International Journal Of Geriatric Psychiatry[JOURNAL]
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200 papers
Functional Connectivity Changes Associated With Depression in Dementia With Lewy Bodies.
Querry M, Botzung A, Sourty M … +10 more , Chabran E, Sanna L, Loureiro de Sousa P, Cretin B, Demuynck C, Muller C, Ravier A, Schorr B, Philippi N, Blanc F
Int J Geriatr Psychiatry · 2025 Mar · PMID 40011213 · Full text
OBJECTIVES: Depressive symptoms are frequent in the early stages of dementia with Lewy bodies (DLB), and more than half of DLB patients would have a history of depression. Our study sought to investigate the functional c...
OBJECTIVES: Depressive symptoms are frequent in the early stages of dementia with Lewy bodies (DLB), and more than half of DLB patients would have a history of depression. Our study sought to investigate the functional connectivity (FC) changes associated with depressive symptoms in prodromal to mild DLB patients compared with controls. METHODS: MRI data were collected from 66 DLB patients and 18 controls. Depression was evaluated with the Mini International Neuropsychiatric Interview. Resting-state FC (rsFC) was investigated with the CONN toolbox using a seed-based approach and both regression and comparison analyses. RESULTS: Correlations were found between the depression scores and the rsFC between fronto-temporal and primary visual areas in DLB patients (p < 0.05, FDR corrected). Depressed DLB patients also showed decreased rsFC within the salience network (SN), increased rsFC between the default mode network (DMN) and the language network (LN) and decreased rsFC between the cerebellar network (CN) and the fronto-parietal network (FPN) compared to non-depressed DLB patients (p < 0.05, uncorrected). Comparison analyses between antidepressant-treated and non-treated DLB patients highlighted FC changes in treated patients involving the SN, the DMN, the FPN and the dorsal attentional network (p < 0.05, uncorrected). CONCLUSIONS: Our findings revealed that depressive symptoms would especially be associated with rsFC changes between fronto-temporal and primary visual areas in DLB patients. Such alterations could contribute to difficulties in regulating emotions, processing biases towards negative stimuli, and self-focused ruminations. TRIAL REGISTRATION: This study is part of the cohort study AlphaLewyMA (https://clinicaltrials.gov/ct2/show/NCT01876459).
Correction to Pre-Stroke and Early Post-Stroke Apathy Is Associated With Increased Risk of Dementia 3 Months After Stroke.
Int J Geriatr Psychiatry · 2025 Mar · PMID 40011206 · Publisher ↗
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Non-Pharmacological Interventions for People With Dementia Who Live Alone: A Systematic Review.
Polack S, Bell G, Silarova B … +6 more , Hebditch M, Tingle A, Sommerlad A, Portacolone E, Sykes K, Tabet N
Int J Geriatr Psychiatry · 2025 Mar · PMID 40011198 · Full text
OBJECTIVES: Approximately one third of people with dementia live on their own and they face an increased risk of unmet needs and loneliness. This systematic review aimed to identify and describe non-pharmacological inter...
OBJECTIVES: Approximately one third of people with dementia live on their own and they face an increased risk of unmet needs and loneliness. This systematic review aimed to identify and describe non-pharmacological interventions that have been evaluated for people with dementia living alone and to examine the effectiveness of these interventions. METHODS: Following PRISMA guidelines, six databases were systematically searched: MEDLINE, Embase, CINAHL, PsycINFO, Social Care online, and ClinicalTrials.gov. Studies that reported on the impact or experience of an intervention for people with dementia living alone in the community (not long-term care) and that had been published since 2000 were included in the review. No restrictions were applied in terms of study design or outcome measures. Study risk of bias was assessed, and a narrative approach was used to synthesize findings. RESULTS: Thirteen studies of 13 different interventions were included, grouped into five intervention categories: home-based dementia case/care management (n = 4), technology (n = 3), social (n = 3), cognitive (n = 2) and psychological (n = 1). There was one randomized controlled trial (RCT), and two economic evaluations that used data from RCTs. Most other studies were small-scale, and only two were evaluated to have low risk of bias. Most studies reported positive or mixed findings in terms of the intervention's impact on the person with dementia or aspects of feasibility. However, studies were heterogeneous in terms of intervention, study design, and outcomes. CONCLUSIONS: This review of a limited body of research highlights the potential for interventions to support people with dementia who live alone. It also identifies key evidence gaps and the need for more robust and comparable research to better understand what works, why, for who, and how. Involving people with dementia who live alone in the design, implementation, and evaluation of these interventions will be crucial to ensure that their needs and preferences are met.
