International Journal Of Geriatric Psychiatry[JOURNAL]
Sun
200 papers
Associations Between Sleep Duration Trajectories and Depressive Symptoms Among Middle-Aged and Older Adults: Findings From a Nationally Representative Survey.
Jia T, Kou C, Zhang Y … +10 more , Sun Z, Ding Q, Feng Y, Guo X, Wu S, Wang Q, Huang Q, Sun X, Han W, Bai W
Int J Geriatr Psychiatry · 2025 Sep · PMID 40898651 · Publisher ↗
OBJECTIVES: The relationship between sleep duration and depressive symptoms remains controversial in middle-aged and older adults. The aim of this study is to investigate the relationship of sleep duration trajectories w...
OBJECTIVES: The relationship between sleep duration and depressive symptoms remains controversial in middle-aged and older adults. The aim of this study is to investigate the relationship of sleep duration trajectories with depressive symptoms and conduct further exploration through network analysis. METHODS: Based on the five waves of data on 8681 middle-aged and older adults from 2011 to 2020 in the China Health and Retirement Longitudinal Study database, group-based trajectory modeling was employed to depict their sleep trajectories. Binary logistic regression and network analysis were conducted to assess the relationship between sleep trajectories and depressive symptoms. Subgroup analysis was performed based on age (< 60, ≥ 60 years). RESULTS: The study identified three nighttime sleep duration trajectories, three daytime nap duration trajectories, and nine combined trajectories. People with initially low or moderate then decreasing nighttime sleep duration trajectory were more likely to have depressive symptoms compared with those with persistently recommended trajectory. And people with the combination of initially low then decreasing nighttime sleep and initially moderate or low then increasing daytime nap duration trajectories and the combination of initially moderate then decreasing nighttime sleep and initially high then increasing daytime nap duration trajectories were prone to have depressive symptoms compared with the combination of persistently recommended nighttime sleep and initially moderate then increasing daytime nap duration trajectories. The association between sleep trajectories and depressive symptoms may be modified by age groups (< 60 vs. ≥ 60 years). In network analyses, "felt depressed" was the most central item, and there were structural differences across different sleep duration trajectory networks. CONCLUSIONS: Taking naps could offset the risk of depressive symptoms for people who lacked sleep at night. Developing different intervention strategies based on different sleep trajectories might help alleviate the onset of depressive symptoms.
Ten-Year Cognitive Trajectories and Determinants in Chinese Older Adults Without Formal Schooling: Chinese Longitudinal Healthy Longevity Survey 2008-2018.
Tu L, Lv X, Zhang Q
Int J Geriatr Psychiatry · 2025 Sep · PMID 40879068 · Publisher ↗
OBJECTIVES: Lack of formal schooling remains prevalent among older adults in China, particularly in rural areas. This study investigates the cognitive function trajectory and influencing factors in older adults without f...
OBJECTIVES: Lack of formal schooling remains prevalent among older adults in China, particularly in rural areas. This study investigates the cognitive function trajectory and influencing factors in older adults without formal schooling from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS: The study included 2159 individuals without formal schooling (NFS) and 2234 individuals with formal schooling (FS), all cognitively healthy and aged over 60 at the first observation from the 2008 - 2018 CLHLS cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10 years. Logistic regression was used to investigate associations between baseline characteristics (age, sex, marital status, functional abilities, leisure activity, and health status and behaviors) and trajectory classes. RESULTS: NFS individuals were generally older (80 vs. 75.3 years), more likely to be female (72.2% vs. 29.9%), unmarried (43.1% vs. 68.2%), and underweight (27.3% vs. 17.8%). They also had higher prevalence of hearing impairment (40.1% vs. 30.5%), functional limitations (39.6% vs. 19.2%), and extreme sleep length, while lower baseline cognitive function (MMSE score: 26.5 vs. 28.2). Additionally, they were less likely to engage in exercise, leisure activities, or alcohol consumption. Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both groups. For the NFS group, both the slow and rapid decline groups accounted for a larger proportion (15.0% and 12.3%, respectively) than the FS decline groups (6.5% and 5.3%, respectively), and the NFS individuals had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, hearing impairment, poorer functional abilities, and lower baseline MMSE scores were significantly associated with cognitive decline in both groups compared to the stable group. For the NFS individuals, female sex was a risk factor for slow decline, while marital status was associated with rapid decline. CONCLUSIONS: These findings underscore the importance of considering formal schooling status in cognitive aging research. They also emphasize the need to address educational disparities and promote social and economic well-being, particularly for vulnerable populations, to mitigate the risk of cognitive decline and dementia.
