Geriatric Depression Score Research Articles

The connection between anemia and limitations in daily activities among older males: the critical role of dynapenia

AimThe aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older male patients.MethodsA total of 223 older males attending one geriatric outpatient clinic were included in this cross-sectional study. Anemia was defined as a hemoglobin level below 13 g/dL. Patients’ demographic characteristics, comorbidities, and comprehensive geriatric assessment parameters were also recorded. Handgrip strength of < 27 kg for males was accepted as dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity.ResultsThe mean age (standard deviation) of the participants was 80.17 (7.69) years. The prevalence of patients with anemia was 43.9%. There was differences between anemic and non-anemic groups in terms of presence of diabetes mellitus (DM), congestive heart failure (CHF), chronic kidney disease (CKD), malnutrition, dynapenia, geriatric depression, BADL and IADL scores (all p < 0.05). In multivariate analysis, after adjusting for all confounding variables except for dynapenia, patients with anemia were associated with reduced BADL and IADL (all p < 0.05). After adjusting for all confounding variables including dynapenia, deterioration in total BADL and IADL scores did not remain significant in the anemic group compared to the non-anemic group (p > 0.05).ConclusionClose to one in two older outpatient men had anemia. Anemic men had a higher incidence of DM, CHF, CKD, malnutrition, geriatric depression and dynapenia. Anemia was associated with dependence in both BADL and IADL in older men. However, comorbidities, nutritional status, depressive mood and, specifically muscle strength, were important contributors to this association.

Association of cognitive status, anxiety and depression with hearing loss in the elderly

Objective: Hearing loss is an important problem that is common among older people. Dementia can be defined as a group of disorders that adversely affect memory, thinking function and the ability to perform daily activities. Hearing loss leads to poor quality of life due to loneliness, social isolation, anxiety and susceptibility to depression. Hearing aids are the primary tool used in the management of hearing loss. In this study, we aimed to compare participants with and without hearing loss in terms of cognitive status, depression and anxiety, and to assess the effect of hearing aid use on this process. Method: Between June 2023 and June 2024, 608 patients over the age of 50 who registered at the psychiatric outpatient clinic of Hatay Training and Research Hospital were included in the study. Participants were enrolled if they presented to the Psychiatry outpatient clinic during the selected time interval, were over 50 years of age and agreed to participate in the study. Participants' demographic information, educational status, social information, hearing aid use, minimental score, Beck anxiety score, and geriatric depression score were recorded. Results: When comparing patients with and without hearing loss, statistically significant differences were observed on the Minimental Test, Beck Anxiety Score and Geriatric Depression Score. Conclusion: In this study, a statistically significant relationship was found between hearing loss and cognitive status, depression and anxiety, and it was suggested that the use of hearing aids may be beneficial in terms of preventing the development or slowing the progression of these pathologies.

Differences in the Distribution of Aβ in the Brain between U.S. Veterans and Adults aged 62+ and suffering from Alzheimer's Disease.

Elevated concentration of amyloids in the cerebrum results in elevated risks for cerebral hemorrhage and early AD onset following early depression/dementia onset. In this study, we compare patterns of amyloid depositions across eight regions of interest of the human brain between U.S. Veterans and non-Veterans adults aged 62+. Data were taken from the ADNI and DoD-ADNI studies. A pseudo-randomization algorithm was applied to achieve comparability, reduce bias due to age mismatching, and account for non-treatment-related differences between subsamples extracted from DoD-ADNI and ADNI databases. The pool of participants included data about age, race, apolipoprotein ε4 allele (APOE) status, modified Hachinski Ischemic Score, education level, and geriatric depression score, which were used to build a propensity score. Aβ concentration, resulting from the PET image analysis, in key brain regions of interest, and two categorical variables describing the 0.79 and 1.11 cutoffs were used as outcomes, while the Veteran and AD status were used as predictors. To balance subsamples, we applied a pseudo-randomization algorithm, eliminating the observed sources of heterogeneity. We used a generalized linear model for continuous variables and the logistic regression model for binary variables. The pattern of the Aβ distribution in Veteran's brains was found to be different from the classic AD pattern. The amyloid depositions following Veteran status were concentrated in cerebellar gray matter and the cerebellum in general. In contrast, the AD pattern shows more Aβ depositions in the frontal lobe, cingulate cortex, parietal, and temporal lobes, along with higher whole-cerebrum concentration of amyloids. Since Florbetapir PET cannot distinguish between senile plaques and depositions in blood vessels, the elevated concentration of amyloids in a cerebellum for participants with the Veteran status may suppose elevated risks for cerebral hemorrhage and early AD onset following early depression/dementia onset.