What Works Well for People With Dementia and Their Supporters From South Asian, African and Caribbean Communities in the UK: A Narrative Synthesis Systematic Review and Expert Consultations.
McDermott O, Sobers T, Mukadam N … +2 more , Lee AR, Orrell M
Int J Geriatr Psychiatry · 2025 Mar · PMID 40011077 · Full text
OBJECTIVES: This review aims to synthesise the evidence regarding the use and provision of dementia services and support for people with dementia and/or supporters from South Asian, African or Caribbean backgrounds livin...
OBJECTIVES: This review aims to synthesise the evidence regarding the use and provision of dementia services and support for people with dementia and/or supporters from South Asian, African or Caribbean backgrounds living in the UK. METHODS: A narrative synthesis systematic review of the original research articles published up to April 2024 was conducted. A lay summary of the initial review findings was evaluated by experts-by-experience (n = 15) for scrutiny and to enable further discussions, to produce key recommendations for further developing dementia services. RESULTS: A total of 18 studies (16 qualitative and 2 mixed methods studies) met the full inclusion criteria and were included in the review. The review findings and experts-by-experience consultations highlighted that: (1) dementia is not openly discussed or disclosed within many diverse ethnic communities. This can lead to family carers and people with dementia feeling isolated and unsupported. (2) Mainstream dementia support services and hospitals often do not meet diverse communities' cultural and religious needs, and (3) home-based care supported by external care agencies can be helpful but ensuring consistency of care staff in their culturally appropriate care can be extremely difficult to ensure. CONCLUSIONS: Encouraging South Asian, African and Caribbean communities to increase their dementia knowledge is important. However, mainstream dementia support services also need to incorporate their cultural and religious essentials into care packages to encourage their help seeking behaviours and tackle dementia stigma. Collaborative service developments between the diverse communities, Health and Social Care providers and policy makers are essential to ensure equitable and culturally appropriate dementia care for diverse community members in the future.
Attitudes and Preferences Towards Screening for Dementia From the Perspectives of Healthcare Professionals: An Updated Systematic Review.
Mc Ardle R, Dsouza A, Hagan A … +8 more , Al-Oraibi A, Hanjari M, Stephan BCM, Brayne C, Lafortune L, Bains M, Qureshi N, Robinson L
Int J Geriatr Psychiatry · 2025 Feb · PMID 39978789 · Full text
OBJECTIVES: Approximately 55 million people are living with dementia globally. Global policies have suggested that screening for dementia in asymptomatic populations may support risk-reduction approaches to stem the risi...
OBJECTIVES: Approximately 55 million people are living with dementia globally. Global policies have suggested that screening for dementia in asymptomatic populations may support risk-reduction approaches to stem the rising numbers of people with the condition. A previous systematic review of literature up to 2012 indicated that healthcare professionals negatively view dementia screening; however, the research and clinical landscape has made significant advances in the last decade. Therefore, the aim of this systematic review is to re-examine the attitudes and preferences of healthcare professionals since 2012 regarding primary and community care-based dementia screening. METHODS: This review was pre-registered on PROSPERO (CRD42024531455) and followed PRISMA guidelines. Key terms relevant to the aim were input into six databases, and articles between 2012 and 2024 were considered. Titles, abstracts and full texts were independently screened by two reviewers. Articles were eligible for inclusion if peer-reviewed, written in English, considered primary or community care-based dementia screening and included healthcare perspectives from either quantitative or qualitative methods. RESULTS: From 18,732 identified titles, 19 articles were included in this review. Seventeen studies presented perspectives from primary care practitioners. Key findings suggest that healthcare professionals have mixed views regarding their willingness to conduct dementia screening, although limited studies suggest an interest in engaging in dementia risk reduction. Common influences on perspectives included knowledge, skills and training; resource provision; access to a dedicated screening service and referral pathways; and stigma. CONCLUSIONS: These findings suggest that healthcare professionals' perspectives and resource are not aligned with international policies promoting dementia screening. When considering implementing evidence-based dementia screening in the future, a dedicated screening service is recommended.
The Incidence and Prevalence of Dementia Among Ontario Adults With and Without Intellectual and Developmental Disabilities.
