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Development and validation of a Geriatric Depression Screening Scale: A preliminary report
... The Geriatric Depression Scale (GDS) is widely used to screen for depression in clinical practice and to assess symptoms of depression in research about older adults [1]. Originally published in 1982 as a 30 item measure and subsequently shortened to 15 items in 1986, the GDS was designed to measure affective rather than somatic symptoms in order to assess symptoms of depression that were not also symptoms of dementia or physical illness [1,2]. Little is known about the validity and reliability of GDS scores in people living with dementia, a population who were excluded from the development of the instrument. ...
... At the test level, sample-based DTF effect size was quantified using the expected test score standardized difference (ETSSD) [30] which can also be evaluated against Cohen's d standards [31]. The ETS (ranging from 0 to 15 for GDS-15) are simply the sum of the aforementioned expected item scores, and ETSSD is the average difference between two sets of ETS divided by a scale-level pooled SD (see equations [2] and [10] in Meade's article for more computational details) [30]. ...
... To accommodate the multidimensionality structure of the modified model under IRT, we adopted a bifactor model approach [40]. With the modified structure, although both SRMRs still exceeded their cutoff criteria, 2 and M 2 were nonsignificant and CFI was excellent (see Table 3). Therefore, we accepted the modified structure for the subsequent DIF/DTF testing only when comparing CDR-3 against CDR-0. ...
Purpose
The Geriatric Depression Scale (GDS) is widely used to screen for depression in clinical practice and to assess symptoms of depression in research about older adults. To determine whether the 15-item GDS can be used in adults with dementia, this study investigated whether item- or test-level bias in the GDS-15 is associated with the respondent’s level of cognitive impairment.
Methods
Using a large U.S. sample of 24,674 adults, we first conducted sample matching procedures between the five groups defined by CDR® Dementia Staging Instrument scores to control for potential confounding effects of common demographic variables. Then, we employed confirmatory factor analysis (for single-group and configural-invariance models only) and item response theory models to test potential differential item/test functioning effects associated with the GDS-15 across the five CDR groups. Practical consequences of the identified biases were quantified using sample-based Cohen’s d effect sizes and misclassification rates.
Results
In general, people with higher CDR scores were older and had fewer years of education. In comparison to the normal cognition group (CDR–0), negligible biases in GDS-15 scores were found for the groups with questionable, mild, or moderate cognitive impairment (CDR–0.5/1/2). For individuals with severe cognitive impairment (CDR–3), their responses were inconsistent with the normal cognition group and their depression scores were significantly biased with a small-to-medium effect size.
Conclusions
The GDS-15 can be used to assess depression in individuals with mild or moderate cognitive impairment, but not in individuals with severe cognitive impairment.
... Adolescents range in age from 10 to 19 years old and account for 24.19% of the global population. It is the second most rapidly growing and changing period of life, after infancy [2][3][4]. To maintain continuity and stability, individuals, groups, and circumstances must be able to adjust to the rapid changes of life. ...
... Nonetheless, the concept of psychosocial issues associated with adolescence revolves around experimentation and discovery, requiring adaptation to physical development, redefining roles within families and among peers in school, and the emergence of a more independent way of life [13,17,32]. Adolescents often experience more emotional and psychosocial challenges, such as antisocial behavior, traumatic experiences, and academic difficulties, compared to adults [4,18]. Significant psychological distress can stem from issues related to identity formation and differentiation [33]. ...
... This can lead to poorer mental health and well-being, a reduced sense of social cohesion, and an increased risk of future instability and conflict [12]. Some studies indicate that at least one in five children and teenagers are affected by a mental health condition, while six million people worldwide, or at least one in ten, suffer from a major emotional disorder [4,35]. ...
While there has been extensive research on well-known psychosocial problems like depression, anxiety, and stress among higher education students, emerging issues such as emotional problems, antisocial behavior, trauma experiences, and academic difficulties are not as thoroughly studied, particularly in the context of Ethiopian higher education students. These updated psychosocial problems are crucial to explore due to their potentially significant impact on students’ academic performance, personal development, and future prospects. Therefore, this study aims to explore the current psychosocial issues faced by adolescent students at Arba Minch University and identify the factors associated with them. To accomplish this objective, a survey questionnaire was distributed to a sample of 300 university students through a cross-sectional study. The survey questionnaire was designed to provide a thorough understanding of the various types of psychosocial problems experienced by the students. The findings revealed that the most prevalent psychosocial problems among higher education adolescent students were emotional problems (6.7% high/severe, 46.3% moderate), antisocial behavior (5% high/severe, 54.7% moderate), trauma experiences (7% high/severe, 23% moderate), and academic problems (8.3% high/severe, 23% moderate). The prevalence of no/low psychosocial problems was 47%, 40.3%, 69.3%, and 68.7%, respectively. Additionally, statistically significant (p < 0.05) associated factors to these psychosocial problems were identified: gender for academic problems, religion affiliation for antisocial behavior, trauma experiences, marital status for trauma experiences, living situation during holidays for emotional problems, age for emotional problems and antisocial behavior, and educational sponsorship for antisocial behavior. The study found that students who lacked a support system, such as family or friends, were more likely to experience psychosocial problems. In conclusion, psychosocial problems among adolescent students in higher education are a pressing issue that requires immediate attention. By understanding the challenges faced by these students, universities can implement effective interventions to support their mental well-being.
... Participants were asked how frequently they had experienced 20 different feelings over the past week. Responses ranged from "rarely or never" to "most of the time or all of the time", with the responses then coded from 0 to 3 resulting in a total possible score ranging from 0 to 60. OATS used the 15-item Geriatric Depression Scale (GDS-15) 21 . The version used included Question 9 as described by Brink 22 . ...
... The version used included Question 9 as described by Brink 22 . The GDS-15 has shown to be a reliable and valid measure of depressive symptoms in older adults 21,23 . A summary score of 0-15 was calculated based on completed answers. ...
Beneficial associations between higher fruit and vegetable intakes and risk of depression appear to exist but few studies have focused on adults aged 45 + years and the potential that associations are due to residual confounding has not been tested. This longitudinal study of twins (n = 3483, age 45–90 years) from Australia, Denmark, Sweden and USA, assessed the associations between baseline fruit/vegetable intake and depressive symptoms over 5–11 years using linear mixed effects models. Intakes from food frequency questionnaires were trichotomized. Depressive symptoms were assessed using validated measures. The co-twin method was used to examine familial confounding. Compared with low intakes, both high fruit and high vegetable intakes were associated with lower depressive symptoms (fruit: β -.007 [95%CI − .014, < − .001], p = .040; vegetables: β − .006 [95%CI -.011, -.002], p = .002); whereas only moderate vegetable intakes, were associated with lower depressive symptoms (vegetables: β − .005 [95%CI − .009, − .001], p = .014). No familial confounding was found for vegetables, while the results for fruit were inconclusive, likely due to smaller sample size and the marginal significance of the main result. Higher fruit and vegetable intakes may protect against depressive symptoms, presenting another argument for increasing intakes in adults aged 45 + years.
... The GDS cutoff range of 8-12 represents moderate depression and is used for wide-ranging identification of significant depressive symptoms in older adults, including those with cognitive impairments. [38][39][40] The NPID score range of 2-12 was chosen to capture significant depressive symptoms rated on the NPI. 41,42 The NPI is a multi-faceted instrument in the assessment of a variety of psychopathologies occurring in dementias, and scores in this range reflect moderate to severe depressive symptoms in AD and MCI populations. ...
... Due to the limited sample size in the AD+ group, the study focused on the MCI groups, comparing them with 35 cognitively normal individuals who were matched for age and gender and only those who underwent both whole brain DWI and structural MRI (T1 MPRAGE) were considered eligible, per the study design depicted in Table 1. These inclusion/exclusion criteria were carefully selected to ensure the study accurately represents the intended spectrum of cognitive impairment associated with AD. [33][34][35][36][37][38][39][40][41][42][43][44] In step with this line of reasoning, the entire pre-study design, data mining, and statistical analysis were conducted using Python 3.10.1. 45,46 Structural MRI and DTI data acquisition Structural MRI scans were conducted using 3 T MRI scanners from GE Medical Systems. ...
... Respondents were required to answer 'yes' or 'no' to the 15 statements that describe either a positive or a negative emotion/condition. The score of depression in the GDS were categorized in this presented study with > 10 representing "depressed" while scores of GDS ≤ 10 representing "not depressed" [49]. GDS is a reliable and valid measure have been ascertained with large samples of depression in post stroke patients [48,50]. ...
... On the BI, lower score indicates greater dependency with ADL. Geriatrics depression scale was the secondary contains fifteen items (GDS_SF) for the assessment depression [49].GDS is a reliable and valid measure of depression in post stroke patients [50].Timed up and go (TUG) were another secondary tool which assess speed of mobility respectively. ...
Introduction Balance impairment is one of the common impairments in patients after stroke. It can lead to depression reduced speed of mobility, dependent on assistive device and reduce quality of life. However, evidence on balance impairment and its risk factors among stroke survivors in Ethiopia was lacking particularly in the study area. Therefore, this study aimed to investigate prevalence and associated factors of balance impairment among stroke survivor's attendee at an outpatient clinic in Amara regional state comprehensive specialized hospital. Methods An institutional based cross-sectional study was conducted from April1-June 30, 2022. A total of 400 participants were selected using the systematic random sampling technique. Standard Berg balance scale tool and semi-structure questionnaire was used. Multicollinearity and model fitness were checked. Variables with a p-value of less than 0.25 in the Bivariable regression were entered into a multivariable logistic regression and p value < 0.05 was used as the cutoff point for significant variables. Result The prevalence of balance impairment was 51.5% (95% CI (46.58, 56.39). Being depressed (AOR = 12.25:95% CI (4.727, 31.779), using walking aids (AOR = 8.76:95%CI3.469, 22.117)), abnormal speed (AOR = 6.73:95%CI (2.671, 16.977)), did not have physiotherapy treatment (AOR = 3.96:95%CI (1.483, 10.586), and unmarried (AOR = 2.71, 95% CI = 1.061, 6.903) were significantly associated with balance impairment. Conclusion and recommendation The prevalence of balance impairment in the study was high. Being depressed, use walking aids, did not have physiotherapy treatment, abnormal speed of mobility, and unmarried were significantly associated factors. Therefore; it is better to give greater emphasis for those factors.
... Respondents were required to answer 'yes' or 'no' to the 15 statements that describe either a positive or a negative emotion/condition. The score of depression in the GDS were categorized in this presented study with > 10 representing "depressed" while scores of GDS ≤ 10 representing "not depressed" [49]. GDS is a reliable and valid measure have been ascertained with large samples of depression in post stroke patients [48,50]. ...
... On the BI, lower score indicates greater dependency with ADL. Geriatrics depression scale was the secondary contains fifteen items (GDS_SF) for the assessment depression [49].GDS is a reliable and valid measure of depression in post stroke patients [50].Timed up and go (TUG) were another secondary tool which assess speed of mobility respectively. ...
