International Journal Of Geriatric Psychiatry[JOURNAL]
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200 papers
Simplified Screening for Depression in Acutely Hospitalized Geriatric Patients: Comparison of the Two-Item Whooley Questions With the Geriatric Depression Scale-15.
Trabert J, Bauer E, Golbach R … +4 more , Jekel K, Wunner C, Singler K, Schütze S
Int J Geriatr Psychiatry · 2025 Apr · PMID 40263643 · Publisher ↗
OBJECTIVE: The aim of the study is to investigate sensitivity and specificity of the two-item Whooley questions compared to the 15-item Geriatric Depression Scale (GDS-15) for the detection of depressive symptoms in acut...
OBJECTIVE: The aim of the study is to investigate sensitivity and specificity of the two-item Whooley questions compared to the 15-item Geriatric Depression Scale (GDS-15) for the detection of depressive symptoms in acutely hospitalized geriatric patients. METHODS: Patients were prospectively recruited. Two-item Whooley questions and GDS-15 were performed within 24 h of admission, the GDS-15 being part of the routine geriatric assessment. Montgomery-Asberg Depression Rating Scale (MADRS) served as gold standard in the form of a structured interview which was performed within 48 h of admission. In addition, all patients were examined for independence (Barthel Index), cognition (mini-mental status examination), vision and hearing (finger rub test) and multimorbidity (Charlson Comorbidity Index). RESULTS: 248 patients were recruited. Median (Q1/3) age was 83 (/3 79/86) years, 157 patients (63%) were female. Whooley questions had a sensitivity of 0.95 (95% CI: 0.81-0.99) and specificity of 0.49 (95% CI: 0.43-0.56) identifying moderate depressive symptoms (MADRS ≥ 20 points) with a negative predictive value (NPV) of 0.99. This is compared to a sensitivity of 0.57 (95% CI: 0.37-0.75) and specificity of 0.62 (95% CI: 0.56-0.68) using GDS-15 to identify moderate depressive symptoms. Both functional impairment and cognitive deficits had an impact on the result of GDS-15, but did not influence the result of Whooley questions. CONCLUSIONS: Compared to the GDS-15, the two-item Whooley questions are more accurate to screen for symptoms of depression in acutely hospitalized geriatric patients.
The Impact of Behavioral and Psychological Symptoms of Dementia on Mental Health, Sleep Quality, and Caregiver's Burden.
Chen IW, Sung JY, Wang WH
Int J Geriatr Psychiatry · 2025 Apr · PMID 40261108 · Publisher ↗
OBJECTIVES: This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psych...
OBJECTIVES: This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psychological Symptoms of Dementia (BPSD). METHODS: A total of 280 dementia patients (130 with BPSD, 150 without) and their caregivers were included. Patients with Clinical Dementia Rating scores from 0.5 to 2 were assessed. Caregivers' psychological symptoms, sleep quality, and burden were evaluated using the Symptom Checklist-90-Revised, Pittsburgh Sleep Quality Index, and Caregiver Burden Inventory. RESULTS: Caregivers of patients with BPSD reported significantly greater psychological distress, burden, and poorer sleep quality than those caring for patients without BPSD. Their distress spanned multiple symptom dimensions, including depression and anxiety. Somatization and phobic anxiety were also more pronounced in caregivers of mild and moderate dementia with BPSD. Among caregivers of patients with BPSD, those of individuals with moderate dementia experienced the highest distress, burden, and poorest sleep quality compared to those with very mild dementia. CONCLUSIONS: BPSD is a major contributor to greater caregiver distress, sleep disturbances, and burden, regardless of dementia severity, or duration alone. These findings highlight the need for targeted interventions to manage BPSD, which may help alleviate caregiver psychological distress and improve sleep quality.
Delirium in Elderly Hospitalized Patients: Analyzing Clinical and Social Determinants in a Colombian Retrospective Cohort.
Ospina-Lehmann A, Castañeda-Gómez MC, Pabón-Martínez EJ … +4 more , Vigoya-Aponte JP, Orozco-Castro S, Chavarro-Carvajal DA, Cano-Gutiérrez CA
Int J Geriatr Psychiatry · 2025 Apr · PMID 40254716 · Full text
OBJECTIVE: This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá,...
OBJECTIVE: This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia, between June 2019 and June 2022. METHODS: We conducted a retrospective analytical study. Data were extracted from the hospital's electronic medical records. The primary outcome was delirium upon admission. Exposure variables included clinical (e.g., malnutrition, dementia, oropharyngeal dysphagia) and social factors (e.g., living alone, social networks). Associations between delirium and exposure variables were assessed using a multivariate logistic regression model. RESULTS: The studied cohort comprised 4601 patients, mean age of 83.93 years and 56.26% were women. The prevalence of delirium upon admission was 22.39%. Key factors associated with delirium included older age (OR 1.04, 95% CI 1.01-1.06), malnutrition (OR 2.42, 95% CI 1.93-2.79), dementia (OR 2.57, 95% CI 2.02-3.38), functional impairment (OR 2.50, 95% CI 1.74-3.59), and oropharyngeal dysphagia (OR 1.49, 95% CI 1.08-1.99). Social determinants such as female sex, limited social networks, living alone, and enrollment in the subsidized health regime were not significantly associated with delirium. CONCLUSION: Delirium upon admission is highly prevalent among elderly inpatients and is associated with clinical factors, particularly malnutrition, dementia, and oropharyngeal dysphagia. Although no significant associations were found between social determinants of health (SDH) and delirium in this cohort, further research in diverse healthcare settings is needed to better understand the broader impact of SDH on delirium risk.
