International Journal Of Geriatric Psychiatry[JOURNAL]
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200 papers
A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care.
Nguyen HXT, Hyde Z, Smith K … +18 more , Malay R, Flicker L, Watson R, Radford K, Russell S, Quigley R, Sagigi B, Strivens E, Withall A, Timbery A, Donovan T, Draper B, Delbaere K, Lavrencic L, Cumming R, Hughson JA, McNamara BJ, LoGiudice D
Int J Geriatr Psychiatry · 2025 Jul · PMID 40660785 · Full text
INTRODUCTION: Dementia is prevalent within Aboriginal and Torres Strait Islander communities but clients attending primary care often remain undiagnosed. This project aimed to develop a rapid dementia screen for primary...
INTRODUCTION: Dementia is prevalent within Aboriginal and Torres Strait Islander communities but clients attending primary care often remain undiagnosed. This project aimed to develop a rapid dementia screen for primary care. METHODS: Logistic regression was used to identify candidate items from the Kimberley Indigenous Cognitive Assessment (KICA-Cog). The psychometric properties of different scales were assessed using receiver operating characteristic curve analysis and validated in a separate cohort. RESULTS: Four items in the KICA-Cog demonstrated high sensitivity (82.6%), specificity (83.2%) and area under the curve (AUC = 0.90; 95% CI: 0.87-0.94) for dementia at a cut-off point of 7/8 out of 10. This scale has favourable psychometrics (sensitivity 87.5%, specificity 80.9%, AUC = 0.92; 95% CI: 0.85-0.98) when validated in separate cohort. DISCUSSION: The proposed prototype tool, ready for community piloting and validation, may be useful in primary care to enable rapid cognitive screening as part of routine health care.
Barriers and Facilitators to Implementing Cognitive Stimulation and Reminiscence Therapy for Dementia in Care Homes: Systematic Review.
Fisher E, Chick I, Fossey J … +1 more , Spector A
Int J Geriatr Psychiatry · 2025 Jul · PMID 40650918 · Full text
OBJECTIVES: Psychosocial interventions play a vital role in addressing the complex needs of people with dementia in care homes. Cognitive stimulation and reminiscence therapy are recommended by the UK National Institute...
OBJECTIVES: Psychosocial interventions play a vital role in addressing the complex needs of people with dementia in care homes. Cognitive stimulation and reminiscence therapy are recommended by the UK National Institute for Health and Care Excellence to support the cognition, independence, and wellbeing of people with dementia, and crucially, they can be delivered by care home staff or non-specialist interventionists. This review aims to explore factors that influence the implementation of cognitive stimulation and reminiscence therapy for people with dementia delivered by staff in care homes. METHODS: Ten electronic databases were searched between 2000 and April 2024. Two reviewers systematically appraised the studies for inclusion using pre-specified criteria and their quality using the Critical Appraisal Skills Programme (CASP) and Mixed Methods Appraisal Tool (MMAT) checklists. Data was analysed thematically using a deductive approach based on the updated Consolidated Framework for Implementation Research (CFIR), and findings were synthesised narratively. RESULTS: Nine studies were included; three focussed on reminiscence therapy, and six on cognitive stimulation. All interventions were delivered in care homes by care home staff. Many studies were excluded because a research team member delivered the intervention. Overall, the quality of the studies was low. Key facilitators to implementation were the availability of standardised manuals or resources, the adaptability of interventions, and staff training and support. Barriers included a lack of staff time and availability and a lack of perceived support from care home management. Most studies collected quantitative outcomes, and a minority collected qualitative information about implementation experiences and perceptions of the intervention. No studies collected qualitative data from people with dementia or their carers. CONCLUSIONS: The review highlights the field's reliance on research staff to deliver interventions rather than training and involving care home staff in evaluating interventions. Additionally, there is a lack of qualitative data from people with dementia and their families regarding their views, preferences, and experiences related to participating in psychosocial interventions in care homes. There is a pressing need for high-quality evidence on the implementation of interventions for dementia, which involves collaboration, consultation and co-design with those who will deliver the intervention routinely and the people with dementia who will receive the intervention. TRIAL REGISTRATION: CRD42022313337.
The Relationship Between Facial Emotion Recognition and Executive Function Varies Depending on the Level of Cognitive Impairment.
Brandt M, Oliveira F, Belfort T … +6 more , Nogueira M, Baptista MA, Lacerda I, de Lucena AT, Rangel R, Dourado MCN
Int J Geriatr Psychiatry · 2025 Jul · PMID 40634792 · Publisher ↗
BACKGROUND: Cognitive domains related to attention and executive functions (a set of cognitive processes that regulate, control, and manage other cognitive abilities) seem to influence the recognition of facial expressio...