Introduction
Balance impairment is one of the common impairments in patients after stroke. It can lead to depression reduced speed of mobility, dependent on assistive device and reduce quality of life. However, evidence on balance impairment and its risk factors among stroke survivors in Ethiopia was lacking particularly in the study area. Therefore, this study aimed to investigate prevalence and associated factors of balance impairment among stroke survivor’s attendee at an outpatient clinic in Amara regional state comprehensive specialized hospital.
Methods
An institutional based cross-sectional study was conducted from April1-June 30, 2022. A total of 400 participants were selected using the systematic random sampling technique. Standard Berg balance scale tool and semi-structure questionnaire was used. Multicollinearity and model fitness were checked. Variables with a p-value of less than 0.25 in the Bivariable regression were entered into a multivariable logistic regression and p value < 0.05 was used as cutoff point for significant variables.
Result
The prevalence of balance impairment was 51.5% (95% CI (46.58, 56.39). Being depressed (AOR = 12.25:95% CI (4.727, 31.779), using walking aids (AOR = 8.76:95%CI3.469, 22.117)), abnormal speed (AOR = 6.73:95%CI (2.671, 16.977)), did not have physiotherapy treatment (AOR = 3.96:95%CI (1.483, 10.586), and unmarried (AOR = 2.71, 95% CI = 1.061, 6.903) were significantly associated with balance impairment.
Conclusion and recommendation
The prevalence of balance impairment in the study was high. Being depressed, use walking aids, did not have physiotherapy treatment, abnormal speed of mobility, and unmarried were significantly associated factors. Therefore; it is better to give greater emphasis for those factors.
... motor, non-motor and cognitive function. For this analysis we utilized demographic data (age, sex, race, time since diagnosis, education level), Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS)-Parts I-IV, 25 Hoehn & Yahr (H&Y), 26 Schwab-England activities of daily living score (S&E), 27 age/sex adjusted University of Pennsylvania Smell Identification Test (UPSIT) score, 28 Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) total score, 29 Geriatric Depression Scale (GDS) score, 30 REM sleep behavior disorder (RBD) screening questionnaire (RBDSQ) score, 31 Levodopa Equivalent Daily Dose (LEDD). 32 which was not fully implemented until study year 3. 34 The site investigator is provided a guidance document on how to assess for subjective cognitive change compared with pre-Parkinson's Disease state, impairment in cognitive abilities, and functional impairment due to cognitive deficits (i.e., providing specific examples of how cognitive impairment might adversely impact instrumental activities of daily living requiring cognitive abilities), with the option to review cognitive test results (e.g., MoCA, Hopkins Verbal Learning Test-Revised [HVLT-R], 35 Benton Judgment of Line Orientation [JLO], 36 Symbol-Digit Modalities Test ...
... While MoCA scores differed across NSD stage (p=0.041) with the lowest being the NSD Stage 3 group (27 [17][18][19][20][21][22][23][24][25][26][27][28][29][30]), there were no differences in cognitive categorization between groups. ...
Long-term longitudinal data on outcomes in sporadic Parkinsons Disease are limited, especially from cohorts with extensive biological characterization. Recent advances in biomarkers characterization of Parkinsons Disease necessitate an updated examination of long-term progression within contemporary cohorts like the Parkinsons Progression Markers Initiative, which enrolled individuals within 2 years of clinical diagnosis of Parkinsons Disease. Our study leverages the Neuronal Synuclein Disease framework, which defines the disease based on biomarker assessed presence of neuronal alpha-synuclein and dopamine deficit, rather than based on conventional clinical diagnostic criteria. In this study we aimed to provide a comprehensive long-term description of disease progression using the integrated biological and clinical staging system framework.
We analyzed data from 344 participants from the sporadic Parkinsons Disease cohort in the Parkinsons Progression Markers Initiative, who met Neuronal Synuclein Disease criteria. We assessed 11-year progression in a spectrum of clinical measures. We used Cox proportional hazards models to assess the association between baseline stage and time to key outcomes, including survival, postural instability (Hoehn & Yahr >= 3), loss of independence (Schwab & England < 80%), cognitive decline, and domain-based milestones such as walking and balance, motor complications, autonomic dysfunction, and activities of daily living. Additional analyses were completed to account for death and participant dropout. Biomarker analysis included dopamine transporter binding measures, as well as serum urate, neurofilament light chain and CSF amyloid-beta, phosphorylated tau and total tau.
At baseline, despite the cohort consisting of individuals within 2 years of clinical diagnosis, there was clear separation of participants in Neuronal Synuclein Disease Stages (23% Stage 2b, 67% Stage 3, 10% Stage 4). At 11 years, data were available for 153 participants; 35 participants had died over the follow up period. Of retained participants, 59% presented normal cognition, 24% had evidence of postural instability and mean Schwab & England score was 78.5. Serum neurofilament light chain consistently increased over time. No other biofluids had a consistent change in trajectory. Of importance, baseline Neuronal Synuclein Disease Stage predicted progression to clinically meaningful milestones.
This study provides data on longitudinal, 11-year progression in Neuronal Synuclein Disease participants within 2 years of clinical diagnosis. We observed better long-term outcomes in this contemporary observational study cohort. It highlights the heterogeneity in the early Parkinsons Disease population as defined by clinical diagnostic criteria and underscores the importance of shifting from clinical to biologically and functionally based inclusion criteria in the design of new clinical trials.
... 19 The GDS-15 assesses depressive status, with lower values indicating better mood (range, 0-15). 20 The VI assesses motivation (getting up, communicating, eating, toileting, and doing rehabilitation and other activities), with higher values indicating greater motivation (range, 0-10). ...
... Regarding IADL, frailty was observed in 68 (36.6%) of the male patients and 29 (42.0%) of the female patients. The median MMSE score was 26 (range, [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], and 72 patients (28.2%) had a frailty score of 23 or lower. The median GDS-15 score was 3 (range, 0-15), and 64 patients (25.1%) had a frailty score of 6 or higher. ...
Background
Postoperative delirium is especially common and often problematic among elderly patients undergoing surgery. This study aimed to explore factors that can predict postoperative delirium in elderly patients undergoing gastric cancer surgery.
Methods
This cohort study included 255 patients age 75 years or older who underwent gastric cancer surgery between July 2010 and December 2020. All the patients underwent preoperative comprehensive geriatric assessment (CGA) evaluation by a geriatrician. In addition to the CGA items, this study investigated the association between postoperative delirium and clinicopathologic factors, including Eastern Cooperative Oncology Group performance status (ECOG-PS).
Results
The most common postoperative complication was delirium, present in 31 patients (12.2%). The group with delirium was significantly more likely to have ECOG-PS ≥ 2, diabetes mellitus, cardiovascular disease, or cerebral infarction. The CGA showed frailty in the Instrumental Activities of Daily Living scale (IADL), the Mini-Mental State Examination (MMSE), the Vitality Index (VI), and the Geriatric Depression Scale 15 (GDS-15). In the multivariate analysis, the independent risk factors for delirium were ECOG-PS ≥ 2 ( P = 0.002) and MMSE-frailty ( P < 0.001). Using an MMSE score of ≤ 23 and an ECOG-PS score of ≥ 2 as cutoffs, postoperative delirium was predicted with a sensitivity of 80.7% and a specificity of 74.1%.
Conclusion
Postoperative delirium might be more easily predicted based on the combination of MMSE and ECOG-PS for elderly patients with gastric cancer undergoing gastrectomy.
... In addition, those suspected of having dementia, as evidenced by a score of ≥ 14 points on the Touch Paneltype Dementia Assessment Scale (TDAS) 15) , and those with depression symptoms, as evidenced by a score of ≥ 5 points on the Geriatric Depression Scale -15 (GDS -15) 16) , were excluded from the analyses. Therefore, a final total of 67 participants were analyzed and divided into the MCI and non -MCI groups. ...
... iii. Depression symptoms Depression symptoms were measured using the GDS -15 16) , a 15 -item measure of depression for older people. The scores ranged from 0 -15, with 0 -4 rated as normal, 5 -9 as having depressive tendencies, and ≥ 10 as having depression. ...
Background and Purpose: Mild cognitive impairment (MCI) is a predictor of future age-related dementia. We herein investigated associations of MCI with higher-level functional capacities, as well as with subjective difficulty regarding these functions, in community-dwelling older people, to identify a simple method for early MCI detection.
Method: We administered a test battery to 118 community-dwelling older people living in an urban area. The battery consisted of three tests;the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the Touch Panel-type Dementia Assessment Scale (TDAS), and the Geriatric Depression Scale-15. We then excluded participants with possible dementia or depression symptoms, and divided the remainder (n = 67) into an MCI group (n = 16) and a non-MCI group (n = 51), according to TDAS performance.
Results: Logistic regression analysis with the MCI and non-MCI groups as dependent variables indicated that TMIG-IC was a significant variable. Male sex and the perception that preparing meals and filling out pension forms had become more difficult were significantly associated with MCI, each independently increasing the probability of MCI.
Conclusions: Subjective difficulty with higher-level functions and impairment in higher-level functional capacity may serve as indices for mass screening for MCI.
... In addition, the CLOX Test part 1 (clock drawing/planning, maximum score 15) (33) and the MMSE (34) were administered. Depression was assessed using the Geriatric Depression Scale -30 items (GDS) (35). Cerebrovascular burden was assessed by two experienced neuroradiologists (MG, SM) on T2-weighted images using the Fazekas scale (36), a visual four-grade rating scale (0 = no white matter lesions to 3= severe white matter lesions) that quantifies white matter hyperintensities. ...
Introduction
The increasing prevalence of Alzheimer’s disease (AD) has created an urgent need for rapid and cost-effective methods to diagnose and monitor people at all stages of the disease. Progressive memory impairment and hippocampal atrophy are key features of the most common so-called typical variant of AD. However, studies evaluating detailed cognitive measures combined with region of interest (ROI)-based imaging markers of progression over the long term in the AD dementia (ADD) stage are rare.
Method
We conducted a retrospective longitudinal follow-up study in patients with mild to moderate ADD (aged 60-92 years). They underwent magnetic resonance imaging (MRI; 3 Tesla, MPRAGE) as well as clinical and neuropsychological examination (Consortium to Establish a Registry for Alzheimer’s Disease [CERAD] -Plus test battery) at baseline and at least one follow-up visit. ROI-based brain structural analysis of baseline MRIs was performed using the Computational Anatomy Toolbox (CAT) 12. Clinical dementia progression (progression index [PI]) was measured by the annual decline in the Mini Mental State Examination (MMSE) scores. MRI, demographic, and neuropsychological data were included in univariate and multiple linear regression models to predict the PI.
