Showing papers in "International Journal of Geriatric Psychiatry in 2022"
TL;DR: For instance, this article examined longitudinal associations between depression, anxiety, post-traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia. But they did not find evidence of an overall association.
Abstract: Although psychiatric disorders have been found to be associated with increased risk of dementia, previous findings are mixed, and the nature of these relationships remains poorly understood. We examined longitudinal associations between depression, anxiety, post-traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia.We searched three databases for longitudinal, population-based studies investigating associations between psychiatric disorders and dementia (PROSPERO registration: CRD42020209638). We conducted narrative synthesis, and random-effects meta-analyses to obtain pooled estimates. We used meta-regression and stratified analyses to examine variation by sex, age-at-onset and follow-up time.Fifty-seven citations met eligibility criteria. Most studies focussed on depression (n = 33), which was associated with subsequent all-cause dementia (pooled relative risk [RR]: 1.96, 95% confidence interval [CI]: 1.59-2.43; I2 = 96.5%), Alzheimer's Disease (pooled RR: 1.9, 95% CI: 1.52-2.38; I2 = 85.5%), and Vascular Dementia (pooled RR: 2.71, 95% CI: 2.48-2.97; I2 = 0). Associations were stronger in studies with shorter follow-up periods and for severe and late-onset depression. Findings regarding anxiety were mixed, and we did not find evidence of an overall association (pooled RR: 1.18, 95% CI: 0.96-1.45; I2 = 52.2%, n = 5). Despite sparse evidence, psychotic disorders (pooled RR: 2.19, 95% CI: 1.44-3.31; I2 = 99%), PTSD and BPD were associated with subsequent dementia.People with psychiatric disorders represent high-risk groups for dementia, highlighting the importance of ongoing symptom monitoring in these groups. Findings regarding temporality and age-at-onset indicate that depression symptoms could reflect prodromal dementia for some individuals. Further longitudinal research is required to determine whether psychiatric disorders represent causal risk factors or early markers of dementia neuropathology.
17 citations
TL;DR: This paper examined longitudinal associations between depression, anxiety, post-traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia and found that depression was associated with increased risk of dementia.
Abstract: Although psychiatric disorders have been found to be associated with increased risk of dementia, previous findings are mixed, and the nature of these relationships remains poorly understood. We examined longitudinal associations between depression, anxiety, post‐traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia.
16 citations
TL;DR: In this article , the authors developed machine learning-based models for the diagnosis of neurodegenerative disorders using cognitive tests and found high levels of accuracy for diagnosis using exclusively neuropsychological tests, which supports the usefulness of cognitive assessment in diagnosis.
Abstract: Neuropsychological assessment is considered a valid tool in the diagnosis of neurodegenerative disorders. However, there is an important overlap in cognitive profiles between Alzheimer's disease (AD) and behavioural variant frontotemporal dementia (bvFTD), and the usefulness in diagnosis is uncertain. We aimed to develop machine learning-based models for the diagnosis using cognitive tests.Three hundred and twenty-nine participants (170 AD, 72 bvFTD, 87 healthy control [HC]) were enrolled. Evolutionary algorithms, inspired by the process of natural selection, were applied for both mono-objective and multi-objective classification and feature selection. Classical algorithms (NativeBayes, Support Vector Machines, among others) were also used, and a meta-model strategy.Accuracies for the diagnosis of AD, bvFTD and the differential diagnosis between them were higher than 84%. Algorithms were able to significantly reduce the number of tests and scores needed. Free and Cued Selective Reminding Test, verbal fluency and Addenbrooke's Cognitive Examination were amongst the most meaningful tests.Our study found high levels of accuracy for diagnosis using exclusively neuropsychological tests, which supports the usefulness of cognitive assessment in diagnosis. Machine learning may have a role in improving the interpretation and test selection.
12 citations
TL;DR: Levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English‐speaking regions worldwide are explored by investigating outcomes before and during the COVID‐19 pandemic.
Abstract: Public health restrictions due to the COVID‐19 (SARS CoV‐2) pandemic have disproportionately affected informal caregivers of people living with long term health conditions. We aimed to explore levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English‐speaking regions worldwide, by investigating outcomes before and during the COVID‐19 pandemic.
9 citations
TL;DR: The course of neuropsychiatric symptoms in nursing home residents with dementia during the step‐by‐step lifting of restrictions after the first wave of the COVID‐19 pandemic in the Netherlands and psychotropic drug use throughout the whole first wave are described.
Abstract: To describe the course of neuropsychiatric symptoms in nursing home residents with dementia during the step‐by‐step lifting of restrictions after the first wave of the COVID‐19 pandemic in the Netherlands, and to describe psychotropic drug use (PDU) throughout the whole first wave.
