Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults.

We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects.

We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant.

Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.

To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.

We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents’ functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents’ cognitive status independently.

The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.

A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.

Episodic memory starts to decline very early in the development of Alzheimer’s disease (AD). Subtle impairments in memory binding may be detected in mild cognitive impairment (MCI). This study aims to examine the psychometric properties of the Chinese version of the memory binding test (MBT).

One hundred and sixty-four subjects (26 individuals with AD, 67 individuals with amnestic MCI (aMCI), 30 individuals with subjective cognitive impairment (SCI), and 41 cognitively normal elderly individuals (NC)) participated in the study. Twenty-two subjects repeated the assessment of the MBT within 6 weeks (± 2 weeks). Pearson correlation was used to calculate the convergent validity. The test––retest reliability was determined by the calculation of the intraclass correlation coefficient (ICC). Discriminative validity was calculated to evaluate the receiver–operating characteristic curves. The optimal index was chosen by comparing the area under the curve for specificity and sensitivity ≥ 0.80. The optimal cutoff score of the index was chosen to maximize the sum of sensitivity and specificity.

The absolute value of the convergent validity of the direct indexes of MBT ranged from 0.443 to 0.684. The ICC for each of direct indexes was 0.887–0.958. Total delayed paired recall (TDPR) was the optimal index for discriminating aMCI from NC. The cutoff score for TDPR was ≤25 to distinguish aMCI from NC (sensitivity = 0.896, specificity = 0.707).

The Chinese version of MBT is a valid and reliable instrument to detect MCI.

Engagement of people with dementia who are living in the community, their family or carers, and healthcare professionals in decision-making related to their future care is an area yet to be explored in the literature. In particular, little is known about the factors most likely to underpin their engagement.

To identify key factors for the engagement of the person with dementia living in the community, as well as their family or carer and their healthcare professionals in decision-making processes related to future care.

This is an integrative review guided by the PRISMA guidelines; the Mixed Methods Appraisal Tool was used to assess study quality. MEDLINE, PubMed, CINAHL, PsycINFO and Embase databases were searched for articles published from 2012 to 2018 that focused on people with dementia who live in the community, their family or carers, and community-based healthcare professionals.

Twenty articles were included in the review, and six key factors were identified through thematic analysis: knowledge and understanding of dementia and decision-making for the future, valuing decision-making for the future, healthcare professionals’ communication skills, timing of initiating conversations, relationship quality, and orientation to the future.

This review identifies the six key factors required for the engagement of the three primary key stakeholders in decision-making about the future care of people with dementia. It also situates the factors within the complex context in which people with dementia, their family or carers, and healthcare professionals typically find themselves.

Older adults tend to exhibit more prosocial behavior than younger adults. However, little research has focused on understanding the factors that may explain such differences in the social decision-making process. The first aim was to examine if, and to what degree, the content of social information about a recipient has an impact on young vs. older adults’ prosocial behavior. The second aim was to understand if empathic concern, Theory of Mind, and reasoning explain the (expected) age differences in prosociality.

Cross-sectional study.

The study was conducted in northern Italy in a laboratory setting.

Forty-eight younger adults (Mage = 23.29; SD = 2.20) and 48 older adults (Mage = 70.19; SD = 5.13).

Prosocial behavior was measured using the Dictator Game in which participants split a sum of money with recipients presented with four levels of description: no information, physical description, positive psychological description, and negative psychological description. In addition, participants performed tasks on emphatic concern, Theory of Mind, and reasoning.

Results showed that older adults are more prosocial than younger adults in the Dictator Game. This finding was evident when the recipient was described with positive psychological and physical features. This pattern of results was statistically explained by the reduction in reasoning ability.

These findings suggest a relationship between age-related reduction in reasoning ability and older adults’ prosocial behavior. The theoretical and practical implication of the empirical findings are discussed.

Childhood maltreatment is an important factor associated with adverse mental health outcomes including geriatric depression and the “big five” personality characteristics. The objective of this study was to evaluate a model where personality characteristics mediate the relationship between childhood maltreatment and geriatric depression.