Confounding factors of the expression of mTBI biomarkers, S100B, GFAP and UCH-L1 in an aging population.

To evaluate some confounding factors that influence the concentrations of S100 calcium binding protein B (S100B), glial fibrillary acidic protein (GFAP), andubiquitin carboxyl-terminal hydrolase L-1 (UCH-L1) in older individuals. Indeed, recent guidelines have proposed the combined use of S100B and the "GFAP-UCH-L1" mTBI test to rule out mild traumatic brain injuries (mTBI). As older adults are the most at risk of mTBI, it is particularly important to understand the confounding factors of those mTBI rule-out biomarkers in aging population. The protein S100B and the "GFAP and UCH-L1" mTBI test were measured using Liaison XL (Diasorin) and Alinity I (Abbott), respectively, in 330 and 341 individuals with non-suspected mTBI from the SarcoPhAge cohort. S100B, GFAP and UCH-L1 were all significantly correlated with renal function whereas alcohol consumption, Geriatric Depression Score (GDS), smoking habits and anticoagulant intake were not associated with any of these three biomarkers. Body mass index (BMI) and age were associated with GFAP and UCH-L1 expression while sex and mini-mental state examination (MMSE) were only associated with GFAP. According to the manufacturer's cut-offs for mTBI rule-out, only 5.5 % of participants were positive for S100B whereas 66.9 % were positive for the "GFAP-UCH-L1" mTBI test. All positive "GFAP-UCH-L1" mTBI tests were GFAP+/UCH-L1-. Among individuals with cystatin C>1.55 mg/L, 25 % were positive for S100B while 90 % were positive for the mTBI test. Our data show that confounding factors have different impacts on the positivity rate of the "GFAP-UCH-L1" mTBI test compared to S100B.

Cognition, depression, and functional health profiles (CoDe-F) of non-debilitated aged in the coastal belt of southern India: An explorative study at homes for the aged

IntroductionCognitive function, depression, and functional health profiles of older adults directly predict overall well-being. Family dynamics in India are changing mainly due to urbanization, migration of the younger generation for education or employment, and change in the social system, making the elderly parents alone and slowly getting transferred to old age homes. Hence, the investigators were interested in determining the functional health, depression, and cognitive decline among young and middle-aged non-debilitated institutionalized older adults. ObjectivesTo determine the correlation between cognitive function and depression among the young-old and old-old elderly and determine the functional health profiles of non-debilitated older adults residing at the old age homes of the coastal part of southern India. Study designAn exploratory study at the homes for the aged. MethodologyThe survey was conducted at old age homes after obtaining permission from the respective authorities. Socio-demographic proforma, functional health profiles, Modified Barthel Index, Short-form depression scale, and Muscle strength assessments were the data collection instruments. Statistical Analysis was done through Jamovi. (Version 2.3). Descriptive statistics and Karl Pearson's parametric statistic test were applied. ResultsMontreal's cognitive assessment revealed that 81% of the elderly had borderline cognitive impairment. The short-form geriatric depression score revealed that 87% reported mild depressive symptoms. As cognitive ability declined, depressive symptoms were common among institutionalized older adults (r = −0.494, p < 0.05) ConclusionDepression, cognitive impairment, and functional health profiles of older adults residing at old age homes need to be monitored regularly, and appropriate interventions must be employed to improve their quality of life.