Social Frailty and Social Isolation in the Context of Dementia: A Simultaneous Concept Analysis.
Wang Z, Casey D, Sezgin D
Int J Geriatr Psychiatry · 2025 Apr · PMID 40252055 · Full text
OBJECTIVES: Early management of risk factors related to social health such as social frailty and social isolation could modify the progression of dementia and reduce its impact on people with dementia. However, due to ov...
OBJECTIVES: Early management of risk factors related to social health such as social frailty and social isolation could modify the progression of dementia and reduce its impact on people with dementia. However, due to overlapping definitions and interchangeable use of measurement tools, the precise distinction between these two concepts is unclear. This simultaneous concept analysis aimed to examine the definitions and interrelationships between the concepts of social frailty and social isolation within the context of dementia. METHODS: The simultaneous concept analysis method developed by Haase et al. was employed. A literature search was conducted across six databases (Ovid Medline, CINAHL, PsycINFO, Scopus, Embase and Cochrane Library) to retrieve original research, review and theoretical papers, published in English. Data from the literature was synthesised and analysed thematically following Braun and Clarke's six steps. RESULTS: The attributes of concepts of social frailty and social isolation overlap, including being alone and having limited or less social activities, engagements or interactions. The specific attributes of social frailty are financial difficulties and less talk while social isolation is distinctly marked by a lack of social networks or social relationships. Socio-economic welfare is a specific antecedent of social frailty, while decreased access to social resources and lower social well-being are distinctive consequences of social isolation. Cognitive decline and dementia are distinctive antecedents of social isolation; however, they also exist as shared consequences of both social frailty and social isolation. CONCLUSIONS: This simultaneous concept analysis clarified the similarities and differences between social frailty and social isolation in the context of dementia. A clearer understanding of the interrelationships between social frailty and social isolation and distinct and overlapping characteristics of them will support strategies to comprehensively address social health issues experienced by people with dementia.
A Cross Sectional and Longitudinal Assessment of Neuropsychiatric Symptoms and Brain Functional Connectivity in Patients With Mild Cognitive Impairment, Cerebrovascular Disease and Parkinson Disease.
Rashidi-Ranjbar N, Churchill NW, Black SE … +24 more , Kumar S, Tartaglia MC, Freedman M, Lang A, Ramirez J, Saposnik G, McLaughlin PM, Symons S, Pollock BG, Rajji TK, Borrie M, Masellis M, Pasternak SH, Frank A, Seitz D, Ismail Z, Tang-Wai DF, Scott CJM, Dowlatshahi D, Hassan A, Munoz DG, Fornazzari L, Fischer CE, Schweizer TA
Int J Geriatr Psychiatry · 2025 Apr · PMID 40246706 · Full text
INTRODUCTION: Mild Behavioral Impairment (MBI) is characterized by later-life emergent and persistent neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a potential precursor to various forms of...
INTRODUCTION: Mild Behavioral Impairment (MBI) is characterized by later-life emergent and persistent neuropsychiatric symptoms (NPS) in older adults without dementia, serving as a potential precursor to various forms of dementia. This study explores the association between NPS and functional connectivity (FC) of the default mode network (DMN), executive control network (ECN), and salience network (SN) across three cohorts: mild cognitive impairment due to AD (MCI), cerebrovascular disease (CVD), and Parkinson's disease (PD). Additionally, the effect of CNS medication on NPS-FC associations was explored. METHODS: Participants were recruited from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). NPS were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). We used dual regression to generate subject-specific whole-brain FC maps of the DMN, ECN, and SN. Using permutation testing we examined the association between NPS scores and FC maps at baseline (n = 349) and over a 2-year period (n = 225), controlling for age, sex, and years of education. A post-hoc linear model was used to assess the effect of CNS medication on each significant NPI-FC association within each group. RESULTS: In the MCI group (n = 73), baseline disturbed nighttime behavior was positively correlated with functional connectivity (FC) between the anterior sensorimotor network. Longitudinally (n = 46), appetite changes were positively associated with FC between the anterior SN and fusiform gyrus. Disinhibition and apathy correlated with FC between the posterior SN and DMN. In the CVD group (n = 144), baseline anxiety was negatively associated with FC within the DMN and between the right ECN and DMN in the left hippocampus. Longitudinally (n = 99), agitation/aggression changes were negatively associated with FC between the right ECN and left anterior cerebellum. Irritability, the most common symptom in both MCI and CVD, did not have identifiable neural correlates, possibly due to its complexity or analysis limitations. In the PD group (n = 132), baseline disturbed nighttime behavior was positively associated with FC between the right ECN and DMN in the precuneus and left ECN and fusiform gyrus. Longitudinally (n = 80), changes in nighttime behavior correlated with FC between the left ECN and DMN in the precuneus. CNS medications had no effect on NPI-FC associations in the MCI group. In the CVD group, the absence of CNS medications was linked to decreased right ECN FC. In the PD group, Parkinson's medications changed the direction of the NPI night-time score-FC correlation at both baseline and the 2-year assessment, with higher scores associated with reduced left ECN FC in medicated individuals. CONCLUSIONS: In conclusion, our study highlights the critical role of the DMN, ECN, and SN in processing neuropsychiatric symptoms (NPS) across MCI, CVD, and PD populations. We found significant associations between NPS and functional connectivity (FC) within and between these networks. MCI and PD showed positive associations with FC, particularly for disturbed nighttime behavior, while CVD exhibited negative associations, notably with anxiety and agitation. Although irritability was common in both MCI and CVD groups, its neural correlates remain unclear, emphasizing the need for further investigation. These findings support existing literature and pave the way for targeted therapeutic approaches, such as brain stimulation, to alleviate NPS. Additionally, the complex role of CNS medications in modulating NPS and FC warrants further investigation.