In this cross-sectional study, elderly subjects from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil (n = 260) completed the Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and Mini International Neuropsychiatric Interview 5.0 (MINI plus). We used structural equation modeling (SEM) to evaluate the mediation hypothesis.

The five personality factors (neuroticism, extraversion, agreeableness, openness, and conscientiousness) were related to childhood maltreatment and depression. Mediation analysis revealed that neuroticism and extraversion are complete mediators, agreeableness and conscientiousness are partial mediators, and openness is not a mediator.

These findings support the hypothesis in which childhood maltreatment is associated with geriatric depression and mediated by personality factors. These results suggest that reducing the maladaptive personality trait in elderly people who suffered childhood maltreatment could prevent geriatric depression.

The Core Symptom Index (CSI) is designed to measure anxiety, depression and somatization symptoms. This study examined the construct validity of CSI using confirmatory factor analysis (CFA) including a bifactor model and explored differential item functioning (DIF) of the CSI. The criterion and concurrent validity were evaluated.

In all, 803 elderly patients, average age 69.24 years, 70% female, were assessed for depressive disorders and completed the CSI and the geriatric depression scale (GDS). A series involving CFA for ordinal scale was applied. Factor loadings and explained common variance were analyzed for general and specific factors; and Omega was calculated for model-based reliability. DIF was analyzed using the Multiple-Indicator Multiple-Cause model. Pearson’s correlation, ANOVA, and ROC analysis were used for associations and to compare CSI and GDS in predicting major depressive disorders (MDD).

The bifactor model provided the best fit to the data. Most items loaded on general rather than specific factors. The explained common variance was acceptable, while Omega hierarchical for the subscale and explained common variance for the subscales were low. Two DIF items were identified; ‘crying’ for sex items and ‘self-blaming’ for education items. Correlation among CSI and clinical disorders and the GDS were found. AUC for the GDS was 0.83, and for the CSI was 0.81.

CSI appears sufficiently unidimensional. Its total score reflected a single general factor, permitting users to interpret the total score as a sufficient reliable measure of the general factors. CSI could serve as a screening tool for MDD.

The aim of this study was to investigate survival time and life-expectancy in people with young-onset dementia (YOD) and to examine the relationship with age, sex, dementia subtype and comorbidity.

Survival was examined in 198 participants in the Needs in Young-onset Dementia study, including participants with Alzheimer’s dementia (AD), vascular dementia (VaD) and frontotemporal dementia (FTD).

The primary outcomes were survival time after symptom onset and after date of diagnosis. Cox proportional hazards models were used to explore the relationship between survival and age, sex, dementia subtype and comorbidity. Additionally, the impact on remaining life expectancy was explored.

During the six-year follow-up, 77 of the participants died (38.9%), 78 participants survived (39.4%) and 43 were lost to follow-up (21.7%). The mean survival time after symptom onset and diagnosis was 209 months (95% CI 185-233) and 120 months (95% CI 110-130) respectively. Participants with AD had a statistically significant shorter survival compared with VaD participants, both regarding survival after symptom onset (p = 0.047) as well as regarding survival after diagnosis (p = 0.049). Younger age at symptom onset or at diagnosis was associated with longer survival times. The remaining life expectancy, after diagnosis, was reduced with 51% for males and 59% for females compared to the life expectancy of the general population in the same age groups.

It is important to consider the dementia subtype when persons with YOD and their families are informed about the prognosis of survival. Our study suggests longer survival times compared to other studies on YOD, and survival is prolonged compared to studies on LOD. Younger age at symptom onset or at diagnosis was positively related to survival but diagnosis at younger ages, nevertheless, still diminishes life expectancy dramatically.

Advanced Parkinson’s disease (PD) may place a high burden on patients and their caregivers. Understanding the determinants of caregiver burden is of critical importance. This understanding requires the availability of adequate assessment tools. Recently, the Parkinson’s disease caregiver burden questionnaire (PDCB) has been developed as a PD-specific measure of caregiver burden. However, the PDCB has only been evaluated in a sample of Australian caregivers of patients at a less advanced stage of the disease.

We tested whether a German translation of the PDCB qualifies as an adequate measure of caregiver burden in a German sample of caregivers of advanced patients with PD.