Association between geriatric nutritional risk index and depression prevalence in the elderly population in NHANES

BackgroundThe prevalence of depression is increasing in the elderly population, and growing evidence suggests that malnutrition impacts mental health. Despites, research on the factors that predict depression is limited.MethodsWe included 2946 elderly individuals from National Health and Nutrition Examination Survey (NHANES) spanning the years 2011 through 2014. Depressive symptoms were assessed using the PHQ-9 scale. Multinomial logistic regression was performed to evaluate the independent association between Geriatric Nutritional Risk Index (GNRI) and depression prevalence and scores. Subgroup analysis was conducted to explore potential factors influencing the negative correlation between GNRI and depression. Restricted cubic spline graph was employed to examine the presence of a non-linear relationship between GNRI and depression.ResultsThe depression group had a significantly lower GNRI than the non-depression group, and multivariate logistic regression showed that GNRI was a significant predictor of depression (P < 0.001). Subgroup analysis revealed that certain demographic characteristics were associated with a lower incidence of depression in individuals affected by GNRIs. These characteristics included being female (P < 0.0001), non-Hispanic black (P = 0.0003), having a moderate BMI (P = 0.0005), having a college or associates (AA) degree (P = 0.0003), being married (P = 0.0001), having a PIR between 1.50 and 3.49 (P = 0.0002), being a former smoker (P = 0.0002), and having no history of cardiovascular disease (P < 0.0001), hypertension (P < 0.0001), and diabetes (P = 0.0027). Additionally, a non-linear negative correlation (non-linear P < 0.01) was found between GNRI and depression prevalence, with a threshold identified at GNRI = 104.17814.ConclusionThe GNRI demonstrates efficacy as a reliable indicator for forecasting depression in the elderly population. It exhibits a negative nonlinear correlation with the prevalence of depression among geriatric individuals.

Impact of a peer-support programme to improve loneliness and social isolation due to COVID-19: does adding a secure, user friendly video-conference solution work better than telephone support alone? Protocol for a three-arm randomised clinical trial

IntroductionThe COVID-19 pandemic has forced the implementation of physical distancing and self-isolation strategies worldwide. However, these measures have significant potential to increase social isolation and loneliness. Among older people, loneliness...

LOCALIZATION OF Β-AMYLOID PLAQUES IN THE BRAINS OF WAR VETERANS, PARTICIPANTS OF THE DOD-ADNI STUDY

Abstract We examined the allocation of β-amyloid (Aβ) plaques in the brains of Veterans, long-time survivors of traumatic brain injury (TBI), and those, who did not report brain trauma, and compared it with a spatial distribution of Aβ plaques in the brains of participants of the ADNI program as well as with the pattern of the spatial distribution of Aβ in the brains of participants of ADNI with Alzheimer’s disease. This study included 675 community-dwelling male participants from the ADNI and DoD-ADNI databases (137 veterans, 131 cases of TBI, and 123 AD cases) 62 years old or older. We performed regression analysis, using a pseudo-randomization algorithm, and propensity-score inverse-probability weighting to equalize the subsamples for fourteen outcomes, 12 standardized uptake value ratio variables, and 0.79 and 1.11 cutoffs. Race, educational level, geriatric depression score, age when florbetapir-18 (18F) PET scans were performed, APOE genotype, and Modified Hachinski Ischemic Score were used as predictors. The pattern common for AD showed the highest levels of β-amyloid in the cingulate cortex as well as in the frontal, parietal, and temporal lobes. Veterans have shown a statistically significant increase of 18F concentration in the cerebellum gray matter along with a lower concentration of it in the whole cerebrum as well as in neocortical regions than patients, who did not participate in combats. The continuous exposition to micro-TBI events, which does not necessarily suppose the loss of consciousness or severe contusion likely can explain the high concentration of 18F in cerebellum gray matter in ex-combatants.

