Geriatric Depression Scale Score Research Articles

Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study

BackgroundRecently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer’s disease (MiND) and to individuals without cognitive impairment.MethodsCognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models.ResultsThe study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups.ConclusionsPatients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.

The trajectory of non-depressed suicidal ideation in community-dwelling older people in a rural area in Japan: a prospective longitudinal study with a 3-year follow-up.

Suicidal ideation is closely related to severe suicidal behaviour and is an important predictor of suicide attempt and completion, including in older people. Older people tend to have many opportunities to be conscious of death, and may have vague suicidal ideation because of various loss experiences, even if they are not depressed. We hypothesised that suicidal ideation among older people might be a risk factor for later transition to depression. The present study aimed to clarify risk factors that predict the incidence of depression in older people 3 years post-baseline in a rural area of Japan, and to examine the subsequent course of depression among non-depressed older people with suicidal ideation. In 2015 and 2018, survey questionnaires were mailed to residents aged 65 years and over living in a rural area in Japan. Participants were divided into a depression group and a non-depression group using 15-item Geriatric Depression Scale scores 3 years post-baseline. Logistic regression analysis was used to identify predictive factors of late-life depression 3 years post-baseline. We received 597 valid responses, with a 3-year follow-up rate of 78.8%. Regarding suicidal ideation, 6.7% of non-depressed older people exhibited suicidal ideation at baseline. Of these, 9.8% exhibited depression after 3 years post-baseline. Logistic regression analysis indicated that development of late-life depression is significantly associated with suicidal ideation, being female, and poor health-related quality of life (HRQOL). The results revealed that suicidal ideation, being female, and poor HRQOL were predictive factors of the development of late-life depression 3 years post-baseline in a rural area of Japan. These findings provide novel information regarding the transition to depression among community-dwelling older people who are not depressed but have suicidal ideation. Whereas suicidal ideation is considered to be a symptom of depression, the current results suggest that suicidal ideation may precede depression in some older people.

Geriatric Depression Scale predicts mortality in elderly patients on chronic hemodialysis.

The aim of this study was to determine if the Geriatric Depression Scale (GDS) was predictor of mortality in elderly patients on chronic hemodialysis (HD). A total of 140 HD patients ≥65 years were studied. Symptoms of depression were assessed through GDS and cognitive function through the Mini Mental State Examination (MMSE). GDS scores 0-9 are considered normal (Group 1); scores of 10-20 (Group 2) and 21-30 (Group 3) indicate mild and severe depression. Median GDS was 13 (11-15): 54 patients in Group 1, 49 in Group 2, and 37 in Group 3. After a follow-up of 58.85 ± 38.8 months, 94 patients died and 46 were alive. Kaplan-Meier survival was significantly lower in patients of Groups 2 and 3 than in Group 1 (log-rank χ2 : 101.9; DF: 2; p < 0.0001). According to Cox regression analysis, mortality was associated with age and GDS, and inversely associated with MMSE and Kt/V. GDS predicts mortality in elderly HD patients.

ASSOCIATION BETWEEN SLEEP QUALITY AND GERIATRIC SYNDROMES IN NURSING HOME RESIDENTS

Background: With aging, an increase is observed in some geriatric syndromes as well as sleep disorders. Objective: The aim of this study is to investigate the relationship between sleep quality and geriatric syndromes (dementia, depression, sarcopenia, malnutrition, and frailty) in nursing home residents. Methods: The participants’ demographic characteristics, comorbid diseases, number of drugs, cognitive performance, mood and nutritional states, sarcopenia and fraility screening tests and sleep quality test were evaluated by two geriatricians. The participants were divided into two groups as good sleep quality and poor sleep quality. Correlation analysis of sleep quality and geriatric and mental functionality tests was performed with Spearman correlation analysis. Results: A total of 104 nursing home residents (34 females, 74 males, aged 61-98) participated in the study. Sleep quality was found to be worse in the elderly between the ages of 75-84, with a higher number of children, using assistive devices, and taking selective serotonin reuptake inhibitors. In addition, in participants with poor sleep quality, SARC-f (strength, assistance with walking, rising from a chair, climbing stairs, and falls) and geriatric depression scale scores were significantly higher. The Pittsburgh Sleep Quality Index global score was negatively associated with total sleep time and positively associated with geriatric depression scale score and SARC-f score. Conclusion: Findings from the present study in relation between poor sleep quality and some geriatric evaluation parameters suggests that there may be a common pathophysiological alteration with aging.

