Geriatric Depression Scale Short Form Research Articles

The Impact of the COVID-19 Pandemic on Suicidal Ideation and Depression in Community-Dwelling Elderly.

This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea. Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation. Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation. These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation.

Depression and its Association with Insomnia among Geriatric Population of Selected Slums of Bankura Municipality, West Bengal

Background: While depression is a major health concern among older people, sleep disorders are also very common among them and often persist simultaneously. The study was conducted to assess the prevalence of depression and insomnia, and any correlation of association between them, in the geriatric people living in study area. Methodology: A cross-sectional analytical study was conducted among 186 older people living in three selected slums of Bankura Municipality, West Bengal, India. A pre-tested, structured interviewer-administered-questionnaire including Geriatric Depression Scale-Short form and Insomnia Severity Index were used for data collection. Results: The prevalence of geriatric depression and insomnia in the study setting were 54.3% and 37.6% respectively. While illiteracy, complete financial dependency and taking sedative were associated with geriatric depression, history of smoking was associated with insomnia among participants. Geriatric depression was significantly associated with insomnia. There was statistically significant positive correlation between GDS-S score and ISI score. Conclusions: A significant proportion of elderly population suffers from depressive disorders and sleep disorders. Early detection and management of these conditions will provide the society with healthy ‘senior citizens.

Exploring the Relationship Between Amyloid Burden and Depression in Pre-clinical Alzheimer's Disease.

Background Alzheimer's disease (AD) is a form of dementia, marked by amyloid-β plaques, neurofibrillary tangles, and neuronal loss. The amyloid burden has been associated with cognitive impairment and depression, suggesting a potential link between these conditions. Objective This study investigates the relationships between amyloid burden, cognitive impairment, and depression in the preclinical stages of AD. Methods Data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study, involving 4486 cognitively unimpaired individuals aged 65-85, was analyzed. The amyloid burden was assessed using positron emission tomography (PET) standardized uptake value ratio (SUVR), cognitive function viacognitive function index (CFI) and tests, and depression via the short-form geriatric depression scale. Mediation analyses, adjusted for age, sex, and education, were employed to measure the impact of amyloid deposition on depression into direct and cognition-mediated indirect effects. Results No significant direct correlation between amyloid burden and depression was found (p=0.2935). Significant indirect effects were observed in cognition measures: CFI (0.3203, 95% CI: (0.2382, 0.4010)), digit symbol substitution test (0.0401, 95% CI: (0.0180, 0.0683)), and immediate recall (0.0169, 95% CI: (0.0014, 0.0354)). However, free and cued selective reminding (0.0056, 95% CI: (-0.0078, 0.0268)) and delayed recall (0.0105, 95% CI: (-0.0009, 0.0259)) showed no significant indirect effects. Conclusions The findings indicate significant mediation by CFI, digit symbol substitution test, and immediate recall in the relationship between amyloid burden and depression while free and cued selective reminding and delayed recall showed no significant mediation. These results underscore the importance of further research using longitudinal data and a broader range of confounders to fully understand cognition's mediating role.

A - 33 Impact of Cognitive Stimulation Therapy on Neuropsychiatric Symptoms and Everyday Functioning in a Veteran Sample

Abstract Objective Cognitive stimulation therapy (CST) is a well-supported nonpharmacological intervention, found to improve or maintain global cognition, daily functioning, and quality of life with persons with dementia. There are fewer studies assessing the effect of CST on neuropsychiatric symptoms; however, pilot studies have identified improvement in depression and anxiety in studies of persons with Alzheimer’s disease. The purpose of this program evaluation was to evaluate the impact of CST on neuropsychiatric symptoms and everyday functioning is a veteran sample. Method Twenty-six male veterans diagnosed with cognitive disorder (84.6% dementia, 15.4% mild cognitive impairment) completed a 7-week CST program. The sample was diverse (46.2% White/Caucasian, 42.3% Hispanic/Latino, 7.7% Black/African American; 38.5% bilingual). Most frequent etiologies included mixed (26.8%), Alzheimer’s (23.1%), and vascular (19.2%). Ages ranged from 43–86 (M = 74.5; SD = 7.6). Pre-group/post-group assessment included Geriatric Depression Scale-Short Form (GDS-SF), Geriatric Anxiety Inventory (GAI), Neuropsychiatric Inventory (NPI-informant), Everyday Cognitive (ECOG), and Texas Functional Living Scale (TFLS). Analyses included paired-samples t-test and Wilcoxon signed-rank test. Results Post-group GAI scores were significantly lower (Median = 1) than pre-group scores (Median = 3), z = −2.574, p = 0.01, r = −0.515. There were no significant declines or improvements across other measures of neuropsychiatric symptoms. Measures of IADLs/everyday functioning also remained stable. Conclusions Consistent with prior studies, CST was effective in reducing anxiety symptoms of veterans with cognitive disorders. While measures of everyday functioning did not improve, performance and informant-report remained stable. CST presents a unique opportunity to impact both cognition and neuropsychiatric symptoms that may cause significant distress in veterans with dementia and their caregivers.