Comparison of Executive Functioning between Ageing Urban and Rural Participants in India: A Cross‐sectional Analysis

AbstractBackgroundOlder adults living in urban areas differ from their rural counterparts in many ways, including the cognitive performance. Executive functioning is one of the few cognitive domains that is implicated to be affected in early stages of dementia. However, there are very few studies that have explored differences in cognitive functioning across rural and urban contexts in India. Our objective was to evaluate differences in executive functioning across urban and rural participants.MethodOur study sample includes ageing individuals (≥ 45 years): 1089 from the urban Tata Longitudinal Study on Ageing (TLSA) cohort and 4913 from the rural Srinivaspura Ageing, Neuro Senescence and COGnition (SANSCOG) study cohort. The TLSA and SANSCOG are parallel, harmonised, community‐based cohort studies in urban and rural India exploring the risk and protective factors associated with cognitive changes due to normal ageing, dementia and other related disorders. The difference in executive functioning measured by Categorical fluency, Letter fluency, Visuospatial span and Stroop tests were compared across both cohorts.ResultUrban participants were older, had more years of education had less Geriatric Depression Score (GDS) as shown in Table 1. They did not differ in gender and proportion of cognitive impairment. Multiple Linear Regression analysis was performed to examine the effects of each executive functioning tests between both the cohorts (urban participants were coded as reference category) while age, years of education and GDS were adjusted.Urban participants performed better than Rural participants on Categorical fluency (β = ‐2.379, p &lt; 0.001), Letter fluency (β = ‐4.343, &lt; 0.001), Visuospatial span (β = ‐0.279, &lt; 0.001) and Stroop (β = 0.934, &lt; 0.001). Similar results were obtained after gender stratification as shown in Table 2.ConclusionUrban participants performed better than their rural counterparts in all tests examining executive functioning. Poorer cognitive functioning in the rural ageing cohort could be due to a number of reasons including limited or less cognitively demanding occupations. There is a need for more such longitudinal studies in India that explore community environment on cognitive function across different cohorts.

U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER): Baseline Characteristics of a Trial Cohort Enriched for Risk of Cognitive Decline

AbstractBackgroundU.S. POINTER is a two‐year clinical trial to evaluate whether lifestyle interventions targeting multiple risk factors protect cognitive function in older adults at increased risk for cognitive decline. We describe the baseline characteristics of the U.S. POINTER clinical trial cohort overall, and before and after changes in risk factor enrichment inclusion criteria.MethodU.S. POINTER is a Phase 3, multicenter, randomized 2‐year clinical trial of two lifestyle interventions varying in intensity and format, in older adults at increased risk for cognitive decline and dementia. The study closed enrollment with 2111 individuals at 5 sites (North Carolina, Northern California, Chicagoland, Houston, Rhode Island). Eligible participants were sedentary and consumed a suboptimum diet and met other risk enrichment criteria that included first degree family history of memory impairment, and suboptimum cardiovascular health status (meeting specific cut‐points of systolic blood pressure, LDL cholesterol or hemoglobin A1c). 20 months into enrollment, risk enrichment criteria were revised to account for two other factors: older age (70‐79 years), and African American/Black or Native American race or Hispanic/Latine ethnicity.ResultMean age at baseline is 68.2 years, 31% represent communities of color, 69% are women, and 30% are not college graduates. 58% reported maternal memory loss, mean systolic blood pressure = 131 mmHg, mean total cholesterol = 193 mg/dl, mean HbA1C = 5.9%, and mean body mass index (BMI) = 29.9 kg/m2. Mean adjusted modified Telephone Interview for Cognitive Status (TICSm) score is = 37.6 (max = 50 pts), Geriatric Depression Score (GDS) is = 1.8, and Short Physical Performance Battery Chair Stand Score (SPBC) is = 3.3. Some baseline characteristics (BMI, total cholesterol, SBBP chair stand) vary by clinical site. The change to risk score enrichment criteria (Table 1) increased representation of participants from communities of color and number of males in the study cohort.ConclusionU.S. POINTER successfully enrolled 2111 participants across 5 sites who are at high risk for cognitive decline and dementia, with appropriate representation by groups typically underrepresented in clinical trials, individuals aged 75 or older, and men, with the expansion of risk score enrichment criteria.

Evaluation of 'Normal' Cognitive Functions and Correlation With MRI Volumetry: Towards a Definition of Vascular Cognitive Impairment.