BACKGROUND: Cognitive domains related to attention and executive functions (a set of cognitive processes that regulate, control, and manage other cognitive abilities) seem to influence the recognition of facial expressions in people with Alzheimer's disease (AD). PURPOSE: We examined the relationship between facial expression recognition, global cognition and executive function in people with AD according to their cognitive level. RESEARCH DESIGN: In a cross-sectional design, we included 130 participants with AD divided into three groups based on their Mini-Mental State Examination (MMSE) scores: MMSE 1 (scores 23-28), MMSE 2 (scores 17-22), and MMSE 3 (scores 11-16). Facial expression recognition ability was analyzed using the Faces Test. Executive function was analyzed using the Trail Making Test (TMT), the Verbal Fluency Test (VFT), the Semantic Fluency Test (SFT), the Digit Span Forward (DSF) and Backward (DSB) tests, and the Clock Drawing Test (CDT). RESULTS: In MMSE 1 group difficulties in divided attention and cognitive flexibility impacted the accuracy of facial expression recognition. In the MMSE 2 group, facial expression recognition was related to impairment in working memory. In the MMSE 3 group, the impact on facial expression recognition was directly related to visuoconstructive abilities. CONCLUSIONS: We observed that the executive resources involved in each evaluated group differed in terms of facial recognition task performance efficacy. Interventions at stimulating executive and visuoconstructive abilities in people with AD may contribute to better preservation of facial expression recognition.
Knowledge and Beliefs About Medical and Non-Medical Interventions to Control Alzheimer's Disease Among Latinos in New York City.
Tran E, Cabán M, Meng A … +3 more , Wetmore JB, Ottman R, Siegel K
Int J Geriatr Psychiatry · 2025 Jul · PMID 40627435 · Full text
OBJECTIVES: Latinos experience significant health disparities for Alzheimer's disease (AD) with an increased likelihood in developing the disease relative to non-Latino Whites. Our study sought to examine Latinos' belief...
OBJECTIVES: Latinos experience significant health disparities for Alzheimer's disease (AD) with an increased likelihood in developing the disease relative to non-Latino Whites. Our study sought to examine Latinos' beliefs about controlling the symptoms and progression of AD to identify gaps in community knowledge and improve understanding of culturally based perceptions of health and illness. METHODS: We conducted in-depth, semi-structured interviews in English or Spanish with 216 Latinos aged 40-60 years (average age 53 years) living in the neighborhoods of northern Manhattan. We asked them whether they believed there were interventions that could help control AD. The data was analyzed using content analysis. RESULTS: Most participants viewed medications as important in the management of AD, though they had limited specific knowledge about existing medications for AD. Some participants thought herbal and nutritional supplements could have some benefits. Many believed activities for mental stimulation could help enhance cognitive functioning. A few suggested that a healthy diet and exercise could help slow the progression of AD. Some participants believed that emotional wellness and degree of support influenced AD progression. CONCLUSIONS: Limited knowledge of available medications and evidence-based non-medical approaches to control AD may adversely impact help-seeking behavior and use of effective management strategies among those with AD. Future interventions should strive to expand knowledge about ways to effectively manage and treat AD in Latino communities. TRIAL REGISTRATION: The ClinicalTrials.gov ID is NCT04471779. The date registered was July 15, 2020.
Cost of Psychiatric Inpatient Treatment for Dementia in Switzerland: A Case-Level Analysis of Billing Data.
Bleibtreu E, Riese F
Int J Geriatr Psychiatry · 2025 Jul · PMID 40616254 · Full text
OBJECTIVE: The objective of this study was to investigate the cost of care for patients with a primary diagnosis of dementia in Swiss hospitals under the new TARPSY reimbursement system. METHODS: We used a dataset of the...
OBJECTIVE: The objective of this study was to investigate the cost of care for patients with a primary diagnosis of dementia in Swiss hospitals under the new TARPSY reimbursement system. METHODS: We used a dataset of the Swiss hospital reimbursement system TARPSY from 2016 to 2019, including all relevant remuneration variables at the patient level, to investigate hospital costs. Costs were analyzed by geographic location and hospital type. Homogeneity coefficients were used to analyze case cost homogeneity. RESULTS: We identified 7090 cases in the TARPSY database who were treated in Swiss hospitals under the primary diagnosis of dementia from 2016 to 2019. Of these, 6747 cases were included in our analysis. The total case costs and daily costs increased from 2016 to 2019, whereas the length of stay decreased. The average total case cost in 2019 was CHF 34,917 (σ = 32,926), corresponding to a daily cost of CHF 946 (σ = 373.44). Patients were treated for an average of 39.7 (σ = 32.40) days. In 2019, the total costs billed according to TARPSY for 57,939 days of hospital care for dementia as the primary diagnosis were CHF 51.3 million. The case costs differed by region and hospital type. Overall, cost homogeneity for total case cost as a proxy for the quality of the cost calculation was "satisfactory, sufficient" and did not show a clear trend towards improvement during the introduction of TARPSY. DISCUSSION: Our analysis provides reliable, case-level cost data for dementia hospital treatment in Switzerland. The total cost of dementia treatment in psychiatric hospitals appears to be much lower than previous estimates had indicated. When correcting for changes in accounting practices, total case costs only increased modestly from 2016 to 2019.
An International Validation of the Stigma Impact Scale With People With Dementia.
Bhatt J, Evans-Lacko S, Scior K … +1 more , Saunders R
Int J Geriatr Psychiatry · 2025 Jul · PMID 40611436 · Full text
OBJECTIVE: A robust psychometric instrument is imperative to measure the devastating impact of self-stigma in dementia to adequately inform policy and practice. Our objective was to evaluate the psychometric properties o...
