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Xu X, Li Y, Lu H, Wang H, Guo Y, Dregan A, Sun L, Shen Y, Geng T, Gao X. Prospective study of bipolar disorder and neurodegenerative diseases. NPJ Parkinsons Dis 2024; 10:184. [PMID: 39362870 PMCID: PMC11450157 DOI: 10.1038/s41531-024-00794-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 09/15/2024] [Indexed: 10/05/2024] Open
Abstract
Bipolar disorder (BD) is linked to an increased risk of neurodegenerative diseases such as dementia and Parkinson disease (PD), yet several uncertainties still remain and the extent to which the associations could be explained by BD-related medications (antipsychotics, lithium, and antiepileptics) was unknown. This study included 501,233 UK Biobank participants (mean [standard deviation] age, 56.5 [8.10] years; 54.4% women), free of dementia and PD at baseline. After a median 13.8 year follow-up, 9422 cases of dementia and 3457 PD cases were identified. Participants with BD had a significantly higher risk of dementia (adjusted hazard ratio [HR] 2.52, 95% CI 2.00-3.19) and PD (adjusted HR 2.88, 95% CI 2.03-4.08). Findings suggest that up to two-thirds of the association of neurodegenerative diseases with BD may be mediated by BD-related medications. Further research is needed to confirm these findings and explore the underlying mechanisms.
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Affiliation(s)
- Xinming Xu
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China
| | - Yaqi Li
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China
| | - Hanyu Lu
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China
| | - Han Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yi Guo
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China
| | - Alexandru Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Liang Sun
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China
| | - Yun Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200030, China.
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Carlson KF, Gilbert TA, Joyce M, Edmunds S, Govier D. Lifetime Psychotropic Medication Use Among Service Members and Veterans With and Without History of Mild Traumatic Brain Injury: A Pilot Study. Mil Med 2024; 189:323-331. [PMID: 39160877 DOI: 10.1093/milmed/usae120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/12/2024] [Accepted: 03/06/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Military Service Members, Veterans, and other patient populations who experience traumatic brain injury (TBI) may have increased risk of early neurodegenerative diseases relative to those without TBI history. Some evidence suggests that exposure to psychotropic medications may play a role in this association. The Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) prospective longitudinal study provides an ideal setting to examine the effects of psychotropic medication exposure on long-term neurological health of those with and without mild TBI history. In this study, we sought to develop and pilot test a self-report electronic survey instrument to measure participants' psychotropic medication histories for use across LIMBIC-CENC study sites. MATERIALS AND METHODS We developed a new survey instrument measuring psychotropic medication history and fielded it among Service Members and Veterans enrolled in a single site of the LIMBIC-CENC study to evaluate response rates and patterns, and to compare survey responses to prescription data extracted from participants' Veterans Affair (VA) records. Descriptive statistics estimated survey respondents' lifetime psychotropic medication exposures by their TBI history and other demographic and clinical characteristics of interest. We also compared survey responses to participants' VA outpatient prescription records to estimate sensitivity and negative predictive values (NPVs) for participants' self-reported medication exposures relative to this single prescription data source. RESULTS Among 310 Veterans enrolled at the study site, 249 completed the survey (response rate = 80%), of whom 248 also had VA health records and were included in the analysis. Most (69%) had a history of mild TBI. Over three-fourths of survey respondents (78%) reported ever having used prescription opioids, 26% reported benzodiazepines, 50% reported muscle relaxants, 42% reported antidepressants, 13% reported non-benzodiazepine sedative-hypnotics, 15% reported stimulants, 7% reported mood stabilizers, and 6% reported antipsychotics. Veterans with, versus without, a history of mild TBI were more likely to self-report psychotropic medication history as well as have confirmed receipt of VA prescriptions for each medication class. Using VA records as a criterion standard, the sensitivity of the survey for detecting VA prescriptions ranged from 19% to 84%, while the NPVs ranged from 64% to 97%. Sensitivity and NPVs were similar for participants with, versus without, mild TBI history. CONCLUSIONS Service Members and Veterans may receive psychotropic medications from multiple sources over their lifetimes. Valid methods to examine and quantify these exposures among those with a history of TBI are important, particularly as we evaluate causes of neurodegenerative disorders in this population over time. The measurement of Veterans' lifetime psychotropic medication exposures using a self-report survey, in combination with health care records, holds promise as a valid approach, but further testing and refinement are needed.