Prevalence and associated factors of geriatric depression among institutionalised senior citizens: a cross-sectional study

Background: Ageing is an inevitable process. As a result of empty nest syndrome, the senior citizens of Kerala, are forced for institutionalization. Prevalence of mental morbidity among institutionalized senior citizens outnumbers those living in families. Depression is one of the most common psychiatric morbidities among senior citizens. The present study aims to determine the prevalence and factors associated with geriatric depression among institutionalized senior citizens of Ernakulam district. Methods: A cross-sectional descriptive study was conducted over a period of 3 months among 238 institutionalised senior citizens aged 60 years and above using geriatric depression scale- short form (GDS-SF). Data was entered and analysed using SPSS. Results: Among participants, 23.11% reported mild depression, 4.20% had moderate and 7.14% had severe depression. Chi-square test was used to study the association of various factors with geriatric depression. Previous employment status, source of income, frequency of visit by relatives, contact with relatives through phone, duration of leisure time activities and sleep quality showed a statistically significant association. Conclusions: The study highlights the need for regular screening activities. Further research is necessary on identification of modifiable risk factors.

Effect of a Group-Based Personal Assistive RObot (PARO) Robot Intervention on Cognitive Function, Autonomic Nervous System Function, and Mental Well-being in Older Adults with Mild Dementia: A Randomized Controlled Trial

ObjectivesPersonal Assistive RObot (PARO) interventions have been used to treat agitation and mood symptoms of dementia effectively. However, the effects of a PARO intervention on physiological and cognitive function are unclear. To examine the effects of a group-based PARO intervention for older adults with mild dementia. DesignUsing a group-based PARO intervention randomized controlled trial with 2-arm parallel groups. Setting and ParticipantsOlder adults with mild dementia aged 65 years or older from 4 dementia day care centers were recruited. MethodsPhysiological parameters were assessed using the finger tapping test (FTT) and heart rate variability (HRV). The Mini-Mental State Examination (MMSE), Geriatric Depression Scale–Short Form (GDS-SF), University of California Los Angeles loneliness scale–version 3 (UCLA-3), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS) were assessed before the intervention, end of the intervention, and 1-month after the intervention. ResultsUsing a repeated-measures generalized linear model, significant time × group interactions were found in the MMSE [F(2, 115) = 19.54, P < .001], FTT [F(2, 115) = 4.87, P = .01], HRV high-frequency [F(2, 115) = 3.57, P = .03], and high-frequency/low-frequency ratio [F(2, 115) = 0.96, P = .01], UCLA-3 [F(2, 115) = 54.7, P < .001], GDS-SF [F(2, 115) = 3.36, P = .04], and WEMWBS [F(2, 115) = 5.93, P < .001]. Furthermore, psychological parameters improved significantly and continuously even 1 month after the PARO intervention was finished. Physiological parameters significantly improved at week 6, but the effects had diminished by week 10. Conclusions and ImplicationsA PARO intervention may effectively improve the physiological and psychological responses of people with mild dementia.

The relationship between the frequency of use of non-medication coping strategies with urinary incontinence and depression in older adults.