Feasibility of Telephone-Based Cognitive Assessments and Healthcare Utilization in US Medicare-Enrolled Older Adults Following Emergency Department Discharge.
Dawson WD, Spoden N, Gothard S … +3 more , Mattek N, Kaye J, Wright K
Int J Geriatr Psychiatry · 2025 Apr · PMID 40238121 · Full text
BACKGROUND: Wider screening and assessment for Alzheimer's disease and other related dementias (ADRD) may increase access to supportive care, improve allocation of medical care, and foster the use of interventions that p...
BACKGROUND: Wider screening and assessment for Alzheimer's disease and other related dementias (ADRD) may increase access to supportive care, improve allocation of medical care, and foster the use of interventions that prevent or delay disease progression. Yet, the effect of diagnostic timing on clinical and utilization outcomes is poorly understood. Community-based settings such as a hospital emergency department (ED) may be an underrecognized opportunity to assess cognition and impacts on individuals and health systems. This study assessed the feasibility of recruiting older adults for telephone-based trials following presentation to the ED and administering telephone based cognitive assessments over the phone in this population. METHODS: Medicare-enrolled individuals 65+ years of age (n = 160) presenting to the Oregon Health & Science University Emergency Department (Portland, Oregon) between May 2022 and February 2023 were recruited by telephone. Participants were administered the Telephone Interview for Cognitive Status (TICS) Assessment and the Patient Reported Outcomes Measurement Information System (PROMIS) Cognitive Measure Questions on Mental Clarity via telephone 1-12 weeks post-discharge to evaluate cognition. Electronic medical records (EMR) were reviewed for medical care utilization including primary care provider (PCP) visits, hospital admissions, and ED visits for the 3 years prior to ED presentation. RESULTS: Twenty-six percent of eligible ED users contacted elected for study enrollment. The TICS Assessment score had a significant relationship with the three evaluated health care utilization measures (ED, PCP visits, or hospitalizations); the PROMIS Assessment had significant but weak correlations to ED and PCP visits. CONCLUSIONS: Older adults 65+ years presenting to the ED are amenable to enroll in telephone-based cognition-focused trials and cognitive assessments can be carried out over the telephone in this population. The PROMIS Assessment may be a better cognition assessment tool when evaluating for cognition and care utilization in this population. In addition to the limits of the screening tools used in this study, a lack of a representative sample is a limitation of the study design. Future studies could use other validated cognitive assessment tools and utilize a study design with a recruitment strategy focused on obtaining a representative sample of older ED patients.
Primary Care Provider Perspectives on Depression Management in Older Adults With Multimorbidity.
Mindlis I, Kiosses D, Reid MC
Int J Geriatr Psychiatry · 2025 Apr · PMID 40238079 · Full text
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Association Between Religious Service Attendance and Depression, Anxiety Among Older Amdo Tibetans.
Zhou L, Zhang A, Liu Q … +7 more , Ji Q, Ye M, Xu Y, Zhang Y, Meng Y, Hu Z, Zhan Y
Int J Geriatr Psychiatry · 2025 Apr · PMID 40229985 · Publisher ↗
OBJECTIVES: Religious service attendance has previously been associated with greater levels of well-being, as well as milder symptoms of depression and anxiety. However, few studies have explored this association within...
OBJECTIVES: Religious service attendance has previously been associated with greater levels of well-being, as well as milder symptoms of depression and anxiety. However, few studies have explored this association within the Amdo Tibetan population. This study aims to estimate the association between religious service attendance and psychiatric symptoms among older Amdo Tibetans. METHODS: A cross-sectional face-to-face field survey was conducted in the Tibetan Plateau of China, focusing on older Amdo Tibetans from May 21 to July 26, 2023. The study utilized self-reported data on religious service attendance (never, < 1/week, ≥ 1/week) alongside validated scales, including Center for Epidemiological Studies Depression-8 (CESD-8) and the Generalized Anxiety Disorder-7 (GAD-7), to assess depressive and anxiety symptoms. These instruments demonstrated robust psychometric validity. Generalized linear mixed models were used to estimate the odds ratio (OR) of depression and anxiety associated with religious service attendance, adjusting for potential confounders including sociodemographic characteristics, lifestyle factors, and medical history. RESULTS: This study included 538 older Amdo Tibetans, among whom the prevalence of depressive (scores ≥ 3) and anxiety symptoms (scores ≥ 5) was 46.10% and 24.91%, respectively. In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week showed significantly less severe symptoms of depression (OR = 0.43, 95% CI: 0.20, 0.96) and anxiety (OR = 0.20, 95% CI: 0.05, 0.75). Moreover, ≥ 1/week attendees (vs. never-attendees) also had lower levels of depression (OR = 0.64, 95% CI: 0.43, 0.96). CONCLUSIONS: Our findings suggest that religious service attendance was associated with lower risks of depression and anxiety among older Amdo Tibetans. This highlights the importance of considering religious and spiritual practices as potential factors in promoting mental well-being, particularly within unique cultural and ethnic contexts such as the Amdo Tibetan community.