8 citations
TL;DR: Evidence on the effectiveness of digital health interventions on physical, cognitive, behavioural and psychological outcomes, and Activities of Daily Living in people living with dementia and MCI is gathered.
Abstract: Digital health interventions enable services to support people living with dementia and Mild Cognitive Impairment (MCI) remotely. This literature review gathers evidence on the effectiveness of digital health interventions on physical, cognitive, behavioural and psychological outcomes, and Activities of Daily Living in people living with dementia and MCI.
8 citations
TL;DR: Dementia was associated with an increased COVID-19 risk and lower adherence to handwashing among U.S. older adults, and adherence to CO VID-19 mitigation behaviors did not mediate COVID -19 risk by dementia status.
Abstract: To examine how dementia is associated with COVID‐19 risk and adherence to COVID‐19 mitigation behaviors, and whether mitigation behaviors mediate the relationship between dementia and COVID‐19 risk.
8 citations
TL;DR: This study sought to explore the impact of the COVID‐19 pandemic on carers for community‐dwelling people with dementia and compare responses with pre‐pandemic data.
Abstract: Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID‐19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID‐19 pandemic on carers for community‐dwelling people with dementia and compare responses with pre‐pandemic data.
8 citations
TL;DR: Policy guidelines in England recommend that people diagnosed with mild‐to‐moderate dementia receive information and psychosocial interventions to improve their ability to ‘live well’, but it remains unclear to what extent these recommendations are being achieved.
Abstract: Global initiatives that promote public health responses to dementia have resulted in numerous countries developing new national policies. Current policy guidelines in England, for example, recommend that people diagnosed with mild‐to‐moderate dementia receive information and psychosocial interventions to improve their ability to ‘live well’. However, it remains unclear to what extent these recommendations are being achieved.
7 citations
TL;DR: In this article , the authors examined the association between perceived discrimination, including everyday perceived discrimination and major lifetime perceived discrimination in older Puerto Ricans, and cognitive function and the mediating role of depression.
Abstract: To examine (1) the association between perceived discrimination, including everyday perceived discrimination and major lifetime perceived discrimination, and cognitive function and (2) the mediating role of depression between discrimination and cognitive function among older Puerto Ricans.
7 citations
TL;DR: This paper examined the role of resilience on social isolation among older Chinese Americans, the fastest growing aging population across all racial/ethnic groups in the United States, and examined the associations of social isolation with indicators of psychological well-being.
Abstract: Social isolation imposes risks to an individual's psychological well‐being. However, few studies have examined the role of resilience on these associations among older Chinese Americans, the fastest‐growing aging population across all racial/ethnic groups in the United States. We aim to examine the associations of social isolation with indicators of psychological well‐being and the mediating role of resilience in these associations.
TL;DR: The results failed to show a significant relationship between the presence of CP and long-term dementia risk, suggesting that the cognitive decline associated with CP observed in the literature does not appear to be related to Alzheimer's disease or related disorders.
Abstract: Chronic pain (CP) was associated with cognitive impairment in previous studies. However, the longitudinal association between CP and dementia remains under debate. We aimed to assess the prospective link between CP and long‐term dementia risk in a population‐based cohort of older participants, considering covariables linked to CP and cognitive functioning.
TL;DR: This work sought to estimate the rate of burden and psychological distress in carers of YOD at a state‐wide tertiary service based in Australia.
Abstract: Carer burden in dementia is associated with poor outcomes, including early nursing home placement for people with dementia and psychological distress for their carers. Carers of people with young‐onset dementia (YOD) are particularly vulnerable to carer burden. Yet they are often overlooked by clinicians as dementia services are generally designed for older people. We sought to estimate the rate of burden and psychological distress in carers of YOD at a state‐wide tertiary service based in Australia.
TL;DR: In this article , the potential off-label use of antidepressants among adults ≥ 65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications was studied.
Abstract: Off‐label prescriptions of antidepressants may be of special concern in older‐adults. We aimed to study the potential off‐label use of antidepressants among adults ≥65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications.
TL;DR: This randomised controlled trial aimed to investigate the cognitive effects of a DHA fish oil supplement in older adults with mild cognitive impairment, and to examine the moderating effect of the apolipoprotein E (APOE) ɛ4 allele on cognition and well‐being.
Abstract: Several recent clinical trials have shown that docosahexaenoic acid (DHA) supplements have a significant effect on cognition in cognitively impaired older adults. This randomised controlled trial aimed to investigate the cognitive effects of a DHA fish oil supplement in older adults with mild cognitive impairment, and to examine the moderating effect of the apolipoprotein E (APOE) ɛ4 allele on cognition and well‐being.