The therapeutic use of art as a form of nonpharmacological treatment for those living with a dementia diagnosis

The therapeutic use of art has been acknowledged as an effective nonpharmacological intervention for those living with a dementia diagnosis, with a vast array of mental health benefits. However, despite these benefits, nonpharmacological interventions are widely underused in favour of pharmacological treatments for the management of mental health and cognitive difficulties following a diagnosis of dementia in older people’s services. Case studies detailing three artistic interventions that were carried out as part of each service user’s treatment from an older people’s service in North Cumbria are discussed to demonstrate the therapeutic use of art following a dementia diagnosis, and to share the clinical observations and improvements on Geriatric Depression Scale (GDS) scores achieved within each intervention. These interventions suggest support for existing literature and aim to encourage other healthcare professionals to use person-centred, nonpharmacological interventions in the management of cognitive and mental health difficulties in later life following a dementia diagnosis.

Association between the mental domain of the comprehensive geriatric assessment and prolonged length of stay in hospitalized older adults with mild to moderate frailty.

Previous researches have shown the risk factors of prolonged length of stay (PLOS) in hospitalized older adults, but it is unclear what are the risk factors of PLOS in hospitalized older adults with mild to moderate frailty. To identify the risk factors of PLOS in hospitalized older adults with mild to moderate frailty. We recruited adults aged ≥65 years old with mild to moderate frailty admitted to a tertiary medical center in the southern Taiwan from June 2018 to September 2018. Each individual underwent a structural questionnaire interview within 72 h after admission and 72 h after discharge. The data were collected face-to-face, including demographic characteristics, comorbidities, length of stay (LOS), and multiple domains of the comprehensive geriatric assessment. The main outcome was PLOS. Individuals who had two or more drugs, were female, did not have cognitive impairment and had a Geriatric Depression Scale score ≥ 1 had a higher risk of PLOS (probability = 0.81), and these individuals accounted for 29% of the overall study population. Among male individuals younger than 87 years old, those with cognitive impairment had a higher risk of PLOS (probability = 0.76), and among male individuals without cognitive impairment, living alone was associated with a higher risk of PLOS (probability = 0.88). Early detection and management of mood and cognition in older adults, together with comprehensive discharge planning and transition care, may be an important part of reducing LOS in hospitalized older adults with mild to moderate frailty.

Fall-Risk-Increasing Drugs and Gait Performance in Community-Dwelling Older Adults: Exploratory Results from the Gait and Brain Study.

While several psychotropic and cardiovascular drugs have been identified as fall-risk-increasing drugs (FRIDs) in older adults, the intervening mechanisms linking FRIDs and falls are unclear. It is plausible that gait performance is an intermediate variable on the causal pathway between FRIDs and falls. The current evidence on the relationship between medication use and gait performance in older adults is scarce. We aimed to assess the association between FRIDs and gait performance in community-dwelling older adults. This was a cross-sectional analysis using data from the Gait and Brain Study, a study of community-dwelling older adults aged 65years old and over (N=345). The following drug classes were assessed: antidepressants, benzodiazepines, alpha-blockers, beta-blockers, vasodilators, diuretics, statins and aspirin. Medication use was ascertained through validated questionnaires and electronic medical records. Multiple linear regression models were used to assess the association between each of the drug classes and gait speed and gait variability. Gait variability was expressed as the coefficient of variation (CV=mean/standard deviation) of stride time. Models were adjusted for age, sex, education, body mass index (BMI), mini-mental status exam (MMSE) score, Geriatric Depression Scale (GDS) score, general activity level, use of other FRIDs and comorbidity propensity score. Diuretic use was associated with significantly reduced gait speed (B=-7.97cm/s, 95% CI: -13.94, -2.00, P=0.009). Statin use was associated with significantly increased stride time CV (B=0.13, 95% CI: 0.02, 0.24, P=0.026). Other drugs did not have a statistically significant relationship with gait speed or variability. The association between diuretic use and reduced gait speed is consistent with existing evidence on diuretic use and increased fall risk. The association between statins and increased stride time variability is notable given inconclusive evidence in previous studies. Our results provide initial estimates of the association between FRIDs and gait performance in older adults for future longitudinal studies.