The aim of this study is to examine the relationship between the frequency of use of non-medication coping strategies with urinary incontinence (UI) and depression in older adults. This study followed a descriptive design and was conducted with 345 older adults over the age of 65. The data of the study were collected using the Geriatric Depression Scale Short Form and the Frequency of Non-Medication Coping Strategies with Urinary Incontinence Scale. The data analysis of the study was conducted using descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis. The significance level was accepted as P < 0.05. The mean age of the participants was 71.86 ± 5.43 years. Among the older adults, 58.8% were male and 50.2% were primary school graduates. It was determined that 43.8% of the participants experienced the frequency of UI more than once a week, 36.2% experienced stress incontinence, 51.9% consulted a physician due to UI, 53.6% received treatment for UI, and 47.8% reported that UI had an impact on their social life. The relationship between the frequency of use of non-medication coping strategies with UI and geriatric depression (β = -0.017; P = 0.043) was found to be significant and negative. It was found that there was a significant and positive relationship between age, frequency of UI, type of UI, the impact of UI on social life, and geriatric depression (P < 0.05). The older adults in this study were found to have moderate depression. It was determined that the level of depression was higher in the older adults who experienced UI more than once a week, those who experienced stress UI, those whose social lives were impacted, and those who had a higher frequency of non-medication coping strategies.

Intervention with strategic metacognitive training in a population of elders with subjective cognitive decline

Objectives: this research, conducted at the University Hospital of Alessandria, aimed to assess the impact of strategic metacognitive training on cognitive abilities, well-being, and the reduction of depressive symptoms in an elderly population. Materials and Methods: the study included a sample of 11 subjects, aged 66 to 81 years, exhibiting subjective cognitive decline. They had to learn mnemonic strategies and, through the metacognitive task, reflecting on the learning and application processes. The training included 10 sessions, once a week. Cognitive functioning was assessed using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) in pre-test and post-test evaluations. Ad hoc tests were employed to investigate the effects of practice and generalization. Well-being, measured through the Psychological Wellbeing Questionnaire (BEN-SSC), and depressive status, assessed with the 15-item short form Geriatric Depression Scale (sfGDS), were also evaluated before and after the intervention. Results: the cognitive measurements yielded no significant findings, except for a tendency toward significance in the visuospatial and language ability index of the RBANS, indicating a slight improvement. Regarding well-being and mood, also here no results emerged in favor of significance. The only significant data was a reduction in personal satisfaction according to the BEN-SSC. Conclusions: the obtained results may be explained by potential inadequacies in the methodology, specifically in the structure and planning of the training. However, participants expressed interest in this type of intervention, demonstrating adherence in other training program.

Association of Frailty, Balance, and Depression with Activities of Daily Living in Older Adults

Purpose: This study aimed to examine the effects of frailty, balance, and depression on the performance of activities of daily living (ADL) in older adults. Methods: Eighty-five older adults registered at a community health center in Amasya-Türkiye volunteered to participate in this one-time data collected observational study. All participants were assessed using the Mini Mental State Test (MMST), simple FRAIL scale, Geriatric Depression Scale–Short Form, and Lawton Instrumental Activities of Daily Living (L-IADL) Scale. Results: According to FRAIL scale scores, 38.8% (n = 33) of the participants were evaluated as frail, 37.6% (n = 32) as pre-frail, and 23.5% (n = 20) as normal. There were statistically significant correlations between all parameters analyzed (p &lt; 0.05). According to the regression analysis performed to determine which factors are associated with L-IADL, it was determined that a 1-unit increase in the Berg Balance Scale score was associated with a 0.639-unit increase in the L-IADL score. Mean L-IADL score differed significantly between the frailty groups, with frail participants having a significantly lower mean L-IADL score compared to pre-frail and normal participants (p &lt; 0.05). Conclusions: Our results demonstrated that frailty, balance, and depression are associated with performance of activities of daily living, with balance being the strongest determinant. Frail older adults showed greater dependence in activities of daily living than those who were pre-frail or normal.

