Behnam Shariati

Introduction: Financial capacity is a key determinant of independence, well-being, and protection against exploitation in older adults. Age-related changes, including cognitive decline, depressive symptoms, and socioeconomic disparities, may impair financial decisionmaking. This study assessed financial capacity and explored associated cognitive, psychological, and demographic factors among hospitalized older adults. Methods: A cross-sectional study was conducted in 2023 at Rasool Akram Hospital, Tehran, involving 207 elderly patients admitted to non-psychiatric wards (neurology, ICU, emergency). Stratified sampling was used. Data were collected through structured interviews with validated instruments: Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Financial Capacity Instrument (FCI), and a demographic checklist. Results: Most participants demonstrated awareness of income and expenses (89.9%) and competence in basic money-handling (97.1%). However, fewer could make independent financial decisions (43.5%) or detect fraudulent messages (65.2%). Cognitive function and depressive symptoms were inversely correlated (r = -0.167, p = 0.016). MMSE scores declined significantly with age (r = -0.445, p < 0.001), while GDS scores slightly increased with age (χ² = 0.147, p = 0.035). Gender and education were strongly associated with cognitive and emotional outcomes: gender with MMSE (χ² = 56.68, p < 0.001) and GDS (χ² = 63.95, p < 0.001); education with MMSE (χ² = 125.91, p < 0.001) and GDS (χ² = 90.89, p < 0.001). Discussion: Targeted interventions aimed at enhancing cognitive resilience, managing depressive symptoms, and providing financial literacy education may be crucial in helping older adults maintain financial independence. Furthermore, gender and educational disparities suggest the need for personalized approaches in interventions. Conclusion: Financial capacity in older adults is shaped by cognitive and emotional health, as well as demographic factors. Interventions that enhance cognitive resilience, reduce depressive symptoms, and strengthen financial literacy are crucial to preserving independence. Gender and educational disparities highlight the need for tailored strategies. These findings emphasize the complex interplay of cognitive, psychological, and social determinants in safeguarding older adults’ financial well-being.

Background: Delirium is an acute condition marked by disturbances in cognition, awareness, and attention, commonly observed in hospitalized patients due to factors such as illness severity and medication. It is particularly prevalent in intensive care unit settings, affecting up to 80% of ventilated patients. This study investigates whether coronavirus disease 2019 (COVID-19) delirium aligns with expectations of non–COVID-19 delirium incidence in other hospitalized patients and identifies unique or common factors contributing to delirium in these groups. Methods: An observational cross-sectional study was conducted on 107 hospitalized patients diagnosed with delirium, comprising 56 COVID-19 patients and 51 non–COVID-19 patients. Data were collected through detailed medical record reviews and structured interviews with patients and their caregivers to evaluate factors associated with delirium. Results: The findings revealed a higher prevalence of medication-related stressors in COVID-19 delirium compared to non–COVID-19 delirium. This suggests that overmedication may play a critical role in the development of delirium, regardless of the underlying critical illness condition. Conclusions: This study highlights the significant association between medication stressors and COVID-19 delirium. These findings emphasize the importance of minimizing unnecessary medications and closely monitoring pharmacological treatments to reduce delirium incidence and improve outcomes in hospitalized populations.

Background: Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide. With survivors often exhibiting degrees of function loss, a significant burden is exerted on their caregivers. The purpose of this study was to explore the predictive factors of caregiver burden among caregivers of patients with TBI. Methods: Sixty-eight family members of individuals with a TBI who had been admitted to three hospitals were assessed in terms of caregiver burden using the Zarit Burden Interview. The association of caregiver burden with patients’ baseline cognitive function according to the Montreal Cognitive Assessment (MoCA) test, as well as caregivers’ sociodemographic characteristics, were evaluated using multiple regression analysis. Results: Based on the multiple regression model, the MoCA score of the patients (std β=-0.442, p < 0.001), duration of caregiving (std β = 0.228, p = 0.044), and higher education of the caregivers (std β = 0.229, p = 0.038) were significant predictors of caregiver burden. Conclusion: Overall, our findings highlight the importance of taking caregivers’ psychosocial needs into account. Long-term caregivers of TBI patients with cognitive impairment should be viewed as vulnerable individuals who could benefit from psychosocial intervention programs, to improve their well-being and enabling them to enrich their care of the TBI patient.

Dementia poses a significant societal and health challenge in the 21st century, with many hospitalized patients experiencing dementia without a documented diagnosis. Objective: To evaluate the prevalence of dementia and its associated risk factors among older patients admitted to hospitals. Methods: The study included older patients (≥ 60 years) admitted to medical departments of a general hospital in three major Iranian cities. Researchers utilized the Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, the Geriatric Depression Scale (GDS), the Mini-Cog test, the 4 A’s test (4AT), and the Abbreviated Mental Test Score (AMTS). Among the 420 recruited older inpatients, 228 (54.3%) were female. Results: The mean age of participants was 71.39 years (standard deviation ±7.95), with 30.7% diagnosed with major neurocognitive disorder (dementia). The likelihood of dementia exhibited statistically significant correlations with gender, age, number of children, and occupation. Conclusions: Screening older individuals for cognitive impairment upon hospital admission holds the potential to prevent adverse outcomes and enhance the quality of treatment for patients concurrently dealing with dementia.