Barthel Index Score at Admission to Predict 1-Month and 1-Year Prognosis in Inpatients Aged ≥ 75 Years With Multimorbidity.
Chen X, Zhang CL, Jiang H
Int J Geriatr Psychiatry · 2025 Sep · PMID 40875287 · Publisher ↗
OBJECTIVE: To investigate the Barthel Index (BI) score in predicting the 1-month and 1-year prognosis after discharge. METHODS: This was a retrospective observational single-center study. We retrospectively enrolled cons...
OBJECTIVE: To investigate the Barthel Index (BI) score in predicting the 1-month and 1-year prognosis after discharge. METHODS: This was a retrospective observational single-center study. We retrospectively enrolled consecutive inpatients aged ≥ 75 years from a large public hospital. Information of the basic demographic variables, BI score, disease burden, length of hospital stay, medical cost and outcomes of patients were collected. Then we analyzed the association between BI score and clinical outcomes. RESULTS: A total of 242 subjects were included in this study. The median of BI score was 40 (5, 70). There were 48.76% and 82.23% patients with poor prognosis within 1 month and 1 year after discharge. BI remained an independent predictor of poor outcome within 1 month (P < 0.001) and 1 year (P = 0.027) after adjusting other factors. BI score was negatively correlated with poor outcomes. The calibration of 1-year outcomes was better than that of 1-month outcomes. The ROC analysis showed the AUC of the BI in predicting 1-month and 1-year outcomes were 0.860(P < 0.001) and 0.674(P < 0.001) respectively. The cutoff values for BI to predict 1-month and 1-year outcomes were 42.5 and 52.5. CONCLUSIONS: The BI score at admission was an useful predictor of outcomes within 1 month and 1 year after discharge for very elderly multimorbidity inpatients.
Correction to "Accuracy of the Short-Form Montreal Cognitive Assessment: Systematic Review and Validation".
Int J Geriatr Psychiatry · 2025 Sep · PMID 40855771 · Publisher ↗
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The Relationship of Alzheimer's Disease and Related Dementias Blood-Based Biomarkers and Informant-Reported Neuropsychiatric Symptoms Differs by Informant Type in Older Adults Without Dementia.
Bacci JR, Rudolph MD, Craft S … +3 more , Bateman JR, Lockhart SN, Mielke MM
Int J Geriatr Psychiatry · 2025 Aug · PMID 40828547 · Full text
OBJECTIVES: In a sample of community-dwelling older adults, we examined the association of Alzheimer's Disease and Related Dementias (AD/ADRD) blood-based biomarkers (BBMs) and neuropsychiatric symptoms (NPS) and whether...
OBJECTIVES: In a sample of community-dwelling older adults, we examined the association of Alzheimer's Disease and Related Dementias (AD/ADRD) blood-based biomarkers (BBMs) and neuropsychiatric symptoms (NPS) and whether informant type (i.e., spouse vs. child vs. other) modified that association. METHODS: This study included 430 participants with a cognitively unimpaired or mild cognitive impairment consensus diagnosis from the Wake Forest Alzheimer's Disease Research Center Clinical Core cohort. Informants reported NPS using the Neuropsychiatric Inventory Questionnaire. AD/ADRD BBMs included the Aβ42/40 ratio, p-tau181, p-tau217, NfL, and GFAP. Generalized linear models were used to examine the associations between AD/ADRD BBMs and NPS. Secondary models adjusted for age, sex, education, race, and cognitive status. Tertiary models adjusted for covariates in secondary models, as well as informant type. Interactions between informant type and AD/ADRD BBMs were examined. RESULTS: Higher p-tau217 was associated with higher NPS in both unadjusted models and models adjusted for demographics and cognitive status. This association was attenuated and no longer statistically significant after additionally adjusting for informant type. Significant interactions of informant type and p-tau181 or p-tau217 on NPS were demonstrated, where p-tau181 or p-tau217 were more strongly associated with NPS reported by children compared to spouses. CONCLUSIONS: Informant type modified the association between AD/ADRD BBMs and NPS, with stronger associations observed when symptoms were reported by child informants compared to spouse informants. These findings have important implications for earlier detection of individuals with AD/ADRD pathologies.