Relationship between Nutritional Status and Activities of Daily Living on Geriatric Depression among the Elderly Attending Primary Health Centers in Southern Karnataka

Abstract Introduction: The population of the planet is aging quickly. According to the World Health Organization, the percentage of elderly individuals above 60 years of age worldwide is predicted to be doubled, from 12% in 2015 to 22% by 2050. Depression is the most common psychiatric disorder among the elderly which has a larger influence on their physical and emotional well-being. It is important to recognize the unique physical and mental health issues experienced by older adults. Materials and Methods: A community-based analytical cross-sectional study was conducted among elderly above 60 years of age attending two Primary Health Centres in the field practice areas of JSS Medical College, Mysuru. Based on inclusion and exclusion criteria, 130 elderly people were selected. Pretested semi-structured questionnaire on sociodemographic characteristics was administered, and a Geriatric Depression Scale (short form), Mini Nutritional Assessment Scale of the elderly, and Katz scale of independence were used. Statistical tests such as the Chi-square test and Spearman’s correlation test were used. Results: The prevalence of geriatric depression was 34.6%. Along with that, 5% were malnourished and 60% were at risk of malnutrition. The prevalence of physical dependency was 10%. Malnutrition and daily living activities were significantly associated with depression. Nutritional status and daily living activities show a negative correlation with geriatric depression and among them, nutritional status shows significant negative correlation with geriatric depression. Conclusion: Most of the elderly with poor nutritional status were depressed. Proper nutrition and adequate physical activity can cause a reduction in depression among the elderly.

The Feasibility and Efficacy of a Virtual Reality Tandem Cycling Program for Persons with Parkinson's Disease and Their Care Partners.

Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health. Ten PD dyads were recruited to complete 8weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05. Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (-7.38, p<0.01), FGA scores (+3.50, p<0.01), and 10-m gait speed times (+0.27m/s, p<0.01), in addition to significant self-reported improvements in mobility (-13.61, p=0.02), fatigue (-5.99, p=0.02), and social participation (+4.69, p<0.01). CP depressive symptoms significantly decreased (-0.88, p=0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p=0.04). Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.

Depression, quality of life, and cognitive abilities among older adults

The world’s population is aging at an increasing rate. According to the World Health Organization, the global population over 60 is expected to double between 2015 and 2050. Mental health is crucial at every stage of life, encompassing emotional, psychological, and social well-being. This study aimed to explore the relationship between cognitive abilities, depression, and quality of life among older adults as well as to investigate the impact of depression on cognitive abilities and quality of life. Convenience sampling was used to collect data from 107 older adults (61 females and 46 males) living in residential homes with the family or old age homes. Addenbrooke's Cognitive Examination-III, the Geriatric Depression Scale short form, and The World Health Organization Quality of Life Brief Version were used for administration. Non-parametric approaches using Mann Whitney U test, Spearman correlation, and linear regression were employed for data analysis. A significant difference in the levels of depression between older adults living at home with their families and older adults living in old age homes was found. Depression and cognitive abilities and depression and quality of life were found to be significantly negatively correlated. A significant regression equation was present depicting depression has a notable impact on both cognitive abilities and quality of life. The results of this study can contribute to raising awareness and acknowledging the presence of depression and its related effects among older adults, regardless of their living circumstances.

#1137 Association between cognitive function, depressive symptoms and quality of life in older patients with severely reduced GFR and kidney failure