The combination of olfactory dysfunction and depression increases the risk of incident dementia in older adults.

Olfactory dysfunction and depression are common in later life, and both have been presented as risk factors for dementia. Our purpose was to investigate the associations between these two risk factors and determine if they had an additive effect on dementia risk. Olfactory function was assessed using the Brief Smell Identification Test (BSIT), and depression was classified using a combination of the 15-item Geriatric Depression Scale (GDS) score and current antidepressant use. Cross-sectional associations between depression and olfactory function were examined using correlations. Cox regression analyses were conducted to examine the longitudinal relationship between olfaction and depression and incident dementia across 12-years of follow-up. Participants were 780 older adults (aged 70-90 years; 56.5% female) from the Sydney Memory and Ageing Study (MAS) without a diagnosis of dementia at baseline. Partial correlation revealed a nonsignificant association between baseline depression and olfactory function after accounting for covariates (r = -.051, p = .173). Cox regression showed that depression at baseline (hazard ratio = 1.706, 95% CI 1.185-2.456, p = .004) and lower BSIT scores (HR = .845, 95%CI .789-.905, p < .001) were independently associated with a higher risk of incident dementia across 12 years. Entering both predictors together improved the overall predictive power of the model. Lower olfactory identification scores and depressive symptoms predict incident dementia over 12 years. The use of BSIT scores and depression in conjunction provides a greater ability to predict dementia than either used alone. Assessment of olfactory function and depression screening may provide clinical utility in the early detection of dementia.

The Covid‐19 pandemic, depression, and cognitive decline: Insights from the Srinivaspura Aging, Neuro Senescence, and COGnition (SANSCOG) study

AbstractBackgroundThe COVID‐19 pandemic and the policies to contain it had a widespread impact on the life and livelihood of participants enrolled in the Srinivaspura Aging, Neuro Senescence, and COGnition (SANSCOG) study. We evaluated the prevalence of depression associated with the pandemic and its impact on cognition in our cohort.MethodWe used the geriatric depression scale (GDS) to objectively assess the depression scores of 400 participants before the first wave (March 2020; W1) and after the second (March 2021; W2) wave of the pandemic. We also assessed the cognitive profile of participants at these two timepoints using tests from the COGNITO battery.Based on the GDS score, the participants were classified into three groups‐ (a) Group A: participants with depression (GDS&gt;4) at W1 and no depression W2 assessments (b) Group B: participants without depression at W1 and with depression at W2 assessments, and (c) Group C: participants with depression at W1 and W2. In each subgroup, the neuropsychological scores were compared using the Mann‐Whitney U test.ResultThe overall prevalence of depression was 26.5%. The prevalence of depression at W1 and W2 were 12.5% and 17.7%, respectively.The participants in group A (n = 55) had a significant increase in the reaction time between W1 and W2. In group B (n = 35), there was a significant increase in the reaction time and decrease in auditory attention, dual attention, Immediate and delayed recall scores of logical memory test, category fluency, letter fluency, and copying score in stick‐figure design test. In group C (n = 16), there was a significant increase in the reaction time and a decrease in auditory attention.ConclusionThere was a 5.2% increase in the prevalence of depression between W1 and W2 in our cohort. The cognitive decline was more evident in participants who developed depression during the intercurrent interval between the W1 and W2.

