• Issue
    Volume 37, Issue 6
    1
    June 2022

COVER IMAGE

Free Access

Cover Image

  • Pages: 1
  • First Published: 22 June 2022
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The cover image is based on the Research Article Staff perceptions of the consequences of COVID-19 on quality of dementia care for residents in Ontario long-term care homes by Julia Kirkham et al., https://doi.org/10.1002/gps.5725.

ISSUE INFORMATION

Issue Information

  • First Published: 01 May 2022

REVIEW ARTICLE

Open Access

A systematic review of interventions to reduce anticholinergic burden in older people with dementia in primary care

  • First Published: 27 April 2022
Key points

  • Anticholinergic burden (ACB) remains high among people with dementia (PwD) despite known risks to physical and cognitive functioning. Reducing ACB in PwD is essential to improve quality of life and reduce negative outcomes.

  • The literature was systematically reviewed to assess the types and effectiveness of interventions to reduce ACB among PwD in primary care.

  • However, no studies met the inclusion criteria for this review, highlighting the lack of high-quality evidence in this area.

  • There is a clear need for future studies to develop and test interventions to reduce ACB in PwD, particularly in the primary care setting, using robust study designs.

Open Access

A systematic literature review and meta-analysis on digital health interventions for people living with dementia and Mild Cognitive Impairment

  • First Published: 04 May 2022
Key points

  • Digital health interventions have enabled services to keep delivering health care to people living with dementia during the COVID-19 pandemic, and while evidence on their effectiveness is mounting, an update of the literature is needed.

  • This systematic review of the literature on digital health interventions for people living with dementia included 20 studies on a diverse range of interventions, modes of delivery, activities, duration, length, frequency, and intensity.

  • Digital health interventions produced positive effects on cognitive abilities and negative effects on activities of daily living, compared to non-digital interventions.

  • Stepping exergames generated the largest effect sizes on physical and cognitive abilities, while supervised training produced larger effect sizes than unsupervised interventions.

Open Access

Neuropsychological approach to subjective cognitive complaints in cognitively unimpaired older people: A systematic review

  • First Published: 27 April 2022
Key points

  • Cognitive failures could affect negatively on the emotional and psychosocial well-being.

  • Cognitive training in combination with psychoeducation and psychical exercise showed the strongest evidence in improving subjective and objective cognitive functioning.

  • Initial guidelines for designing successful interventions to target SCCs in cognitively unimpaired older people are provided.

  • The review has implications for promotion of healthy cognitive aging.

RESEARCH ARTICLE

Suicide mortality among the elderly population in Italy: A nationwide cohort study on gender differences in sociodemographic risk factors, method of suicide, and associated comorbidity

  • First Published: 29 April 2022
Key points

  • In Italy, sociodemographic factors influence suicide mortality in old age to a different extent in men and women

  • Suicide mortality is significantly associated with the living arrangement, level of education, citizenship, and degree of urbanization of the municipality of residence, with important gender differences

  • Gender differences also exist in the choice of suicide method and in the pattern of comorbidities associated with suicide

  • Understanding gender differences in suicide mortality in later life would help to improve social support and quality of life for older men and women

Staff perceptions of the consequences of COVID-19 on quality of dementia care for residents in Ontario long-term care homes

  • First Published: 27 April 2022
Key points

  • There is a lack of information on the impact of COVID-19 on quality of dementia care in long-term care (LTC).

  • In this survey of LTC staff, approximately half of respondents reported worsened overall quality of dementia care related to the COVID-19 pandemic and infection control measures.

  • A majority of respondents reported worsening of specific measures of quality of care. In particular, a worsening of resident cognitive functioning, mobility and behavioural symptoms was reported.

  • Worsened quality of care related to the COVID-19 pandemic may have contributed to poor outcomes for those with dementia in LTC.

Mechanisms connecting insomnia to hopelessness among Chinese older adults: Serial mediating roles of fatigue and social support

  • First Published: 30 April 2022
Key points

  • Insomnia was significantly associated with hopelessness among Chinese older adults.

  • Fatigue and social support in serial mediated the relationship between insomnia and hopelessness.

  • Establishing stronger social network could confer resilience against the negative effects of insomnia and fatigue on hopelessness.

Relationship between hearing loss and depression symptoms among older adults in China: The mediating role of social isolation and loneliness

  • First Published: 27 April 2022
Key points

  • Older Chinese adults (≥60 years) with hearing loss are more likely to experience depression symptoms.

  • The relationship of depression symptoms and hearing loss in older adults is mediated by loneliness in particular and social isolation to a lesser extent.

Open Access

Predictors of nursing home placement at 2 years in Alzheimer's disease: A follow-up survey from the THERAD study

  • First Published: 30 April 2022
Key points

  • Nursing home placement (NHP) can be the only solution in some dead-end situations in Alzheimer's disease (AD). There is some evidence on the risk factors of NHP, related to both patients and caregivers (behavioural and psychological symptoms, loss of autonomy, and caregiver burden).

  • We found these factors in our work on a sample of 196 dyads during a 2-year follow-up as part of the randomized controlled trial THERAD, where the primary endpoint was to assess the impact of an educational intervention on the quality of life of people with AD.

  • We found two additional factors: high patient education level and the status of offspring caregiver.

  • The needs of offspring caregivers differ from those of spousal caregivers in AD.

  • Further trials should target subpopulations and take into account these predictors of NHP when testing interventions to delay such an occurrence.

Open Access

Care burden, loneliness, and social isolation in caregivers of people with physical and brain health conditions in English-speaking regions: Before and during the COVID-19 pandemic

  • First Published: 01 May 2022
Key points

  • This study highlights the significant negative impact that COVID-19-related restrictions have had on informal caregivers of people with enduring health conditions in four English speaking regions, globally.