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Affiliation(s)
- Kathleen F Carlson
- VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR 97239, USA
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System (P5-NCRAR), Portland, OR 97239, USA
- Oregon Health and Science University-Portland State University School of Public Health (Epidemiology), Portland, OR 97239, USA
| | - Tess A Gilbert
- VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR 97239, USA
| | - Molly Joyce
- VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR 97239, USA
- Oregon Health and Science University-Portland State University School of Public Health (Epidemiology), Portland, OR 97239, USA
- School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Stephanie Edmunds
- VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR 97239, USA
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System (P5-NCRAR), Portland, OR 97239, USA
| | - Diana Govier
- VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR 97239, USA
- Oregon Health and Science University-Portland State University School of Public Health (Epidemiology), Portland, OR 97239, USA
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Chan WC, Wang WF, Tung YC, Chang MC, Chan HT, Jhang KM. Influence of care modes and social resources on psychotropic medication use in community-dwelling dementia patients. Front Psychiatry 2024; 14:1196801. [PMID: 38293597 PMCID: PMC10824929 DOI: 10.3389/fpsyt.2023.1196801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background Optimal use of psychotropic medications for people living with dementia is important. By finding potentially modifiable factors, dementia care teams may find solutions to achieve the appropriate use of psychotropic drugs. Objective This study aimed to elucidate patient and caregiver factors associated with the use of psychotropic drugs listed in the potentially inappropriate medications (PIMs) in community-dwelling people with dementia. Methods This cross-sectional study enrolled 808 patients newly diagnosed with dementia, and their caregivers, from a dementia clinic at Changhua Christian Hospital. Patient and caregiver characteristics, care mode, and social resource usage were recorded. Multivariate logistic regression was used to identify factors associated with prescribing psychotropic medications. Results Of all the participants, 39.1% used at least one of psychotropic medication categorized as PIM. Patients with frontotemporal dementia, with behavior or psychological symptoms, or cared by sole foreign care workers; caregivers with higher depression scores, employed or non-spouse caregivers carried a higher risk of prescription of psychotropic medications listed in PIMs. Conclusion Psychotropic drug prescriptions are associated with patient and caregiver factors. Therefore, implementing appropriate interventions, especially those targeting potentially modifiable factors, is important to reduce psychotropic medication use.
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Affiliation(s)
- Wei-Chieh Chan
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Chun Tung
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Che Chang
- Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Hong-Ting Chan
- Department of Long-Term Care Medicine, Puli Christian Hospital, Nantou, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
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McIntosh R, Hoogerwoerd H, Ahmad SS, Michel C, Dillon K, Kumar M, Ironson G. A 4-session written emotional disclosure intervention lowers 6-month sympathoadrenal urinary output in persons living with HIV. Psychoneuroendocrinology 2024; 159:106403. [PMID: 37839156 DOI: 10.1016/j.psyneuen.2023.106403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We previously reported that a brief guided written emotional disclosure (WED) intervention resulted in significant reductions in post-traumatic stress disorder (PTSD) symptomology in women, but not men, living with HIV. Levels of 24-hour urinary output of epinephrine (E) and norepinephrine (NE) are shown to be elevated in persons diagnosed with PTSD. The current study tested whether there was an effect for the 4-week WED intervention on 6-month change in urinary E and NE output amongst persons living with HIV. METHOD Fourteen women and 11 men living with HIV randomized to four 30-min expressive writing sessions of either trauma writing or daily events writing in the parent trial were included based upon collection of urine specimens at baseline, 1-, and 6-months after the intervention. Total volume (µg) and concentration (µg/ml) of urinary E and NE were derived from the specimens as study outcomes. RESULTS Four repeated measures analyses of covariance (ANCOVA) were performed to evaluate study outcomes using trauma- versus daily-writing as the between-subject factors and collection time point as the within-subject factor, controlling for age and sex. A group x time interaction was observed wherein the trauma writing treatment group showed a significantly greater decrease in total urinary output, F(2, 46) = 4.03, p = .03, and concentration, F(2, 46) = 4.74, p = .01 of epinepherine. Post-hoc analyses revealed the interaction effect for the total, F(2, 22) = 4.82, p = .03, and concentration, F(2, 22) = 7.57, p = .005, of urinary E output over 6-months was significant for women. Interactions were not observed in urinary NE output. CONCLUSIONS Significant reductions in the total output and concentration of urinary E were found up to 6-months following initiation of a 4-session guided written emotional disclosure intervention. Profiles of sympathoadrenal activity and response to expressive writing differ between men and women living with HIV. Futher research is need to characterize the putative pathways linking sympathoadrenal response to upstream neurobiological function and downstream inflammatory-immune status in women living with HIV and PTSD.