Introduction It is important to establish criteria to define vascular cognitive impairment (VCI) in India as VCI is an image-based diagnosis and magnetic resonance imaging (MRI) changes resulting from age with prevalent vascular risk factors may confound MRI interpretation. The objective of this study was to establish normative community data for MRI volumetryincluding white matter hyperintensity volume (WMHV), correlated with age-stratified cognitive scores and vascular risk factors (VRFs), in adults aged 40 years and above. Methods We screened 2651 individuals without known neurological morbidity, living in Mumbai and nearby rural areas, using validated Marathi translations of Kolkata Cognitive Battery (KCB) and geriatric depression score (GDS). We stratified 1961 persons with GDS ≤9 by age and cognitive score, and randomly selected 10% from each subgroup for MRI brain volumetry. Crude volumes were standardized to reflect percentage of intracranial volume. Results MRI volumetry studies were done in 199 individuals (F/M = 90/109; 73 with body mass index (BMI) ≥25; 44 hypertensives; 29 diabetics; mean cognitive score 76.3). Both grey and white matter volumes decreased with increasing age. WMHV increased with age and hypertension. Grey matter volume (GMV) decreased with increasing WMHV. Positive predictors of cognition included standardized hippocampal volume (HCV), urban living, education, and BMI, while WMHV and age were negative predictors. Urban dwellers had higher cognitive scores than rural, and, paradoxically, smaller HCV. Conclusion In this study of MRI volumetry correlated with age, cognitive scores and VRFs, increasing age and WMHV predicted lower cognitive scores, whereas urban living and hippocampal volume predicted higher scores. Age and WMHV also correlated with decreasing GMV. Further study is warranted into sociodemographic and biological factors that mutually influence cognition and brain volumes, including nutritional and endocrine factors, especially at lower cognitive score bands. In this study, at the lower KCB score bins, the lack of laboratory data pertaining to nutritional and endocrine deficiencies is a drawback that reflects the logistical limitations of screening large populations at the community level.Our volumetric data which is age and cognition stratified, and takes into account the vascular risk factors associated, nevertheless constitutesimportant baseline data for the Indian population. Our findings couldpossibly contribute to the formulation of baseline criteria for defining VCI inIndia and could help in early diagnosis and control of cognitive decline and its key risk factors.

Effects of Economic Status on Changes in Social Networks and Mental Health after Using Hearing Aids.

Hearing impairment affects social networks and mental health. Hearing aids (HA) can improve these deficits. However, their effects might be affected by various factors such as economic status (ES). This study aimed to identify how ES could moderate the effects of HA on social networks, depressive mood, and cognition. A prospective cohort for new HA users was established and classified into two groups based on their ES: a low ES group (LES group) and a medium to high ES group (MHES group). Audiological examination, Lubben social network scale-18 (LSNS-18), Short form of Geriatric Depression Score, Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet, and surveys for satisfaction with HA were conducted before and at six months after wearing HA. Post-HA application LSNS-18 scores were not improved in the LES group whereas they revealed significant improvement in the MHES group (p = 0.003). The LES group showed lower LSNS-18 score (p = 0.020) and its change (p = 0.042) than the MHES group. Additionally, patients with depressive moods in the MHES group showed better improvements than those in the LES group (p = 0.048). The effects of wearing HA on cognition and satisfaction with HA were not significantly different between the two groups. HA did not improve social relationships and depressive moods in the LES group. Comprehensive and multidirectional support as well as hearing rehabilitation may be important for patients with LES. 3 (Nonrandomized controlled cohort/follow-up study) Laryngoscope, 134:2387-2394, 2024.