Identifying and Addressing Unmet Needs in Dementia: The Role of Care Access and Psychosocial Support.
Scharf A, Michalowsky B, Rädke A … +8 more , Kleinke F, Schade S, Platen M, Buchholz M, Pfaff M, Iskandar A, van den Berg N, Hoffmann W
Int J Geriatr Psychiatry · 2025 Apr · PMID 40148225 · Full text
OBJECTIVES: People with dementia often have various unmet care needs across physical, psychological, environmental, and social domains. There's a need to explore the association between domains of unmet needs and charact...
OBJECTIVES: People with dementia often have various unmet care needs across physical, psychological, environmental, and social domains. There's a need to explore the association between domains of unmet needs and characteristics of people with dementia. The aim of this paper was to describe the domains of unmet and met needs among community-dwelling people living with dementia, focusing on the home environment, physical, psychological, and social areas, and to identify sociodemographic, clinical, and health-related parameters associated with unmet needs. METHODS: We analyzed the InDePendent trial's baseline data of N = 417 people with dementia. The Camberwell Assessment of Needs for the Elderly (CANE) was used to identify needs. Descriptive statistics were used to evaluate the distribution of needs and Logistic and Poisson regression models to detect sociodemographic and clinical factors associated with unmet needs in the four need domains. RESULTS: People with dementia were on average 80.6 years old, mostly female (56%) and mildly to moderately cognitively impaired (85%). 98.6% of the participants had at least one need, of which just over a third (36.5%) were rated as met and just under two-thirds (63.5%) as unmet. Lacking a care grade (access to social care) and low education were found to be risk factors for the occurrence of unmet needs in almost all areas. Factors such as increased medication use (OR = 1.10 [95%CI 1.02 to 1.19]) and loneliness (OR = 2.51 [95%CI 1.44 to 4.36]) were associated with a higher likelihood of unmet environmental needs. Similarly, the absence of a caregiver (OR = 2.81 [95%CI 1.03 to 7.64]), lower social support (OR = 1.71 [95%CI 1.02 to 2.84]), and poor physical health (OR = 8.40 [95%CI 3.39 to 20.81]) correlated with unmet physical needs. Participants living alone demonstrated higher levels of unmet physical needs (β = 0.27 [95%CI 0.01 to 0.53]). Depression (OR = 2.13 [95%CI 1.10 to 4.08]), living alone (OR = 1.73 [95%CI 1.04 to 2.86]) and poor physical health (OR = 2.82 [95%CI 1.15 to 6.93]) significantly increased the risk of unmet psychological needs. Social needs are more likely to be unmet in females (OR = 1.88 [95%CI 1.05 to 3.37]). Sensitivity analyses showed the positive effects of regular General Practitioner (GP) visits on the fulfillment of social needs (β = -0.61 [95%CI -1.01 to -0.22]). CONCLUSION: Access to comprehensive care, for example, through a care grade, education and regular visits to the GP, is just as important for meeting needs in various areas as psychosocial measures aimed at reducing loneliness, living alone, and social exclusion. Both areas must be given equal consideration to improve the living and care situation of people with dementia sustainably. TRIAL REGISTRATION: The study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT04741932). The study protocol is published elsewhere.
Individualized Music Playlist Based on Iso-Principle for De-Escalating Agitation of People With Dementia: A Randomized Controlled Feasibility Study.
Cheung DSK, Tse HYJ, Lee PH … +3 more , Ho KHM, Bai X, Lai CKY
Int J Geriatr Psychiatry · 2025 Apr · PMID 40148224 · Full text
OBJECTIVES: To evaluate the feasibility of the Individualized Music Playlist based on Iso-Principle for de-escalating agitation of people with dementia and provide preliminary evidence about its efficacy. METHODS: The ra...
OBJECTIVES: To evaluate the feasibility of the Individualized Music Playlist based on Iso-Principle for de-escalating agitation of people with dementia and provide preliminary evidence about its efficacy. METHODS: The randomized participants listened to either a 30-min music playlist or a book-reading audio script twice weekly for six weeks, and when agitation occurred. Their agitation level was observed every 5 min from the beginning of an agitation episode for an hour to monitor its trajectory over a 2-week period. Multilevel models with maximum likelihood analysis was conducted. The frequency of agitation and other behavioural symptoms was assessed at baseline and the 6th week and analysed with Generalized Estimating Equations. RESULTS: Twenty-four participants were recruited, and 10 presented 36 agitation episodes during the first two weeks of observation. The recruitment and retention rates were 85.7% and 83.3%, respectively. A total of 97.2% of the intervention and control conditions were delivered as planned. The intervention was not more effective than the control condition in de-escalating agitation or reducing agitation and other behavioural symptoms. Overall, agitation symptoms were apparently alleviated in the first 10 min, with a decelerated pace observed thereafter. CONCLUSIONS: The intervention was feasible, and its efficacy in de-escalating agitation is yet to be confirmed.