Neurodegenerative Disorders: Advances in Neurobiology and New Treatment Perspectives.
Chen Y
Int J Geriatr Psychiatry · 2025 Aug · PMID 40827115 · Publisher ↗
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Latent Transition and Predictors of Cognitive Function Among Community-Dwelling Chinese Older Adults With Cardiovascular Metabolic Diseases.
Wang Y, Wan B, Xu X … +8 more , Lv Q, He Y, Liu J, Chang H, Zhao Y, Fu L, Zang X, Zhang X
Int J Geriatr Psychiatry · 2025 Aug · PMID 40827006 · Publisher ↗
OBJECTIVES: Despite the recognized heterogeneity of cognitive function in older adults and its propensity for transition, this phenomenon remains inadequately understood among older adults with cardiovascular metabolic d...
OBJECTIVES: Despite the recognized heterogeneity of cognitive function in older adults and its propensity for transition, this phenomenon remains inadequately understood among older adults with cardiovascular metabolic diseases (CMD). We aimed to explore the latent profiles of cognitive function among older adults with CMD, along with the transition probabilities between profiles and associated predictors. METHODS: A cohort study including 2304 older adults with CMD was drawn from the Chinese Longitudinal Healthy Longevity Survey. Cognitive function assessments and covariate data were gathered in 2011, with cognitive function reassessed in 2014. Latent profile analysis was employed to explore the latent profiles of cognitive function at two time points, latent transition analysis to examine transition probabilities between profiles, and multinomial logistic regression to investigate predictive factors of profile transitions. RESULTS: Latent profile analysis supported 3-profile model: normal cognitive function, mild cognitive impairment, and severe cognitive impairment. Over the 3-year period, the normal cognitive function profile exhibited greater stability, with probabilities of 0.834, while the mild cognitive impairment profile demonstrated a higher likelihood of transitioning to the normal cognitive function profile, with a probability of 0.630. Age, sleep duration, and social participation emerged as predictive factors of profile transitions. CONCLUSIONS: Significant heterogeneity exists in cognitive function among older adults with CMD, characterized by three distinct profiles. Varied transition patterns and probabilities underscore the importance of identifying and intervening with individuals at elevated risk of negative transitions, potentially improving their cognitive function.
The Association Between Sensory Impairment and Cognitive Impairment Among Older Adults: Insights From a National Cohort Study in China.
Ma B, Sun Y, Shen Q … +6 more , Zhang Y, Wang D, Ma J, Dong X, Zhao Y, Lu Q
Int J Geriatr Psychiatry · 2025 Aug · PMID 40817847 · Publisher ↗
OBJECTIVES: Cognitive impairment and sensory impairment are highly prevalent in older adults, but the relationship between the two remains inconclusive. This study aimed to investigate the relationship between visual imp...
OBJECTIVES: Cognitive impairment and sensory impairment are highly prevalent in older adults, but the relationship between the two remains inconclusive. This study aimed to investigate the relationship between visual impairment (VI), hearing impairment (HI), dual sensory impairment (DSI), and the onset of cognitive impairment among Chinese older adults. METHODS: Data were obtained from the 2011-2018 China Longitudinal Healthy Longevity Survey (CLHLS) cohort. Cognitive impairment was defined using the Chinese version of the Mini-Mental State Examination (CMMSE), with a score below 18 indicating its onset. VI and HI were identified through self-reported questionnaires. Cox proportional hazard regression models were applied to estimate crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between single and dual SI with cognitive impairment. RESULTS: A total of 3239 adults aged 65 and older were analyzed, with 329 participants (10.2%) developing cognitive impairment over 21,039 person-years of follow-up. Participants with single VI (HR 1.42, 95% CI 1.08-1.87), single HI (HR 2.24, 95% CI 1.58-3.15), and DSI (HR 2.08, 95% CI 1.44-3.01) exhibited significantly higher risks of cognitive impairment compared to those without SI. CONCLUSIONS: In this nationally representative sample of Chinese older adults, VI, HI, and DSI, were significantly associated with an increased risk of cognitive impairment. Future studies are encouraged to employ standardized tools to assess sensory and cognitive impairments, further explore the mechanisms linking the two, and consider the potential benefits of incorporating sensory impairment assessment and management into primary healthcare to reduce the risk of cognitive impairment.
Age and Sex Differences in Adverse Events Associated With Antipsychotics: An Analysis of the FDA Adverse Events Database.