Depression level, nutritional status, and dietary nutrient intake of the older adult at the community level in a selected area of Bangladesh

Malnutrition is associated with higher rates of morbidity and death in the older population. Depression or mental health is a major component of older adult malnutrition. The aim of the study was to measure the level of malnutrition and depression in older adults, as well as their correlated factors, such as dietary energy and nutrient consumption. A cross-sectional study was conducted among 108 older individuals living in two areas of Faridpur, Bangladesh. The Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression (GD) Scale, and 24-h dietary recall were used to measure the nutritional status, depression level, and dietary nutrients, respectively. A total of 20.4% and 55.6% were malnourished or at risk of malnutrition, respectively. Around 81.5% of the study subjects exhibited a different degree of depression and 9.3% were identified as having severe depression. There was a significant inverse association between the MNA-SF score and the GD score (r = −0.684, p=<0.001). The average energy and protein consumption was 1387 kcal and 45.52 g, respectively; and energy and protein intake were significantly lower in the depressed group (1353 Kcal, 43.8 g) than in the non-depressed group (1530 Kcal, 52.4 g). An extremely low energy consumption (<20 kcal/kg body weight/day) was noted in 27.1% of the older adults. None of the participants in this study were able to meet the requirements for dietary fiber, calcium, vitamin B6, folate, vitamin D, and vitamin E. Specific nutrition-related intervention programs as well as social and familial support are recommended to improve the nutritional status of older adults.

Association of cardiac rhythm with cognitive performance in atrial fibrillation patients

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation, Background Atrial fibrillation (AF) is strongly associated with an increased risk of cognitive decline and dementia. AF-induced cerebral hypoperfusion, caused by loss of atrial contraction and RR interval variation, is discussed as one possible underlying mechanism. However, the short-term association between heart rhythm and cognitive performance is not clear. Here, we aimed to investigate the association of rhythm (AF vs. sinus rhythm, SR) with cognitive performance in AF patients. Methods We enrolled patients from a prospective, multicenter cohort study. At study visits, patients underwent 5-minute resting ECG recordings and extensive cognitive testing including the Montreal Cognitive Assessment (MoCA) and cognitive construct score (CoCo). Multivariable adjusted mixed effect linear regression models were used to investigate the association between acute heart rhythm on ECG (AF vs. SR) and cognitive performance. Further, we investigated the association between heart rhythm and the Geriatric Depression Score (GDS) as well as the European Quality of Life Visual Analogue Scale (EQ-VAS 100). Results 5206 ECGs from 1648 AF patients were available for analysis. 46% of ECGs were in AF. Mean age of the patients was 72 years and 27% were females. After adjustment for pre-defined covariables, we did not identify an independent association between heart rhythm (AF vs. SR) and cognitive performance in any test. However, patients with present AF on ECG had reported worse GDS and EQ-VAS 100 scores. Conclusion In our large cohort of AF patients, there was no acute association between heart rhythm (AF or SR) and cognitive performance.

The Relationship between Handgrip Strength, Timed Up-and-Go, and Mild Cognitive Impairment in Older People during COVID-19 Pandemic Restrictions

The COVID-19 lockdown restrictions affected physical performance and cognitive function in older people as they were confined to their homes. There is an association between physical and cognitive functions. Mild Cognitive Impairment (MCI) is a condition that risks progressing to dementia. This study aimed to identify the relationship between handgrip strength (HGS), Timed Up-and-Go (TUG), and MCI in older people during the COVID-19 pandemic restrictions. The cross-sectional study recruited 464 eligible participants for an interview and anthropometric measurement. The Montreal Cognitive Assessment-Basic (MoCA-B), HGS, and TUG were measured in addition to demographic and health characteristics. A total of 398 participants (85.8%) were found to have MCI when screened with the MoCA-B. Their mean age was 71.09 ± 5.81 years. Forward multiple regression analysis demonstrated that HGS (β = 0.032, p < 0.001), education level (β = 2.801, p < 0.001), TUG (β = -0.022, p = 0.013), Thai Geriatric Depression Score, TGDS (β = -0.248, p = 0.011), and age (β = -1.677, p = 0.019) were associated with MCI. A decrease in HGS and an increased TUG might allow for the early detection of MCI and promote physical training in order to reduce the risk of MCI. Further studies can investigate multidomain indicators for MCI, for example, fine motor skills and pinch strength as components of the motor abilities.

Neuropsychiatric Symptoms and Caregiver Stress in Parkinson's Disease with Cognitive Impairment, Alzheimer's Disease, and Frontotemporal Dementia.