Background: For screening and distinguishing between mild neurocognitive disorder (mNCD) and normal cognitive age-related changes in primary care centers, a simple and practical tool is necessary. Therefore, this study aims to determine the validity and reliability of the Farsi version of the Ascertain Dementia 8-item (AD8-F) informant interview in patients with mNCD. Methods: This is a study of the psychometric properties of the Farsi AD8. The participants include sixty informant-patient dyads with mNCD and sixty controls with normal cognition. The AD8 was compared to the mini-mental state examination (MMSE) and the Mini-Cog. As a gold standard, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for mNCD was used. The reliability was measured using internal consistency and test-retest. Validity was assessed by evaluating the content, concurrent, and construct validity. Data were analyzed via Cronbach’s α, Pearson correlation, independent t-test, and analysis of variance (ANOVA) and area under the curve (AUC) by statistical package for the social sciences (SPSS) v.23. Results: Cronbach’s α was 0.71. Test-retest reproducibility was 0.8. The AD8 had inverse correlations with the Mini-Cog (r = − 0.70, P < 0.01) and MMSE (r = − 0.56, P < 0.01). The area under the curve was 0.88. The optimal cutoff score was > 2. Sensitivity and specificity were 80 and 83%, respectively. The positive predictive value was 83%. The negative predictive value was 81%. Conclusion: Our results suggest that this tool can be used as a screening tool to detect a mild neurocognitive disorder in primary care centers.

The preva lence of long-COVID symptoms is rising but it is not still possible to predict which patients will present them, and which types of symptoms they will present. We followed up 95 patients with confirmed COVID-19 for 9 months to identify and characterize long-COVID symptoms. Easy fatigability was the most common symptom (51.04%), followed by anxiety (38.54%), dyspnea (38.54%), and new-onset headache (38.54%). There was no association between COVID-19 severity in the acute phase and the number of long-COVID symptoms (F(1,93) = 0.75, p = 0.45), and cognitive function (MoCA) scores (F(1,90) = 0.073, p = 0.787) at follow-up. Being female (F(1,92) = − 2.27, p = 0.02), having a higher number of symptoms (F(1,93) = 2.76, p = 0.0068), and experiencing constitutional neuropsychiatric symptoms (F(1,93) = 2.529, p = 0.01) in the acute phase were associated with having chronic fatigue syndrome at follow-up. Moreover, constitutional neuropsychiatric symptoms in the acute phase were associated with a lower MoCA score (F(1,93) = 10.84, p = 0.001) at follow-up. Specific clinical presentations such as constitutional neuropsychiatric symptoms in the acute phase might be predictors of debilitating long-COVID symptoms such as chronic fatigue syndrome and cognitive deficits.

Background: Cognitive disorders are one of the important issues in old age. There are many cognitive tests, but some variables affect their results (e.g., age and education). This study aimed to evaluate the reliability and validity of A Quick Test of Cognitive Speed (AQT) in screening for mild cognitive impairment (MCI) and dementia.Methods: This is a psychometric properties study. 115 older adults participated in the study and were divided into three groups (46 with MCI, 24 with dementia, and 45 control) based on the diagnosis of two geriatric psychiatrists. Participants were assessed by AQT and Mini-Mental State Examination (MMSE). Data were analyzed using Pearson correlation, independent t-test, and ROC curve by SPSS v.23.Results: There was no significant correlation between AQT subscales and age and no significant difference between the AQT subscales in sex, educational levels. The test-retest correlations ranges were 0.84 from 097. Concurrent validity was significant between MMSE and AQT. Its correlation was with Color − 0.78, Form − 0.71, and Color-Form − 0.72. The cut-off point for Color was 43.50 s, Form 52 s, and Color-Form 89 s were based on sensitivity and specificity for differentiating older patients with MCI with controls. The cut-off point for Color was 62.50 s, for Form 111 s, and Color-Form 197.50 s based on sensitivity and specificity measures for differentiating older patients with dementia and MCI.Conclusion: The findings showed that AQT is a suitable tool for screening cognitive function in older adults.

Background: Accurate diagnosis and management of patients with rapidly progressive dementia may be challenging during the COVID-19 pandemic, which has negatively influenced the diagnostic performan...

Objective This study aimed to determine the relationship between the personality traits of cancer patients and their preferences when receiving bad news. Methods In this descriptive correlational study, 200 cancer patients who were selected by the continuous sampling method participated. Patients self-reportedly completed the demographic and medical information questionnaire, the Measure of Patients’ Preference (MPP) scale, and the short form of the Eysenck Personality Inventory (EPI). Results The majority of participants were female (73%), 42.5% had higher education, and 47.5% suffered from breast cancer. In this study, the mean scores of extraversion and neuroticism in patients were 14.59 ± 2.47 and 15.17 ± 3.43, respectively. Regarding patients’ preferences for receiving bad news, the score obtained by them in the content category was greater compared to two categories of context and support. This study showed a significant and negative correlation between neuroticism and patients’ preferences in the support category (P < 0.001 and r = − 0.265). Regarding the categories of the MPP, there was a significant relationship between gender (P = 0.018) and marital status (P = 0.049) with context category, education (P = 0.011) with content category, and marital status (P = 0.003) and employment (P = 0.009) with support category. Conclusion Personality traits and demographic characteristics of cancer patients can influence their preferences for receiving bad news. Therefore, the consideration of these traits by health care team members is of particular importance to communicate with and deliver bad news to patients.