Associates of cognitive functions in aged Turkish adults: Insights from a psychiatry outpatient clinic

Introduction: The aim of this study was to determine the cognitive function and its influential factors in elderly adults in Turkey. Materials and Methods: 127 patients aged over 65 years referred to a psychiatry outpatient clinic for the first time were included to cross-sectional and descriptive study. Patients were assessed by Carlson Comorbidity index, Montreal Cognitive Assessment Test, Geriatric Depression Scale, Beck Anxiety Inventory, Nottingham Health Profile and Lawton Instrumental Activities of Daily Living Scale. Results: The mean age of the patients was 69.7±4.2 years and 55.1% (n=70) of the participants were female. The primary diagnosis was Generalized Anxiety Disorder in 48.8% and Major depressive disorder in 51.2% of the patients. In multivariate analysis, age (OR:0.759, 95% CI:0.630-0.914, p=0.004), income &lt;3800 TL (OR:14.72, 95% CI:1.78-121.51, p=0.013), medication usage (OR:0.171, 95% CI:0.035-0.845, p=0.030) and Geriatric Depression Scale score (OR:0.876, 95% CI:0.785-0.977, p=0.017) remained as independent predictors of Montreal Cognitive Assessment Test score. Conclusion: In Turkish adults with Generalized Anxiety Disorder or Major depressive disorder who admit to a psychiatry outpatient clinic for the first time, various parameters including age, education, income, leisure activity, medication usage, depression, Lawton Instrumental Activities of Daily Living Scale score and Nottingham Health Profile score are linked with cognitive impairment. However, only age, income, medication usage and depression independently associate with cognitive impairment in this highly specific patient population. Keywords: Cognitive Dysfunction; Geriatric Psychiatry; Depression; Quality of Life.

Validation of the distress thermometer score in a geriatric oncology population.

e24030 Background: The geriatric oncology population is uniquely vulnerable to increased levels of psychological distress due to age related challenges such as social isolation, change in lifestyle, and comorbid conditions. In the general population, higher levels of psychological distress have been shown to impact treatment course, quality of life, and survival. The NCCN Distress Thermometer (DT) is a validated fast and effective screening tool for psychological distress, with a cutoff score of 4 yielding optimal sensitivity and specificity in a general cancer population. However, the best cutoff for detecting psychological morbidity in older cancer patients is unclear. In this study, we aim to compare the sensitivity and specificity of various cutoff values for the Distress Thermometer score to predict Geriatric Depression Scale (GDS) score. Methods: Data is derived from 242 geriatric oncology patients from the Senior Adult Oncology Center at Jefferson Health. Using a cutoff of 5 for the GDS as the clinical standard guideline, we use receiver operating characteristic (ROC) curve analysis of the univariable logistic regression model to predict clinical depression. Results: A cutoff DT score of 3.5 was found to be most sensitive and specific (0.66,0.68) for predicting clinical depression (Area Under the ROC Curve (AUC) = 0.70). Multivariable logistic regression including age improved the predictive ability of the DT score to an AUC of 0.75. Conclusions: The increase in AUC with the addition of age indicates the potential use of a composite value of age and DT score to best determine at-risk patients in a clinical setting. While these results indicate the utility of the Distress Thermometer as an effective screening tool in the geriatric oncology population, our findings also suggest that a lower threshold score is advised for clinicians who are hoping to identify older cancer patients who are distressed. Patients who meet the threshold criteria would then be assessed further for triage into appropriate levels of geriatric supportive services.

Associations of Microvascular Dysfunction with Mild Cognitive Impairment and Cognitive Function Among Rural-Dwelling Older Adults in China.