A better understanding of factors associated with caregiver burden might facilitate the construction of coping strategies to improve their clinical outcomes and the comprehensive care model for dementia. To investigate the cognitive and neuropsychiatric domains that contribute to caregiver burden in three types of neurodegenerative disorders: Parkinson's disease (PD), Alzheimer's disease (AD), and frontotemporal disease (FTD). Eight hundred and fourteen patients and their caregivers were invited to participate; among them, 235 had PD with cognitive impairment; 429 had AD, and 150 had FTD. The evaluation protocol included the Neuropsychiatric Inventory (NPI), the Mini-Mental State Examination, the Chinese Version Verbal Learning Test, the modified Trail Making Test B, semantic fluency, and a geriatric depression score. Statistical comparisons of the cognitive tests, NPI total scores, and caregiver burden among the three diagnosed types of dementia, matched for a Clinical Dementia Rating (CDR) of 0.5 or 1, were performed, and multivariate linear regression models were used to evaluate the parameter significance. Caregivers for patients with PD and FTD showed significant burden increments when the CDR scores changes from 0.5 to 1. For CDR = 0.5, the PD group had significantly lower caregiver burdens than the AD group, but the NPI total scores were significantly higher. Factors related to caregiver burden were the presence of delusion among all diagnosis groups, while the impact of NPI total scores related to caregiver burden was the highest in FTD, followed by AD and PD. At the mild to moderate stages, our results suggested different degrees of significance in terms of the cognitive test scores or NPI subdomains for predicting caregiver stress among the three types of dementia.

Frailty and Effects of a Multidomain Physical Rehabilitation Intervention Among Older Patients Hospitalized for Acute Heart Failure

Frailty is common among older patients with acute decompensated heart failure (ADHF) and is associated with worse quality of life (QOL) and a higher risk of clinical events. Frailty can also limit recovery and response to interventions. In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a 3-month innovative, early, transitional, tailored, multidomain physical rehabilitation intervention improved physical function and QOL (vs usual care) in older patients with ADHF. To evaluate whether baseline frailty modified the benefits of the physical rehabilitation intervention among patients with ADHF enrolled in the REHAB-HF trial and to assess the association between changes in frailty with the risk of adverse clinical outcomes on follow-up. This prespecified secondary analysis of the REHAB-HF trial, a multicenter randomized clinical trial, included 337 patients 60 years and older hospitalized for ADHF. Patients were enrolled from September 17, 2014, through September 19, 2019. Participants were stratified across baseline frailty strata as assessed using modified Fried criteria. Data were analyzed from July 2021 to September 2022. Physical rehabilitation intervention or attention control. Primary outcome was the Short Physical Performance Battery (SPPB) score at 3 months. Clinical outcomes included all-cause hospitalization or mortality at 6 months. This prespecified secondary analysis included 337 participants; 181 (53.7%) were female, 167 (49.6%) were Black, and the mean (SD) age was 72 (8) years. A total of 192 (57.0%) were frail and 145 (43.0%) were prefrail at baseline. A significant interaction was observed between baseline frailty status and the treatment arm for the primary trial end point of overall SPPB score, with a 2.6-fold larger improvement in SPPB with intervention among frail patients (2.1; 95% CI, 1.3-2.9) vs prefrail patients (0.8; 95% CI, -0.1 to 1.6; P for interaction = .03). Trends consistently favored a larger intervention effect size, with significant improvement among frail vs prefrail participants for 6-minute walk distance, QOL, and the geriatric depression score, but interactions did not achieve significance. In this prespecified secondary analysis of the REHAB-HF trial, patients with ADHF with worse baseline frailty status had a more significant improvement in physical function in response to an innovative, early, transitional, tailored, multidomain physical rehabilitation intervention than those who were prefrail. Clinical Trials.gov Identifier: NCT02196038.

The effect of the Mindfulness-Based Stress Reduction program on the level of perceived stress and geriatric depression in older adults: a randomised controlled study.