Ramin T, Peter JU, Schneider M … +2 more , Dahling V, Zolk O
Int J Geriatr Psychiatry · 2025 Aug · PMID 40817421 · Full text
OBJECTIVES: While the risks of antipsychotics in older adults are well recognized, clinical trials often exclude frail older patients, have short follow-up periods, and provide limited comparative data on specific drugs....
OBJECTIVES: While the risks of antipsychotics in older adults are well recognized, clinical trials often exclude frail older patients, have short follow-up periods, and provide limited comparative data on specific drugs. This study aimed to explore age-related differences in the adverse effects of six commonly prescribed antipsychotics using a pharmacovigilance database, with additional analysis of sex-based variations. METHODS: We analyzed adverse event (AE) reports associated with aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and haloperidol from the FDA Adverse Event Reporting System (FAERS) database between Q4 2003 and Q2 2024. We utilized Standardized MedDRA Queries (SMQs) and self-defined queries to categorize 18 groups of AEs. Adjusted logistic regression was employed to calculate adjusted reporting odds ratios (aRORs) with 95% confidence intervals (CIs). RESULTS: Our analysis revealed substance-specific differences in AE profiles. Risperidone had the highest aROR for hyperprolactinemia (aROR 212, 95% CI 203-221), haloperidol for dystonia (aROR 46, 95% CI 41-51), and aripiprazole for akathisia (aROR 45, 95% CI 42-49). Patients aged 65 and older generally demonstrated a higher likelihood of experiencing cardiac, extrapyramidal motor, and sedative AEs compared to those under 65, with few exceptions across the drugs investigated. In contrast, younger patients showed higher odds for metabolic AEs, including dyslipidemia and hyperglycemia (associated with olanzapine and quetiapine), as well as weight gain (with olanzapine, quetiapine, risperidone, and haloperidol). With few exceptions, women generally showed higher reporting odds of adverse events. Sex-related differences were especially pronounced for hyperprolactinemia, with 4.7-8.0 times higher reporting odds in women for aripiprazole, olanzapine, quetiapine, and haloperidol-except for risperidone, where a post-2014 rise in male reports led to higher odds in men. Risperidone was also associated with increased reporting odds of weight gain in men. Additionally, aripiprazole and olanzapine showed 3 to 6 times higher reporting odds for anticholinergic syndrome in men compared to women. CONCLUSIONS: It is essential to consider both age and sex in treatment decisions to optimize the efficacy and tolerability of antipsychotic therapy.
Stigma Beliefs and Attitudes Against Dementia and Help-Seeking Intentions in Hypothetical Early Signs of Dementia: An Observational Cross-Sectional Study of Middle-Aged and Older Adults in Japan.
Noguchi T, Shang E, Hayashi T
Int J Geriatr Psychiatry · 2025 Aug · PMID 40790834 · Publisher ↗
OBJECTIVES: People's stigma toward dementia may hinder support and care in early dementia. We explored the association of stigma beliefs and attitudes toward dementia with help-seeking intentions among middle-aged and ol...
OBJECTIVES: People's stigma toward dementia may hinder support and care in early dementia. We explored the association of stigma beliefs and attitudes toward dementia with help-seeking intentions among middle-aged and older adults in hypothetical early signs of dementia. METHODS: This cross-sectional study involved individuals aged 40 years and above without dementia, recruited from public facility visitors in Aichi, Japan, between July and August 2024. Dementia stigma was assessed using a short form of the Phillipson Dementia Stigma Assessment, comprising four domains: personal avoidance (avoiding contact and interaction with people with dementia), fear of labeling (fear and anxiety regarding dementia diagnosis), person-centeredness (respect and positive attitudes toward people with dementia), and fear of discrimination (fear of ostracism because of dementia). The participants were asked about their help-seeking intentions from family members, other relatives, healthcare professionals, public facilities, and the phone helpline during the hypothetical early signs of dementia. RESULTS: Data from 380 individuals were analyzed (mean age 75.0 years; 76.1% women), of whom 90.4% had help-seeking intentions from a partner, 85.9% from children, and 85.8% from healthcare professionals. Multivariable regression analysis revealed that higher dementia stigma was associated with a lower likelihood of help-seeking intentions from a partner, children, and healthcare professionals. Of the subdomains, fear of discrimination was negatively related to help-seeking intentions. CONCLUSIONS: This study indicated that people's stigma beliefs and attitudes may pose barriers to help-seeking in the early stage of dementia. Our findings highlight the need to strengthen support for individuals with early dementia, while reducing people's fear of discrimination and prejudice against dementia in the long term.