  • Heightened levels of burden, loneliness, and social isolation occurred during the pandemic compared to pre-pandemic in caregivers of people with enduring physical and brain health or physical health conditions.

  • The increase in burden in caregivers of people with brain health conditions was associated with caregiver factors (including gender, emotional loneliness, and increase in social isolation) and pandemic-related external factors, such as cohabitation with the care recipient and the impact of COVID-19-related restrictions on the ability to provide care.

  • These findings have implications for policy development and healthcare interventions to target care circumstances and psychosocial outcomes of informal caregivers and ensure their equitable access to social support, taking into consideration pandemic-related changes.

Open Access

Deficits in rate of force production during multifinger tasks are associated with cognitive status

  • First Published: 05 May 2022
Key points

  • The multifinger force deficit (MFFD) was not reliably associated with cognitive status, as determined by the Montreal Cognitive Assessment (MoCA)

  • An estimate of the MFFD derived using the rate-of-force-development (rofMFFD) was negatively associated with cognitive status

  • The magnitudes of the negative associations between the rofMFFD and the MFFD, with MoCA scores, were larger than those reported for standard grip strength dynamometry

Relationship between dementia, COVID-19 risk, and adherence to COVID-19 mitigation behaviors among older adults in the United States

  • First Published: 09 May 2022
Key points

  • Older adults with dementia have a higher risk for COVID-19.

  • Older adults with dementia are less likely to wash their hands to prevent the spread of COVID-19.

  • Dementia status is not associated with mask-wearing or social distancing to prevent the spread of COVID-19.

  • The relationship between dementia and COVID-19 risk is primarily mediated by functional impairment, income, and residential setting.

Open Access

Exploring changes to resident thriving and associated factors in Swedish nursing homes: A repeated cross-sectional study

  • First Published: 05 May 2022
Key points

  • Thriving scores increased significantly between baseline and follow-up in this sample of Swedish nursing home residents.

  • Residents' overall neuropsychiatric-index scores decreased significantly, as did the prevalence of most neuropsychiatric symptoms.

  • Associations between resident thriving, cognitive impairment, and neuropsychiatric symptoms were confirmed and elucidated.

  • Further research is needed to explore the impact of person-centred interventions to improve resident outcomes over time, particularly among residents at risk of lower thriving.

A precision medicine tool to understand who responds best to hearing aids in late-life depression

  • First Published: 27 April 2022
Key points

  • Using a combined moderator approach, we identified pre-treatment characteristics of older adults with hearing loss whose depression was more likely to improve with active versus sham hearing aids.

  • Older adults with relatively worse hearing loss-related, physical, and cognitive functioning were observed to benefit most from hearing aids in depression.

  • Given the large number of older adults with hearing loss and depression and the underutilization of hearing aids, these results may represent a non-invasive and scalable means of targeting those most likely to respond to treatment.

Open Access

Prevalence and correlates of alexithymia in older persons with medically (un)explained physical symptoms

  • First Published: 09 May 2022
Key points

  • We examined the prevalence and physical, psychological and social correlates of alexithymia in older patients with Medically Unexplained Symptoms (MUS) compared to older patients with Medically Explained Symptoms (MES)

  • We've shown the prevalence and severity of alexithymia to be higher among older persons with MUS compared to MES and severity of alexithymia was associated with depressive symptoms, especially in the MUS population.

  • The combination of MUS and alexithymia may culminate in a high disease burden in older patients which stresses the need to develop better understanding of the associations between alexithymia and MUS in later life.

Caregiving concerns and clinical characteristics across neurodegenerative and cerebrovascular disorders in the Ontario neurodegenerative disease research initiative

  • First Published: 05 May 2022
Key points

  • We identified multiple types of caregiving burden from the Zarit's Burden Interview across five neurodegenerative and cerebrovascular disorders.

  • Overall burden showed strong relationships with neuropsychiatric symptoms (measured via Neuropsychiatric Inventory - Questionnaire) and functional dependence (measured via instrumental and basic activities of daily living (ADL)).

  • We found little to no differences between disorders.

  • Through our analyses we identified two questions that stood out with very high responses, and these two questions briefly capture the four types of burdens we identified: “Are you afraid of what the future holds for your relative?” and “Do you feel your relative is dependent on you?”.

Prevalence, clinical features, and risk factors of delusions in patients with delirium

  • First Published: 16 May 2022
Key points

  • This study aimed to focus on the delirium subtype in which delusions are conspicuous and explore its prevalence, clinical characteristics, and risk factors.

  • In this study of 601 delirium cases, the prevalence of delusions was 13.0%. Most were classified as delusion of reference. Older age, female sex, and living alone were significantly associated with delusions.

  • The features and risk factors of the delusions suggested a formal similarity with late paraphrenia and “lack-of-contact paranoia.” Psychological interventions that consider the isolation, anxiety, and fear behind delusions may be necessary.

Predictors of the change in burden, strain, mood, and quality of life among caregivers of Parkinson's disease patients

  • First Published: 17 May 2022
Key points

  • The present study is, to date, the largest prospective longitudinal study conducted for analyzing how burden, strain, mood, and quality of life change (QoL) in the principal caregiver of a patient with Parkinson's disease (PD).

  • After 2 years of follow-up, the status of the principal caregiver of a patient with PD worsens as a whole with an increase in burden and stress and a worsening in mood and QoL.

  • Mood changes in the patient and in the caregiver as well are key aspects related to increase in caregiver burden.

  • These findings suggest that it could be essential to detect depressive symptoms both in the patient and in the caregiver too.