Abstract Background and Aims Impaired cognitive function and reduced health-related quality of life (HRQoL) are common in older patients with chronic kidney disease (CKD) with severely reduced GFR and kidney failure. Older patients with CKD often regard HRQoL as a health priority, but it is unknown whether cognitive function associates with HRQoL and whether depressive symptoms mediate this association. We therefore aim to examine the association between cognitive function and HRQoL, and explore the mediating role of depressive symptoms. Method Patients aged 65 years and older with an eGFR between 20 and 10 mL/min/1.73 m2 participating in the ongoing DIALysis or not: Outcomes in older kidney patients with GerIatriC Assessment (DIALOGICA) study were included. Cognitive function, depressive symptoms and HRQoL were assessed using the Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15) and Twelve-Item Short Form Health Survey (SF-12) questionnaire, respectively. The SF-12 yields a Mental Component Summary (MCS) score and Physical Component Summary score (PCS). We created a diagram of the hypothesized direct and indirect pathways between cognition and HRQoL, with depressive symptoms as the purported mediator (Fig. 1). We used cross-sectional multivariable linear regression analyses to examine the association between cognitive function and both mental and physical HRQoL, and multivariable mediation analyses to explore the role of depressive symptoms. Results In total, 403 patients were included with a mean age of 76.5 years, with a standard deviation (SD) of 5.8 and a mean eGFR of 14.5 mL/min/1.73 m2 (SD 3.0). A majority of patients were male (71.5%). Cognitive function associated significantly with mental HRQoL (adjusted β 0.30, 95% confidence interval (CI) 0.05; 0.55, p 0.021), but not with physical HRQoL (adjusted β 0.18, 95% CI −0.09; 0.44, p 0.20). The mediation effect of depressive symptoms between cognitive function and MCS remained significant after adjustment (indirect effect 0.15, 95% CI 0.04; 0.26). Thus, lower cognitive function was associated with lower mental HRQoL, which was partly mediated by corresponding increases in depressive symptoms. Conclusion Cognitive function is associated with mental HRQoL, but not with physical HRQoL in older patients with severely reduced GFR and kidney failure. This association is partially mediated by depressive symptoms. These findings underline the importance of screening for cognitive impairment and depressive symptoms in this population and may increase the understanding of what potentially affects HRQoL. As HRQoL is seen as a health priority, further research should explore whether cognitive interventions or treatment of depressive symptoms result in improvement of HRQoL in this population.

IT’S NEVER TOO LATE TO START: A CASE FOR PREVENTATIVE OUTPATIENT GERIATRIC SERVICES

INTRODUCTION &amp; AIMS The population is ageing and the chronic disease burden growing, seeing more older adults present to hospital with preventable non-communicable diseases. Multidisciplinary outpatient teams are well placed to manage modifiable risk factors to prevent disease progression and hospitalisations. A preventative service was launched at Concord Hospital integrating geriatrician, exercise physiologist and dietitian care to optimise the physical and mental health of older adults with chronic disease and frailty. This evaluation aims to determine the success of service implementation and feasibility of the model. METHODS Between November 2022 and June 2023, 59 patients (mean age 80.2 years (SD 6.2), 47.5% female) completed 12-weeks of concurrent exercise and diet interventions with medical oversight. Patients were assessed pre- and post-interventions. Exercise was individualised and multimodal, performed twice weekly in a supervised group. Diet was individualised with a protein supplement prescribed as appropriate. The outcomes measured were Fried Frailty Phenotype (FFP), leg strength (one repetition maximum leg press), Short Physical Performance Battery (SPPB), Geriatric Depression Scale Short Form (GDS), and Mini Nutritional Assessment Long Form (MNA). Service activity was measured monthly via rate of referral and occasions of service (OOS). Data were analysed using JASP (v.0.18.1). RESULTS Monthly rate of referral and OOS increased from 18 to 51 patients and 49 to 479 occasions respectively, indicating service demand. After 12-weeks there were significant improvements in FFP (mean difference [95%CI] -0.4 [-0.7, -0.2] points), leg strength (34.0 [27.1, 40.8] kilograms), SPPB (1.1 [0.8, 1.5] points), GDS (-1.4 [-2.2, -0.6] points) and MNA (2.6 [1.6, 3.5] points), with no effect of sex observed. CONCLUSION Initial implementation of a preventative outpatient geriatric service was successful with increasing service demand and significant physical and mental health improvements. The service model is feasible; however, further evaluation is required to determine outcomes after continued service provision.

Burden of frailty and its correlates among the elderly: a cross-sectional study in a rural community of West Bengal.