Inequalities in Dementia Care and Research.
Soysal P, Slachevski A, Chen Y
Int J Geriatr Psychiatry · 2025 Aug · PMID 40781530 · Publisher ↗
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The Association Between Health Literacy and Depressive Symptoms With the Mediation Role of Family Health and Perceived Social Support in Older Adults: A Nationwide Cross-Sectional Study in China.
Cai S, Zhuang Z, Lu W … +8 more , Wang Y, Tian Z, Ren J, Li J, Chen J, Luo G, Lin B, Yang X
Int J Geriatr Psychiatry · 2025 Aug · PMID 40769778 · Publisher ↗
OBJECTIVES: There was a lack of in-depth understanding of the relationship between health literacy and depressive symptoms, and it was also unclear whether family health and perceived social support mediated this relatio...
OBJECTIVES: There was a lack of in-depth understanding of the relationship between health literacy and depressive symptoms, and it was also unclear whether family health and perceived social support mediated this relationship and were negatively associated with the presence of depressive symptoms in older adults. This study aimed to explore the relationship between health literacy and depressive symptoms among older adults, while assessing the mediating roles of family health and perceived social support. METHODS: A cross-sectional study was conducted in China in 2021, involving 1147 participants aged 60 and older recruited using a nationwide multistage random sampling method. Ordered logistic regression and generalized additive models were employed to examine the association between health literacy and depressive symptoms, and the mediating effects of family health and perceived social support were assessed using mediation analysis with non-parametric bootstrapping. The Karlson-Holm-Breen (KHB) method was used to evaluate combined indirect associations, and subgroup mediation analyses were performed for "young-old" (65-74 years) and "old-old" (≥ 75 years) participants. RESULTS: Higher health literacy was associated with a lower likelihood of depressive symptoms (OR = 0.98, 95% CI: 0.97-0.99). Mediation analysis showed that the total indirect effect was thus estimated at -0.01, and the total effect of health literacy on depressive symptoms was approximately -0.03. The negative association between health literacy and depressive symptoms, as well as the mediating role of family health, remained significant in both the 65-74 and ≥ 75 age groups. However, the mediating effect of perceived social support was significant only in the 65-74 age group. CONCLUSIONS: Health literacy is negatively associated with depressive symptoms in Chinese older adults and could be considered as a focus for intervention strategies. Enhancing health literacy may improve family health and perceived social support, and potentially lower depressive symptoms.
Meaningful Moments of Connection: How People Affected by Dementia and Their Carers Living at Home Understand, Interpret and Experience Everyday Aesthetics.
Fox S, Thompson J, Keady J
Int J Geriatr Psychiatry · 2025 Aug · PMID 40754722 · Full text
OBJECTIVES: This study considers how people affected by dementia living in their own homes understand and interpret everyday aesthetics and what relevance this holds in their everyday lives. METHODS: Nine households, com...
OBJECTIVES: This study considers how people affected by dementia living in their own homes understand and interpret everyday aesthetics and what relevance this holds in their everyday lives. METHODS: Nine households, comprising ten family carers and seven people living with dementia, shared their self-identified meaningful moments of connection reflective of their personal understanding and interpretation of everyday aesthetics. Data collection involved a range of creative and self-initiated approaches, including scrapbooking, photography, and elicitation interviews. Data were analysed using reflective thematic analysis. RESULTS: Six discrete but interlinked themes were identified, namely: (1) Connection with others; (2) Connection with materiality; (3) Connection with self-image; (4) Connection with pride and societal value; (5) Connection with enjoyable activities; and (6) Connection with the lived environment, that revealed how people affected by dementia self-identify everyday aesthetic experiences in their daily lives. DISCUSSION: Our findings show these self-identified experiences span multiple physical and psychological domains of everyday life, each of which acts to support the personhood and identity of the person living with dementia. We suggest that development of a new model of care based on everyday aesthetic needs and informed by people affected by dementia, might bridge the gap between theory and practice in person-centred care. Going forward, developing care practices and support systems which focus on identifying and fulfilling the aesthetic needs of people living with dementia may offer a novel way to enhancing independence and personal well-being.