Results
104 ADD patients (age 63 to 90 years, 73% female, mean MMSE score 22.63 ± 3.77, mean follow-up 4.27 ± 2.15 years) and 32 age- and gender-matched cognitively intact controls were included. The pattern of gray matter (GM) atrophy and the cognitive profile were consistent with the amnestic/typical variant of ADD in all patients. Deficits in word list learning together with temporal lobe GM atrophy had the highest predictive value for rapid cognitive decline in the multiple linear regression model, accounting for 25.4% of the PI variance.
Discussion
Our results show that temporal atrophy together with deficits in the encoding of verbal material, rather than in immediate or delayed recall, is highly predictive for rapid cognitive decline in patients with mild to moderate amnestic/typical ADD. These findings point to the relevance of combining detailed cognitive and automated structural imaging analyses to predict clinical progression in patients with ADD.
... Alzheimer's Research & Therapy (2024) 16:256 word list memory test were used to assess learning and recall [30,31], the Trail Making Test A and B (TMT-A/B) for mental processing speed and executive function [32], animal fluency for language and executive function [33], and forward and backward digit span for attention and executive functioning [34]. To assess neuropsychiatric symptoms, we used the Geriatric Depression Scale (GDS) [35] and the Neuropsychiatric Inventory (NPI, [36]). Missing data ranged from 177 (20%) for the NPI to 4 (0.5%) for the MMSE. ...
Background
The increasing prevalence of dementia and the introduction of disease-modifying therapies (DMTs) highlight the need for efficient diagnostic pathways in memory clinics. We present a data-driven approach to efficiently guide stepwise diagnostic testing for three clinical scenarios: 1) syndrome diagnosis, 2) etiological diagnosis, and 3) eligibility for DMT.
Methods
We used data from two memory clinic cohorts (ADC, PredictND), including 504 patients with dementia (302 Alzheimer’s disease, 107 frontotemporal dementia, 35 vascular dementia, 60 dementia with Lewy bodies), 191 patients with mild cognitive impairment, and 188 cognitively normal controls (CN). Tests included digital cognitive screening (cCOG), neuropsychological and functional assessment (NP), MRI with automated quantification, and CSF biomarkers. Sequential testing followed a predetermined order, guided by diagnostic certainty. Diagnostic certainty was determined using a clinical decision support system (CDSS) that generates a disease state index (DSI, 0–1), indicating the probability of the syndrome diagnosis or underlying etiology. Diagnosis was confirmed if the DSI exceeded a predefined threshold based on sensitivity/specificity cutoffs relevant to each clinical scenario. Diagnostic accuracy and the need for additional testing were assessed at each step.
Results
Using cCOG as a prescreener for 1) syndrome diagnosis has the potential to accurately reduce the need for extensive NP (42%), resulting in syndrome diagnosis in all patients, with a diagnostic accuracy of 0.71, which was comparable to using NP alone. For 2) etiological diagnosis, stepwise testing resulted in an etiological diagnosis in 80% of patients with a diagnostic accuracy of 0.77, with MRI needed in 77%, and CSF in 37%. When 3) determining DMT eligibility, stepwise testing (100% cCOG, 83% NP, 75% MRI) selected 60% of the patients for confirmatory CSF testing and eventually identified 90% of the potentially eligible patients with AD dementia.
Conclusions
Different diagnostic pathways are accurate and efficient depending on the setting. As such, a data-driven tool holds promise for assisting clinicians in selecting tests of added value across different clinical contexts. This becomes especially important with DMT availability, where the need for more efficient diagnostic pathways is crucial to maintain the accessibility and affordability of dementia diagnoses.
... Participants went to the laboratory on three different days ( Figure 1) within a month. At the first visit was performed anamnesis and neuropsychological test that include: the Mini-Mental State Examination (MMSE) 28 , verbal fluency (VF) 29 , clock drawing test (CDT) 30 and Geriatric Depression Scale (GDS) 31 . And to evaluate the physical condition: the time to up and go (TUG) and Sitting-rising test (SRT) 32 . ...
O processo de envelhecimento pode promover alterações no eixo hipotálamo-pituitária-adrenal (HPA), causando desregulação nos níveis de cortisol (resposta e recuperação inadequadas) após um estímulo estressor agudo. Para os indivíduos com comprometimento cognitivo leve (CCL), os níveis elevados de cortisol podem estar associados ao estresse crônico apesar de não conhecermos as respostas agudas ao estressor agudo. No entanto, existe uma diferença entre os gêneros e os indivíduos principalmente devido a patologias relacionadas ao envelhecimento como demência ou CCL. O objetivo do trabalho foi comparar o efeito do estressor físico agudo nos níveis de cortisol salivar entre mulheres com CCL e mulheres saudáveis. Foram selecionados idosas com diagnóstico clínico de CCL (n = 8) e idosas saudáveis (n = 10). Ambos os grupos realizaram uma triagem com teste cognitivo e físico. O estressor físico consistiu em uma caminhada de intensidade moderada em esteira por 30 min. O cortisol salivar foi coletado 3 vezes: antes, logo após e 15 minutos após a caminhada. Observou-se redução do cortisol imediatamente após o estressor físico para ambos os grupos com tamanho de efeito grande, porém esses resultados não alcançaram diferença significativa (F = 3,979; p = 0,063). A terceira coleta de cortisol pós 15 minutos mostrou um efeito significativo para o momento (F = 4,075; p = 0,031) com tamanho do efeito grande e redução dos níveis de cortisol. Independente do diagnóstico, as idosas apresentam baixa responsividade do cortisol a um estímulo físico. Apesar disso, os desfechos devem ser interpretados com cautela devidos as limitações.
... Analogamente, è necessario un inquadramento cognitivo e psico-emozionale, tramite le consuete scale di valutazione geriatrica, come il Mini-Mental State Examination (MMSE) 30 e la Geriatric Depression Scale (GDS) 31 . Questi test, in realtà non diagnostici in fase acuta di malattia, possono tuttavia rappresentare un indicatore fondamentale dello stato psico-affettivo alla dimissione e, quindi, della possibilità di effettuare in maniera efficace un eventuale intervento riabilitativo, oltre a costituire un elemento di riferimento per il personale sanitario del team riabilitativo che prenderà in carico il paziente. ...
Riassunto. La Cardiologia riabilitativa (CR) rappresenta una indicazione di classe IA nei pazienti dopo un evento cardiova-scolare (CV), con efficacia confermata anche nei cardiopatici anziani o fragili. Tuttavia il tasso di invio alla CR dei pazienti CV anziani rimane molto basso. Le ragioni sono molteplici: i pazienti con patologia indice CV sono spesso complessi, con più patologie croniche concomitanti e fragili; tuttavia tra di essi vi è una quota con presentazione di malattia CV suscet-tibile di miglioramento con la CR. Il presente documento si occupa del possibile referral alla CR dei cardiopatici anziani dalle geriatrie, dal momento che il modello multidisciplinare della CR può offrire l'insieme delle valutazioni e degli inter-venti, accuratamente adattati allo stato funzionale e clinico, orientati al raggiungimento di obiettivi appropriati per il sin-golo paziente. Il cardiologo, il geriatra e gli altri professionisti dovrebbero integrare sinergicamente le loro competenze, delineando così un nuovo paradigma di "Riabilitazione e prevenzione cardiogeriatrica", che potrebbe portare a una maggiore consapevolezza dell'effetto favorevole della CR, favorendo così un maggiore invio alla CR da parte dei reparti geriatrici. Vengono fornite raccomandazioni operative per la selezione dei pazienti, basate su priorità delle indicazioni, rischio clinico e livello di fragilità, integrando diverse com-petenze per raggiungere programmi di cura più appropriati. Parole chiave. Anziani, cardiologia riabilitativa, fragilità, multimorbilità, riabilitazione cardiogeriatrica. ITACARE-P/SIGG/SIGOT/SICGE position paper: referral of elderly cardiac patient from geriatrics to cardiac rehabilitation. Summary. Cardiac rehabilitation (CR) is Class IA indication in patients after an acute cardiovascular (CV) event, with efficacy confirmed even in elderly or frail CV patients CV and geriatric outcomes. However, rate of referral and admission to CR of elderly CV patients remains very low. CV patients admitted in geriatric wards are often complex, multimorbid and frail. Therefore, the present position paper addressees their possible referral to CR, since many have various forms of CV diseases amenable to improve with CR. The multidisciplinary and comprehensive model of CR is applicable to these patients where evaluation and interventions should be tailored to the patient functional and clinical status, aiming to appropriate targets. Cardiologist, Geriatrician and other professionals , should synergistically integrate their competences, thus outlining also the new paradigm of "Cardiogeriatric Rehabilitation and Prevention", possibly leading to an increased awareness of the beneficial effect of CR and to an increased referral to CR from Geriatric departments. Operative recommendations are given, based on appropriateness and priority of indications, clinical risk and frailty level, integrating different expertise to reach more effective programs of care. 527 La Cardiologia riabilitativa La Cardiologia riabilitativa (CR) è una disciplina della Cardiologia che si occupa della cura del pa-ziente post-acuto e cronico con evento o patolo-gia cardiovascolare (CV). L'intervento di CR viene raccomandato con la massima classe di evidenza dalle principali linee guida di settore in quanto fa-vorisce la stabilizzazione clinica, il miglioramento del profilo di rischio cardiovascolare, la riduzione della disabilità, l'adozione di uno stile di vita fa-Copyright-Il Pensiero Scientifico Editore downloaded by redazione interna IP 2.47.136.130 Tue, 19 Nov 2024, 08:52:15
... Mental health was measured using several metrics across these studies, 10 studies reported data on depression, five studies reported on anxiety and one study reported on stress. Most frequently, researchers utilized standardized scales, with the Geriatric Depression Scale (GDS; Yesavage et al., 1982), being the predominant choice, to measure mental health (see Table 1.8). Alternatively, some studies investigated participants' self-reported history of depression or anxiety (Garo-Pascual et al., 2023;Saint Martin et al., 2017;Trammell et al., 2024a). ...
Background: A subset of older adults, known as SuperAgers (SAs), exhibit exceptional resilience to these effects, displaying cognitive abilities at the same level or exceeding those 20-30 years younger. To date however, there is little understanding as to which factors may be responsible for SA enhanced cognitive abilities in old age. This systematic review aimed to identify and evaluate the evidence for an association between lifestyle factors and SA status.
Methods: A systematic literature search in accordance with the PRISMA guidelines was conducted across MedLine, Embase, Ovid, Global Health, APA PsychArticles, and PsycINFO from inception to 06/11/23 of studies investigating the link between SA status and one or more lifestyle factors.
Results: A systematic search identified 13 studies which met the inclusion criteria. Eleven investigated the relationship between two or more lifestyle factors with the most common lifestyle factor examined being mental health followed by physical activity, social engagement and smoking. Mixed results were observed across the included studies while social engagement and mental health emerged as the most likely lifestyle factors to be positively associated with SA status, there was considerable heterogeneity in the measures used to assess different lifestyle factors.