Suicide Among Older People in Spain: The Role of Sex and Urbanicity.
Rodríguez-Rodríguez GJ, Martínez-Alés G, López-Cuadrado T
Int J Geriatr Psychiatry · 2025 Mar · PMID 40122772 · Full text
OBJECTIVES: Suicide rates are driven by availability of lethal means, increase with age, and are often higher in rural versus urban areas. This study examines temporal and geographic variations in suicides among elderly...
OBJECTIVES: Suicide rates are driven by availability of lethal means, increase with age, and are often higher in rural versus urban areas. This study examines temporal and geographic variations in suicides among elderly with a focus on rural-urban differences in method-specific suicide rates among people aged 65 and older in Spain, a rapidly aging country. METHODS: Population-based study including all suicides among people over 65 in Spain between 2010 and 2022. We examined overall and method-specific suicide rates and their temporal and geographical variation, stratifying results by sex and urbanicity level. Time trends were estimated via joinpoint regression. Maps were created to analyze the geographical distribution of suicide rates. RESULTS: While 2010-2022 suicide rates in people aged 65 and older remained largely stable overall, they increased by an annual 2.6% for women living in urban areas. The most common suicide methods were hanging for men living in rural and urban areas (68.5% and 47.3%, respectively) and for women living in rural areas (42.1%); for women living in urban areas jumping was the modal suicide method (46.9%). Method-specific trend analyses revealed recent increases in male suicide by poisoning and hanging in rural areas, decreases in male suicide by hanging and increases in male suicide by jumping in urban areas, and increases in female suicide by poisoning and jumping in urban areas. We identified and mapped remarkable geographic variation in overall and sex-specific suicide rates across Spain's regions. CONCLUSIONS: These results, highlighting recent increases in female suicides in urban areas and in specific method-specific male suicides both in rural and urban areas, and demonstrating geographical variation across regions, should help guide targeted suicide prevention efforts.
Exploring Socio-Economic Differences and Developer Medical Involvement of Dementia-Related English Version Mobile Health Applications.
Chen TH, Ma WF
Int J Geriatr Psychiatry · 2025 Mar · PMID 40118652 · Publisher ↗
INTRODUCTION: The rise of mobile health interventions offers significant potential to improve the well-being of the aging global population, particularly individuals at an increased risk of dementia. To fully leverage th...
INTRODUCTION: The rise of mobile health interventions offers significant potential to improve the well-being of the aging global population, particularly individuals at an increased risk of dementia. To fully leverage this potential, it is crucial to evaluate the mobile health applications across different demographic and socio-economic landscapes. This study investigated the relationship between a country's development status and the quality of dementia-focused mobile health applications, as well as the influence of developers' medical expertise on app quality and perceived impact. METHODS: This cross-sectional observational design study utilized the uMARS tool to evaluate the objective and subjective quality of dementia-related mobile health applications. Objective quality was assessed across engagement, functionality, aesthetics, and information domains, while subjective quality included user recommendations, anticipated usage, and perceived impact. A stratified random sampling method selected 17 apps for evaluation, and inter-reviewer reliability was confirmed (Kendall's W = 0.143, p = 0.045). Data analysis involved descriptive statistics, independent sample t-tests, and Pearson's correlation coefficients, with statistical significance set at p < 0.05. RESULTS: Among the 51 dementia-related mobile health app analyzed, only one was developed in a low-income country. Additionally, this study found a linear correlation between the perceived impact of a mobile health app for dementia and the medical background of the development team, with a Pearson correlation coefficient of t = 3.708 (p < 0.001). Engagement was highly correlated with subjective quality (Pearson correlation coefficient r = 0.955, p < 0.001), and there was a strong correlation between the information provided by the apps and the perceived impact (Pearson correlation coefficient r = 0.884, p < 0.001). CONCLUSION: The adoption of mobile health apps must be prioritized to assist individuals with dementia and their caregivers in low income countries. Future apps should focus on improving engagement and involving medical experts in development to increase credibility and utilization across socioeconomic levels and healthcare systems.
Changes in the Disease Burden of Depressive Disorders Among Middle-Aged and Older Adults (Aged 45-89) in China Over 30 years: Insights From the Global Burden of Disease Study 2021.
Xiao Y, Chen TT, Zhang Z … +2 more , Liu L, Du N
Int J Geriatr Psychiatry · 2025 Mar · PMID 40090859 · Publisher ↗
OBJECTIVES: In China, depressive disorder (DD) among middle-aged and older adults is a significant public health concern. This research utilized the latest Global Burden of Disease Study (GBD) database to evaluate the ev...