Microvascular dysfunction (MVD) may contribute to cognitive impairment and Alzheimer's disease, but evidence is limited. To investigate the association of composite and organ-specific MVD burden with mild cognitive impairment (MCI) and cognition among rural-dwelling Chinese older adults. In this population-based cross-sectional study, we assessed MVD makers using optical coherence tomographic angiography for retinal microvasculature features, brain magnetic resonance imaging scans for cerebral small vessel disease (CSVD), and serum biomarkers for MVD. A composite MVD score was generated from the aforementioned organ-specific parameters. We used a neuropsychological test battery to assess memory, verbal fluency, attention, executive function, and global cognitive function. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were diagnosed following the Petersen's criteria. Data was analyzed with the linear and logistic regression models. Of the 274 dementia-free participants (age≥65 years), 56 were diagnosed with MCI, including 47 with aMCI and 9 with naMCI. A composite MVD score was statistically significantly associated with an odds ratio (OR) of 2.70 (95% confidence interval 1.12-6.53) for MCI and β-coefficient of -0.29 (-0.48--0.10) for global cognitive score after adjustment for socio-demographics, lifestyle factors, APOE genotype, the Geriatric Depression Scale score, serum inflammatory biomarkers, and cardiovascular comorbidity. A composite score of retinal microvascular morphology was associated with a multivariable-adjusted OR of 1.72 (1.09-2.73) for MCI and multivariable-adjusted β-coefficient of -0.11 (-0.22--0.01) for global cognitive score. A composite CSVD score was associated with a lower global cognitive score (β= -0.10; -0.17--0.02). Microvascular dysfunction, especially in the brain and retina, is associated with MCI and poor cognitive function among rural-dwelling older adults.

Hearing handicaps, communication difficulties and depression in the older adults: a comparison of hearing aid users and non-users.

Age-related hearing loss has potential effects on communication, cognitive, emotional, and social aspects of the older person's life. Evaluating the role of hearing aids in reducing these difficulties is important. This study aimed to evaluate communication difficulties, self-perceived handicaps, and depression in hearing-impaired older adults who are either hearing aid users or non-users. A total of 114 older adults in the age range of 55-85years with moderate to moderately severe hearing loss (two hearing-matched groups; hearing aid users: n = 57; hearing aid non-users: n = 57) took part in this study during the COVID-19 pandemic. Self-perceived hearing handicaps and communication were evaluated using the Hearing Handicap Inventory in the Elderly-Screening (HHIE-S) and Self-Assessment Communication (SAC) questionnaires. Depression was assessed using the geriatric depression scale (GDS). The average score of HHIE-S was significantly higher in the hearing aid users than the non-users (16.61 ± 10.39 vs. 12.49 ± 9.84; p = 0.01). Differences between groups were not significant for SAC or GDS scores (p ≥ 0.05). There were strong positive correlations between HHIE-S and SAC scores in both groups. Moderate correlations were found between SAC and GDS scores in the hearing aid users and between the duration of using hearing aid with SAC and HHIE-S scores. It seems that self-perceived handicaps, communication difficulties and depression are affected by many factors, and only receiving hearing aids without subsequent support such as auditory rehabilitation and programming services cannot bring the expected output. The effect of these factors was clearly observed due to reduced access to services in the COVID-19 era.

Association between serum oxytocin levels and depressive state in community-dwelling older adults: A cross-sectional study.

Identifying peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults would be extremely beneficial. This study aimed to evaluate serum oxytocin levels in older adults living in a rural community and their association with cognitive function, anxiety, depressive state, and well-being. This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum oxytocin level analysis, which was performed using peptide enzyme immunoassay. Participants underwent neuropsychological assessments, including the Mini-Mental State Examination, Clinical Dementia Rating, Frontal Assessment Battery, State-Trait Anxiety Inventory, 15-item Geriatric Depression Scale, and 17-item Philadelphia Geriatric Center Morale Scale. We examined the association between serum oxytocin levels and neuropsychological assessment results. Out of 94 participants, 25 were men and 69 were women, with mean ages of 78.24 ± 3.85 years and 78.10 ± 5.43 years, respectively. Serum oxytocin levels were negatively associated with 15-item Geriatric Depression Scale scores. Additionally, nondepressive state/depressive state was classified by the 15-item Geriatric Depression Scale (cut-off 5/6). Logistic regression analysis showed that higher serum oxytocin levels tended to be associated with a less depressive state at that time. Serum oxytocin levels may be associated with depressive state in adults aged ≥65 years.