Patel P, Sun W, Mataruga A … +2 more , Fung K, Balogh R
Int J Geriatr Psychiatry · 2025 Feb · PMID 39939115 · Full text
OBJECTIVES: There are more than 66,000 Ontario adults living with intellectual and developmental disabilities (IDD). While the risk of dementia is well established among those with Down Syndrome (DS), there is limited re...
OBJECTIVES: There are more than 66,000 Ontario adults living with intellectual and developmental disabilities (IDD). While the risk of dementia is well established among those with Down Syndrome (DS), there is limited research in persons with IDD excluding DS (Non-DS IDD). This study aimed to compare the incidence and prevalence of dementia in Ontario adults with and without IDD over time and by demographic information. METHODS: Administrative data were used to calculate and compare the annual age- and sex-adjusted cumulative incidence and period prevalence of dementia from fiscal years 2011/12 to 2020/21 in three cohorts: (1) Non-DS IDD, (2) DS, and (3) No IDD. RESULTS: Compared to persons without IDD, cumulative incidence of dementia was on average 4.27 and 5.33 times higher in persons with Non-DS IDD and DS respectively and period prevalence of dementia was on average 4.87 and 5.93 times higher in persons with Non-DS IDD and DS respectively. CONCLUSIONS: Given the increased rates of dementia within the IDD population, it is imperative that early dementia screening take place, appropriate health and social services are implemented and more actions are taken to delay the onset of dementia, while considering the needs of this population.
Mapping the Numbers of Dementia in Brazil: A Delphi Consensus Study.
Aliberti MJR, Suemoto CK, Laks J … +16 more , Caramelli P, Dozzi Brucki SM, Farina N, Apolinario D, Camargos EF, d'Orsi E, Alves GS, César-Freitas KG, Rangel LF, Chaves MLF, Lopes MA, Coletta MVD, Barbosa MG, Frota NAF, Nitrini R, Ferri CP
Int J Geriatr Psychiatry · 2025 Feb · PMID 39938925 · Publisher ↗
OBJECTIVES: As the global dementia crisis intensifies, especially in low-and middle-income countries (LMICs), there is a pressing need for comprehensive prevalence data across diverse regions, including Brazil, where stu...
OBJECTIVES: As the global dementia crisis intensifies, especially in low-and middle-income countries (LMICs), there is a pressing need for comprehensive prevalence data across diverse regions, including Brazil, where studies have been predominantly limited to affluent urban centers. This study aimed to conduct an expert consensus to determine the prevalence of all-cause dementia in Brazil, considering various age groups, sexes, and geographical areas. METHODS: A Delphi consensus process with clinical and academic experts from across Brazil was conducted to provide dementia prevalence estimates in people aged ≥ 60 years living throughout Brazil for 2019. Each round consisted of answering structured questionnaires that incorporated information from the literature. A priori criteria were used to ascertain the point in which consensus was achieved for > 70% of the 15 prevalence estimates-for (1) total, (2) women and men, and (3) the five Brazilian macro-regions. The current and projected dementia cases in Brazil were calculated based on age and sex population distributions. RESULTS: Fifteen experts, with a mean professional experience of 25 ± 10 years, reached a consensus in the fourth round. Experts agreed with a mean all-cause dementia prevalence of 8.5% among Brazilians aged ≥ 60 years, which comprised 2.46 million people in 2019 in this age. They reported higher dementia rates in women (9.1%) than men (7.7%); the highest total prevalence was in those over 80 where it exceeds 20%. Regional variations were also noted, with lower prevalence in the South (7.3%) and higher in the North (8.9%) and Northeast (10.1%). Projections estimate that considering Brazil's rapidly aging population, dementia cases will rise to 8.89 million by 2060. CONCLUSIONS: This Delphi study estimated that dementia already affects roughly 1 in 12 older Brazilians aged 60 and above, with slightly higher prevalence in women and significant geographical variations. These results underscore the urgency for targeted public health strategies in Brazil and offer a framework for similar challenges in other LMICs, especially given that dementia cases are projected to increase by approximately 3.6 times in 4 decades.
Cost-Effectiveness of the Tailored Activity Programme for Person With Dementia-Caregiver Dyads: A Markov Model.
Gannon B, Vo V, Gitlin LN … +1 more , Bennett S
Int J Geriatr Psychiatry · 2025 Feb · PMID 39924472 · Full text
OBJECTIVES: The Tailored Activity Programme (TAP) is a home-based programme with compelling outcomes for reducing behavioural and psychological symptoms of dementia and functional decline. We conducted a cost-utility ana...