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Affiliation(s)
- Roger McIntosh
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA.
| | - Hannah Hoogerwoerd
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA
| | - Salman S Ahmad
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA
| | - Cassandra Michel
- Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kaitlyn Dillon
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA
| | - Mahendra Kumar
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Gail Ironson
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA
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Fink A, Dodel R, Georges D, Doblhammer G. The Impact of Sex-Specific Survival on the Incidence of Dementia in Parkinson's Disease. Mov Disord 2023; 38:2041-2052. [PMID: 37658585 DOI: 10.1002/mds.29596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE The aim of our study is to analyze sex-specific patterns of Parkinson's disease dementia (PDD) incidence. We are investigating the extent to which sex differences in survival after initial Parkinson's disease (PD) diagnosis influence differences in PDD risk among PD patients. METHODS We used a random sample of German longitudinal health claims data of persons ages 50+ (2004-2019; n = 250,000) and identified new PD cases ages 65+ who were followed-up for a PDD diagnosis or death between 2006 and 2017. We performed Cox and competing-risk regression models, with death as competing event, to calculate PDD hazard ratios (HR) adjusted for age at PD onset, PD severity as measured by the modified Hoehn and Yahr (HY) scale, comorbidities, and medications. RESULTS Of 2195 new PD cases, 602 people died before PDD and 750 people developed PDD by the end of 2017. The adjusted risk of PDD differs by sex, with men having a higher PDD risk than women. When accounting for death, men and women do not differ in their PDD risk (HR = 1.02, P = 0.770). Sex-specific analyses showed significant age and severity effects in women (age: HR = 1.05, P < 0.001; HY 3-5 vs. 0-2.5: HR = 1.46, P = 0.011), but not in men. CONCLUSION Older age at first PD diagnosis and higher disease severity increase PDD risk, but this association is attenuated for PD men when controlling for death. This implies that the most frail PD men die rapidly before receiving a dementia diagnosis, whereas women with PD survive at higher rates, regardless of their age at onset and disease severity. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anne Fink
- German Center for Neurodegenerative Diseases, Rostock, Germany
| | - Richard Dodel
- Chair of Geriatric Medicine and Center for Translational Neuro- and Behavioural Sciences, University Duisburg-Essen, Essen, Germany
| | - Daniela Georges
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
| | - Gabriele Doblhammer
- German Center for Neurodegenerative Diseases, Rostock, Germany
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
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Chandramouleeshwaran S, Khan WU, Inglis F, Rajji TK. Impact of psychotropic medications on cognition among older adults: a systematic review. Int Psychogeriatr 2023:1-18. [PMID: 37860872 DOI: 10.1017/s1041610223000844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES The aim of this systematic review is to examine the cognitive impact of psychotropic medications including benzodiazepines, antidepressants, mood stabilizers, antipsychotics, or a combination of these drugs on older adults. DESIGN Systematic review. SETTING We searched Medline, PsycINFO, and Embase through the Ovid platform, CINAHL through EBSCO, and Web of Science. PARTICIPANTS AND INTERVENTIONS Randomized control trials (RCTs) and cohort studies that used a validated scale to measure cognition with a follow-up period of at least six months were included. MEASUREMENT The primary outcome of interest was cognitive change associated with psychotropic medication use. RESULTS A total of 7551 articles were identified from the primary electronic literature search across the five databases after eliminating duplicates. Based on full-text analysis, 27 articles (two RCTs, 25 cohorts) met the inclusion criteria. Of these, nine each examined the impact of benzodiazepines and antidepressants, five examined psychotropic combinations, three on antipsychotic drugs, and one on the effects of mood stabilizers. CONCLUSIONS This is the first systematic review to examine the cognitive impact of multiple psychotropic drug classes in older adults over an extended follow-up period (six months or more) using robust sample sizes, drug-free control groups, and validated cognitive instruments. We found evidence to indicate cognitive decline with the cumulative use of benzodiazepines and the use of antidepressants, especially those with anticholinergic properties among older adults without cognitive impairment at baseline. Further, the use of antipsychotics and psychotropic combinations is also associated with cognitive decline in older adults.
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Affiliation(s)
- Susmita Chandramouleeshwaran
- Center for Addiction and Mental Health, Toronto, ON, Canada
- The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Waqas U Khan
- Center for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University Hospital Limerick, Limerick, Ireland
| | - Fiona Inglis
- Wilfrid Laurier University, Waterloo, ON, Canada
| | - Tarek K Rajji
- Center for Addiction and Mental Health, Toronto, ON, Canada
- Toronto Dementia Research Alliance, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Wu CC, Liao MH, Su CH, Poly TN, Lin MC. Benzodiazepine Use and the Risk of Dementia in the Elderly Population: An Umbrella Review of Meta-Analyses. J Pers Med 2023; 13:1485. [PMID: 37888096 PMCID: PMC10608561 DOI: 10.3390/jpm13101485] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
The prevalence of dementia among the elderly is high, and it is the leading cause of death globally. However, the relationship between benzodiazepine use and dementia risk has produced inconsistent results, necessitating an updated review of the evidence. To address this, we conducted an umbrella review of meta-analyses to summarize the available evidence on the association between benzodiazepine use and dementia risk and evaluate its credibility. We systematically evaluated the meta-analyses of observational studies that examined the connection between benzodiazepine use and dementia risk. For each meta-analysis, we collected the overall effect size, heterogeneity, risk of bias, and year of the most recent article and graded the evidence based on pre-specified criteria. We also used AMSTAR, a measurement tool to evaluate systematic reviews, to assess the methodological quality of each study. Our review included five meta-analyses encompassing 30 studies, and the effect size of the association between benzodiazepine use and dementia risk ranged from 1.38 to 1.78. Nonetheless, the evidence supporting this relationship was weak, and the methodological quality of the studies included was low. In conclusion, our findings revealed limited evidence of a link between benzodiazepine use and dementia risk, and more research is required to determine a causal connection. Physicians should only prescribe benzodiazepine for appropriate indications.