MMPs/TIMPs ratio: A Biomarker of Bone Resorption in Geriatric Osteoporosis?

Matrix metalloproteinases (MMPs) play an important role in bone resorption and are regulated by tissue inhibitors of metalloproteinases (TIMPs). We investigated the use of MMP2/TIMP2 and MMP9/TIMP1 ratios as biomarkers of bone resorption in geriatric osteoporosis and evaluated the relationship between osteoporosis and geriatric syndromes. This analytical cross-sectional study involved 87 patients (41 with osteoporosis) treated at the geriatric outpatient clinic of a university hospital. The demographic characteristics, comprehensive geriatric assessment scores, laboratory findings, and bone mineral density of the patients were recorded. Serum MMP9, TIMP1, MMP2, and TIMP2 levels were analyzed by enzyme-linked immunosorbent assay (ELISA). We enrolled 41 and 46 patients with and without osteoporosis, respectively. The groups showed no significant differences in MMP2/TIMP2 and MMP9/TIMP1 ratios (p=0.569 and p=0125, respectively). While the basic activities of daily life (BADL) scores in the osteoporosis group were higher than those in the group without osteoporosis, the instrumental activities of daily life (IADL) scores were significantly lower (p=0.001 and p=0.007, respectively). No significant differences were observed in Mini-Nutritional Assessment (MNA), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS) scores (p=0.598, p=0.898, and p=0.287, respectively). This is the first study to examine the relationship between osteoporosis and several geriatric syndromes, as well as the relationship between osteoporosis and serum MMP, TIMP values, and MMP/TIMP ratios in geriatric patients. Our results showed that osteoporosis causes dependency in both BADLs and IADLs, and that the MMP2/TIMP2 and MMP9/TIMP1 ratios provided no additional benefit in demonstrating bone resorption in geriatric osteoporosis.

Polypharmacy in the Elderly: A Double-Edged Sword

Aim: Polypharmacy is a very important geriatric syndrome related to critical health conditions. The purpose of this study is to research the association of polypharmacy with comprehensive geriatric assessment’s (CGA) various parameters which are indicators of health and life quality in older individuals. Material and Methods: 515 older adults admitted to a university hospital were included in this cross-sectional study. Along with CGA, European Quality of Life (EQ-5D) was performed on the participants. Geriatric Depression Scale (GDS) was used to evaluate depressive symptoms. Daily living activities were assessed by using Lawton &amp;amp; Brody index of Instrumental Activities of Daily Living (IADL) and Katz Index of Activities of Daily Living (ADL). The Full Mini-Nutritional Assessment (MNA) questionnaire was performed to evaluate nutritional status. Results: The participants’ mean age was 72.2±6.3 years and 58.6% of them were female. 242 participants using 5 or more drugs were included in the polypharmacy group. The polypharmacy group had lower IADL, MNA, EQ-5D, Hand Grip Strength (HGS), and gait speed scores and higher GDS scores compared to those without polypharmacy. According to the correlation analysis results, the number of the medications had a moderate positive correlation with GDS scores and a moderate negative correlation with EQ-5D and MNA. Conclusion: As the number of medications increases; patients tend to have depression, malnutrition, and a decline in functional status. Polypharmacy also impairs the quality of life. We should address polypharmacy as a crucial health problem, optimize the number of medications and thereby make the health condition better.

The relationships between physical function, nutrition, cognitive function, depression, and sleep quality for facility-dwelling older adults with dynapenia

