bodies (DLB) are unknown. Therefore, this study examined the core clinical feature...OBJECTIVE: The association between core clinical features and anxiety and the neural basis of anxiety in patients with dementia with Lewy bodies (DLB) are unknown. Therefore, this study examined the core clinical features associated with anxiety in DLB and identified the brain regions associated with anxiety using statistical imaging analysis. METHODS: This study was conducted using a part of the data from "The Japan multicenter study: Behavioral and psychological symptoms Integrated Research in Dementia-Retrospective Neuroimaging part". Overall, 40 patients with probable DLB whose clinical dementia rating score was either 0.5 or 1 were included in this study. Anxiety was evaluated using the Neuropsychiatric Inventory (NPI). The incidence of each of the 4 core features was compared between patients with and without anxiety, and the brain regions associated with anxiety were examined using single-photon emission computed tomography data. RESULTS: Patients with DLB with anxiety had a significantly higher percentage of fluctuating cognition than those without anxiety. The NPI anxiety score was significantly negatively correlated with regional cerebral blood flow in the right supramarginal gyrus in patients with DLB. CONCLUSION: Anxiety in DLB is associated with fluctuating cognition. It is also likely that the brain regions associated with anxiety in DLB are potentially influenced by the neurofunctional characteristics of DLB, in which the parietal lobes are more likely to be impaired.