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Affiliation(s)
- Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 111396, Taiwan; (C.-C.W.); (C.-H.S.)
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 111, Taiwan
| | - Mao-Hung Liao
- Superintendent Office, Yonghe Cardinal Tien Hospital, New Taipei City 23148, Taiwan;
- Department of Healthcare Administration, Asia Eastern University of Science and Technology, Banciao District, New Taipei City 220303, Taiwan
| | - Chun-Hsien Su
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 111396, Taiwan; (C.-C.W.); (C.-H.S.)
- Graduate Institute of Sport Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei 111396, Taiwan
| | - Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan;
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
| | - Ming-Chin Lin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan;
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
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Aranda MP, Liang J, Wang X, Schneider LS, Chui HC. The relationship of history of psychiatric and substance use disorders on risk of dementia among racial and ethnic groups in the United States. Front Psychiatry 2023; 14:1165262. [PMID: 37168087 PMCID: PMC10165105 DOI: 10.3389/fpsyt.2023.1165262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction Dementia is characterized by significant declines in cognitive, physical, social, and behavioral functioning, and includes multiple subtypes that differ in etiology. There is limited evidence of the influence of psychiatric and substance use history on the risk of dementia subtypes among older underrepresented racial/ethnic minorities in the United States. Our study explored the role of psychiatric and substance use history on the risk of etiology-specific dementias: Alzheimer's disease (AD) and vascular dementia (VaD), in the context of a racially and ethnically diverse sample based on national data. Methods We conducted secondary data analyses based on the National Alzheimer's Coordinating Center Uniform Data Set (N = 17,592) which is comprised a large, racially, and ethnically diverse cohort of adult research participants in the network of US Alzheimer Disease Research Centers (ADRCs). From 2005 to 2019, participants were assessed for history of five psychiatric and substance use disorders (depression, traumatic brain injury, other psychiatric disorders, alcohol use, and other substance use). Cox proportional hazard models were used to examine the influence of psychiatric and substance use history on the risk of AD and VaD subtypes, and the interactions between psychiatric and substance use history and race/ethnicity with adjustment for demographic and health-related factors. Results In addition to other substance use, having any one type of psychiatric and substance use history increased the risk of developing AD by 22-51% and VaD by 22-53%. The risk of other psychiatric disorders on AD and VaD risk varied by race/ethnicity. For non-Hispanic White people, history of other psychiatric disorders increased AD risk by 27%, and VaD risk by 116%. For African Americans, AD risk increased by 28% and VaD risk increased by 108% when other psychiatric disorder history was present. Conclusion The findings indicate that having psychiatric and substance use history increases the risk of developing AD and VaD in later life. Preventing the onset and recurrence of such disorders may prevent or delay the onset of AD and VaD dementia subtypes. Prevention efforts should pay particular attention to non-Hispanic White and African American older adults who have history of other psychiatric disorders.Future research should address diagnostic shortcomings in the measurement of such disorders in ADRCs, especially with regard to diverse racial and ethnic groups.
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Affiliation(s)
- María P. Aranda
- Alzheimer’s Disease Research Center, University of Southern California, Los Angeles, CA, United States
- USC Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States
| | - Jiaming Liang
- Alzheimer’s Disease Research Center, University of Southern California, Los Angeles, CA, United States
- USC Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States
| | - Xinhui Wang
- Alzheimer’s Disease Research Center, University of Southern California, Los Angeles, CA, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lon S. Schneider
- Alzheimer’s Disease Research Center, University of Southern California, Los Angeles, CA, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Helena C. Chui
- Alzheimer’s Disease Research Center, University of Southern California, Los Angeles, CA, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Yang SN, Chueh CH, Peng LN, Tsai YW. Impacts of Intervals Between Sequential Development of Depression and Dementia in Older Adults: A Nationwide Population-based Study. Arch Gerontol Geriatr 2022; 101:104693. [DOI: 10.1016/j.archger.2022.104693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/20/2022] [Accepted: 03/20/2022] [Indexed: 11/02/2022]
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