This study aims to reveal the effect of the Mindfulness-Based Stress Reduction (MBSR) program on the perceived stress and geriatric depression levels of older adults. The data of this randomised controlled experimental study were obtained from older adults living in a nursing home in Turkey, between May and November, 2021. The target population consisted of 54 older adults living in the specified nursing home, and the sample consisted of 48 older adults who met the inclusion criteria (n=24 intervention group, n=24 control group). The MBSR program was applied to the older adults in the intervention group. Data were collected using the Personal Information Form, the Perceived Stress Scale, and the Geriatric Depression Scale-Short Form. It was revealed that the MBSR program led to a 54.7% decrease in the perceived stress total scores of the participants, and a 49.9% and 49.8% decrease in the sub-dimensions of perceived insufficient self-efficacy and perceived stress/distress, respectively. It was also found that the program reduced geriatric depression scores by 14.1% and created a significant effect (P < 0.05). It can be concluded that the MBSR program is an effective method in reducing the perceived stress and geriatric depression levels of older adults. This effect has been maintained 1 month after the completion of the program.

Preoperative Comprehensive Geriatric Assessment Predicts Postoperative Risk in Older Patients with Esophageal Cancer.

Preoperative risk assessment is important in older patients because they often have comorbidities and impaired organ function. We performed preoperative comprehensive geriatric assessment (CGA) for older patients with esophageal cancer. A total of 217 patients over 75 years old who underwent esophagectomy for thoracic esophageal cancer were analyzed. The CGA was performed preoperatively and included the Mini-Mental State Examination (MMSE), Geriatric Depression Score (GDS), vitality index, Barthel index, and instrumental activities of daily living (IADL). We defined the robust group as patients with normal function on every instrument, and the pre-frail and frail groups as those with functional impairment on one instrument or two or more instruments, respectively. We assessed how the CGA correlated with postoperative complications and prognosis. Of the 217 patients, 86 (39.6%) were in the robust group, 68 (31.3%) in the pre-frail group, and 63 (29.0%) in the frail group. Postoperative pneumonia (P = 0.026) and anastomotic leakage (P = 0.032) were significantly more common in the frail group. The frail group had a significantly longer postoperative hospitalization period (P = 0.016) and significantly lower rate of discharge to home (P = 0.016). Overall survival (OS) was significantly worse in the frail group (5-year overall survival rate, frail group versus others, 37.8% versus 52.0%, P = 0.046), but it was not significant on multivariate analysis. The preoperative CGA in older patients with esophageal cancer was associated with risk of postoperative complications.

356 OLDER PERSONS LIVING ALONE IN INTEGRATED CARE: DEPRESSION, LOW EDUCATION AND FUEL POVERTY

Abstract Background An important consequence of population ageing has been the increasing number of older adults who live alone. According to TILDA data, older adults with the lowest levels of education tend to experience most social isolation and there is a strong association between living alone and loneliness. We sought to compare the cohort of patients open to the Integrated Care for Older Persons (ICPOP) team in a University Teaching Hospital serving a community area of approx. 300,000 population, to this national dataset. Methods A convenience sample of 174 patients who underwent comprehensive geriatric assessment via domiciliary visit between July 2021-May 2022 by was analysed. Data was anonymised and analysis was performed using SPSS v.27. Results The average age was 81.5 (±8.1) with 63% women in the sample. Eighty-five older adults i.e. 49% of the sample either lived alone or spent more than 21 hours alone per 24-hour period. Compared to those who live with someone, those who lived alone had higher rates of likely depression as determined by Geriatric Depression Score (6.6 vs 4.8 p=0.007). They were also likely to have less educational attainment, as determined by years spent in full time education (11.81 vs 10.42 42 p= 0.0016) and those living alone had overall less central heating in their homes than those not living alone (64/85 vs 81/89 p=0.0109). There were no significant differences in the rates of polypharmacy, falls, dementia and home ownership between groups. There were higher levels of frailty in the group living with someone than those living alone as determined by Clinical Frailty Scale (6.14 vs 5.23 p&amp;lt;0.001). Conclusion A high proportion of patients seen by our ICPOP team live alone and have complex care needs that require an innovative, multidisciplinary approach. Financial vulnerability in this group is likely to compound isolation and loneliness.