OBJECTIVES: The Tailored Activity Programme (TAP) is a home-based programme with compelling outcomes for reducing behavioural and psychological symptoms of dementia and functional decline. We conducted a cost-utility analysis of TAP compared to usual care, for the person with dementia and their caregiver. METHODS: We developed a Markov Model, from the healthcare sector perspective. Using parameters from the dementia care literature. Base-case and probabilistic sensitivity analyses were applied to handle uncertainty. RESULTS: Given the growing need for cost-effective dementia care, understanding the cost-effectiveness of TAP is crucial for health service design and its implementation into healthcare settings. Our study shows that TAP is cost-effective for both males and females with dementia and their caregivers. The most favourable cost-effectiveness acceptability curves were found in men and women with dementia, aged 50 to 70, with lower costs and higher QALYs compared to those over 80. The probability of TAP being cost-effective rises with public higher willingness-to-pay thresholds, especially for people with dementia in the age group of 50-70. CONCLUSIONS: These findings indicate TAP is highly cost-effective for individuals living with dementia compared to usual home care, which provides evidence for policy makers towards their decisions on resource allocation and for implementing TAP in Australia.
Association of Longitudinal Trajectories of Physical Frailty With Dementia Status in Older Adults: A National Cohort Study.
Ye F, Zhou W, Pu J … +3 more , Chen H, Wang X, Lee JJ
Int J Geriatr Psychiatry · 2025 Feb · PMID 39900556 · Full text
BACKGROUND AND OBJECTIVES: The longitudinal patterns of change in physical frailty and their associations with the subsequent dementia risk remain unclear. This study aimed to (1) explore the long-term trajectories of ph...
BACKGROUND AND OBJECTIVES: The longitudinal patterns of change in physical frailty and their associations with the subsequent dementia risk remain unclear. This study aimed to (1) explore the long-term trajectories of physical frailty over a 6-year period in older adults without dementia at baseline; (2) identify the socio-demographic and health-related factors associated with different physical frailty trajectories; and (3) examine the longitudinal relationships between different physical frailty trajectories and subsequent risk of dementia. RESEARCH DESIGN AND METHODS: This national cohort study used data from the National Health and Aging Trends Study (NHATS) conducted in the United States from 2015 to 2021 and included adults aged ≥ 65 without dementia (n = 2245) at baseline in 2015. Group-based trajectory modeling was used to describe the longitudinal changes. Socio-demographic and health-related characteristics were compared across the identified physical frailty trajectories using bivariate analyses, employing Rao-Scott chi-square tests for categorical variables and design-based F-tests for continuous variables. Multinomial logistic regression analyses were conducted to examine the relationships between different frailty trajectories and subsequent dementia status. RESULTS: Three frailty trajectories were identified: low-stable (74.00%), low-increasing (21.14%), and high-level (4.86%). Participants in the low-increasing and high-level groups were predominantly older, female, minorities, unmarried, and less educated and had a lower income, more comorbidities, and greater anxiety and depression symptoms (p < 0.001). Compared with the low-stable group, older adults in the low-increasing group had higher risk of possible dementia (RRR: 2.37, 95% CI: 1.41-3.97, p < 0.001) and probable dementia (RRR: 1.71, 95% CI: 1.08-2.73, p = 0.02); similarly, older adults in the high-level group had higher risks of possible dementia (RRR: 4.24, 95% CI: 1.74-10.36, p < 0.001) and probable dementia (RRR: 2.99, 95% CI: 1.32-6.76, p = 0.01). No significant differences were found in the risk of dementia between the high-level frailty group and the low-increasing frailty group (p > 0.05). CONCLUSION AND IMPLICATIONS: This study highlighted the importance of regular frailty monitoring for early detection and informed future interventions that could delay frailty progression and potentially reduce dementia risk.
The Influence of a Dementia Diagnosis on Clinical Decision-Making in Dysphagia Management.
Van Sickle AJ, Bice EM
Int J Geriatr Psychiatry · 2025 Feb · PMID 39891320 · Full text
OBJECTIVES: The main objective of this survey was to determine the effects of a dementia diagnosis on dysphagia management by speech-language pathologists (SLP). METHODS: A survey of SLPs interested and/or working with i...