OBJECTIVES: In China, depressive disorder (DD) among middle-aged and older adults is a significant public health concern. This research utilized the latest Global Burden of Disease Study (GBD) database to evaluate the evolving disease burden of DD in this demographic over the past 3 decades. METHODS: Data on the incidence and disability-adjusted life years (DALY) of DD among people aged 45-89 in China between 1992 and 2021 were collected from the GBD 2021. The age-period-cohort (APC) model was applied to determine the effects of age, period, and cohort on the incidence and DALY rates of DD. RESULTS: (1) Over the last 30 years, there was a 6.49% increase in the overall age-standardized incidence rate (ASIR) and a 3.99% increase in age-standardized DALY rates (ASDR) for DD among middle-aged and older adults in China, with females consistently exhibiting higher ASIR and ASDR than males. In 2020, COVID-19 significantly increased the ASIR and ASDR of DD in the population, especially in females. (2) The APC analysis revealed an annual net drift of 0.38% in incidence and 0.17% in DALY rate. For both genders, local drifts of incidence were negative for the 45-54 age group and positive for the 55-89 age group; DALY rates showed negative local drifts for the 45-59 age group and positive for the 60-89 age group. (3) Incidence and DALY rates increased with age, displaying a trend of initial decline followed by an increase in period effects, but a trend of initial increase followed by a decrease in cohort effects. Moreover, the impacts of age, period, and cohort exhibited gender differences. CONCLUSIONS: Our findings provide a comprehensive and in-depth perspective for studying the changing trends of DD's burden in China and for identifying targeted prevention and treatment policies for DD from different aspects.
Norms of Hong Kong Brief Cognitive Test and the Utility for Screening Cognitive Impairment Among Chinese Older Adults.
Zheng Y, Zhu J, Li N … +20 more , Pei M, Chiu HFK, Tan S, Wang X, Xia Y, Huang C, Zeng Y, Liu S, Li Y, Zou S, Zhang Y, Hu S, Xu L, Cai Y, Wu D, Zeng H, Jiang G, Shi C, Wang H, Yu X
Int J Geriatr Psychiatry · 2025 Mar · PMID 40083071 · Publisher ↗
OBJECTIVE: To establish the norms of the Hong Kong Brief Cognitive Test (HKBC) among Chinese older adults and to examine its utility for differentiating neurocognitive disorders from cognitively normal controls. METHODS:...
OBJECTIVE: To establish the norms of the Hong Kong Brief Cognitive Test (HKBC) among Chinese older adults and to examine its utility for differentiating neurocognitive disorders from cognitively normal controls. METHODS: Two thousand three hundred twelve participants aged 40 years and above were recruited from six regions of China as the norm construction sample. 93 normal participants and 246 cognitive impairment patients were included for diagnostic test of HKBC. Based on the multinomial regression model, which analyzed the relationship between HKBC score and demographic information, the norm of HKBC score and converted T score (HKBC-T) were constructed. The ROC curve of HKBC-T was depicted to calculate the optimal cutoff value of screening cognitive impairment. RESULTS: The results showed that HKBC score was negatively correlated with age (SE = -5.48, p < 0.001) and positive correlation with education (SE = 1.53, p < 0.001), with no significant association with gender and living area. The AUC value of HKBC-T is 0.85 in distinguishing cognitive impairment and normal older adults. The optimal cutoff value was 45.79 points, achieving a sensitivity of 91.4% and a specificity of 66.7%. CONCLUSION: Age and education must be adjusted when creating the HKBC norms. The HKBC-T is promising in detecting cognitive impairment at the population level.
Dementia in Turkey-Physician's Perspectives on Facilitating and Challenging Aspects in the Diagnostic Process.
Neugebauer T, Brzoska P, Özcebe H … +1 more , Yilmaz-Aslan Y
Int J Geriatr Psychiatry · 2025 Mar · PMID 40083042 · Full text
OBJECTIVES: Facilitating and challenging aspects of a non-linear diagnostic process of dementia were explored in interviews with physicians from outpatient clinics of a major hospital in Turkey. METHODS: Semi-structured...
OBJECTIVES: Facilitating and challenging aspects of a non-linear diagnostic process of dementia were explored in interviews with physicians from outpatient clinics of a major hospital in Turkey. METHODS: Semi-structured interviews were conducted with 15 physicians between March and April 2023. Purposive sampling was used to identify clinics that perform dementia diagnostics, including neurology, geriatrics, and psychiatry outpatient clinics. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis. RESULTS: Facilitating and challenging aspects were perceived on three levels: (1) diagnostic procedures and methods, which focus on the assessment of dementia and the aspects that arise in the process; (2) communication, which describes the verbal and nonverbal relationships between health care professionals, patients, and their caregivers, as well as their communication styles; (3) care environment, which describes the various environmental influences on patients, both on a sociocultural and institutional level. CONCLUSION: The diagnostic process for dementia involves several interrelated aspects, making a flexible, holistic approach essential. In this study, the social and cultural context of the patients and the involvement of the family emerged as crucial elements. By integrating these aspects, along with a mix of informal and formal communication between healthcare providers and families, the diagnostic process can become more patient-centered and effective. To further improve outcomes, raising awareness and providing education about dementia could reduce stigma and encourage earlier recognition and better management of the condition during the diagnostic process.
Determining the Psychometric Properties of the Turkish Version of the Positive Caregiving Experience Scale in Dementia.
Kabataş Yıldız M, Çal A
Int J Geriatr Psychiatry · 2025 Mar · PMID 40082957 · Full text
BACKGROUND: Caring for individuals with dementia presents significant challenges for caregivers. However, positive experiences such as personal growth and emotional satisfaction play a vital role in fostering resilience...