With the ageing of Indian society, providing a healthy life among older people is a public health precedence. Therefore, beforehand discovery and possible forestalment of frailty may help promote healthy ageing and dwindle the social, mental and financial burden of their families and caregivers. The study aimed to assess the proportion of frailty and its associated factors among the elderly aged 65 years and above in a rural community of West Bengal. A community-based cross-sectional study was conducted among 270 elderlies selected from 15 villages out of a total 64 villages of Singur under the Hooghly District of West Bengal from January 2019 to February 2020. Cluster sampling technique was used. Data was collected using a pre-designed, pre-tested structured schedule including Fried frailty phenotype (FFP), geriatric depression scale short form (GDS 15) and mini nutritional assessment (MNA) tool. Associated factors of frailty were assessed by univariate and multivariable logistic regression using SPSS version 16 software and MS Excel 2019. The proportion of frailty was observed to be 23.7% and that of prefrailty 40.7%. Frailty was significantly associated with increasing age [AOR(CI) 1.2(1.1-1.3)], decreasing years of schooling [AOR(CI) 1.3(1.1-1.5)], loss of spouse [AOR(CI) 4.2(1.2-15.2)], financial dependency [AOR(CI) 19.3(2.7-139.0)], staying at home [AOR(CI) 16.3(2.7-98.2)], presence of anaemia [AOR(CI) 3.6(1.3-9.5)], at risk of malnutrition [AOR(CI) 6.5(1.9-22.3)], increasing number of falls in the last 1 year [AOR(CI) 4.3(1.2-15.6)], presence of 3 or more chronic diseases [AOR(CI) 154.7(12.1-1981.9)] and depression [AOR(CI) 8.3(2.5-27.0)]. The burden of frailty among the study population is relatively high. It's an intimidating situation that needs bettered screening provisions for early discovery with special stress on nutritive upliftment. Screening for depression should also be done regularly.

The effect of frailty levels of older individuals on their mental well-being and depression levels.

Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels. This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used. The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001). Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.

Association between Controlling Nutritional Status (CONUT) Score and Body Composition, Inflammation and Frailty in Hospitalized Elderly Patients.

a total of 361 patients were retrospectively recruited and divided into three groups based on the CONUT score. patients with a score ≥5 exhibited significantly higher levels of inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil/Lymphocytes ratio (NLR), main platelet volume (MPV), and ferritin, compared to those with a lower score. Furthermore, these patients showed unfavorable changes in body composition, including a lower percentage of skeletal muscle mass (MM) and fat-free mass (FFM) and a higher percentage of fatty mass (FM). A positive correlation was found between the CONUT score and inflammatory markers, Geriatric Depression Scale Short Form (GDS-SF), and FM. Conversely, the Mini Nutritional Assessment (MNA), Mini-Mental Status Examination, activity daily living (ADL), instrumental activity daily living (IADL), Barthel index, FFM, and MM showed a negative correlation. Frailty was highly prevalent among patients with a higher CONUT score. The receiver operating characteristic (ROC) curve demonstrated high accuracy in identifying frail patients (sensitivity). a high CONUT score is associated with a pro-inflammatory status as well as with unfavorable body composition. Additionally, it is a good tool to identify frailty among hospitalized elderly patients.

Is it possible to deprescribe benzodiazepine receptor agonists in older adults?

Aim: to analyze the viability and related factors for deprescribing benzodiazepine receptor agonists (BZRA).Methods: this is a longitudinal, prospective, interventional study performed with older adults assisted at a geriatric psychiatry outpatient clinic; these were divided into two groups: BZRA users and non-users. The instruments used in this study were a general questionnaire, the Geriatric Depression Scale (short form), the Geriatric Anxiety Inventory, and the Pittsburgh Sleep Quality Index.Results: we evaluated 74 patients, 40 (54.1%) of which were BZRA users and 34 (45.9%) were non-users, with an average age of 71.3 ± 7.5 years. Patients who used BZRA had a higher dropout rate of the deprescription process 26 (65%). Seven patients completely stopped using BZRAs (17.5%) and five reduced their use (12.5%). The mean scores for depression and anxiety symptoms were lower at the final assessment. As to sleep quality, BZRA users presented higher baseline values and both groups presented reductions in scores at the end of the treatment.Conclusion: deprescribing is viable and safe. However, there is resistance by both the patient and prescribers. The levels of anxiety, depression, and sleep quality improved after discontinuing BZRA.