Correction to "The Influence of a Dementia Diagnosis on Clinical Decision-Making in Dysphagia Management".
Int J Geriatr Psychiatry · 2025 Aug · PMID 40751328 · Full text
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Dose-Response Association of Handgrip Strength With Alzheimer's Disease: A Longitudinal Study Involving 85,979 Adults.
Núñez-Cortés R, Calatayud J, Calonge-Pascual S … +4 more , Andersen LL, Bláfoss R, López-Gil JF, López-Bueno R
Int J Geriatr Psychiatry · 2025 Aug · PMID 40736876 · Full text
OBJECTIVE: To investigate the dose-response relationship between handgrip strength and incidence of Alzheimer's disease (AD) in middle-aged and older adults. DESIGN: Longitudinal study. PATIENTS AND METHODS: A longitudin...
OBJECTIVE: To investigate the dose-response relationship between handgrip strength and incidence of Alzheimer's disease (AD) in middle-aged and older adults. DESIGN: Longitudinal study. PATIENTS AND METHODS: A longitudinal study was conducted in people over 50 years old in 27 European countries and Israel. Data were collected from waves 1, 2, 4, 5, 6, 7 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) between February 2004 and January 2021. Handgrip strength was measured with a hand dynamometer. AD was self-reported based on previous diagnosis. Dose-response associations were assessed by restricted cubic splines. RESULTS: A total of 85,979 (55.8% female) participants were followed for a median of 9.3 years. Over this time, 3324 (3.9%) developed AD. In the adjusted model, for participants < 65 years, those in the middle third of handgrip strength showed a lower risk of AD compared to the lower third (HR = 0.63, 95% CI: 0.47-0.84), as well as participants in the upper third (HR = 0.63, 95% CI: 0.47-0.85). The spline model determined that the minimum and optimal doses of handgrip strength for a significant reduction in the risk of AD for those aged < 65 years were 54 kg (HR = 0.99; 95% CI: 0.08-0.99) and 56 kg (HR = 0.27; 95% CI: 0.08-0.91), respectively. Among those aged ≥ 65 years, the minimum and optimal doses were 31 kg (HR = 0.69; 95% CI: 0.48-0.99) and 49 kg (HR = 0.57; 95% CI: 0.43-0.76), respectively. CONCLUSION: Higher levels of handgrip strength showed a lower risk of developing AD, among adults aged 50 years and over. However, the dose-response relationship is limited to specific ranges according to age group. We identified a range between 54 and 56 kg years and a range between 31 and 49 kg as suitable to prevent AD in adults aged 50-64 and ≥ 65 years, respectively. Routine assessment of hand grip strength can help healthcare professionals identify people at increased risk of AD. Strength-based interventions could provide a practical strategy to support cognitive health and reduce the risk of dementia in clinical practice.
Associations of Plasma p-tau181 With Age, Adjusted for Kidney Function and Sociodemographic Factors.
Hazan J, Liu KY, Zetterberg H … +3 more , Fox N, Howard R, with ADNI
Int J Geriatr Psychiatry · 2025 Aug · PMID 40729462 · Full text
INTRODUCTION: Plasma phosphorylated tau (p-tau) levels, such as p-tau181, are elevated in Alzheimer's disease compared to cognitively unimpaired individuals. They represent potential candidate blood biomarkers for use in...
INTRODUCTION: Plasma phosphorylated tau (p-tau) levels, such as p-tau181, are elevated in Alzheimer's disease compared to cognitively unimpaired individuals. They represent potential candidate blood biomarkers for use in memory services where CSF examinations are not available. However, the effect of age on plasma p-tau levels remains undetermined. Limited studies have investigated the association between age and plasma p-tau thus far, and fewer still have differentiated levels by brain amyloid pathology. Characterising these associations and determining if this is influenced by sociodemographic factors or medical comorbidities is important for establishing blood biomarker reference ranges. METHODS: Using ADNI data, we analysed 860 observations (581 participants; age range: 55-95 years; 56.0% male; 93.6% White). Linear mixed models (LMMs) estimated fixed effects of age, creatinine, baseline BMI, sex, ethnicity, and group (Control vs. AD) on plasma p-tau181 concentration, with a random intercept for participant ID. Separate LMMs assessed covariate effects and interactions with group status. RESULTS: Analysis of ADNI data revealed a significant positive association between p-tau181 levels, group status, and creatinine in the fully adjusted LLM. Group status may have obscured the total effect of age on p-tau181, as its removal from the model resulted in a significant age effect. Single-variable models showed the positive association between either age, or creatinine and p-tau181 levels did not differ between control and AD groups. There was a significant negative association between BMI and plasma p-tau, which was stronger in AD versus control groups. CONCLUSIONS: This study provides insights into the factors that may influence plasma p-tau181 levels. These findings underscore the need to account for clinical and demographic factors when interpreting p-tau181. Future research should validate these associations in diverse populations and explore underlying mechanisms.