OBJECTIVES: The main objective of this survey was to determine the effects of a dementia diagnosis on dysphagia management by speech-language pathologists (SLP). METHODS: A survey of SLPs interested and/or working with individuals with dysphagia was conducted via a website. The SLPs viewed two written cases of patients with dysphagia, one with dementia and one without dementia. Both cases included a video capture of the patients' swallows. SLPs answered specific questions related to each case and video. RESULTS: Frequency counts, McNemar's Test, and descriptive analysis of responses showed that participants were less likely to initiate dysphagia therapy (p < 0.001) or use rehabilitative swallowing strategies (p = 0.008) for individuals with dysphagia and a dementia diagnosis than for an individual with dysphagia without a dementia diagnosis. In addition, SLPs overidentified impairments and chose treatment targets not present. CONCLUSIONS: Based on the current survey, SLPs displayed a bias when the diagnosis of dementia was present. The bias appears to exist regardless of experience or education. Not initiating treatment or not providing rehabilitative strategies may have detrimental effects on the health and quality-of-life of individuals with dementia.
Recorded Loneliness and Adverse Outcomes in Older Acute Care Inpatients Receiving Psychiatric Assessment.
Joseph M, Lockie K, Mbazira A … +1 more , Stewart R
Int J Geriatr Psychiatry · 2025 Feb · PMID 39887439 · Full text
OBJECTIVES: We investigated the prevalence of loneliness recorded during assessment of general hospital inpatients by older adult liaison psychiatry services and its associations with level of subsequent hospitalisation,...
OBJECTIVES: We investigated the prevalence of loneliness recorded during assessment of general hospital inpatients by older adult liaison psychiatry services and its associations with level of subsequent hospitalisation, emergency presentation and mortality. METHODS: Data were drawn from a large south London mental healthcare provider of older adult liaison psychiatry services to four acute general hospitals. The sample comprised all patients receiving assessments from these services from 2007-2017. Recorded loneliness was ascertained from text fields via a bespoke natural language processing algorithm and, via a linkage with national hospitalisation data, was investigated as a risk factor for repeat emergency department (ED) attendance, inpatient days in the subsequent 12 months, and mortality. RESULTS: In 11,631 patients assessed, loneliness was recorded in 11.2%. After adjustment for a range of demographic and health covariates, recorded loneliness was associated with an increased risk of ED attendance, but with lower mortality and, in survivors, with fewer hospitalisation days over a 12-month follow-up. CONCLUSIONS: Loneliness is recorded in over 10% of inpatients assessed by older adult liaison services and is likely to be present in substantially more. Lack of recording in more severe illness and/or cognitive disorders may explain associations with lower mortality and hospitalisation days. Its association with higher likelihood of repeat ED attendance suggests that loneliness should be considered more routinely in clinical assessments, possibly with formal screening.
ApoE Genotype, Age, and Cognitive Decline in Old Chinese Individuals Without Dementia: A Population-Based Study With Five-Year Follow-Up.
Wu H, Gu X, Liu S … +5 more , Wang P, Lu H, Guan Y, Shi Z, Ji Y
Int J Geriatr Psychiatry · 2025 Jan · PMID 39814697 · Publisher ↗
BACKGROUND: Apolipoprotein E (ApoE) ε4 genotype is a well-known risk factor for Alzheimer's disease (AD). However, its effect on predicting cognitive decline in individuals without dementia and its association with age a...
BACKGROUND: Apolipoprotein E (ApoE) ε4 genotype is a well-known risk factor for Alzheimer's disease (AD). However, its effect on predicting cognitive decline in individuals without dementia and its association with age are unclear. OBJECTIVE: To investigate the relationship between ApoE polymorphism and risk of cognitive decline and dementia incidence in the elderly without dementia. METHODS: This population-based prospective study was conducted between 2011 and 2016. The study involved 767 dementia-free individuals who had undergone ApoE genotype analysis, were aged ≥ 60 years, and lived in rural China. Participants were divided into three ApoE groups: E3 (genotype 3/3), E4 (genotypes 3/4 and 4/4), and E2 (genotype 2/3) groups. RESULTS: After 5 years, 666 (86.8%) individuals were followed up. The rate of change in MMSE score was faster in the E4 group than in the E3 and E2 groups (5.0 ± 4.4 vs. 3.5 ± 3.8 vs. 3.9 ± 3.9, p = 0.001), after adjusting for age, sex, educational level and baseline MMSE scores, especially in the 70-79 years age group. In the same age group, the incidence rate of dementia was higher in the E4 group than in the E3 group (OR = 2.850; 95% CI: 1.146-7.090). After adjusting for age, sex, hypertensive status, educational level, marital status, engagement in social activities, and past history of stroke, the ApoE ε4 allele remained an independent risk factor for dementia incidence (OR = 3.070; 95% CI: 1.162-8.110) in individuals aged 70-79 years after follow-up. CONCLUSIONS: ApoE ε4 carriers with age ≥ 60 years had faster cognitive decline. The ApoE ε4 allele was an independent risk factor for dementia incidence in extremely old individuals.