OBJECTIVE: A robust psychometric instrument is imperative to measure the devastating impact of self-stigma in dementia to adequately inform policy and practice. Our objective was to evaluate the psychometric properties of the Stigma Impact Scale in a global sample of people with dementia. METHOD: Data were analysed from the World Alzheimer Report including 710 participants in 42 countries who completed the SIS. Detailed psychometric analyses of the SIS included estimating reliability, convergent validity with the Warwick-Edinburgh mental Well-being Scale (WEMWBS) and the Dementia Quality of Life instrument (DQoL), the factor structure of the measure (through both exploratory and confirmatory factor analysis). RESULTS: The SIS and its subscales had 'good' to 'excellent' internal consistency (Cronbach's Alpha: 0.883-0.943). However, convergent validity correlations were not in the predicted direction; no significant correlations were noted between the SIS and the WEMWBS and DQoL. Factor analysis suggested marginal improvements in global fit indices for the observed model compared to the theoretical model, though none met the thresholds for acceptable fit. The final proposed model had three factors: rejection and secrecy, loneliness and belonging and perceived social isolation. Most SIS items were strongly endorsed by participants. CONCLUSION: The SIS is the most robustly tested instrument measuring self-stigma in dementia. The SIS has good to excellent reliability and relevance to the target population, however future work is required to improve the factor structure of the scale. Further the results of the validity testing pose a number of theoretical and empirical questions for future research.
Utilization Patterns and Clinical Factors Associated With Hospitalization in Early-Stage Dementia With Lewy Bodies.
Wyman-Chick KA, Chrenka EAB, Kane JPM … +5 more , Barrett MJ, Miller MJ, Schousboe JT, Werner AM, Rossom RC
Int J Geriatr Psychiatry · 2025 Jul · PMID 40611368 · Full text
OBJECTIVES: Characterize patterns of hospitalization and emergency department (ED) visits in early-stage dementia with Lewy bodies (DLB). METHODS: We analyzed electronic health records and claims data from a U.S. healthc...
OBJECTIVES: Characterize patterns of hospitalization and emergency department (ED) visits in early-stage dementia with Lewy bodies (DLB). METHODS: We analyzed electronic health records and claims data from a U.S. healthcare system up to 3 years before/after initial diagnosis of DLB (n = 175), Alzheimer's disease (AD, n = 2478), or vascular dementia (VD, n = 513). Controls were randomly matched 3:1 with the DLB group on sex/age (n = 525). Generalized linear models were used to compare rates and types of utilization between diagnosis group with adjustment for patient characteristics. RESULTS: Patients with DLB had significantly greater rates of hospitalization and ED visits compared to patients with AD (Incidence Rate Ratio (IRR): 1.46, 95% CI 1.24, 1.73, IRR: 1.46, 95% CI 1.29, 1.77, respectively) and controls (IRR: 1.77, 95% CI 1.46, 2.14, IRR: 2.21, 95% CI 1.82, 2.69, respectively) and ED visits compared to those with VD (IRR: 1.24, 95% CI 1.03, 1.50). Patients with DLB were over 50% more likely to have a hospitalization associated with falls compared to those with AD and VD (OR: 1.75, 95% CI 1.16, 2.62 OR: 1.56, 95% CI: 1.01, 2.48, respectively). Compared to patients with AD, DLB patients were found to have 2.9-time higher likelihood of experiencing at least one hospitalization (Odds Ratio: 2.89. 95% CI: 1.17, 6.45). CONCLUSIONS: Patients with DLB were substantially more likely to utilize ED services than patients with AD, VD, or controls, and more likely to experience hospitalizations compared to AD and control groups. Fall prevention and psychiatric treatment may be particularly important in reducing hospitalizations in early-stage DLB.
The Combination of Physical Activity and Cognitive Games is Associated With Better Cognitive Performance and Gray Matter Volume in Older Adults.
Rattray B, Northey JM, Pryor DJ … +3 more , Bielak AAM, Anstey KJ, Cherbuin N
Int J Geriatr Psychiatry · 2025 Jul · PMID 40610392 · Full text
OBJECTIVES: Investigate whether engaging in cognitive and physical activity is associated with cognitive performance and gray matter volume. Specifically, this study investigated the role of both activity types performed...
OBJECTIVES: Investigate whether engaging in cognitive and physical activity is associated with cognitive performance and gray matter volume. Specifically, this study investigated the role of both activity types performed in close temporal proximity to each other. METHODS: Cognitively healthy older adults (n = 155; 73-78 years; 45% female) enrolled in the PATH Through Life study with valid cognitive, MRI and physical activity (PA) measures were included in the study. PA was objectively measured with a SenseWear Armband for 7 days. PA and cognitive engagement were self-reported through a 1-week activity diary. The number of 3-h periods in which ≥ 15 min of objective moderately vigorous physical activity (MVPA) > 3METs, cognitive activity, or both occurred, were assessed. Cognitive game activity periods were also coded. Associations between activity engagement and outcome measures were assessed with hierarchical regression models while controlling for age, sex, and education. RESULTS: For cognitive engagement, greater activity diversity was associated with better symbol digits modalities test performance (SDMT), while a greater number of cognitive activity periods were associated with better SDMT, and digit span backward performance. Greater cognitive game periods improved model fit for several cognitive outcomes and right hippocampal volume. MVPA periods were not associated with any outcome. The number of periods in which cognitive activity and MVPA were present together was associated with better immediate recall. Periods in which cognitive games and MVPA co-existed were associated with cognitive and volumetric outcomes. DISCUSSION: These findings support the notion that both cognitive and physical activity are positively related to brain health. They highlight the potential importance of performing both activity types in close temporal proximity to support the aging brain.
