Search Results (66,153)

Introduction: Live attenuated vaccines (LAVs) are generally avoided in patients with inflammatory bowel disease (IBD) receiving immunomodulatory therapy due to concerns about infection risk. However, real-world data evaluating their safety in this population remain limited. We aimed to assess adverse outcomes following LAV administration in IBD patients treated with biologic agents. Methods: We conducted a retrospective cohort study using the TriNetX multi-institutional database. Adults with IBD receiving immunomodulatory therapy were categorized into two cohorts: those who received an LAV and those who did not. Biologic therapies included tumor necrosis factor inhibitors (infliximab, and adalimumab), integrin antagonists (vedolizumab), interleukin (IL)-12/23 inhibitors (ustekinumab), IL-23 inhibitors (risankizumab, and guselkumab), and Janus kinase inhibitors (tofacitinib, and upadacitinib). LAVs included measles–mumps–rubella (MMR), varicella (Varivax), and yellow fever vaccines. Propensity score matching was performed based on age, sex, IBD subtype (Crohn’s disease vs. ulcerative colitis), and biologic class. Patients with outcomes prior to the risk window were excluded. Adverse outcomes within six months included hospitalization, emergency department (ED) visits, fever, rash, and encephalitis. Results: A total of 672 patients were included in each propensity-score-matched cohort. Live attenuated vaccine (LAV) administration was not associated with significantly increased adverse outcomes compared with no LAV exposure during the six-month follow-up period. Hospitalization occurred in 14.9% versus 15.3% of patients, respectively (risk ratio [RR] 0.97; 95% confidence interval [CI] 0.75–1.25; p = 0.819), while emergency department visits occurred in 12.6% vs 11.3% (RR 1.12; 95% CI 0.84–1.50; p = 0.450). There were no significant differences in fever (3.6% vs. 3.3%; RR 1.09; 95% CI 0.62–1.93; p = 0.764) or rash (4.0% vs. 2.7%; RR 1.50; 95% CI 0.83–2.70; p = 0.172). No cases of measles, mumps, rubella, varicella, yellow fever, or encephalitis were identified in either cohort during follow-up. Conclusions: LAVs were not associated with an increased risk of adverse outcomes within one day to six months among IBD patients receiving immunomodulatory therapy. These real-world findings suggest comparable short-term outcomes between the cohorts of patients with IBD receiving biologic or targeted synthetic therapy who met the predefined eligibility criteria including age ≥ 18 years, and vaccination occurring between two weeks and six months after biologic initiation regarding LAV use in patients with IBD receiving biologic agents. Full article

Presbycusis, or age-related hearing loss (ARHL), is a multifactorial disorder characterized by a gradual, bilateral sensorineural decline in hearing sensitivity, predominantly affecting high-frequency sounds. It is one of the most common chronic conditions in the aging population and represents a major public health concern due to its high prevalence and progressive nature. Presbycusis significantly impairs speech perception, especially in noisy environments, leading to communication difficulties, reduced social participation, increased risk of social isolation, and a decline in quality of life. Moreover, growing evidence highlights a strong association between ARHL and cognitive impairment, dementia, depression, and increased frailty in older adults. The etiology of presbycusis is complex and involves the interplay between genetic predisposition and cumulative environmental and lifestyle-related factors. Genetic susceptibility influences cochlear aging, neural degeneration, and vulnerability to external insults. Non-genetic contributors include chronic noise exposure, cardiovascular and metabolic disorders such as diabetes and dyslipidemia, ototoxic medications, smoking, and other lifestyle factors that may accelerate cochlear damage through oxidative stress and microvascular dysfunction. This narrative review aims to provide an updated overview of the genetic and environmental determinants involved in the development and progression of presbycusis. Furthermore, it discusses the clinical implications of these factors for early identification, audiological evaluation, prevention strategies, and personalized management approaches. A better understanding of the multifactorial nature of presbycusis may support the development of targeted interventions to preserve hearing function and improve overall health outcomes in the aging population. Full article

Academically resilient students achieve high performance despite socioeconomic disadvantages. Although this population has received increasing attention, little is known about its motivational heterogeneity, a critical gap given the central role of motivation in persistence and success. Guided by Self-Determination Theory (SDT), this study examined motivational profiles among a population of academically resilient 10th-grade students in Italy (N = 15,751). Using a person-centered approach, Latent Profile Analysis (LPA) identified three profiles: a “multifaceted regulation resilient” profile (72%), marked by low amotivation and high levels across regulations; a “moderately amotivated resilient” profile (21%), with higher amotivation and lower levels of regulation; and a “strongly amotivated resilient” profile (7%), characterized by the highest amotivation and the lowest levels of regulation. Auxiliary analyses indicated that the amotivated profiles, particularly the “strongly amotivated resilient” profile, exhibited higher school dropout intentions than the “multifaceted regulation resilient” profile. Overall, although the majority of academically resilient students displayed multiple coexisting forms of regulation, a non-negligible subgroup showed significant motivational vulnerability, with amotivation emerging as a central risk factor. These findings challenge the assumption that academic resilience is sufficient to protect students from motivational disengagement and dropout risk. High academic achievement, in other words, should not be taken to imply the absence of motivational concerns. This highlights the importance of moving beyond a one-size-fits-all approach, recognizing that even within resilient populations, specific subgroups remain motivationally vulnerable and in need of tailored support. Full article