BackgroundThe growing population of older adults worldwide is associated with an extended life expectancy and an increasing proportion of older adults with dynapenia. Most research on dynapenia has involved only populations of older adults living in the community; little research has examined the effects of risk factors on sleep quality among older adults with dynapenia residing in assisted living facilities.AimThis study examined the relationships among physical function, nutrition, cognitive function, depression, and sleep quality among older adults with dynapenia residing in assisted living facilities.MethodsIn this cross-sectional study, data on physical function, nutrition, cognitive function, depression, and sleep quality was collected from 178 older adults with dynapenia residing in assisted living facilities, who were selected using purposive sampling. Descriptive statistical analysis, independent-sample t tests, chi-squared tests, and logistic regression analysis were performed using SPSS 25.0.ResultsThe statistical analyses revealed correlations between sleep quality and age (t = 2.37, p < 0.05), level of education (χ2 = 3.85, p < 0.05), grip strength (t = 3.40, p < 0.01), activities of daily living (t = 4.29, p < 0.001), instrumental activities of daily living (t = 2.23, p < 0.001), calf circumference (t = 2.89, p < 0.01), Mini Nutritional Assessment scores (t = 2.29, p < 0.05), Mini Mental State Exam (MMSE) scores (t = 4.50, p < 0.001), and Geriatric Depression Scale (GDS) scores (t = − 4.20, p < 0.001). Calf circumference (OR = 0.8, 95% CI = 0.650.97, p < 0.05), GDS score (OR = 1.42, 95% CI = 1.05–1.92, p < 0.05), and MMSE score (OR = 0.85, 95% CI = 0.73–0.97, p < 0.05) were related to sleep quality among the sample population.ConclusionPhysical function, nutrition, cognitive function, and depression affect the sleep quality of older adults with dynapenia residing in assisted living facilities. Facility nurses must regularly assess these aspects of their patients to ensure that facility-dwelling older adults can maintain their physical function and improve their health to improve the quality of their sleep.

Predicting Conversion from Subjective Cognitive Decline to Mild Cognitive Impairment and Alzheimer's Disease Dementia Using Ensemble Machine Learning.

Subjective cognitive decline (SCD) may represent a preclinical stage of Alzheimer's disease (AD). Predicting progression of SCD patients is of great importance in AD-related research but remains a challenge. To develop and implement an ensemble machine learning (ML) algorithm to identify SCD subjects at risk of conversion to mild cognitive impairment (MCI) or AD. Ninety-nine SCD patients were included. Thirty-two progressed to MCI/AD, while 67 remained stable. To minimize the effect of class imbalance, both classes were balanced, and sensitivity was taken as evaluation metric. Bagging and boosting ML models were developed by using socio-demographic and clinical information, Mini-Mental State Examination and Geriatric Depression Scale (GDS) scores (feature-set 1a); socio-demographic characteristics and neuropsychological tests scores (feature-set 1b) and regional magnetic resonance imaging grey matter volumes (feature-set 2). The most relevant variables were combined to find the best model. Good prediction performances were obtained with feature-sets 1a and 2. The most relevant variables (variable importance exceeding 20%) were: Age, GDS, and grey matter volumes measured in four cortical regions of interests. Their combination provided the optimal classification performance (highest sensitivity and specificity) ensemble ML model, Extreme Gradient Boosting with over-sampling of the minority class, with performance metrics: sensitivity = 1.00, specificity = 0.92 and area-under-the-curve = 0.96. The median values based on fifty random train/test splits were sensitivity = 0.83 (interquartile range (IQR) = 0.17), specificity = 0.77 (IQR = 0.23) and area-under-the-curve = 0.75 (IQR = 0.11). A high-performance algorithm that could be translatable into practice was able to predict SCD conversion to MCI/AD by using only six predictive variables.

Early Neuropsychiatric Symptoms of Mild Cognitive Impairment Subtypes: An Analysis of the National Alzheimer’s Coordinating Center Database (P7-6.004)