Time to Diagnosis in Dementia: A Systematic Review With Meta-Analysis.
Kusoro O, Roche M, Del-Pino-Casado R … +2 more , Leung P, Orgeta V
Int J Geriatr Psychiatry · 2025 Jul · PMID 40716451 · Full text
Timely dementia diagnosis is a global priority, reflected in most national and regional policies and plans. Nevertheless, there are currently no robust estimates of the average time to diagnosis (TTD) and factors influen...
Timely dementia diagnosis is a global priority, reflected in most national and regional policies and plans. Nevertheless, there are currently no robust estimates of the average time to diagnosis (TTD) and factors influencing diagnostic intervals. This article presents the first systematic review of quantitative studies on TTD in dementia and the factors associated with its duration. We systematically searched EMBASE, Psych INFO, MEDLINE, and CINAHL databases for relevant studies published up to December 2024. We defined TTD as the interval between symptom onset (rated by family carers or patients using interviews or medical records) to final diagnosis. Risk of bias was assessed using the Reporting studies on time to diagnosis tool. We included 13 studies reporting data on 30,257 participants, with age at onset ranging between 54 and 93 years. Meta-analysis pooling 10 studies showed that average mean TTD across all types of dementia was 3.5 years [confidence interval (CI): 2.7-4.3; moderate quality evidence]. Analyses of six studies showed that TTD in young onset dementia was 4.1 years (CI: 3.4-4.9; moderate quality evidence). Although the factors influencing TTD were inconsistent, a younger age at onset and having frontotemporal dementia were consistently associated with a longer interval to diagnosis. TTD in dementia remains long, and specific healthcare strategies are urgently needed to improve it. Increasing the evidence base and developing interventions to reduce TTD should be a future research priority. Specialist services are likely to be key in improving TTD in young-onset dementia.
The Moderating Role of Dementia-Related Fear in the Relationship Between Perceived Cognitive Decline and Motivation for Dementia Risk Reduction Behaviors in Community-Dwelling Middle-Aged and Older Adults.
Lin R, Bartels SL, Batalik L … +1 more , Su JJ
Int J Geriatr Psychiatry · 2025 Jul · PMID 40714981 · Publisher ↗
OBJECTIVE: With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing e...
OBJECTIVE: With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing effective policy strategies for dementia risk reduction. This study explores the moderating role of dementia-related fear on the relationship between perceived cognitive decline and engagement in dementia risk reduction behaviors. METHODS: A cross-sectional study was conducted among 200 Chinese community-dwelling middle-aged and older adults. Hierarchical regression and simple slope analysis were used to assess the moderating effect of dementia-related fear on the relationship between perceived cognitive decline and motivation to engage in dementia risk reduction behaviors. RESULTS: A significant correlation was found between perceived cognitive decline and increased motivation to engage in dementia risk reduction behaviors (r = 0.44). Dementia-related fear acted as a significant moderator; motivation was positively associated with low to moderate levels of fear, whereas this association diminished and became non-significant at higher levels of fear. CONCLUSIONS: The findings suggest that while lower levels of dementia-related fear may be linked to increased motivation for engaging in risk reduction behaviors, elevated levels of fear do not appear to support such engagement. Rather than emphasizing the negative impacts of dementia, public health strategies should empower individuals with actionable messages to engage in dementia risk reduction behaviors.
The Cost-Effectiveness of an Intervention to Preserve Independence in People With Dementia (Vs. No Intervention): A Decision-Analytic (Markov) Model Analysis.
Paterson L, Elliott RA, Constantinidou F … +10 more , David R, Dawes P, Frison E, Hann M, Hussain H, Leroi I, Politis AM, Thodi C, Camacho EM, SENSE‐Cog Study Team
Int J Geriatr Psychiatry · 2025 Jul · PMID 40701932 · Full text
OBJECTIVES: Interventions that enable people with dementia to retain some independence in activities of daily living (ADL) may delay transitions into residential care and offset sharp reductions in quality of life (QoL)....