Dementia Education and Training for the Multidisciplinary Student Healthcare Workforce: A Systematic Review.
Muralidhar M, Delray S, Cooper C … +7 more , Zabihi S, Banerjee S, Giebel C, Dening KH, Birks Y, Kenten C, Walpert M
Int J Geriatr Psychiatry · 2025 Jul · PMID 40595031 · Full text
OBJECTIVES: To systematically review research evidence on the effectiveness of dementia education and training for health and social care students. METHODS: We searched electronic databases for primary research studies (...
OBJECTIVES: To systematically review research evidence on the effectiveness of dementia education and training for health and social care students. METHODS: We searched electronic databases for primary research studies (published between 2015 and 2024), evaluating dementia training for health and social care students. We assessed risk of bias using the Mixed Methods Appraisal Tool, prioritising studies scoring 4+ (higher quality) that reported significant findings on primary outcomes from controlled intervention trials. We reported outcomes using Kirkpatrick's framework. We consulted professional stakeholders in a focus group regarding how findings might inform practice. RESULTS: 17/35 included studies were rated 4+ on the MMAT; only one met our criteria for priority evidence. An experiential programme for medical students, 'Time for Dementia', which combined skill-learning and reflective sessions with visits to people with dementia, was found to improve Kirkpatrick Level 2 (learning) outcomes, attitudes and knowledge over 2 years of participation; this was supported from findings from qualitative studies. Asynchronous, self-directed learning did not improve learning outcomes, relative to standard training. Though almost all training programmes incorporated lived experience, no patient reported outcomes were used to evaluate the impact of training. Nine focus group attendees agreed that the evidence reflected their experiences that consistent support, combined with skills-based and reflective sessions, optimised student learning from initial patient-focused encounters. CONCLUSIONS: Effective interventions increased confidence and enjoyment of dementia care encounters, and increased interest in careers in dementia specialities. Mandating evidence-based dementia skills programmes across specialities could ensure that students learn the skills and competencies required to be part of an effective future workforce and drive important improvements in care quality. Evidence based approaches to enhancing dementia education in training could include experiential learning modules in early years of medical school training and allied health and care professional training, using evidence-based approaches to teach communication skills and other essential dementia care skills within clinical placements, and providing dedicated supervision to support their implementation. Future research could usefully consider patient perspectives in determining the impact of educational programmes.
Understanding Interactions Between Life Satisfaction and Genetic Predisposition on Risk of Alzheimer's Disease up to 14 Years Later: Findings From the UK Biobank.
John A, Desai R, Bartres-Faz D … +8 more , Cadar D, Gaysina D, Gonzalez AS, Marchant NL, Willroth E, Richards M, Saunders R, Stott J
Int J Geriatr Psychiatry · 2025 Jul · PMID 40581914 · Full text
OBJECTIVES: Previous research investigating associations between life satisfaction and risk of Alzheimer's disease (AD) has been mixed. This association may differ depending on genetic risk for AD. The aim of this study...
OBJECTIVES: Previous research investigating associations between life satisfaction and risk of Alzheimer's disease (AD) has been mixed. This association may differ depending on genetic risk for AD. The aim of this study was to test interactions between life satisfaction and genetic predisposition on the future incidence of AD diagnosis. METHODS: Data were used from 66,668 participants aged 60+ from the UK Biobank. Participants attended an assessment centre at baseline, and data were linked to hospital admissions data and death records up to 14 years later. Cox proportional hazards models were used to test interactions between life satisfaction and a polygenic risk score (PRS) for AD on incident AD diagnosis. Models were also run stratified by genetic risk for AD. RESULTS: Models adjusted for age, sex, ethnicity, deprivation, education, and depression showed main effects of both life satisfaction (OR = 0.78, 95% CI = 0.68-0.90, p = 0.001) and the AD PRS (OR = 2.26, 95% CI = 2.12-2.40, p < 0.001) on incident AD. There was a significant interaction between the two (OR = 1.21, 95% CI = 1.09-1.35, p < 0.001). Stratified models showed that life satisfaction was associated with lower incident AD in the low, but not in the high genetic risk group (low: OR = 0.56, 95% CI = 0.42-0.75, p < 0.001; high: OR = 0.88, 95% CI = 0.75-1.04, p = 0.13). CONCLUSIONS: Results show that genetic risk for AD modified the relationship between life satisfaction and the risk of AD. This suggests that genetic risk may weaken associations between life satisfaction and AD risk. The findings clarify the mixed results of previous research on this topic and may contribute to more tailored approaches to the prevention of AD in the future.
Real-World Effectiveness and Tolerability of Prolonged Intermittent Theta Burst Stimulation in Older Adults With Treatment-Resistant Depression.
Cheng CM, Jeng JS, Chen MH … +7 more , Chang WH, Liu MN, Lin WC, Tsai SJ, Bai YM, Su TP, Li CT
Int J Geriatr Psychiatry · 2025 Jun · PMID 40509535 · Publisher ↗
BACKGROUND: Older treatment-resistant depression (TRD) patients with transportation concerns may struggle to complete 30-36 repetitive transcranial magnetic stimulation (rTMS) sessions. Uninsured rTMS medical costs may b...