TL;DR: The impact of covid‐19 on Black and South‐Asian people living with dementia and their carers as well as exploring the experiences of dementia care using an ecological model is explored.
Abstract: People from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their White counterparts in the United Kingdom (UK). Covid‐19 has exacerbated health inequalities and diminished trust from underserved communities in the government and health services. The wider aim of the study was to explore the impact of covid‐19 on Black and South‐Asian people living with dementia and their carers as well as exploring the experiences of dementia care. The present paper specifically explores their views on trust and mistrust using an ecological model.
TL;DR: Recommendations for the management of HAD are still lacking, partly due to a poor understanding of the underlying processes, and existing data on risk factors, pathophysiology, measurement tools, and potential interventions are reviewed.
Abstract: Hospital‐associated deconditioning (HAD) or post‐hospital syndrome is well recognized as reduced functional performance after an acute hospitalization. Recommendations for the management of HAD are still lacking, partly due to a poor understanding of the underlying processes. We aimed to review existing data on risk factors, pathophysiology, measurement tools, and potential interventions.
TL;DR: In this paper , cognitive scores and neurodegenerative and vascular biomarkers in healthy older adults who later developed depression were assessed and compared with healthy adults who did not develop depression.
Abstract: Understanding the biological changes that occur prior to onset of late‐life depression (LLD) is key to its prevention. To investigate potential predictors of LLD, we assessed cognitive scores and neurodegenerative and vascular biomarkers in healthy older adults who later developed depression.
TL;DR: In this article , the authors demonstrate the strategy of using single point assessment of cognitive performance with scoring normed for degree of intellectual disability to generate age related prevalence data for acquired mild cognitive impairment (AMCI).
Abstract: Individuals with Down syndrome (DS) are at significant risk for early onset Alzheimer's disease (AD), likely due to the triplication of genes on chromosome 21 that facilitate AD neuropathology. To aid the effective early diagnosis of dementia in DS, we demonstrate the strategy of using single point assessment of cognitive performance with scoring normed for degree of intellectual disability to generate age related prevalence data for acquired mild cognitive impairment (AMCI).Four hundred and twelve adults with DS were assessed using the Neuropsychological Assessment of dementia in adults with Intellectual Disability. Normative data, banded by degree of intellectual disability, allowed identification of AMCI by atypical deviation from expected performance.AMCI was evident in approximately 20% of adults with DS aged 40 and under, 40% aged 41-50 and 45% aged 51 and over. Relative risk increased significantly in those aged 46 and over. Analysis of prevalence by 5-year age bands revealed two peaks for higher prevalence of AMCI.Psychometric data indicate single point assessment of AMCI is possible for the majority of adults with DS. Two peaks for age-related prevalence of AMCI suggest the risk for onset of AD conferred by trisomy of chromosome 21 is moderated by another factor, possibly ApoE status.
TL;DR: Aim of current study is to reach consensus on the terminology and operational definition of dementia at a young age (i.e., age‐related criteria and possible causes) to aid further research.
Abstract: Dementia at a young age differs from late onset dementia in pathology and care needs. This requires further research to improve the understanding of this group, support and service provision. Aim of current study is to reach consensus on the terminology and operational definition (i.e., age‐related criteria and possible causes) of dementia at a young age, to aid further research.
TL;DR: The pandemic‐related challenges faced by people recently diagnosed with dementia are identified and the ways in which they actively coped with, and adapted to, these challenges are examined.
Abstract: Research into people with dementia's experiences of the Covid‐19 pandemic has tended to focus on vulnerabilities and negative outcomes, with the risk of reproducing a discourse in which people with dementia are positioned as passive. Informed by concepts positioning people with dementia as ‘active social agents’, we aimed to identify the pandemic‐related challenges faced by people recently diagnosed with dementia and examine the ways in which they actively coped with, and adapted to, these challenges.
TL;DR: This work aimed to assess whether the cognitive prodrome of dementia with Lewy bodies, mild cognitive impairment (MCI‐LB), would have more severe reported autonomic symptoms than cognitively healthy older adults, with MCI due to Alzheimer's disease ( MCI‐AD) also included for comparison.
Abstract: Autonomic symptoms are a common feature of the synucleinopathies, and may be a distinguishing feature of prodromal Lewy body disease. We aimed to assess whether the cognitive prodrome of dementia with Lewy bodies, mild cognitive impairment (MCI) with Lewy bodies (MCI‐LB), would have more severe reported autonomic symptoms than cognitively healthy older adults, with MCI due to Alzheimer's disease (MCI‐AD) also included for comparison. We also aimed to assess the utility of an autonomic symptom scale in differentiating MCI‐LB from MCI‐AD.