Conclusion: No clear conclusions could be drawn as to which lifestyle factors are associated with SA status due to scarcity of studies and heterogeneity in the measurement of different lifestyle factors.
... All participants were right-hand dominant (Oldfield, 1971), of Chinese Han ethnicity, and reported no known history of drug/alcohol abuse, psychiatric or sleep disorders. Included participants scored greater than 23 on the Mini-Mental State Examination [MMSE; (Cockrell and Folstein, 1988)] and less than 10 on the Geriatric Depression Scale [GDS; (Yesavage et al., 1982)]. The study sample included 42 de novo, drug-naïve individuals with a clinical diagnosis of unilateral PD as well as 29 age-similar control subjects with no known history of neurological disorders or motor impairments. ...
Whereas memory consolidation research has traditionally focused on longer temporal windows (i.e., hours to days) following an initial learning episode, recent research has also examined the functional significance of the shorter rest epochs commonly interspersed with blocks of task practice (i.e., “micro-offline” intervals on the timescale of seconds to minutes). In the motor sequence learning domain, evidence from young, healthy individuals suggests that micro-offline epochs afford a rapid consolidation process that is supported by the hippocampus. Consistent with these findings, amnesic patients with hippocampal damage were recently found to exhibit degraded micro-offline performance improvements. Interestingly, these offline losses were compensated for by larger performance gains during online practice. Given the known role of the striatum in online motor sequence learning, we hypothesized that individuals with dysfunction of the striatal system would exhibit impaired online, yet enhanced micro-offline, learning (i.e., a pattern of results opposite to those observed in patients with hippocampal lesions). We tested this hypothesis using Parkinson’s disease (PD) as a model of striatal dysfunction. Forty-two de novo , drug-naïve individuals (men and women) with a clinical diagnosis of unilateral PD and 29 healthy control subjects completed a motor sequence learning paradigm. Individuals with PD exhibited deficits during online task practice that were paralleled by greater improvements over micro-offline intervals. This pattern of results could not be explained by disease-related deficits in movement execution. These data suggest that striatal dysfunction disrupts online learning, yet total learning remains unchanged because of greater micro-offline performance improvements that potentially reflect hippocampal-mediated compensatory processes.
Significance Statement
The short rest intervals commonly interspersed between periods of active task engagement have traditionally been employed to minimize the build-up of fatigue. There is recent evidence, however, suggesting that these rest epochs may play an active role in motor learning and memory processes and the hippocampus appears to be a critical brain region supporting this rapid “offline” learning. Here, we show that individuals with Parkinson’s disease, a movement disorder characterized by dysfunction in the basal ganglia including the striatum, exhibit deficits during active task practice but greater learning over the interspersed offline intervals. Results potentially suggest that the relatively intact hippocampus may help compensate for motor sequence learning deficits linked to a disrupted striatal system in Parkinson’s disease.
... At baseline, right after diagnosis as iRBD, patients were led to conduct questionnaires and qEEG. Assessments included the Geriatric Depression Scale (GDS) for depression [39], the Pittsburgh Sleep Quality Index (PSQI) for sleep quality [40], and the Epworth Sleepiness Scale (ESS) for daytime sleepiness [41]. ...
Background: This study was aimed at analyzing cognitive function and quantitative electroencephalogram (qEEG) in patients with isolated REM sleep behavior disorder (iRBD) based on the presence of depression and at evaluating the impact of depression on phenoconversion to neurodegenerative diseases.
Methods: Individuals diagnosed with iRBD via polysomnography were included. Based on the presence of depression, patients were categorized into two groups. Neuropsychological tests and qEEG were conducted following the diagnosis of iRBD, and outcomes were compared between the two groups. Patients were regularly followed to monitor their phenoconversion status. Cox regression analysis was performed to assess the hazard ratio associated with depression.
Results: Ninety iRBD patients (70% males) were included, with a median age of 66.3 years. Depression was identified in 26 (28.9%) of these patients. The depressed group showed significantly poorer performance only in color reading subtest of Stroop (p=0.029) compared to the nondepressed group, showing reduced processing speed. In qEEG, relative gamma power (p=0.034) and high gamma power (p=0.020) in the parietal region were significantly higher in the depressed group than in the nondepressed group. Depression was associated with a hazard ratio of 3.32 for the risk of phenoconversion to neurodegenerative diseases in iRBD patients (p=0.011).
Conclusion: Depressive symptoms in iRBD patients should be closely monitored as they could aggravate cognitive dysfunction and increase the risk of phenoconversion to neurodegenerative diseases.
... Na literatura se discutem as contribuições do sentimento de esperança em processos que requerem modos de enfrentar as dificuldades, como, por exemplo, os processos de saúde e doença, que geram inseguranças e angústias, mas também são permeados de esforços para ultrapassar as adversidades estabelecidas (Oliveira et al., 2018). A literatura traz poucos estudos que avaliam a esperança em idosos (Silva et al., 2020;Oliveira et al., 2018;Souza et al., 2017) (Yesavage et al., 1983). ...
Objetivou-se avaliar a relação da resiliência e variáveis demográficas (idade, sexo, estado civil, religiosidade), com fatores de risco (eventos de vida, estresse, depressão) e de proteção (apoio social, esperança) no envelhecimento. Foram utilizados os seguintes instrumentos: Questionário Sociodemográfico, Inventário de Eventos Estressantes, Escala de Depressão Geriátrica, Escala de Resiliência, Escala de Esperança de Herth, Inventário de Rede de Suporte Social. Participaram 508 idosos com média de 71,16 anos. Os índices de resiliência, de esperança e de apoio social foram satisfatórios. Destacaram-se os eventos que afetam o bem-estar pessoal e 23,6% dos idosos apresentaram sintomatologia depressiva. A idade se correlacionou negativamente com a resiliência e a esperança. O teste de regressão linear múltipla resultou em um modelo no qual 22% do índice de resiliência foram explicados pelas variáveis esperança e depressão. Idosos mais longevos indicaram aumento de agravos à saúde mental; assim, práticas de promoção da resiliência devem ser privilegiadas com esse grupo.
... The score range was 0-10 points, and 0~3 score was for those with mild pruritus, 4~6 score for moderate pruritus, while 7~10 for severe pruritus. Using the self-rating scale (SDS) 11 , the degree of depression before and after treatment was assessed. The score <53 was those with no depression; 53~62 was mild depression; 63~72 was moderate depression; while >72 was severe depression. ...
This was a retrospective study. Vulva pruritus is a common symptom in gynaecology and causes mental burden in patients. This study aimed to analyze effects of the Vitamin E and physical therapy on alleviating the symptoms of vulva pruritus. Forty nine (49) women diagnosed with vulva pruritus in the Huai’an First People’s Hospital from November 2019 to November 2020 were included. All diagnosed cases received oral administration of Vitamin E, topical application of Vitamin E, and physical therapy consisting of low-frequency pelvic circulation and trigger point acupuncture. Clinical data, degree of itching, visual analog scale for evaluating pain, self-rating scale score for evaluating depression, and sexual function index were recorded. After treatment, the degree of itching, pain, and depression levels were significantly decreased. We conclude that a combination of Vitamin E plus physical therapy can alleviate symptoms of patients with vulva pruritus. We therefore recommend the use of this approach in clinical practice.
... 25 Additionally, participants completed questionnaires to evaluate their form of the day, QoL 26 and depressive symptoms using the Geriatric Depression Scale. 27 The participants' expectations regarding cognitive training and their subjective cognitive performance change (nine-point Likert scale), including an informant-rated version completed by a close friend or relative, was assessed. Dementia worries (self-and informant-rated) were assessed on a ten-point Likert scale. ...
Background
Investigations of computerised cognitive training (CCT) show heterogeneous results in slowing age-related cognitive decline.
Aims
To comprehensively evaluate the effectiveness of serious games-based CCT, integrating control conditions, neurophysiological and blood-based biomarkers, and subjective measures.
Method
In this bi-centric randomised controlled trial with parallel groups, 160 participants (mean age 71.3 years) with cognitive impairment ranging from subjective decline to mild cognitive impairment, were pseudo-randomised to three arms: an intervention group receiving CCT immediately, an active control (watching documentaries) and a waitlist condition, which both started the CCT intervention after the control period. Both active arms entailed a 3-month intervention period comprising a total of 60 at-home sessions (five per week) and weekly on-site group meetings. In the intervention group, this was followed by additional 6 months of CCT, with monthly booster sessions to assess long-term training effects. Behavioural and subjective changes were assessed in 3-month intervals. Biological effects were measured by amyloid blood markers and magnetic resonance imaging obtained before and after training.
Results
Adherence to the training protocol was consistently high across groups and time points (4.87 sessions per week). Domain-specific cognitive scores showed no significant interaction between groups and time points. Significant cognitive and subjective improvements were observed after long-term training. Voxel-based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness.
Conclusions
Our study demonstrates no benefits of 3 months of CCT on cognitive or biological outcomes. However, positive effects were observed subjectively and after long-term CCT, warranting the inclusion of CCT in multicomponent interventions.
... It has a maximum score of 33 points, and a cutoff point of 23 is commonly employed to identify cognitive decline [55]. The GDS is an instrument used to identify the presence of depressive symptoms in older people [56]. It consists of 15 yes/no questions and is considered a screening tool for depressive symptoms. ...
Background
Successful aging is associated with an increase in life expectancy. For a better understanding of the aging process, recognize the relationship between telomere length and nutritional status is a novel approach in geriatric science. Telomers shortening coincides with a decrease in life expectancy, and an increased risk of malnutrition-related diseases.
Goals
The goal of this study was to investigate whether a shorter telomere length is associated with a greater likelihood of malnutrition in community-dwelling older adults.
Methods
A cross-sectional study with a probabilistic sample of 448 older people aged 60 years old or over, and living in the urban area of an inland Brazilian municipality was conducted. The information was gathered in two stages: a) a personal interview was conducted to obtain sociodemographic, cognitive, and functional autonomy data. The Mini Nutritional Assessment was used to assess the risk of malnutrition. b) a blood sample was taken to proceed with the relative quantitative study of telomere length using real-time qPCR method. The differences between the groups were estimated using Pearson’s v2 and Fisher’s exact tests. In the data analysis, descriptive statistics and multiple logistic regression were applied.
Results
In 34.15% of the total sample, malnutrition was recognized as a risk factor. Older people with the shortest telomere length had more chances of getting malnutrition (OR = 1.63; IC:95% = 1.04–2.55) compared to those with longer telomeres, independent of age groups, family income, multimorbidity, cognitive decline, and depressive symptoms.
Conclusion
The creation of clinical trials and the implementation of therapies to reduce the risk of malnutrition will be aided using the telomere length as an aging innovative biomarker, connected with nutritional status.
... The GDS is a valid and dependable self-rating depression screening tool for elderly population than other tools. 11 It contains 15 items (GDS-15) and 30 items (GDS-30), which are both reliable instruments for evaluating depression in the elderly. 12 Inclusion criteria: Studies that are cross-sectional and community-based, involving participants 60 years of age and older, and reporting on the prevalence of depression. ...