OBJECTIVES: Interventions that enable people with dementia to retain some independence in activities of daily living (ADL) may delay transitions into residential care and offset sharp reductions in quality of life (QoL). The aim of this study was to estimate how effective a hypothetical intervention needs to be at preserving independence in home-dwelling people with dementia, to be cost-effective. METHODS: A decision-analytic model was constructed to compare costs and outcomes of a cohort of people with dementia in the United Kingdom and European Union over a 10-year period. At model entry, the cohort was distributed across low, moderate, or high levels of dependence. The impact of a hypothetical intervention that preserves independence was evaluated by reducing the proportion of people entering the model with moderate and high dependence. The model included costs for the intervention and health and social care resource use. Secondary analysis included estimated costs of informal care. Health benefit was measured as quality-adjusted life-years (QALYs). RESULTS: The cost of the intervention was £570/person. At this cost, an intervention that resulted in 7.5% of the sample entering the model in a lower level of dependence (compared with no intervention) was likely to be cost-effective (£8690/QALY). An intervention costing £250/person would only need a 2.5% effect and one costing £1000/person would need to have a 10% effect to be potentially cost-effective. Including informal care costs increased the size of the effect required for the intervention to be cost-effective because more of the care provided at lower levels of dependence is informal. CONCLUSIONS: Preserving independence in people with dementia may be a cost-effective way to help them live well for longer. Our results provide a guide on costs and required effects for those developing interventions to preserve independence in people with dementia.
Criminal Trajectories Across the Dementia Timeline-A Nationwide Finnish Register Study.
Ginters M, Talaslahti T, Kautiainen H … +6 more , Vataja R, Palm A, Elonheimo H, Suvisaari J, Lindberg N, Koponen H
Int J Geriatr Psychiatry · 2025 Jul · PMID 40671191 · Full text
OBJECTIVES: The aim of this longitudinal register study was to examine the crime counts, crime incidence and timing of criminal activity in relation to the diagnosis of Alzheimer's disease (AD), frontotemporal dementia (...
OBJECTIVES: The aim of this longitudinal register study was to examine the crime counts, crime incidence and timing of criminal activity in relation to the diagnosis of Alzheimer's disease (AD), frontotemporal dementia (FTD) and Lewy body dementias (LBD). The objective was to analyse the associated risk factors and risk relations among the offender categories. METHODS: We collected register data from Finnish nationwide registers (Finnish Care Register for Health Care and Finnish National Police Register) between 1998 and 2015. Mortality statistics were collected until the end of 2018 (Statistics Finland). Our study included a total of 92,189 patients, of whom 80,540 had AD, 1059 had FTD, and 10,590 had LBD. We examined the crimes committed by the study population before and after diagnosis. In the follow-up, we primarily focussed on the 4-year period and secondarily on the 10-year period after diagnosis. First, we measured the post-diagnostic crime rates in patients who had committed crimes before diagnosis and in those who had not; we also calculated the incidence rate ratio (IRR) of post-diagnosis crimes in these groups. Second, we calculated the cumulative incidence of first post-diagnoses crimes and investigated the risk of the first post-diagnoses crime by calculating the adjusted subhazard ratio (sHR) in pre-diagnosis offenders and non-offenders. RESULTS: Most of the study population did not exhibit criminal behaviour before or after diagnosis. However, individuals who had engaged in criminal behaviour before diagnosis also showed a higher incidence of criminal activity in the 4-year period after diagnosis compared to patients with no criminal history prior to diagnosis. They also showed a steep increase in the cumulative incidence of the first post-diagnosis crime, particularly in the first 2 years after diagnosis. The age- and sex-adjusted sHR for the occurrence of the first post-diagnosis crime was 4.42 (95% confidence interval: 3.83-5.11) in AD, 4.36 (2.15-8.83) in FTD and 4.87 (3.88-6.12) in LBD in pre-diagnosis offenders versus non-offenders. CONCLUSIONS: Individuals with a history of criminal behaviour before diagnosis of a neurocognitive disorder showed higher rates and a higher risk of future criminal activity. The cumulative incidence rose steeply during the first 2 years after diagnosis and after more gradually. Criminal activity closer to the time of diagnosis, especially 1 year prior, was the strongest predictor in increasing the risk of future criminal behaviour.
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