TL;DR: This work aimed to assess whether abnormal blood pressure and heart rate responses to orthostatic challenge and Valsalva manoeuvre would be more common in mild cognitive impairment with Lewy bodies than MCI due to Alzheimer's disease (MCI‐AD).
Abstract: Orthostatic hypotension is a common feature of normal ageing, and age‐related neurodegenerative diseases, in particular the synucleinopathies including dementia with Lewy bodies. Orthostatic hypotension and other abnormal cardiovascular responses may be early markers of Lewy body disease. We aimed to assess whether abnormal blood pressure and heart rate responses to orthostatic challenge and Valsalva manoeuvre would be more common in mild cognitive impairment with Lewy bodies (MCI‐LB) than MCI due to Alzheimer's disease (MCI‐AD).
TL;DR: The aim of the present study was to analyze the change in burden, strain, mood, and quality of life after a 2‐year follow-up in a cohort of caregivers of patients with PD and also to identify predictors of these changes.
Abstract: Caregiver burden in Parkinson's disease (PD) has been studied in many cross‐sectional studies but poorly in longitudinal ones. The aim of the present study was to analyze the change in burden, strain, mood, and quality of life (QoL) after a 2‐year follow‐up in a cohort of caregivers of patients with PD and also to identify predictors of these changes.
TL;DR: There is scarce evidence on the effects of COVID‐19 on quality of dementia care in LTC, but anecdotal reports indicate that this negatively affected LTC residents' quality of care and wellbeing.
Abstract: The first wave of the COVID‐19 pandemic necessitated extensive infection control measures in long‐term care (LTC) and had a significant impact on staffing and services. Anecdotal reports indicate that this negatively affected LTC residents' quality of care and wellbeing, but there is scarce evidence on the effects of COVID‐19 on quality of dementia care in LTC.
TL;DR: This work aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID‐19, and study the association ofDelirium independent of frailty with in‐hospital outcomes in older CO VID‐19 patients.
Abstract: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID‐19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID‐19. Furthermore, we aimed to study the association of delirium independent of frailty with in‐hospital outcomes in older COVID‐19 patients.
TL;DR: In this paper , the authors explored the use of technology and its perceived effects across different settings and countries, and found that the benefits of technology for health and psychosocial care were limited.
Abstract: Objectives Considering the adverse outcomes of COVID-19, it is essential to provide adequate support and care for people with dementia and informal carers. Technology can reduce the distress associated with social distancing rules and the decreased access to in-person services. This study aimed to explore the use of technology and its perceived effects across different settings and countries. Methods The sample was composed of 127 informal carers and 15 people with dementia from the UK, Italy, Australia and Poland. Semi-structured interviews explored participants' experiences of using technology and their perceived effects. Transcripts were analysed by researchers in each country using an inductive approach. Results Three overarching themes were developed: (1) Technology kept us alive during COVID-19; (2) Remote care was anything but easy; (3) Perceived technology limitations. Many similarities emerged between countries supporting the role of technology for being socially engaged, having a routine, and staying active. However, the benefits of technology for health and psychosocial care were more limited. Across countries, barriers to the access and use of technology included lack of digital literacy, dementia severity, and lack of appropriate digital environments. Help and supervision from carers were also necessary and sometimes perceived as an additional burden. Conclusions Technology can effectively reduce the shrinking world that may be amplified by the pandemic, thus preserving people with dementia's social skills and maintaining family connections. However, for more extensive and well-adapted use of technology in dementia care, actions should be taken to overcome the barriers to the access and use of technology by older and vulnerable people globally.
TL;DR: Active engagement in art and cultural activities may contribute to preventing depressive symptoms among older adults, and especially dancing and photography were protective against depressive symptoms.
Abstract: Art and cultural activities can benefit mental health. However, there is insufficient evidence on active engagement in art and cultural activities for preventing depressive symptoms among older adults. Therefore, we examined the association of active engagement in art and cultural activities with depressive symptom onset among older adults using 3‐year longitudinal data.
TL;DR: This work evaluated how well Mini–Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) predicted high costs in Ireland.
Abstract: Policymakers want to better identify in advance the 10% of people who account for approximately 75% of health care costs. We evaluated how well Mini–Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) predicted high costs in Ireland.
TL;DR: Interventions that address older adults' social isolation and loneliness may ameliorate depression in older adults with hearing loss.
Abstract: To evaluate whether social isolation and loneliness mediates the relationship between hearing loss and depression symptoms in older adults in China.