Background: Depression among the elderly is a global public health concern, impacting quality of life and overall well-being. However, there is a lack of recent systematic reviews or meta-analyses on its prevalence in India. This study aims to update this information through a systematic review and meta-analysis. Methods: The study utilized the Geriatric Depression Scale (GDS) as a screening tool for depression among individuals aged 60 and older in India, utilizing electronic databases for community-based cross-sectional studies from inception to date. Pooled prevalence with 95% CI was performed using R statistical software. Results: 23 community-based cross-sectional studies were included representing 13 Indian states, meeting the inclusion criteria. The combined prevalence of depression among the elderly was estimated to be 47% (95% CI: 0.39; 0.55), with significant heterogeneity observed among studies (I²=98%, p<0.01). The study underscores the considerable depression issue among India's elderly population, emphasizing the urgent need for tailored mental health interventions. Conclusion: The meta-analysis reveals a high prevalence of depression among India's senior population, highlighting the need for targeted public health initiatives to address this growing crisis and support the mental health needs of the elderly.
... The Geriatric Depression Scale (GDS) is a 30-item questionnaire that is entirely yes or no questions pertaining to how they felt over the past week (Yesavage et al., 1982). It is entirely self-reported and does not have a trained interviewer. ...
Clinicians treating older adults should do
multi-morbidity and individualized patientcentered
assessment by a multidisciplinary collaborative
team, including the patient’s individual
health history, standardized rating
scales, and laboratory workup. This assessment
allows for a multi-morbidity patient-centered
individualized treatment plan which
takes into account both the old age patient’s
physical and mental health and aims for the
same values as the assessment, namely, a
patient-centered, population-focused, and
measurement-guided medical treatment. This
chapter describes the two critical elements of
this approach to geriatric psychiatry:
(1) Establishing a correct diagnosis by way of
targeted foundational aspects of the diagnostic
interview, rating scales, and the laboratory
workup of older adults and (2) Utilization of
evidence-based collaborative care models for
the elderly, with a description of the need for
collaborative care models in the elderly, the
necessary elements, the team structure, the
evidence-based models in the elderly, and the
limitations of the current state of
collaborative care.
... Exclusion criteria included: (i) cognitive performance below the normal range on two tests within a single cognitive domain (i.e., memory, executive function, or attention); (ii) the presence of current major neurological (including stroke, dementia or cognitive impairment, and cancer) or psychiatric (including major depressive disorder, bipolar disorder, and drug and alcohol dependence) disorders; (iii) severe depressive symptoms, as indicated by scores > 17 on the 30-item Geriatric Depression Scale [32] (current psychotropic therapy was allowed if at a stable dose over the previous 8 weeks); (iv) the presence of a chronic disease or acute unstable illness (respiratory, cardiovascular, digestive, renal, metabolic, hematologic, endocrine, infectious, or malignant) that would interfere with the aims of the study protocol; and (v) the use of supplements that could interfere with the study nutraceutical (e.g. cognitive enhancers). ...
Background
Developing interventions for older adults with subjective cognitive decline (SCD) has the potential to prevent dementia in this at-risk group. Preclinical models indicate that Citrus-derived phytochemicals could benefit cognition and inflammatory processes, but results from clinical trials are still preliminary. The aim of this study is to determine the effects of long-term supplementation with Citrus peel extract on cognitive performance and inflammation in individuals with SCD.
Methods
Eighty participants were randomly assigned to active treatment (400 mg of Citrus peel extract containing 3.0 mg of naringenin and 0.1 mg of auraptene) or placebo at 1:1 ratio for 36 weeks. The primary endpoint was the change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total score across the 36-week trial period. Other cognitive outcomes included tests and scales evaluating verbal memory, attention, executive and visuospatial functions, and memory concerns. The secondary endpoint was the change of interleukin-8 (IL-8) levels over the 36-week trial period in a subsample of 60 consecutive participants. An Intention-to-treat approach with generalized linear mixed models was used for data analysis.
Results
The RBANS total score showed significant improvement in both Citrus peel extract and placebo groups at 36 weeks (p for time < .001, d = 0.36, p time x treatment = .910). Significant time effects were also found in cognitive domains of short- and long-term verbal memory (p < .001) and scales of subjective memory (p < .01), with no significant time x treatment interaction. The largest effect sizes were observed in verbal memory in the placebo group (d = 0.69 in short-term, and d = 0.78 in long-term verbal memory). Increased IL-8 levels were found at 36-week follow-up in both Citrus peel extract and placebo groups (p for time = .010, d = 0.21, p time x treatment = .772). Adverse events were balanced between groups.
Conclusions
In this randomized clinical trial, long-term Citrus peel extract supplementation did not show cognitive benefits over placebo in participants with SCD, possibly due to high placebo response. These findings might have specific implications for designing future nutraceutical trials in individuals experiencing SCD.
Trial registration
The trial has been registered at the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT04744922 on February 9th, 2021 (https://www.clinicaltrials.gov/ct2/show/NCT04744922).
... The Geriatric Depression Scale (GDS) 18 , abbreviated Brazilian version 19 was used to measure DS at each follow-up. This tracking instrument contains 10 items with "yes or no" answers and refers to a recall period of seven days before the interview. ...
To evaluate bidirectional and longitudinal association between physical activity (PA) and depressive symptoms (DS). This is a cohort study called “Como Vai?” (How are you?), conducted by older population representative sample of the city of Pelotas-Rio Grande do Sul. The analyses used data from the first interview (2014) and follow-up (2019/20). The long version of the International Physical Activity Questionnaire (IPAQ) was applied to assess PA in the leisure, commuting and total domains. The presence of DS was measured using the Geriatric Depression Scale (GDS-10). Linear regression models were used to evaluate bidirectional associations between PA and DS. Analytical sample included 515 individuals with a mean age of 70.7 (± 9.2) years. Each weekly minute of total PA (β: -0.0006; 95% CI: -0.0011; -0.0001) and commuting PA (β: -0.0008; 95% CI: -0.0016; -0.0001) in 2014 predicts worse DS scores in 2019/20. At the same time, DS score in 2014 (β: -9.79; 95% CI: -18.81; -0.76) was a negative predictor of leisure-time PA in the 2019/20 follow-up adjusted for sociodemographic and other health behaviors. However, when adjusted for the respective outcomes at baseline, the associations found were not statistically significant. The present study did not find evidence of bidirectionality between PA and DS and the prospective associations lost statistical significance after adjustment for the respective outcomes at baseline. Other investigations are necessary including more periods of follow-up, objective analyses of PA to complement analyses by domains and, therefore, provide a better understanding of this complex relationship.
... The CAIDE score is able to detect intervention effects and is validated for use in clinical trials from midlife onwards. 21 Main secondary effectiveness outcomes included change in individual risk factors, number of uncontrolled risk factors, change in 10-year cardiovascular disease risk (Framingham risk score), 22 depressive symptoms (15-item Geriatric Depression Scale [GDS-15]), 23 anxiety symptoms (Hospital Anxiety and Depression Scale [HADS]-anxiety part), 24 score on the Lifestyle for Brain health index (LIBRA), 25 and diet (assessed with the Cleghorn questionnaire in UK and the China Kadoorie questionnaire in China). 26,27 Full details of efficacy outcomes are in appendix 2 (p 6). ...
Background
The expected increase of dementia prevalence in the coming decades will mainly be within low-and middle-income countries and those with low socioeconomic status (SES) in high income countries. Forty percent of dementia is associated with modifiable, lifestyle-related cardiovascular risk factors. Mobile health interventions with remote coaching can help reach underserved high-risk populations globally.
Methods
This open label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in persons aged 55-75 years of low SES in UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in CAIDE dementia risk score (including age, education, sex, systolic blood pressure, total cholesterol, BMI, physical exercise) after 12-18 months of intervention. Main implementation outcomes were coverage, acceptability, appropriateness, adoption, feasibility, sustainability, fidelity, and costs using a mixed methods approach.
Findings
Between 15th January 2021 and 18th April 2023, 1,488 persons were included and randomised (734 intervention, 754 control), with 1,229 (82·6%) available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months, the mean CAIDE score improved by 0·16 points in the intervention group vs. 0·01 in the control group (Mean Difference (MD) 0·16, 95% Confidence Interval (CI) 0·03-0·29). The effect was larger in those who adhered to the intervention (MD 0·27, 95%CI 0·12-0·44) and those planning to change lifestyle (MD 0·33, 95%CI 0·10-0·57). Ten percent of those invited participated; of these, 81% adopted the intervention and 50% continued active participation throughout the study. For the individual components of the CAIDE score, there were no statistically significant differences for systolic blood pressure, total cholesterol and BMI, but in the intervention group physical inactivity was reduced more than in the control group (MD 6·7%, 95%CI 2·1 to 11·2) and more participants quit smoking (MD -3·1%, 95%CI -4·8 to -1·5).
Interpretation
A coach-supported mHealth intervention to improve lifestyle is modestly effective in reducing dementia risk factors in those with low SES in the UK and any SES in China. Implementation is challenging in these populations, but those reached actively participated. Whether this will result in less cognitive decline and dementia requires a larger RCT with long follow-up.
... The Geriatric Depression Scale (GDS-30) is a self-report questionnaire which measures depressive symptoms in older adults (Yesavage et al., 1982), and has been widely used in both clinical and research settings. The GDS-30 consists of 30 yes/no questions which ask participants to assess their mood over the past week, with scores ranging from 0 to 30. ...
The subjective happiness scale (SHS) is a brief instrument used to measure global subjective happiness that has been translated from its original English to many other languages. To date, there is no reported translation of this scale into Malayalam, a language spoken by over 32 million people especially in the southern state of Kerala, India. In the present study, 656 community-dwelling older adults participating in the Kerala Einstein study (KES) completed the Malayalam version of the SHS. The Malayalam version demonstrated high internal consistency and good convergent validity, as assessed by comparison to measures of depression and anxiety. We also used factor analysis to determine that the Malayalam version of the SHS has a unidimensional structure, akin to the original English as well as other language adaptations. Our study adds to the repertoire of tools to measure happiness in non-English-speaking populations, enabling future research to explore the foundations of well-being across diverse cultures.
... The ISGO proposes the Center for Epidemiological Studies Depression Scale test, which allows the identification of cases of depression and anxiety, ensuring a staging of the severity and, therefore, taking the appropriate treatment options [42]. This scale allows for heterogeneous management of the geriatric population, unlike other widely used scales, such as the Geriatric Depression Scale (GDS), which is used as a screening test in the geriatric setting but does not allow for disease staging [43], which can be applied to all patients. ...