BACKGROUND: Older treatment-resistant depression (TRD) patients with transportation concerns may struggle to complete 30-36 repetitive transcranial magnetic stimulation (rTMS) sessions. Uninsured rTMS medical costs may be another issue in certain nations. 2-Week prolonged intermittent theta-burst stimulation (iTBS1800) to the left-sided dorsolateral prefrontal cortex (DLPFC) demonstrated similar antidepressant efficacy to standard rTMS or iTBS in adults with TRD. However, no study has yet confirmed the antidepressant effect of iTBS1800 in geriatric TRD patients. METHODS: We analyzed chart data from May 2018 to September 2022 to identify TRD patients aged ≥ 50 years who received self-pay TMS treatments at a single medical center in Taiwan. All patients had major depressive disorder and had failed at least one prior antidepressant treatment. The Hamilton Depression Rating Scale (HDRS-17) was evaluated before and after TMS stimulation. RESULTS: 97 older patients with TRD (mean ± SD, age, 62.81 ± 7.89; 69.1%% female) was identified. Approximately 70% of patients reported anxious depression and prior antidepressant failures (≥ 3). The average number of self-pay TMS sessions was 11.71 ± 3.15) (range:10-30). Patients receiving iTBS1800 demonstrated a greatly higher remission rate than those receiving 10 Hz rTMS (29.5% vs 13.2%, respectively, p = 0.048), particularly in patients with mild and moderate depression. Age was not a clinically significant determinant of remission following TMS therapy. CONCLUSION: Left-sided DLPFC iTBS1800 may be a feasible option for treating older patients with TRD due to its favorable effect and shorter treatment period, which may be ideal for patients with transportation, budgetary and vacation restrictions. More study is needed to compare the antidepressant efficacy of iTBS1800 to other TMS protocols in older patients with TRD.
Neuropsychiatric Symptoms and White Matter Hyperintensities in Older Cognitively Unimpaired Men Versus Women.
Liampas I, Tsirelis D, Demiri S … +7 more , Siokas V, Tsika A, Zoupa E, Stamati P, Messinis L, Nasios G, Dardiotis E
Int J Geriatr Psychiatry · 2025 Jun · PMID 40495289 · Full text
OBJECTIVES: We aimed to examine association patterns of white matter hyperintensities (WMH) with neuropsychiatric symptoms (NPS) in men versus women. METHODS: We performed a cross-sectional analysis of data acquired from...
OBJECTIVES: We aimed to examine association patterns of white matter hyperintensities (WMH) with neuropsychiatric symptoms (NPS) in men versus women. METHODS: We performed a cross-sectional analysis of data acquired from the National Alzheimer's Coordinating Center database. Cognitively unimpaired participants aged ≥ 50 years with data on WMH severity were studied. Using Cardiovascular Health Study scores, WMH were coded as no to mild (score: 0-4), moderate (score: 5-6) or extensive (score: 7-8). NPS were quantified on the Neuropsychiatric Inventory Questionnaire. For the purposes of the main analysis, participants were dichotomized for presence of each NPS (0: absent; 1: present). Adjusted binary logistic regression models estimated the odds of having each of 12 NPS by sex-WMH status. To confirm the validity of our findings, the correlations between NPS severity and WMH burden were also separately explored in men and women. RESULTS: Among 4617 participants with normal cognition, there were 1502 men and 2685 women with no to mild WMH changes, 102 men and 274 women with moderate WMH changes and 19 men and 35 women with extensive WMH changes. Greater WMH burden (especially extensive changes) was related to increased odds of lability symptoms (agitation, disinhibition, irritability) and apathy in men but not women. Elation and appetite disorders followed the same trend but failed to achieve statistical significance. The exploratory analysis revealed positive correlations between these symptoms' severity with WMH burden in men but not in women. CONCLUSIONS: WMH burden was differentially associated with NPS in older men versus women with normal cognition.
Prevalence and Associated Factors of Depressive Symptoms and Major Depressive Disorder Among the Oldest-Old in India.
Pengpid S, Peltzer K, Hajek A … +1 more , Gyasi RM
Int J Geriatr Psychiatry · 2025 Jun · PMID 40490894 · Publisher ↗
OBJECTIVES: Few studies have assessed the prevalence and correlates of major depressive disorder (MDD) and depressive symptoms among the oldest-old (≥ 80 years) in low- and middle-income countries. Using national data fr...
OBJECTIVES: Few studies have assessed the prevalence and correlates of major depressive disorder (MDD) and depressive symptoms among the oldest-old (≥ 80 years) in low- and middle-income countries. Using national data from India, the study's objective was to determine the prevalence of MDD and depressive symptoms, as well as the characteristics that are related to them, among people aged 80 and beyond. METHODS: Data from the nationally representative cross-sectional 2017-2018 Longitudinal Aging Study in India (LASI) were analyzed. The analytical sample consisted of 3163 community-dwelling people aged 80 and older (proxy interviews were excluded). MDD and depressive symptoms were evaluated using established measures. Multiple logistic regressions were used (with demographic, health, and social-related explanatory factors). RESULTS: The prevalence of depressive symptoms was 34.8% and MDD 10.3%. Regressions found that higher food insecurity (Adjusted Odds Ratio-AOR: 1.22, 95% Confidence Interval-CI: 1.03-1.44), lower subjective economic status (AOR: 0.90, 95% CI: 0.82-0.98), lower self-rated health status (AOR: 0.78, 95% CI: 0.66-0.93), lower life satisfaction (AOR: 0.66, 95% CI: 0.56-0.78), higher functional disability (AOR: 1.18, 95% CI: 1.06-1.32), physical inactivity (AOR: 1.57, 95% CI: 1.09-2.28), and higher perceived discrimination (AOR: 1.49, 95% CI: 1.35-1.64) increased the odds of depressive symptoms, and higher food insecurity (AOR: 1.31, CI: 1.02-1.68), lower self-rated health status (AOR: 0.65, 95% CI: 0.50-0.85), higher functional disability (AOR: 1.23, 95% CI: 1.08-1.40), and higher perceived discrimination (AOR: 1.23, 95% CI: 1.06-1.42) increased the odds of MDD. CONCLUSIONS: Depression was prevalent among the oldest-old in India. Appropriate intervention strategies should be applied to prevent MMD among the oldest-old in India.