<h3>Objective:</h3> To analyze the neuropsychiatric profiles between Amnestic versus Nonamnestic subtypes of mild cognitive impairment. <h3>Background:</h3> Mild cognitive impairment (MCI) reflects cognitive deficits without significant functional decline in activities of daily living. MCI subtypes are based on phenotypic patterns of impairment in cognitive domains (memory, attention, language, executive, visuospatial) as follows: Amnestic single domain (ASD) or multi-domain (AMD), Nonamestic single domain (NASD), or multi-domain (NAMD). Previous studies have suggested Nonamnestic subtypes demonstrate more neuropsychiatric symptoms, but conclusions have been limited by small sample sizes. <h3>Design/Methods:</h3> Using the National Alzheimer’s Coordinating Center (NACC) database (National Institute’s of Aging grant U24 AG072122), we selected all initial Uniform Data Set assessments diagnosed as MCI with subtyping. The NACC data was collected from 37 participating Alzheimer’s Disease Research Centers. Baseline demographic and clinical features, Geriatric Depression Scale (GDS), and Neuropsychiatric Inventory (NPI-Q) were collected. Chi-square analyses were used to compare NPI-Q symptoms and severity across MCI subtypes. <h3>Results:</h3> <h3>Participants:</h3> 9852 individuals with MCI were analyzed: 45.4% AMD, 33.7% ASD, 12.6% NASD, 8.2% NAMD. On NPI-Q, hallucinations, depression, anxiety, apathy, disinhibition, motor disturbances, nighttime behaviors, and appetite changes were significantly more common in Nonamnestic MCI compared to other subtypes (p&lt;.001 for all domains except agitation and irritability [p&lt;.05]). NPI-Q severity scores were significantly higher in Nonamnestic subtypes for depression, apathy, irritability and nighttime behaviors (all p&lt;.01). NAMD was most frequent for all neuropsychiatric symptoms except irritability, wherein NASD had a higher prevalence. NAMD and NASD severity scores were equal for nighttime behaviors and irritability but with higher severity for apathy in NASD. GDS scores were highest in NAMD participants. <h3>Conclusions:</h3> Nonamnestic MCI subtypes are characterized by greater frequency and severity of neuropsychiatric symptoms compared to Amnestic MCI subtypes. <b>Disclosure:</b> Dr. Malone has nothing to disclose. Dr. Elkasaby has nothing to disclose. Dr. Appleby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. Dr. Appleby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ionis. Dr. Appleby has received personal compensation in the range of $0-$499 for serving as a Consultant for Sangamo. The institution of Dr. Appleby has received research support from CJD Foundation. The institution of Dr. Appleby has received research support from Ionis. The institution of Dr. Appleby has received research support from Alector. The institution of Dr. Appleby has received research support from CDC. The institution of Dr. Appleby has received research support from NIH. Dr. Appleby has received publishing royalties from a publication relating to health care. Dr. Appleby has received publishing royalties from a publication relating to health care. Dr. Duffy has nothing to disclose. Dr. Miller Scott has nothing to disclose. Tamara Murphy has nothing to disclose. Paula K. Ogrocki has nothing to disclose. The institution of Dr. Lerner has received research support from Premier applied biosciences. Dr. Lerner has received publishing royalties from a publication relating to health care.

A different outlook to consequences of anemia in older adults

ABSTRACT Objectives Anemia is a common health issue in older adults with crucial consequences. We aimed to investigate the relationship of anemia with various components of geriatric syndromes. Methods A total of 486 older individuals aged 65 and over admitted to a university hospital were included in this cross-sectional study. According to WHO criteria, we defined anemia as hemoglobin concentration lower than 13 g/dL in men and 12 g/dL in women. The Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to diagnose sarcopenia. Handgrip strength (HGS) was measured by a hand dynamometer. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functionality. Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), Mini-Mental State Examination (MMSE), and European Quality of Life-5 Dimensions (EQ-5D) questionnaires were also used. Results Participants’ mean age was 72.2 ± 6.4 years and 58.8% of them were female. Ninety-two of 486 patients were anemic and 64.1% of anemic patients were female. Anemic group had lower IADL, EQ-5D, HGS scores, and higher GDS scores. According to multivariate logistic regression analysis, age, and anemia were found to be independent risk factors for dependency in IADL in both genders. Anemia, age, and depression were found to be independent risk factors for low HGS in women. Conclusion Anemia and depression are independent factors for low HGS in women, and anemia and age are independent factors for dependency on instrumental daily activities in older persons. Treating depression and raising Hb to optimal levels may be critical interventions to improve the health and life quality of people aged 65 and over, particularly in the female gender.