Urological cancers represent 13.1% of cancer cases in the world, with a mean age of diagnosis of 67 years, making it a geriatric disease. The lack of participation and evaluation of treatments by the geriatric oncologic population has made their mortality rate higher than that of other oncologic population groups, urologic cancers being no exception. The comprehensive management of older people with urological cancers is a bet that is presented to improve the quality of life and survival of this group. Managing elements such as nutritional, physical, cognitive, psychosocial, and sexual status improves the chances of adherence and treatment, contributing significantly to improving the quality of life. The integrated management of the geriatric oncology population has brought positive effects on quality of life, enhancing levels of depression and anxiety and also allowing the classification of oncology patients based on other criteria in addition to their chronologic age, contributing to the management of specialized treatments that have allowed the implementation of more specific interventions with better results.
... A study assess symptoms of depression [35] and there was no difference between MG and CMG for the Geriatric Depression Scale scale [58]. ...
Background
The onset of the symptoms of subcortical NDs is due to a unique part of the brain which strengthens the idea of reciprocal influence of physical activity and cognitive training in improving clinical symptoms. Consequently, protocols combining the two stimulations are becoming increasingly popular in NDs. Our threefold aim was to (A) describe the different combinations of physical and cognitive training used to alleviate the motor and cognitive symptoms of patients with subcortical neurodegenerative disorders, (B) compare the effects of these different combinations (sequential, dual tasking, synergical) on symptoms, and (C) recommend approaches for further studies.
Methods
We conducted literature searches of PubMed, BASE and ACM, to carry out a systematic review of randomized controlled trials and controlled trials of combined physical and cognitive training among patients with Huntington’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, Lewy body dementia, spinocerebellar ataxia, Friedreich’s ataxia, and progressive supranuclear palsy. Physical, neuropsychological, behavioral outcomes were considered. The Cochrane risk-of-bias tool was used to verify the critical appraisal.
Results
Twenty-one studies focused on Parkinson’s disease with 940 participants were included. Despites promising benefits on cognitive and physical function, our results revealed discrepant findings for research on combined training.
Discussion
Inconsistencies were linked to the choice of tests, the functions that were targeted, disease progression, and trainings. There was a dearth of follow-up data.
Conclusions
Differences between combined training are unclear, particularly regarding the role of cognitive load. Future studies should focus on comparing the feasibility, tolerability, and effectiveness of different combinations of motor-cognitive training.
... A versão atual do framework disponibiliza interfaces para sete instrumentos de autorrelato, os quais avaliam respostas emocionais dos usuários frente a sistemas interativos, bem como a usabilidade de soluções computacionais (o que inclui satisfação subjetiva) e também questões relacionadas à qualidade de vida dos respondentes. Os instrumentos são oriundos das áreas da Computação, Psicologia e Gerontologia, sendo eles: 1) Self-Assessment Manikin (SAM) [2]; 2) System Usability Scale (SUS) [4]; 3) Escala de Humor de Brunel (BRUMS) [3]; 4) Escala de Afetos Positivos e Negativos (PANAS) [10]; 5) Escala de Afetos de Zanon (EA) [12]; 6) Lista de Estados de Ânimo Presentes (LEAP) [5]; 7) Escala de Depressão Geriátrica (GDS) [11]. ...
Evaluating a product is essential to understand whether or not the solution meets the defined requirements. In software development, a proper evaluation highlights issues that were not identified in earlier stages of development. However, to achieve a successful evaluation, it is necessary to consider different characteristics, from the target user to the environment in which the evaluation will be conducted, so selecting the proper evaluation method is essential. However, choosing the suitable method can be challenging, especially in Human-Computer Interaction, a field that thrives on its interdisciplinary nature. This project proposes an integrated framework combining tools from different domains to assist computing professionals and others in systematically applying these instruments.
... Contiene respuestas dicotómicas (SI ó NO) para las cuales se suman todas las respuestas. Puntajes de 00 a 05 indican un tamizaje Normal, 06 a 10 tamizaje Depresión moderada y 11 a 15 Tamizaje con depresión severa (Yesavage et al., 1982). Tiene validación en Colombia para su aplicación en adulto mayor desde 2005 (Bacca et al., 2005). ...
El ejercicio es una de las intervenciones no farmacológicas más prometedoras de la actualidad para prevenir o reducir el deterioro cognitivo asociado con enfermedades neurodegenerativas o el envejecimiento. El objetivo de este estudio fue determinar el efecto de un programa de entrenamiento funcional de alta intensidad (HIFT) sobre la calidad de vida, calidad del sueño, estabilidad y niveles de depresión en una población colombiana de adultos mayores con deterioro cognitivo leve (DCL). Para esto, se llevó a cabo un ensayo clínico controlado aleatorizado con una muestra de 162 adultos mayores con DCL. El grupo intervención (GI) recibió tratamiento con HIFT por 12 semanas 3 veces a la semana, mientras que el grupo control (GC) recibió recomendaciones generales de actividad física y realizó actividades manuales. Se observó que, posterior a la intervención, hubo una mejora significativa en el GI comparado con el GC en la calidad de vida en múltiples dominios (p < 0,05), calidad de sueño (p < 0,001), estabilidad postural (p < 0,001) y depresión (p < 0,001). El análisis de covarianza multivariada mostró la influencia de la edad y los niveles de deterioro cognitivo (MMSE) sobre los resultados. Este estudio demuestra que la implementación de un programa corto de HIFT tiene un efecto positivo sobre la calidad de vida, calidad del sueño, estabilidad y niveles de depresión en adultos mayores con DCL.
... The dependent variable in the present study was depression, screening by the 30-item Geriatric Depression Scale (GDS) Thai version. The original GDS was developed by Yesavage et al. 21 . It is widely accepted that the GDS is a valid and reliable screening tool for older depression in English speaking and other non-English speaking countries 9 . ...
Introduction: Depression is a significant public health issue across all sociodemographic groups including the elderly. The aims of this study were to determine the prevalence of depression and gender differences in risk factors of depression among Thai older adults. Materials and Methods: A total of 1,604 community-dwelling older aged 60 years and over in the northeastern region in Thailand were enrolled in this study. This cross-sectional survey was conducted to collect information on demographic characteristics, social support, community participation, and gender roles in a family. Depressive symptoms were assessed using 30-item Geriatric Depression Scale. Odds ratios and 95% confidence intervals were estimated using multiple logistic regression with Forward Stepwise method. Results: The overall prevalence of depression was 15.2%; 17.6% in females and 12.3% in males. The overall risk factors of depressive symptoms were: perceived fair and poor health (OR = 3.52, 1.88, respectively), low social support (OR =3.30), not participating in community activities (OR = 1.73), single (OR = 1.63), not having domestic responsibility (OR = 1.56), and low household income (OR = 1.42). There were different risk factors in depressive symptoms between male and female older adults. The unique risk factor for females was never married/widowed/divorced (OR = 1.52). The unique risk factor for males was living alone (OR =8.14). Conclusion: Our findings confirmed that female older adults have a greater prevalence of depression than the male group. The results of this study may offer meaningful policy implications in planning gender specific interventions to improve older people's mental health..
... We performed a post hoc power analyses based on one dependent variable (conflict resolution) using this sample and the full statistical model, for the predictors Group and Age using the simr package with 1000 permutations 44 To ensure that the groups were comparable, we tested for group differences in education, engagement in social activities, linguistic background, self-perceived health, depression symptoms using the 15item version of the Geriatric Depression Scale (GDS) 45 We also compared the number of participants in each group who regularly engaged in sports (aerobic activities), social activities, cognitive activities, cognitive-motor activities, singing, and playing a musical instrument, using χ 2 tests or Fisher tests when the number of observations in at least one cell was less than 5. The results revealed that the groups were matched in terms of their engagement in sports (χ 2 = 1.446, df = 2, p = 0.485), cognitive activities (χ 2 = 2.975, df = 2, p = 0.226), and social activities (χ 2 = 2.226, df = 2, p = 0.329). ...
Despite the ubiquity of musical activities, little is known about the specificity of their association with executive functions. In this cross‐sectional study, we examined this relationship as a function of age. Our main hypotheses were that executive functions would decline in older age, that this relationship would be reduced in singers and instrumentalists compared to nonmusician active controls, and that the amount of musical experience would be more strongly associated with executive functions compared to the specific type of activity. A sample of 122 cognitively healthy adults aged 20–88 years was recruited, consisting of 39 amateur singers, 43 amateur instrumentalists, and 40 nonmusician controls. Tests of auditory processing speed, auditory selective attention, auditory and visual inhibitory control, and auditory working memory were administered. The results confirm a negative relationship between age and executive functions. While musicians’ advantages were found in selective attention, inhibitory control, and auditory working memory, these advantages were specific rather than global. Furthermore, most of these advantages were independent of age and experience. Finally, there were only limited differences between instrumentalists and singers, suggesting that the relationship between music‐making activities and executive functions may be, at least in part, general as opposed to activity‐specific.
... On the other hand, the progression of dementia can lead to increased loneliness, as patients may become more withdrawn and less able to participate in conversations and social activities. This was consistent with other recent studies on the same topic [27,28]. Indeed, Freak-Poli and colleagues [29] conducted a study based on data from two longitudinal studies that highlighted a correlation between loneliness and cognitive decline measured by the MMSE, as well as an increased risk of dementia. ...
Background: Neurocognitive disorders (NCDs) have a variable decline in cognitive function, while loneliness was associated with cognitive impairment and increased dementia risk. In the present study, we examined the associations of loneliness with functional and cognitive status in patients with minor (mild cognitive impairment) and major NCDs (dementia). Methods: We diagnosed mild NCD (n=42) and major NCD (n=164) through DSM-5 criteria on 206 participants aged>65 years using the UCLA 3-Item Loneliness Scale (UCLA-3) to evaluate loneliness, the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales to measure functional status, and Mini-Mental State Examination (MMSE) to assess cognitive functions. Results: In a multivariate regression model, the effect of loneliness on cognitive functions was negative in major (=-1.05-p<.0001) and minor NCD (=-0.06-p<.01). In the fully-adjusted multivariate regression model (sex-age-education-multimorbidity-depressive symptoms-antidementia drug treatment), the effect of loneliness remained negative for major NCD and became positive for minor NCD (=0.09-p<.001). The effect of loneliness on IADL (=-0.26-p<.0001) and ADL (=-0.24-p<.001) showed a negative effect for major NCD across the different models, while for minor NCD, the effect was positive (IADL:=0.26-p<.0001-ADL:=0.05-p=0.01). Minor NCD displayed different levels of MMSE (=6.68-p<.001), but not ADL or IADL, compared to major NCD for the same levels of loneliness. MANOVA pill’s test suggested a statistically significant and different interactive effect of loneliness on functional and cognitive variables between minor and major NCDs. Conclusions: We confirmed the relationships between loneliness and cognitive and functional status in major NCD, observing a novel trend in minor NCD.