Housing Relocation and Residential Satisfaction After Relocation: Effects of Dwelling Condition Changes on Older Adults in the Community.
Park GR, Seo BK, Namkung EH
Int J Geriatr Psychiatry · 2025 Jan · PMID 39814694 · Publisher ↗
BACKGROUND: This study seeks to analyze the trajectories of residential satisfaction among older adults before and after relocation and explore the variability in the relationship between relocation and residential satis...
BACKGROUND: This study seeks to analyze the trajectories of residential satisfaction among older adults before and after relocation and explore the variability in the relationship between relocation and residential satisfaction based on changes in housing conditions during the relocation process. METHODS: Utilizing a nationally representative longitudinal dataset of older adults (N = 2718), this study employs individual-level fixed effect regression models to estimate the association between the timing of relocation and residential satisfaction. Stratified analyses are also conducted to explore how this association varies based on changes in housing conditions. RESULTS: Residential satisfaction tends to decrease before relocation, peaks at the time of relocation, and maintain higher levels as older adults adapt to their new environment. This adaptation process varies depending on changes in dwelling conditions during relocation, with transitions from poor to non-poor housing conditions positively affecting psychological responses, while moves from non-poor to poor conditions can lead to increased psychological burden and prolonged adjustment periods. DISCUSSION: Aging policies can prioritize programs that facilitate adjustment to new environments to improve residential satisfaction of older adults, thereby promoting healthy aging.
Welfare to Meaningful Work.
Okamura T, Iizuka A, Mitsui M … +3 more , Sakurai H, Nishi M, Ura C
Int J Geriatr Psychiatry · 2025 Jan · PMID 39810229 · Publisher ↗
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Caregiver Psychosocial Factors & Stroke Survivor Cognitive Outcomes: A REGARDS-CARES Cohort Study.
Blake JA, Long DL, Knight AJ … +5 more , Goodin BR, Crowe M, Judd SE, Rhodes JD, Clay OJ
Int J Geriatr Psychiatry · 2025 Jan · PMID 39804282 · Full text
OBJECTIVES: Caring for an individual with cognitive impairment carries a physical, mental, and emotional toll. This manuscript examines the relationship between caregiver psychosocial measures and longitudinal cognitive...
OBJECTIVES: Caring for an individual with cognitive impairment carries a physical, mental, and emotional toll. This manuscript examines the relationship between caregiver psychosocial measures and longitudinal cognitive outcomes of stroke survivors, as well as analyzing the psychosocial factors as moderators of stroke severity and cognition. METHODS: This analysis was conducted on caregiver and stroke survivor dyads (n = 157) that participated in the Caring for Adults Recovering from the Effects of Stroke (CARES) project, an ancillary study of the REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study. Stroke severity at hospitalization discharge was included as the primary predictor of cognitive outcomes and caregiver psychosocial factors were included as additional predictors. Cognition was assessed biennially and measured the domains of learning, memory, and executive functioning. Individual mixed-effect models included each psychosocial factor and were covariate-adjusted for pre-stroke cognitive scores and demographic variables. Caregiver psychosocial factors included caregiver strain, depressive symptoms, life and leisure time satisfaction, and overall quality of life. RESULTS: Decreased caregiver strain (b = -0.230, 95% CI: -0.39 to -0.07; p = 0.006) and increased leisure time satisfaction (b = 0.045, 95% CI: 0.01 to 0.08; p = 0.005) were both found to be significant predictors, alongside stroke severity (b = -0.137, 95% CI: -0.22 to -0.05; p = 0.002), of better stroke survivor cognition overall. No variables were found to be moderating factors of the relationship between stroke severity and cognition. CONCLUSIONS: Understanding the caregiver psychosocial factors that predict stroke outcomes will help clinicians to identify stroke survivor and caregiver dyads at higher risk for worst longitudinal cognitive outcomes following stroke.