Baseline neuropsychiatric symptoms and psychotropic medication use midway through data collection of the Longitudinal Early‐ Onset Alzheimer’s Disease Study (LEADS) Cohort

AbstractBackgroundWe examined neuropsychiatric symptoms (NPS) and psychotropic medication use at the midway point of data collection of the Longitudinal Early‐onset Alzheimer’s Disease Study (LEADS). We compared amyloid‐positive early‐onset Alzheimer’s disease (EOAD) participants and amyloid‐negative early‐onset non‐Alzheimer’s disease [EOnonAD]) participants across NPS domains and psychotropic medication categories.Method282 participants enrolled in LEADS were compared across diagnostic groups – amyloid‐positive EOAD (n = 212) and amyloid‐negative EOnonAD (n = 70). All participants were between ages 40 and 64 at baseline. NPS were measured with the Neuropsychiatric Inventory – Questionnaire (NPI‐Q) and Geriatric Depression Scale – Short Form (GDS‐SF). Medications were categorized into psychotropic category (e.g., antidepressants, antipsychotics, benzodiazepines). Groups were compared on NPI‐Q using binary logistic regression adjusting for sex and disease severity, on GDS‐SF using linear regression adjusting for sex and disease severity, and on psychotropic medication use using Chi square or Fisher’s exact test.ResultDemographic data are presented in Table 1. Average total NPI‐Q score was higher in EOnonAD than EOAD (p = .002, ŋp 2 = .03). Regardless of diagnostic group, informants endorsed Affective behaviors most frequently (76.2%). EOAD informants endorsed fewer Distress‐Tension behaviors (p = .02, OR = .498) and Impulse Control behaviors (p = .01, OR = .438). EOAD informants also endorsed apathy (p &lt; .001, OR = .316), irritability (p = .02, OR = .498), and disinhibition (p = .04, OR = .476) at lower frequency than EOnonAD. GDS‐SF showed that the EOnonAD participants self‐reported more symptoms of depression than the EOAD group (p = .002, ŋp 2 = .03). (Table 2A). A minority of participants, regardless of diagnostic group, reported psychotropic medication use (35%). There was higher use in EOnonAD (38%) than EOAD (24%) (p = .03, Cohen W = .14) (Table 2B).ConclusionNPS burden and psychotropic medication use were higher in EOnonAD than EOAD participants, despite EOnonAD being less severely impaired. LEADS continues to collect data. Future studies will examine etiologies that may be larger drivers of NPS than AD neuropathology, mediators (e.g., race, ethnicity) in the association between NPS and diagnostic group classication, compare NPS in EOAD vs. LOAD, and examine longitudinal changes in neuropsychiatric profiles.

Influences of Cognitive Function and Depressive Symptoms on Pain Trajectories During the First Year Following Hip Fracture Surgery: A Prospective Cohort Study

ObjectivesThe purposes of this study were to explore trajectories for patterns of postoperative pain intensity during the first year following hip fracture surgery and the relationships between pain trajectory groups, cognitive impairment, and depressive symptoms. DesignA prospective cohort correlational study. Setting and ParticipantsA total of 325 patients aged 60 years or older who had received hip fracture surgery at a 3000-bed medical center in northern Taiwan from September 2012 to March 2020. MethodsData were collected before hospital discharge and at 1, 3, 6, and 12 months postdischarge. Pain intensity was measured using a numeric rating scale; cognitive function was measured with the Taiwan version of the Mini-Mental State Examination; and depressive symptoms were measured by the Geriatric Depression Scale–Short Form. Patients with similar postoperative pain trajectories were categorized into groups and compared with group-based trajectory modeling. Cognitive impairment and depressive symptoms associated with each group were identified by logistic regression. ResultsThree different pain trajectory groups were identified: drastic decline–minimum pain (47.7%), gentle decline–mild pain (45.5%), and slight decline–moderate pain (6.8%). Patients with cognitive impairment [odds ratio (OR) 11.01, 95% CI 2.99-10.51] and at risk for depression (OR 49.09, 95% CI 10.46-230.30) were more likely to be in the moderate pain group than the minimum pain group. Patients with cognitive impairment (OR 2.07, 95% CI 1.25-3.42) were more likely to be in the mild pain group than the minimum pain group. Patients at risk for depression (OR 9.68, 95% CI 3.16-29.63) were more likely to be in the moderate pain group than the mild pain group. Conclusions and ImplicationsIdentifying postoperative pain trajectories can provide insight into the most appropriate pain management for older persons following hip fracture surgery. Attention should focus on assessments for cognitive impairment and risk of depression to prevent persistent postoperative pain. Future studies of older patients with clinically diagnosed cognitive impairment and depression are suggested.