BACKGROUND: Caring for individuals with dementia presents significant challenges for caregivers. However, positive experiences such as personal growth and emotional satisfaction play a vital role in fostering resilience and improving caregiving outcomes. This study highlights the need for a culturally relevant tool to assess these positive feelings, focusing on the adaptation and validation of the Dementia Caregiver Positive Feeling Scale for Turkish caregivers. OBJECTIVES: This study aimed to carry out the Turkish validity and reliability study of the 21-item Dementia Caregiver Positive Feeling Scale. METHODS: This methodological study was conducted between February and December 2023 with 200 caregivers of dementia patients receiving treatment at the education and research hospital in Samsun, Türkiye. Data were collected using an individual information form and the 21-item Dementia Caregiver Positive Feeling Scale. Data analysis was performed using SPSS 22.0 and Amos 22.0 software. Cronbach's alpha reliability coefficient was calculated, and exploratory factor analysis and confirmatory factor analysis were conducted to test the construct validity of the scale. RESULTS: The average age of caregivers was 45.18 ± 12.02 (min = 18, max = 78), and 78.0% were female. The average caregiving duration was 4.07 ± 3.00 (1-18) years. The total Cronbach's alpha value of the scale is 0.80. Exploratory factor analysis revealed a KMO coefficient of 0.756 and a Bartlett's test result of χ = 960.382, p < 0.001. Factor loadings ranged from 0.32 to 0.61 and the total variance explained was 47.232. Confirmatory factor analysis supported the scale's 20-item, four-factor structure, with fit indices indicating an acceptable model fit: RMSEA 0.07, GFI 0.85, AGFI 0.80, CFI 0.77 and χ2/sd 2.15 (p < 0.001). CONCLUSIONS: The Dementia Caregiver Positive Feeling Scale has been determined to be a valid and reliable instrument for the Turkish community. It serves as a valuable tool that can be used in research evaluating the positive experiences of caregivers of dementia patients.
Economic Implications of Off-Road Cycle Lanes to Increase Physical Activity and Reduce Sex and Gender Differences in the Risk of Dementia.
Walbaum M, Aguzzoli E, Castro-Aldrete L … +3 more , Cyhlarova E, Chadha AS, Knapp M
Int J Geriatr Psychiatry · 2025 Mar · PMID 40069575 · Full text
BACKGROUND: Dementia represents one of the greatest global health challenges. There are known risk factors that might prevent or delay nearly 50% of the different types of dementia. There are substantial differences in r...
BACKGROUND: Dementia represents one of the greatest global health challenges. There are known risk factors that might prevent or delay nearly 50% of the different types of dementia. There are substantial differences in risk factors and progression of dementia between women and men, including engagement in regular physical activity. The study aimed to quantify the impact of increasing women's participation in physical activity with off-road cycles and its effect on dementia incidence, relative to men and the associated health and social care costs. METHODS: Our study employed a population model with secondary data analysis approach to investigate the potential economic effect of implementing off-cycle lanes in the UK. Data were drawn from published evidence on lifetime risk of dementia relative to physical activity in men and women for the UK population, levels of physical activity in the UK, evidence on the effectiveness of off-road cycle lanes in increasing the level of physical activity in men and women, lifetime costs of dementia in the UK. Two scenarios were compared, assuming an increase from the baseline levels of cycling of 40.3% and 114% for women and by 36.4% and 77% for men, respectively. Sensitivity analysis was conducted to account for variations in key variables. RESULTS: Current dementia related lifetime costs were estimated at £1090.1 billion, and total lifetime costs £3326.1 billion. Under Scenario 1, dementia related lifetime costs decreased by £4.7 billion, and total lifetime costs by £0.11 billion. In Scenario 2, dementia related lifetime costs decreased by £7.0 billion, and total lifetime costs by £1.9 billion. CONCLUSION: Off-road cycle lanes, especially for women, this type of structural and lifestyle intervention has the potential to bring health and economic benefits. Increased physical activity not only provides numerous health benefits, but also contributes to preventing the onset and lifetime costs of dementia.
Brain Signatures of Very Early Cognitive Decline in Asymptomatic Middle-Aged Offspring of People With Alzheimer's Disease.
Ramsingh N, Lin HM, Ouyang Y … +12 more , Ravona-Springer R, Livny A, Soleimani L, Bendlin BB, Matatov A, Niv T, Shamir T, Ganmore I, Heymann A, Sano M, Azuri J, Beeri MS
Int J Geriatr Psychiatry · 2025 Mar · PMID 40050014 · Full text
OBJECTIVE: To assess the relationship of subtle preclinical cognitive changes with white matter microstructure and cortical volume in middle-aged adults at high AD risk due to a parental history. METHODS: Participants (n...
OBJECTIVE: To assess the relationship of subtle preclinical cognitive changes with white matter microstructure and cortical volume in middle-aged adults at high AD risk due to a parental history. METHODS: Participants (n = 278) were AD patients' offspring from the Israel Registry for Alzheimer's Prevention study. Cognitively unimpaired-decliners (CU-D) were based on a linear regression model. In a subsample with MRI (n = 220), we examined relationships of CU-D with white matter (WM) microstructure (fractional anisotropy [FA] and mean diffusivity [MD]) and cortical volume in brain regions commonly affected in AD. RESULTS: CU-D participants had lower FA in the superior longitudinal fasciculus (SLF) (p = < 0.001) and higher MD in the SLF (p = < 0.001), and cingulum adjacent to the corpus callosum (p = < 0.001) and genu (p = 0.006) compared to cognitively unimpaired-stable (CU-S) participants. The groups did not differ in cortical brain volumes. CONCLUSIONS: CU-D participants had poorer WM microstructure in brain tracts affected early in AD. Early interventions can target individuals that fit the CU-D criteria.