Preliminary Evidence for Perturbation-Based tACS-EEG Biomarkers of Gamma Activity in Alzheimer's Disease.
Palmisano A, Pezanko LR, Cappon D … +11 more , Tatti E, Macone J, Koch G, Smeralda CL, Romanella SM, Ruffini G, Rivolta D, Press DZ, Pascual-Leone A, El-Fakhri G, Santarnecchi E
Int J Geriatr Psychiatry · 2025 Jan · PMID 39799469 · Publisher ↗
BACKGROUND: Alzheimer's disease (AD) is characterized by impaired inhibitory circuitry and GABAergic dysfunction, which is associated with reduced fast brain oscillations in the gamma band (γ, 30-90 Hz) in several animal...
BACKGROUND: Alzheimer's disease (AD) is characterized by impaired inhibitory circuitry and GABAergic dysfunction, which is associated with reduced fast brain oscillations in the gamma band (γ, 30-90 Hz) in several animal models. Investigating such activity in human patients could lead to the identification of novel biomarkers of diagnostic and prognostic value. The current study aimed to test a multimodal "Perturbation-based" transcranial Alternating Current Stimulation-Electroencephalography (tACS)-EEG protocol to detect how responses to tACS in AD patients correlate with patients' clinical phenotype. METHODS: Fourteen participants with mild to moderate dementia due to AD underwent a baseline assessment including cognitive status, peripheral neuroinflammation, and resting-state (rs)EEG. The tACS-EEG recordings included brief (6') tACS blocks of gamma (i.e., 40 Hz) stimulation administered through 4 different montages, with Pre/Post 32-Channels EEG for each block. Changes in tACS-EEG and rsEEG γ band power with respect to baseline were adopted as a metric of induction and compared with cognitive scores and neuroinflammatory biomarkers. RESULTS: We found positive correlations between 40 Hz-induced γ activity in fronto-central-parietal areas and patient cognitive status and negative ones with neuroinflammatory markers. Participants with greater cognitive impairment exhibited less γ induction and higher peripheral neuroinflammation. The same analysis performed with spectral power from baseline rsEEG resulted in no significant correlations, promoting the value of tACS-based perturbation for capturing individual differences in pathology-related brain features. CONCLUSIONS: Our work suggests a link between tACS-induced γ band spectral power and clinical severity, with weaker γ induction corresponding to more severe clinical/cognitive impairment. This study provides preliminary support for the development of novel physiological biomarkers and therapeutic targets based on disease severity.
Variation of the Risk Associated With Potentially Modifiable Risk Factors for Dementia Between Ethnic Groups Within One Country. A Retrospective Cohort Study Using Routinely Collected Health Data in Aotearoa New Zealand.
Ma'u E, Cullum S, Cheung G … +3 more , Tamatea J, Livingston G, Mukadam N
Int J Geriatr Psychiatry · 2025 Jan · PMID 39780033 · Publisher ↗
INTRODUCTION: While risk factor prevalence of individual risk factors for dementia varies between ethnic groups in New Zealand (NZ), it is not known whether the effect of these risks is the same in each group. METHODS: T...
INTRODUCTION: While risk factor prevalence of individual risk factors for dementia varies between ethnic groups in New Zealand (NZ), it is not known whether the effect of these risks is the same in each group. METHODS: This retrospective cohort study identified incident cases of dementia. Cox regression models calculated the hazard ratio for dementia for each of the risk factors, after adjustment for age and sex. RESULTS: Education, smoking, diabetes, depression, physical activity and social isolation were associated with a 1.13-1.55 times increased risk of dementia. We did not demonstrate an association between dementia risk and hypertension, alcohol, or air pollution. Differences between ethnic groups is suggested but not confirmed due to study power. DISCUSSION: Differences in dementia prevention potential between ethnic groups in NZ are potentially contributed to by both differential prevalence and risk factor effects. Public health strategies must be tailored for the ethnic populations at most risk.
Prevention Is Better Than Cure: Public Understanding of Preventing Neurodegenerative Disorders.
Thomson A, Kenten C, Banerjee S … +5 more , Browning S, Pouncey T, Horne R, Cooper C, DeNPRU‐QM
Int J Geriatr Psychiatry · 2025 Jan · PMID 39779661 · Publisher ↗
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Creative Aging: Unraveling the Psychosocial Benefits of Art Among Germany's Oldest Old. Findings From the Nationally Representative Study "Old Age in Germany (D80+)".