Autism, Diagnostics, and Dementia: A Consensus Report From the 2nd International Summit on Intellectual Disabilities and Dementia.
Janicki MP, McCallion P, Jokinen N … +6 more , Larsen FK, Service KP, Mughal DT, Watchman K, Gomiero T, Keller SM
Int J Geriatr Psychiatry · 2025 Jun · PMID 40481277 · Full text
OBJECTIVES: The second International Summit on Intellectual Disability and Dementia, held in 2023, highlighted the unique challenges of diagnosing dementia in older autistic adults, particularly those with intellectual d...
OBJECTIVES: The second International Summit on Intellectual Disability and Dementia, held in 2023, highlighted the unique challenges of diagnosing dementia in older autistic adults, particularly those with intellectual disabilities, due to the complex interplay of cognitive, communicative, and behavioral factors. This article addresses key diagnostic issues and post-diagnostic considerations for this population. METHOD: A consensus report was developed by the Summit's Autism/Dementia Working Group through background reviews, expert discussions at the Summit, and iterative draft revisions, incorporating feedback from internal and external stakeholders. Key issues were extracted from the report and abridged for this manuscript. RESULTS: Diagnostic challenges stem from overlapping symptoms of co-occurring neurodevelopmental and psychiatric conditions, rendering standard dementia tools insufficient. Comprehensive evaluations tailored to autism-related traits, sensory sensitivities, and alternative communication methods are essential. Building diagnostic capacity among clinicians and fostering multidisciplinary collaboration are critical. Longitudinal assessments, initiated before dementia symptoms appear, facilitate early detection of subtle changes. Emerging biomarkers and neuroimaging techniques show promise and should be incorporated where feasible. Accommodations, such as virtual assessments in familiar settings, can enhance diagnostic accuracy by reducing anxiety. Creating transition processes from diagnostics to post-diagnostic supports will aid in mitigating challenges and enhance life quality when dementia is a factor. CONCLUSIONS: Research and clinician education are urgently needed to improve diagnostic approaches and streamline the transition from diagnosis to tailored post-diagnostic support. An integrated framework of comprehensive efforts is vital for our better understanding of age-associated neuropathological diagnostics and enabling long-term well-being of older autistic adults with dementia.
Cognitive Stimulation Therapy-Spain (CST-ES): Cultural Adaptation Process and Pilot Study.
Pérez-Sáez E, Sánchez EA, García MT … +2 more , Del Rey TR, Hernández BP
Int J Geriatr Psychiatry · 2025 Jun · PMID 40473573 · Publisher ↗
OBJECTIVES: To assess the validity and acceptability of an adapted version of Cognitive Stimulation Therapy (CST) for the Spanish population and culturally adapt the original UK manuals. METHODS: The process followed the...
OBJECTIVES: To assess the validity and acceptability of an adapted version of Cognitive Stimulation Therapy (CST) for the Spanish population and culturally adapt the original UK manuals. METHODS: The process followed the Formative Method for Adapting Psychotherapy (FMAP). Two focus groups were conducted with healthcare professionals specialized in the care of people with dementia, a pilot study with a small sample size (n = 6), and individual interviews with participants, family caregivers, and group facilitators. The study was conducted at the National Reference Center for Alzheimer's and Dementia Care (CREA), a specialized dementia care center in Spain. The participants included eight healthcare professionals for the focus groups, six persons with dementia from CREA outpatient programs for the pilot study, their family caregivers, and two group facilitators. Assessments for the pilot study included the Mini-Mental State Examination (MMSE), Cambridge Cognitive Assessment Revised (CAMCOG-R), Geriatric Depression Scale (GDS-15), Quality of Life in Alzheimer's Disease Scale (QoL-AD), Barthel Index (BI), and the Lawton and Brody Scale for Instrumental Activities of Daily Living (IADL). RESULTS: The adapted CST principles and structure were deemed suitable for the Spanish context, with necessary linguistic and cultural adjustments. The pilot study reported no implementation issues, with positive feedback from participants, caregivers, and facilitators, alongside significant cognitive and quality of life improvements. DISCUSSION: The culturally adapted Cognitive Stimulation Therapy-Spain (CST-ES) is a valid and appropriate intervention for the Spanish population, providing a valuable addition to non-pharmacological therapies for dementia in Spain.
Depressive Symptoms Before and During the COVID-19 Pandemic in Veteran Nursing Home Residents.