We collected PDCB data from 65 caregivers of advanced patients with PD. Reliability of the scale was assessed and compared against the original version. To validate the German version of the PDCB, we examined the correlations with the caregiver burden inventory (CBI), the short form 36 health survey (SF-36), the Parkinson’s disease quality of life questionnaire 39 (PDQ-39), disease duration, and the amount of caregiving time.

The total PDCB score proved to be reliable and to be significantly related to CBI and SF-36 scores. PDCB scores also increased with increasing amounts of caregiving time.

The German version of the PDCB appears to be an adequate measure of caregiver burden in caregivers of advanced PD patients.

General practices play an important role in the detection and treatment of depressive symptoms in older adults. An adapted version of the indicated preventive life review therapy group intervention called Looking for Meaning (LFM) was developed for general practice and a pilot evaluation was conducted.

A pretest-posttest design was used. One week before and one week after the intervention participants filled out questionnaires.

In six general practices in the Netherlands the adapted intervention was given.

Inclusion criteria were > 60 years and a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D).

The length and number of LFM sessions were shortened and the intervention was given by one mental health care nurse practitioner (MHCNP).

The impact on mental health was analyzed by depressive symptoms (CES-D) as the primary outcome and anxiety symptoms (HADS-A), psychological well-being (PGCMS) and mastery (PMS) as secondary outcomes. An evaluative questionnaire was included to evaluate the feasibility and acceptability.

Most participants were satisfied with the adaptations of the number (72%) and length (72%) of sessions. The overall sample showed a significant decrease in depressive symptoms after the intervention. No impact was found on psychological well-being, anxiety symptoms and mastery.

The intervention is feasible and acceptable for older adults with depressive symptoms and has an impact on their depressive symptoms.

Human beings are social entities – our development occurs in and through interaction with others. Thus, it seems likely that relationships influence the development of wisdom, especially long-term intimate relationships in which couples share many important life experiences, and that wisdom, in turn, influences relationships. How wisdom relates to characteristics of intimate relationships has received little attention in the research literature. As a first step in a research program addressing this question, this study analyzed associations between participants’ levels of wisdom and their views of a good relationship.

A sample of 155 individuals aged 23-90 years participated in two sessions including semi-structured qualitative interviews and questionnaires.

The participants were interviewed about their views of a good intimate relationship. Wisdom was measured using a self-report scale and two open-ended performance measures.

Wisdom was significantly related to some of the content categories identified in participants’ views about a good relationship, although some correlations differed between wisdom measures. Emphasizing the relevance of mutual respect and conscious attention in relationships was related to both performance measures of wisdom. Paying considerate attention to the relationship and viewing it as a chance for personal development were each related to one measure of wisdom.

The results support the notion that wisdom is related to how participants regulate long-term relationships. We consider them as a promising first step in a research program investigating the dynamic interrelation between wisdom and intimate relationships.

To provide additional data concerning the safety, effectiveness and local prescribing trends of clozapine in elderly patients.

Retrospective observational case-series analysis.

Data were collected from the medical files of 167 patients prescribed clozapine.

All patients prescribed clozapine in the last 15 years by the psychogeriatric service in Christchurch, New Zealand. The subjects were mostly aged over 65; however, patients under 65 are also accepted into the service on a case by case basis if they have an age-related health condition.

Twenty-five (15.0%) patients had their clozapine stopped due to a significant adverse reaction, including eleven who developed significant neutropenia. Seventy-four (44.3%) of the patients had no recorded side effects at all. Sixty-five (38.9%) of our elderly patients died while taking clozapine, though none of these deaths was felt to be related to clozapine use. Several patients safely initiated clozapine in either their own home or a nursing home without requiring hospital admission. Only two patients ceased clozapine due to ineffectiveness, and one hundred, forty-two (86.1%) of the patients had positive comments in their medical record regarding the benefits of clozapine for their particular case.

We found clozapine could be used safely and effectively in our patient group, for a wider range of indications and at lower doses than younger patients. Data collection regarding cause of death in elderly patients who were ever prescribed clozapine was problematic, and more research into this area is required.