... Exclusion criteria were exogenous hypercortisolism (by systemic glucocorticoid therapy) and adrenal gland diseases (like Cushing's syndrome or Addison's disease). Every subject received a comprehensive geriatric assessment (CGA), including the Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Cumulative-Illness Rating Scale (CIRS) -severity (-SI) and -comorbidity index (-CI), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS) and Cornell Scale for Depression in Dementia (CSDD) [24][25][26][27][28][29]. The neurocognitive disorders (depression and dementia) were examined according to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) criteria and the International Classification of Diseases tenth revision (ICD-10) [30]. ...
The mechanisms at the basis of depression are still matter of debate, but several studies in the literature suggest common pathways with dementia (genetic predispositions, metabolic and inflammatory mechanisms, neuropathological changes) and other geriatric syndromes.
To evaluate the role of cortisol (as marker of the HPA, hypothalamus–pituitary–adrenal axis hyperactivity) in elderly subjects with depressive symptoms (by the means of the AGICO, AGIng and COrtisol, study), in relationship to the presence of the major geriatric syndromes.
The AGICO study enrolled patients from ten Geriatric Units in Italy. Every subject received a comprehensive geriatric assessment or CGA (including the Mini Mental State Examination or MMSE, Geriatric Depression Scale or GDS and Cornell Scale for Depression in Dementia or CSDD), the neurological examination (with a computed tomography scan or magnetic resonance imaging of the brain), the assessment of the metabolic syndrome (MetS), the evaluation of the cortisol activity by two consecutive urine collections (diurnal and nocturnal), a CGA-derived frailty index (FI) and a modified measure of allostatic load (AL).
The MMSE scores were significantly and inversely related to the values of GDS (p < 0.001) and CSDD (p < 0.05), respectively. The patients with depressive symptoms (GDS/CSDD > 8) showed significantly increased disability, MetS, inflammation, FI and AL and significantly reduced MMSE and renal function.
The diurnal and nocturnal urinary cortisol levels in the patients with depressive symptoms (GDS/CSDD > 8) were higher with respects to controls (p < 0.05 for nocturnal difference).
The AGICO study showed that the stress response is activated in the patients with depression.
The depression in elderly patient should be reconsidered as a systemic disease, with coexisting major geriatric syndromes (disability, dementia, frailty) and combined pathogenetic mechanisms (metabolic syndrome, impaired renal function, low-grade inflammation, and allostatic load). Cortisol confirmed its role as principal mediator of the aging process in both dementia and metabolic syndrome.
... As part of standard practice in the clinic, the following measures were administered at intake: Geriatric Anxiety Inventory (GAI; Pachana et al., 2007); Geriatric Depression Scale (GDS-30; Yesavage et al., 1982); Zarit Burden Interview, 12-item (ZBI; Bédard et al., 2001); and Post Traumatic Stress Screener for Primary Care (PTSD-PC; Prins et al., 2016). Clinically relevant benchmark scores for these measures are reported in Table 1. ...
Family caregivers of persons with neurocognitive disorders sometimes experience heightened emotional burden (i.e., caregiver burden), presenting with symptoms of depression and anxiety. The stress of caregiving may be heightened among those who identify as women, who experience disproportionate rates and consequences of the caregiving role. This case study highlights the use of Caregiver Family Therapy (CFT; i.e., a systems-directed approach targeting the caregiver role and network) and Cognitive Behavioral Therapy (CBT; i.e., an individual-directed approach targeting maladaptive cognitions) with a cisgender White woman caregiving for her spouse, a cisgender man with Parkinson’s disease. The patient reported elevated caregiver burden, depression, and anxiety at intake. Treatment targeted modifications to the caregiving role, maladaptive cognitions, and behavioral activation, often with a focus on the role of gender in shaping the caregiving role and core beliefs about caregiving. Over 20 sessions, the patient reported reductions in anxiety (Geriatric Anxiety Inventory = −6), depression (Geriatric Depression Scale-30 = −10), and caregiver burden (Zarit Burden Interview-12: −20), which were maintained over two booster sessions (6 weeks). This case highlights the benefit of integrating systems- and individual-focused psychotherapies with caregivers as well as the important role of gender in addressing caregiving-related psychological distress.
... El estado funcional en relación con las actividades básicas de la vida diaria se determinó con la escala de Barthel 25 , la cual mide el desempeño en los ítems de: alimentación, aseo, baño, vestido, deposición, micción, uso del inodoro, traslado silla/cama, deambulación y subir escaleras; esta escala puntúa entre 0 y 100, clasificando como dependiente a quien presentaba puntajes < 100. La presencia de síntomas depresivos se determinó con la escala de valoración geriátrica de Yesavage et al. 26 , la cual va de 0 a 15 y se utilizó un punto de corte de 6 o más para considerar la presencia de síntomas depresivos; se incluyó también la escala del índice de valoración de salud oral geriátrica (GOHAI, por sus siglas en inglés), indicador subjetivo de salud bucal, que evalúa la percepción de problemas funcionales y los impactos psicosociales asociados con la condición de salud bucal, tiene un puntaje total que oscila entre 12 y 60, clasificando como baja calidad de vida relacionada con la salud bucal, puntajes < 51, moderada entre 51 y 56 y alta ≥ 57 puntos 27 . ...
Resumen: El objetivo del estudio fue estimar la prevalencia de malnutrición por indicadores antropométricos agrupados y describir los factores sociodemográficos, alimentarios y condiciones de salud determinantes de malnutrición en personas mayores colombianas. Se realizó un análisis secundario del estudio Salud, Bienestar y Envejecimiento (SABE) Colombia, 2015. Incluyó 23.694 personas ≥ 60 años. La malnutrición por exceso se definió agrupando dos indicadores: índice de masa corporal (IMC) y circunferencia de cintura; el déficit de peso se definió agrupando el IMC y las circunferencias de brazo y pantorrilla. Para asociar la malnutrición con variables sociodemográficas, alimentarias y condiciones de salud se usó la prueba chi-cuadrado y para determinar la heterogeneidad de la malnutrición se realizó un análisis de clases latentes. El exceso de peso fue 31,9%; mientras que el déficit de peso según IMC y circunferencia de pantorrilla fue 7,9%, e incrementó a 18,8%, al tener en cuenta además la circunferencia del brazo. Se generaron cinco clases latentes para malnutrición, clase 1: sin exceso de peso y con deterioro en condiciones de salud; clase 2: sin déficit de peso y con deterioro en condiciones de salud; clase 3: sin malnutrición ni deterioro en condiciones de salud; clase 4: exceso de peso y multimorbilidad, y clase 5: bajo consumo de alimentos proteicos sin déficit ni exceso de peso. Se concluye que existe una prevalencia de malnutrición elevada en las personas mayores, representando más el exceso que el déficit. Tanto los factores sociodemográficos, alimentarios y condiciones de salud, se asocian de forma diferente al exceso que al déficit de peso.
... Depressive symptoms were assessed with the 15-item version of the Geriatric Depression Scale. 16 The questions were answered with 'yes' or 'no'. The cumulative score is rated on a scoring grid. ...
Background
Pharmacological treatment options for patients with dementia owing to Alzheimer's disease are limited to symptomatic therapy. Recently, the US Food and Drug Administration approved the monoclonal antibody lecanemab for the treatment of amyloid-positive patients with mild cognitive impairment (MCI) and early Alzheimer´s dementia. European approval is expected in 2024. Data on the applicability and eligibility for treatment with anti-amyloid monoclonal antibodies outside of a study population are lacking.
Aims
This study examined eligibility criteria for lecanemab in a real-world memory clinic population between 1 January 2022 and 31 July 2023.
Method
We conducted a retrospective, single-centre study applying the clinical trial eligibility criteria for lecanemab to out-patients of a specialised psychiatric memory clinic. Eligibility for anti-amyloid treatment was assessed following the phase 3 inclusion and exclusion criteria and the published recommendations for lecanemab.
Results
The study population consisted of 587 out-patients. Two-thirds were diagnosed with Alzheimer's disease (probable or possible Alzheimer's disease dementia in 43.6% of cases, n = 256) or MCI (23%, n = 135), and 33.4% ( n = 196) were diagnosed with dementia or neurocognitive disorder owing to another aetiology. Applying all lecanemab eligibility criteria, 11 (4.3%) patients with dementia and two (1.5%) patients with MCI would have been eligible for treatment with this compound, whereas 13 dementia (5.1%) and 14 (10.4%) MCI patients met clinical inclusion criteria, but had no available amyloid status.
Conclusions
Even in a memory clinic with a good infrastructure and sufficient facilities for dementia diagnostics, most patients do not meet the eligibility criteria for treatment with lecanemab.
... Screening for stress, depression and anxiety symptoms was performed using the Perceived Stress Scale-PSS (Cohen et al., 1983), Geriatric Depression Scale-GDS (Yesavage et al., 1982) and Geriatric Anxiety Inventory-GAI (Pachana et al., 2007), respectively. In Brazil, the PSS was translated and validated by Luft et al. (2007). ...
Introduction. Although studies have demonstrated the impact of the COVID-19 pandemic on mental health, those correlating COVID-19 statistics with the psychosocial repercussions in older adults are as yet incipient. Objective. Evaluate the screening of stress, depression, and anxiety symptoms in older adults throughout the pandemic and their relationship with the occurrence and severity metrics of COVID-19. Method. An ecological, time-series, web-based survey study was conducted in the population aged 60 and over who use digital media. Data collection was undertaken between July 2020 and January 2021 in eight Brazilian cities and included 2,712 older adults. Results. There was an upward trend in anxiety and depression symptoms in Brasília-DF, and a downward trend in these symptoms in Divinópolis-MG. It was also possible to identify correlations between mental disorder symptom scores and COVID-19 occurrence and severity metrics in two of the cities evaluated. Discussion and conclusion. This study is one of the first to explore the relationship between COVID-19 indicators and mental health variables in older adults, showing that changes in the occurrence and severity metrics of the Novel Coronavirus may be followed by changes in the frequency of mental health problems in this population.
Objetivou-se analisar a reprodutibilidade de um instrumento para mensurar a habilidade de cálculos mentais de pessoas idosas, testando sua especificidade e sensibilidade em teste e reteste. Foram avaliadas 207 pessoas idosas saudáveis, em um intervalo de seis meses. A amostra foi selecionada de acordo com critérios rigorosos e a análise estatística incluiu testes não-paramétricos. A análise do desempenho cognitivo da amostra revelou diferenças significativas entre o momento inicial (baseline) e após seis meses (T1). O estudo demonstrou que o instrumento possui boa reprodutibilidade e é adequado para monitoramento cognitivo. No entanto, os achados não demonstraram um efeito generalizado de transferência para habilidades cognitivas que não envolvem tipicamente processamento numérico ou visuoespacial.