Hajek A, Gyasi RM, Peltzer K … +2 more , König HH, Pengpid S
Int J Geriatr Psychiatry · 2025 Jan · PMID 39777746 · Full text
OBJECTIVE: There is a dearth of studies examining the link between artistic activity and psychosocial outcomes exclusively among the oldest old. Therefore, the purpose of this study was to investigate the association bet...
OBJECTIVE: There is a dearth of studies examining the link between artistic activity and psychosocial outcomes exclusively among the oldest old. Therefore, the purpose of this study was to investigate the association between artistic activity and psychosocial outcomes among individuals aged 80 years and over in Germany. METHODS/DESIGN: Data for this analysis were taken from the "Old Age in Germany (D80+)" study, a nationwide sample encompassing both community-dwelling individuals aged 80 and above, as well as those residing in care facilities. The analytic sample included a total of n = 3181 individuals. Established tools were used to quantify the variables of interest. RESULTS: Approximately 25.5% of individuals engaged in artistic activities, with the most popular being singing (9.0%) and making music (7.7%). Most participants engaged in these activities frequently, predominantly at home (84.8%). Regressions showed that overall engagement in the arts was not significantly associated with outcomes, except for reduced loneliness among men. Specific types of arts activities were associated with favorable psychosocial outcomes (e.g., singing and making music were associated with lower loneliness among men, whereas photography/filming was associated with lower loneliness among women). In addition, engaging in artistic activities outside the home was associated with higher life satisfaction among the total sample and women. The frequency of engagement in artistic activities was mainly not associated with psychosocial outcomes. CONCLUSIONS: About one in four individuals aged 80 years and over in Germany is engaged in artistic activities (frequently; mostly at home). Our findings show that engaging in artistic activities may have positive psychosocial benefits (depending on the type and sex-specific), particularly in reducing loneliness and increasing life satisfaction. Artistic engagement, particularly outside the home, may contribute to increased life satisfaction among women. Even rare artistic activities could prove beneficial.
Initiation of Psychotropic Drugs in Spouses of Patients With Early-Onset Alzheimer's Disease: A Matched Cohort Study.
Fukasawa T, Matsumoto K, Sasaki K … +10 more , Nakagami Y, Goto Y, Sakamoto Y, Washimi Y, Tanaka-Mizuno S, Yoshida S, Mizuno K, Kamada Y, Ishii M, Kawakami K
Int J Geriatr Psychiatry · 2025 Jan · PMID 39754353 · Publisher ↗
OBJECTIVES: The diagnosis of early-onset Alzheimer's disease (EOAD) can cause emotional stress not only to the patients themselves but also to their spouses. This study aimed to evaluate the risk of psychiatric disorders...
OBJECTIVES: The diagnosis of early-onset Alzheimer's disease (EOAD) can cause emotional stress not only to the patients themselves but also to their spouses. This study aimed to evaluate the risk of psychiatric disorders in spouses of EOAD patients, using psychotropic drug initiation as a surrogate indicator. METHODS: A cohort study was conducted using a Japanese claims database, with spouses of EOAD patients (exposed spouses) matched with spouses of non-EOAD individuals (reference spouses) up to a 1:10 ratio. Primary outcome was the initiation of mood disorder drugs, and secondary outcomes were the initiation of drugs for anxiety disorders, sleep disorders, and schizophrenia spectrum disorders. Four study cohorts were created according to each outcome analysis. Multivariable Cox regression models were used to estimate adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for study outcomes. RESULTS: The analysis of mood disorder drugs included 395 exposed spouses and 3711 reference spouses. The proportion of patients excluded from the analysis due to prescription of mood disorder drugs during the baseline period was 4.3% higher among exposed spouses than reference spouses. There was no major difference between groups with respect to mood disorder drug initiation after 1 year (aHR, 2.08 [95% CI, 0.61 to 7.13]). In subgroup analysis of females and dependents, exposed spouses showed a higher rate of initiation (females: aHR, 6.39 [95% CI, 1.24 to 32.80]; dependents: aHR, 6.47 [95% CI, 1.25 to 33.55]). No substantial differences in secondary outcomes were observed in any comparison. CONCLUSIONS: This study does not conclusively demonstrate an increase in mood disorder drug initiation among spouses of EOAD patients overall; however, initiation rates may be higher among female or dependent spouses. Our findings also suggest that exposed spouses experience significant psychological stress prior to their partners' EOAD diagnoses.
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