Changes in Loneliness, Social Isolation, and Social Support: A Gender-Disaggregated Analysis of Their Associations With Dementia and Cognitive Decline in Older Adults.
Htun HL, Teshale AB, Sun H … +6 more , Ryan J, Owen AJ, Woods RL, Shah RC, Chong TT, Freak-Poli R
Int J Geriatr Psychiatry · 2025 Mar · PMID 40044457 · Full text
OBJECTIVES: Limited evidence exists on the gender-specific impact of changes in loneliness, social isolation, and social support on dementia risk. We examined these changes and their relationships with dementia and cogni...
OBJECTIVES: Limited evidence exists on the gender-specific impact of changes in loneliness, social isolation, and social support on dementia risk. We examined these changes and their relationships with dementia and cognitive decline. METHODS: Data from over 12,000 community-dwelling Australians aged 70+ years without significant cognitive impairment at enrolment were analysed. Loneliness, social isolation, and social support were self-reported at baseline and ∼2 years later (social isolation and social support) or ∼3 years later (loneliness), classified as never, transient, incident, or persistent. Dementia diagnosis followed DSM-IV criteria, adjudicated by an expert panel. Gender-disaggregated Cox proportional hazards regressions were conducted, adjusting for age and other dementia risk factors. RESULTS: At baseline, participants were aged 70-95 years (mean: 75.2 ± 4.3), with 54% being women. Overall, 81.1% of men and 71.7% of women reported never feeling lonely at baseline, while transient, incident, and persistent loneliness were experienced by 4.9%, 8.4%, and 5.5% of men and 8.5%, 11.6%, and 8.3% of women, respectively. Over a median 8-year follow-up, incident loneliness in men (HR: 1.52, 95% CI: 1.08-2.13) and persistent loneliness in women (HR: 2.14, 95% CI: 1.55-2.97) were associated with a greater dementia risk, compared to those who were never lonely. No increased risk was observed for transient loneliness. Despite the remarkably low prevalence of social isolation and poor social support in this initially healthy cohort, both were associated with cognitive decline (secondary outcome) but not with dementia risk. CONCLUSION: Persistent loneliness in people aged 70+, especially in women, was associated with a higher risk of dementia and cognitive decline.
Effectiveness of Interventions to Support Carers of People With Dementia in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.
Chen F, Hu Z, Li Q … +7 more , Zheng X, Li M, Salcher-Konrad M, Comas-Herrera A, Knapp M, Shi C, STRiDE consortium
Int J Geriatr Psychiatry · 2025 Mar · PMID 40015952 · Full text
OBJECTIVES: Family and other carers of people with dementia can potentially benefit from training and support to reduce the negative impacts of caregiving and prevent harm to care recipients. While interventions for care...
OBJECTIVES: Family and other carers of people with dementia can potentially benefit from training and support to reduce the negative impacts of caregiving and prevent harm to care recipients. While interventions for carers in low- and middle-income countries (LMICs) are emerging, their effectiveness is not well understood. Through a systematic review and meta-analysis, the objective was to evaluate the effectiveness of interventions to support carers of people with dementia in improving the well-being of carers and their care recipients in LMICs. METHODS: This review, registered with PROSPERO (CRD42018106206), built on a systematic mapping of dementia interventions in LMICs under the Strengthening Responses to Dementia (STRiDE) project. It analysed evidence on interventions to support carers in these regions. Title and abstract screening, full-text review, data extraction and risk of bias assessment were each conducted by two reviewers independently, with disagreements resolved through group discussion. Pairwise meta-analyses were conducted, with robustness tested via leave-one-out analysis. Heterogeneity was explored using subgroup analysis, meta-regression and MetaForest. Medline, Embase, Global Health and PsycINFO (via Ovid) and CINAHL (via EBSCO) databases were searched. We included randomised control trials focused on carer well-being in LMICs, 2008-2022. Primary outcomes were perceived burden and depression; other health-related quantitative outcomes were collected. RESULTS: From 5228 records, 48 studies in English and Chinese were identified as eligible, reporting on 67 carer outcomes and 36 care recipient outcomes. Forty-one studies were at high risk of bias. Meta-analysis revealed statistically significant medium-to-large intervention effects on three key carer outcomes-perceived burden, depression, and anxiety-and on four major outcomes for people with dementia-neuropsychiatric symptoms, cognitive function, quality of life (QoL), and activities of daily living (ADL). These effects were larger than those typically observed in previous studies in high-income countries (HICs). CONCLUSIONS: This review provides a comparative overview and summarises the characteristics of published interventions to support carers in LMICs. It reveals medium-to-large beneficial effects of the interventions on several key outcomes for carers and care recipients in LMICs. Future research employing more rigorous methodologies is recommended, particularly for broader and more diverse populations.
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