Introduction. This study evaluated the effects of 12 sessions of treatment with Pulsed Electromagnetic Field (PEMF - Supramaximus®) in elderly individuals with sarcopenia. Sarcopenia involves the loss of muscle mass and function, impacting quality of life and increasing the risk of falls and mortality. Technologies like PEMF may offer effective alternatives for treatment. Objectives. To investigate the effects of PEMF on muscle strength, functional mobility, muscle thickness, and psychological state in the elderly. Methods. A total of 20 elderly individuals (aged 65-80) were recruited and subjected to 12 PEMF sessions. Evaluations included the SARC-F Scale, calf circumference, handgrip strength, rectus femoris thickness, and the Timed Up and Go (TUG) test. Depression scales (Yesavage) and MiniMental were applied before and after treatment. Results. PEMF significantly reduced SARC-F scores (from 13.7 ± 2.2 to 7.09 ± 2.0, p = 0.0019), increased calf circumference (from 33.9 ± 1.3 cm to 36.2 ± 1.1 cm, p = 0.0034), and improved TUG time (from 24.6 ± 5.7 to 20.2 ± 4.4 seconds, p = 0.023). Muscle strength and rectus femoris thickness also increased. The Yesavage scale showed a significant improvement in the depressive state. Conclusions. PEMF proved to be effective in improving functionality, muscle strength, and emotional state in elderly individuals with sarcopenia, making it a promising alternative for those with limitations to physical exercise
Background: Mental health challenges, particularly depression and anxiety, are increasingly prevalent among the elderly, highlighting a need for preventative strategies. Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) combines mindfulness techniques with cognitive restructuring to enhance emotional regulation and resilience in older adults. This pilot study examines the efficacy of MBCBI in reducing symptoms of depression and anxiety, with an emphasis on its potential as a preventative mental health approach for at-risk elderly individuals. Method: This study utilized a mixed-method approach with elderly participants aged 60–75 years who presented mild to moderate symptoms of depression and anxiety. Participants underwent a 10-week MBCBI program, involving weekly 90-minute sessions focused on mindfulness practices and cognitive-behavioral techniques. Quantitative data were collected using the Geriatric Depression Scale-Short Form (GDS-SF), State-Trait Anxiety Inventory (STAI) and a Resilience Scale, while qualitative insights were gathered through semi-structured interviews. Results: The MBCBI program demonstrated significant reductions in participants’ depression and anxiety levels (p < 0.05). Additionally, resilience scores improved, and participants reported enhanced emotional regulation and a stronger sense of social connection and self-awareness. Conclusion: Findings from this pilot study suggest that MBCBI is an effective preventative intervention for elderly individuals at risk of mental health issues, particularly depression and anxiety. MBCBI’s integration of mindfulness and cognitive-behavioral elements offers a promising approach to strengthening resilience and reducing psychological distress among aging populations. Further research with larger, diverse samples is recommended to confirm and generalize these results.
Purpose
Hip fractures in the elderly, especially those discharged to a rehab facility, have historically been associated with poor outcomes. There has yet to be identified which patients have a higher likelihood of a rehab discharge after isolated hip fracture fixation. The purpose of this study was to identify factors that predispose patients to require short or long‐term rehab after surgical intervention of traumatic, isolated hip fractures.
Methods
Patients undergoing operative management of hip fractures (n = 71,849) from 2017 to 2019 at institutions that submitted data to a nationwide database were analyzed retrospectively. Various factors were compared between patients discharged to inpatient rehab (n = 56,178) versus home (n = 15,671).
Results
The rehab discharge group was significantly older and predominantly female. This cohort had a longer average hospital stay, higher incidence of diabetes, congestive heart failure, chronic renal failure, history of cerebrovascular accident, functionally dependent health status, hypertension, chronic obstructive pulmonary disease, dementia, baseline anticoagulation therapy, and history of myocardial infarction. DVT during hospitalization was encountered more often in patients discharged to rehab. Patients with femoral neck fractures and those undergoing total hip arthroplasty were more often discharged home. Patients with intertrochanteric hip fractures and those undergoing fracture fixation were more often discharged to rehab.
Conclusions
Multiple risk factors associated with a significantly higher likelihood of a rehab discharge after isolated hip fracture surgery were identified. Early identification of these patients may provide an opportunity to optimize patients for home discharge and better outcomes.
Level of Evidence
Level III, Case‐Control Study.
Background: The increase in life expectancy and age-related diseases, such as Alzheimer's disease, is a global challenge. Given the drawbacks of pharmacological treatments, it is important to pursue non-pharmacological strategies for dementia risk reduction. To effectively promote health and well-being in later life, multimodal, low-threshold, and cost-effective lifestyle interventions are needed.
Methods: REMINDer is a monocentric, outcome assessor-blinded, randomized controlled pilot study to assess the feasibility and impact of a multimodal intervention delivered online (home-based and live-streamed). The 6-week (two one-hour sessions/week) online mind-body group intervention will be compared to a 6-week passive control (waitlist with delayed intervention) using a cross-over (AB-BA) design. The intervention was specifically designed for older adults and includes music, dance-based movement, and mindfulness. A total of N=50 cognitively unimpaired older adults will be enrolled and randomized into the two intervention arms using a block randomization with a 1:1 allocation ratio.
Results: Outcomes will be assessed at pre-intervention, post-intervention, and follow-up using digital assessments of online questionnaires. Primary outcomes include feasibility, operationalized by adherence rates, and preliminary effectiveness of the intervention. The latter will be assessed by changes in self-reported mental and physical well-being, operationalized by the Short-Form Health Survey (SF-12). Secondary outcomes will include changes in self-reported health outcomes including cognitive, motor, sensory, emotional/affective, social, and lifestyle behaviors.
Discussion: The study will provide evidence of the feasibility and preliminary effectiveness of an online multimodal mind-body intervention. If successful, the study may inform accessible lifestyle strategies to improve mental health and well-being and other risk factors for dementia in older adults.
Registration: NCT06530277
A Faculdade de Medicina e Cirurgia do Pará foi a oitava escola médica
aberta no Brasil em 1919, através do esforço de um grupo pequeno de médicos
locais e em condições adversas. Apenas com a federalização em 1950, a
situação estrutural e financeira da faculdade se estabiliza. Talvez isso explique
o porquê de, apesar de centenária, nossa escola sempre teve dificuldade em
se impor no cenário nacional, em termos de relevância acadêmica.
O ponto de inflexão ocorreu em 1985, quando a Profa. Bettina Ferro de
Souza e seus colegas da cadeira de Propedêutica Médica resolveram publicar
suas experiências conjuntas através do Manual de Propedêutica Médica. Neste
momento, a faculdade fincou seus pés como referência na trabalhosa arte da
anamnese e do exame físico. No cenário local, o “Manual” foi um divisor de
águas entre os ex-alunos da nossa faculdade.
Ao longo deste projeto, pudemos conversar com vários médicos e
alguns professores que foram alunos de Profa. Bettina e estudaram por este
livro, e é nítido como ele marcou diferentes gerações, tanto tecnicamente
quanto emocionalmente. Há uma clara sensação de orgulho do fato de que
um livro tão bem montado possa ter sido gestado em nossa instituição. O
sucesso da obra fez com que o livro ganhasse novas edições e reimpressões
diversas. Contudo, nas últimas décadas, uma série de novos livros de semiologia
com ótima qualidade surgiram no mercado brasileiro, levando o antes
tão lido “Manual” a estantes e armários empoeirados.
O presente projeto surge de dois pilares. Primeiro, a percepção de que
os herdeiros espirituais de Profa. Bettina continuaram a depurar sua arte semiológica
e têm muito conhecimento herdado que merece ser compartilhado
com estudantes de medicina de todo Brasil.
Segundo, a convicção de que o mundo mudou, a medicina mudou
e, principalmente, o modo de aprender dos estudantes mudou desde 1985.
Os professores das escolas médicas têm lutado para se adaptar à revolução
das metodologias ativas no ensino da medicina. Nunca houve tanto acesso à
informação como no mundo da Internet, onde vídeos, áudios e mensagens instantâneas em redes sociais são usados diariamente por nossos estudantes.
Novas questões éticas e desafios sobre promoção de saúde em uma sociedade
mais diversa e igualitária também se incorporaram definitivamente à prática
médica do dia a dia.
Porém, apesar de tantas mudanças, os livros de semiologia parecem
pouco sensíveis a tudo isso. O esquema geral do ensino do exame físico dos
principais sistemas com algo sobre anamnese parece ser reproduzido entre as
obras, com poucas variações. Não conseguimos enxergar este caleidoscópio
de caminhos que a modernidade nos oferece.
Na tentativa de sensibilizar sobre estes pontos, tivemos a honra de
organizar um novo Manual de Propedêutica Médica, concebido e escrito por
múltiplas mãos, de professores e estudantes. Mas esta não é uma outra edição
do livro da Profa. Bettina. Fizemos algo novo, justamente para homenagear a
obra antiga. Escrevemos um manual objetivo, sem a pretensão de um livro-
-texto extenso, com a inovação de adicionar vídeos curtos vinculados a QR
codes inseridos no texto. Tudo para facilitar o estudo do aluno, que poderá
ler a descrição do exame físico e conferir a execução da manobra em um
vídeo dedicado em seu próprio celular.
As inovações continuam no conteúdo. Ousamos ao trazer temas como
anamnese espiritual, tecnologia em semiologia, tópicos de saúde de grupos
específicos (idosos, população LGBTQIAP+, povos indígenas, população
negra e quilombola) e princípios da medicina do estilo de vida. Todos dialogando
com o Brasil atual.
Esperamos que este livro tenha tanto impacto para os estudantes de
medicina do século XXI quanto o seu antecessor. Que ele também possa
fincar seus pés na memória de inúmeros futuros médicos e, mais importante,
ajudar na formação de profissionais de qualidade.
Tenham um ótimo aprendizado!
Belém do Pará, 10 de outubro de 2023
Bruno Lopes Santos-Lobato
Edienny Viana Santos-Lobato
Background
Geriatric depression results in additional difficulties for older people and their residing society. The case-control study intended to assess the association between cognitive social capital and depression in rural older people.
Methods
We conducted this study from January to December 2020 among 420 rural tenants aged ≥60 years in Bangladesh. We enrolled 210 older persons with depression as cases and another 210 without depression as controls. We used a semi-structured questionnaire, the Geriatric Depression Scale (GDS-15), and a cluster sampling technique to collect data through face-to-face interviews. We performed quality control checks and followed all ethics guidelines.
Findings
Geriatric depression had a significant association with gender (p = 0.006), marital status (p < 0.001), education (p < 0.001), occupation (p = 0.001), family type (p < 0.001), family size (p < 0.001), number of family members (p < 0.001), and monthly family income (p < 0.001) of the rural older adults. Both interpersonal trust (p < 0.001) and reciprocity (p < 0.001) were significantly associated with geriatric depression. The older adults who didn’t believe in interpersonal trust (OR = 6.8, p = 0.002) and who disagreed with reciprocity (OR = 31.1, p < 0.001) were more likely to have depression.
Implications
The study findings can contribute to formulating cognitive social capital policy and interventions to promote the psychological well-being of rural older people by alleviating geriatric depression.
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