Benz MB, Rudolph JL, DeVone F … +9 more , Bayer TA, Garbin A, Singh M, Gravenstein S, Hartronft S, Toms R, Gaudiano BA, Metrik J, Browne J
Int J Geriatr Psychiatry · 2025 Jun · PMID 40450594 · Full text
OBJECTIVES: Infection control measures in the Department of Veterans Affairs Community Living Centers (CLCs), analogous to nursing homes, during the COVID-19 pandemic may have impacted residents' mental health. The purpo...
OBJECTIVES: Infection control measures in the Department of Veterans Affairs Community Living Centers (CLCs), analogous to nursing homes, during the COVID-19 pandemic may have impacted residents' mental health. The purpose of this study was to examine changes in depressive symptoms before and during the COVID-19 pandemic in CLC residents. METHODS: This cross-sectional national cohort study evaluated depressive symptoms in Veteran CLC residents from geographically diverse CLCs across four 9-month periods of the COVID-19 pandemic: pre (before COVID-19), early (before vaccine), mid (before booster), and late (after booster). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9), a standardized depression assessment, which is a required measure in the Minimum Data Set (MDS). We computed change in PHQ-9 scores from the initial to the last PHQ-9 assessment for each pandemic period. We also performed a focused analysis of residents with a past year depression diagnosis. RESULTS: The overall sample comprised 47,755 Veteran CLC residents, 43% percent (n = 20,554) of whom had a depression diagnosis. The overall cohort mean PHQ-9 scores were similar across pandemic periods (pre = 2.64, early = 2.48, mid = 2.61, late = 2.45). There was intra-resident decline in PHQ-9 during each period which was statistically, but not clinically significant (pre = -0.54, early = -0.47, mid = -0.55, late = -0.49). Residents with a depression diagnosis followed a similar pattern for scores and decline in the periods compared with the full sample. PHQ-9 average scores indicated minimal depression even among those with a depression diagnosis, limiting ability to detect changes over time. CONCLUSIONS: For CLC residents during the COVID-19 pandemic, PHQ-9 scores were not meaningfully different between time periods. Characteristics of the study (e.g., sample/setting) or of older adults generally (e.g., resilience) may explain the low rates of depression.
Does Frailty Predict Cognitive and Functional Deficits After Nine Years?
de Santana BRF, de Assumpção D, Borim FSA … +8 more , Aprahamian I, Corona LP, Batistoni SST, da Silva Falcão DV, Cachioni M, de Melo RC, Neri AL, Yassuda MS
Int J Geriatr Psychiatry · 2025 Jun · PMID 40445069 · Full text
OBJECTIVES: To identify the variables at baseline, including physical frailty, that might predict cognitive and functional deficits in a 9-year follow-up. METHODS: This investigation included participants from the FIBRA...
OBJECTIVES: To identify the variables at baseline, including physical frailty, that might predict cognitive and functional deficits in a 9-year follow-up. METHODS: This investigation included participants from the FIBRA study in Campinas city and Ermelino Matarazzo, subdistrict of São Paulo city, with complete data collected at baseline and follow-up for the variables sex, age, education, frailty phenotype, number of chronic diseases, and tobacco and alcohol use. Of the initial 1284 participants at baseline, 98 that exhibited cognitive impairment were excluded. At follow-up, 451 participants were located and reinterviewed and 85 scored below the cut-off on the Mini-Mental State Exam (MMSE), of which 45 also presented functional deficit. RESULTS: The follow-up subsample comprised predominantly participants that were female (68.1%), aged 65-74 years (71.6%), and had low education (0-4 years of education, 75.6%). At baseline, 35.5% were non-frail, 57.0% pre-frail and 7.5% frail, whereas at follow-up, 29.4% were non-frail, 62.3% pre-frail and 8.3% frail. Logistic regression showed that age and education but not frailty at baseline were associated with cognitive and functional deficits at follow-up. CONCLUSIONS: Higher age and lower education at baseline were predictors of cognitive and functional deficits after 9 years, whereas frailty was not. Further longitudinal studies should be conducted to elucidate the factors predicting cognitive and functional decline in low-and middle-income countries.
Differentiating Treatment-Resistant Depression With and Without Parkinsonism in the Elderly From a Psychiatric Perspective by Tc-TRODAT-1 SPECT Imaging.
Su TP, Huang CJ, Mao WC … +3 more , Chiu YH, Liu RS, Chen LF
Int J Geriatr Psychiatry · 2025 Jun · PMID 40445019 · Full text
OBJECTIVES: Late-life depression often overlaps with neurodegenerative diseases leading to diagnostic and treatment challenges for neuropsychiatrists. This study aimed to differentiate elderly treatment-resistant depress...
OBJECTIVES: Late-life depression often overlaps with neurodegenerative diseases leading to diagnostic and treatment challenges for neuropsychiatrists. This study aimed to differentiate elderly treatment-resistant depression (TRD) comorbid with parkinsonism from elderly TRD without Parkinsonism as well as elderly healthy controls using striatum dopamine transporter (DAT) imaging by Tc TRODAT-1 SPECT. METHODS: Three groups were enrolled, including patients with TRD, patients with TRD comorbid with parkinsonism, and healthy controls. To obtain the DAT availability, the specific uptake ratios of the bilateral striatum were evaluated. Linear regression analyses were performed to evaluate the relationship between age and DAT level in the subregions of the striatum. Machine learning was applied to categorize the three groups with 10-fold cross-validation. RESULTS: The study enrolled 32 patients with TRD ( ), 36 TRD patients with parkinsonism ( ), and 74 healthy elderly ( ). A normative DAT concentration by age was established, providing a reference for clinical use. DAT levels differed among groups (all pairwise p < 0.01), with healthy controls exhibiting the highest levels, followed by patients with TRD, and then TRD patients with parkinsonism. Further, the Fine k-NN classifier emerged as the top performer to achieve 85.7% accuracy. CONCLUSIONS: Besides clinical assessment, dopaminergic assessment may help differentiate parkinsonism from TRD in old age. The findings of lower DAT availability in TRD suggest that TRD may be a prodromal symptom of Parkinson's disease. Psychiatrists should consider comorbid neurodegenerative disorders in elderly, depressed patients and use clinical assessment, neurological examination, and brain imaging for early Parkinson's Disease screening.
The Relationship Between Caregiver Burden With Insomnia and Malnutrition in Caregivers of Older Hospitalized Patients.
Aydin NO, Tanriverdi I, Pasin O … +4 more , Sumbul Sekerci B, Smith L, Hajek A, Soysal P
Int J Geriatr Psychiatry · 2025 Jun · PMID 40437195 · Publisher ↗
OBJECTIVES: The aim of this study was to investigate among caregivers of older hospitalized patients, the relationship between caregiver burden, caregivers' nutrition, and the two most common sleep disorders-excessive da...
OBJECTIVES: The aim of this study was to investigate among caregivers of older hospitalized patients, the relationship between caregiver burden, caregivers' nutrition, and the two most common sleep disorders-excessive daytime sleepiness and insomnia-as well as the interplay between these factors. METHOD: The study universe consisted of informal caregivers of older inpatients at an university hospital in Turkiye. The sample included 100 caregivers selected through purposive sampling between March 2024-/January 2025. Data were collected on personal information, caregiver burden (assessed using the Multidimensional Caregiver Burden Inventory [MCBI]), nutritional status (evaluated using the Mini Nutritional Assessment Test [MNA] and the Healthy Eating Attitude Scale), sleep status (assessed using the Epworth Sleepiness Scale and the Insomnia Severity Index [ISI]), and muscle strength (measured by a handgrip dynamometer). RESULT: A total of 100 caregivers (79% female, with a mean age of 50.5 years). Females comprised 61% of the patient population, and the mean age was 78.5 years. A significant positive correlation was found between the MCBI score and caregiving duration, ISI score, and patient age (p < 0.005). In contrast, the MCBI score showed a significant negative correlation with the MNA score and muscle strength (p ≤ 0.005). The adjusted linear regression analysis revealed that the MNA score had a significant negative effect on MCBI, while the ISI score had a significant positive effect. CONCLUSION: In the present study caregiver burden was associated with poor nutrition and sleep disturbances. Thus, reducing caregiver burden may improve insomnia and malnutrition. Moreover, addressing sleep and nutrition problems in caregivers suffering from insomnia or malnutrition may contribute to a reduction in overall caregiver burden.
Validity and Sensitivity to Change of a Self-Report Quality of Life Measure in Patients With Korsakoff's Syndrome.
Rensen YCM, de Waal-Gordijn C, Kessels RPC
Int J Geriatr Psychiatry · 2025 May · PMID 40399543 · Full text
BACKGROUND: Assessing (self-reported) quality of life (QoL) in patients with Korsakoff's syndrome (KS) is important to gain insight into these patients' well-being and to optimize their care in long-term care facilities....
BACKGROUND: Assessing (self-reported) quality of life (QoL) in patients with Korsakoff's syndrome (KS) is important to gain insight into these patients' well-being and to optimize their care in long-term care facilities. In this study, we describe the development of the QUALIKO-Self Report (QUALIKO-SR), an instrument for objectifying self-reported QoL in patients with KS. Next, we compared the QUALIKO-SR scores with the scores on the QUALIKO-Proxy Version (QUALIKO-PV) and examined changes in QoL over time. Finally, we assessed the convergent validity and investigated whether QUALIKO-SR scores were related to the severity of the cognitive impairments. METHODS: The study took place in specialized long-term care facilities providing care for patients with KS. 116 patients with alcoholic KS participated in this study. The QUALIKO-SR was developed and validated against the QUALIKO-PV, the Manchester Short Assessment of Quality of Life (MANSA-16), and the Montreal Cognitive Assessment 8.1 (MoCA). RESULTS: Significant differences were found between self- and proxy reported QoL on the subscales Negative Affect, Social Isolation, and Feeling at Home. No significant differences were found on the other subscales. QUALIKO-SR scores did not significantly vary over time. However, caregivers reported significant improvements in Care Relationships, Autonomy, Restless Tense Behavior, Social Isolation, and Feeling at Home over time. A significant, positive association was found between the QUALIKO-SR and the MANSA-16. No significant correlations were found between the QUALIKO-SR and the MoCA. CONCLUSIONS: This study describes the development and validation of a self-report instrument for objectifying QoL in patients with KS living in 24-h care facilities, the QUALIKO-SR. Measuring QoL in patients with severe cognitive impairments, such as patients with KS, is complex and we advise to include both self-report and proxy-report measures in future studies as well as in clinical practice. The availability of the QUALIKO-SR and QUALIKO-PV encourages researchers and clinicians to do so in patients with KS.
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