This study develops a quantitative risk assessment framework that explicitly incorporates site-dependent variability in NATM (New Austrian Tunneling Method) tunnel construction projects. The underlying motivation is that identical risk factors can exhibit substantially different risk levels depending on project-specific site conditions. Conventional risk assessment approaches, which rely primarily on probability and impact ratings, are inherently limited in their ability to capture such variations across different project environments. To address this gap, key site condition factors affecting NATM tunnel construction were systematically identified and integrated into the existing risk assessment framework through a structured scoring and weighting process. Eight site condition factors were selected based on an extensive review of domestic and international literature, underground safety evaluation reports, tunnel design standards, geotechnical information databases, standard cost data, and expert consultation. These factors—Geotechnical Condition, Construction Schedule Float, Construction Budget Contingency, Spoil Bank Location, Likelihood of Civil Petitions, Underground Water Level, Environmental (Noise, Vibration), and Site Accessibility (Traffic Constraints)—were each quantified using a five-level scale ranging from 0.6 (very favorable) to 1.4 (very unfavorable). Subsequently, a composite site condition index was derived by combining the assigned scores with corresponding weights, and this index was incorporated as an adjustment coefficient into the conventional risk scoring system. The results demonstrate that, when the composite site condition index is considered, both the final risk magnitude and management priority vary depending on site-specific conditions, even for identical risk factors. This indicates that the proposed framework provides a more refined representation of actual project environments than traditional probability–impact-based approaches. The model can also serve as an effective decision-support tool for developing risk mitigation strategies tailored to specific site characteristics. Accordingly, the proposed model enhances the accuracy of risk assessment in tunnel projects and facilitates the rational identification of critical risks requiring prioritized management. However, because certain evaluation criteria rely on expert judgment, further validation through diverse real-world case studies and improvements to the objectivity of the evaluation framework remain necessary. Full article

Background: The 2-benzylbenzimidazoles or nitazenes are an evolving class of highly potent mu-opioid receptor agonists. Nitazenes were originally developed in the late 1950s for pharmaceutical use as analgesics; however, due to their extreme potency and the risk of adverse health outcomes, pharmaceutical research was discontinued. Since 2019, nitazenes have emerged as illicit drugs of abuse, causing significant concern. From 2021, they have been detected in both coronial and clinical casework in Victoria, Australia. This study examined nitazene-related coronial casework in Victoria from 2021 to 2025 to explore the trends and characteristics of nitazene-related deaths. Methods: Relevant cases were identified from the Victorian Institute of Forensic Medicine’s (VIFM’s) case management system. Data were collated and analysed from all coronial cases where a nitazene was detected by a toxicological analysis between 1 January 2021 and 31 December 2025. Trend comparisons were made with nitazene detections reported in other countries. Results: Nitazenes were detected in 23 deaths from a total of approximately 33,108 coronial cases admitted to the VIFM for investigation over the time period. The age range was 17–45 years, with a median of 32 and with 87% of the deaths being male. The nitazenes detected were protonitazene (n = 14), metonitazene (n = 5), isotonitazene (n = 2), N-pyrrolidino etonitazene (n = 2), N-desethyl isotonitazene (n = 1), methylenedioxynitazene (n = 1) and etodesnitazene (n = 1). Two cases contained more than one nitazene; both involved protonitazene, one involved metonitazene, and the other involved N-desethyl isotonitazene and methylenedioxynitazene. The timeline of detection of these nitazenes displays similarities with emergence trends in other countries. The nitazene concentrations ranged from 0.1 to 33 ng/mL. Broad polydrug usage was evident in all cases, with other drugs co-detected in the blood including stimulants (particularly, methylamphetamine (48%) and cocaine (44%)) as well as pharmaceutical benzodiazepines (43%) and pharmaceutical opioids (22%), and 13% had 6-monoacetylmorphine detected in either blood or urine. Novel benzodiazepines (39%) were also common, including bromazolam, which was co-detected in 35% of cases. Nineteen deaths were attributed solely to nitazene-related mixed-drug toxicity, while the remaining four cases were attributed to cardiac- and pulmonary-related disease, with polydrug use deemed a contributing factor. Conclusions: This novel case series adds comprehensive toxicological information to the body of evidence reinforcing the high risk of harm associated with the use of nitazenes. It is imperative that toxicology services continue to monitor for nitazenes to promote community awareness against nitazene-related harm. Full article

The gut microbiota is increasingly recognized as an important factor in the pathogenesis of type 1 diabetes (T1D), although its exact role in disease initiation and progression remains uncertain. Earlier interpretations considered alterations in intestinal microbial composition as secondary effects of immune dysregulation or metabolic disturbance. Recent longitudinal studies, however, suggest that specific microbial changes occur before the onset of islet autoimmunity, indicating a potential contributory role in the early phases of disease development. In this narrative review article, the gut–pancreas axis (GPA) is described as a dynamic and reciprocal system in which microbial, metabolic, and immune processes influence each other to shape β-cell outcomes. Evidence from human cohorts and experimental models links early life reductions in microbial diversity, impaired intestinal barrier function, and decreased production of short-chain fatty acids (SCFAs) to altered immune activation and β-cell damage. Microbiota transferred from individuals at risk for T1D has been shown to accelerate disease in animal models, supporting a possible causal relationship. Although experimental models support mechanistic links between microbiota alterations and autoimmune diabetes, current human evidence remains largely associative. Together, these findings suggest that microbial and immune networks interact in a feedback manner that can sustain immune tolerance or promote autoimmunity depending on environmental and host factors. Understanding T1D as a state of disrupted microbial and immune integration provides a basis for restoring gut–pancreas communication and preserving β-cell integrity. Full article

Background: Lifestyle factors such as diet and physical activity significantly impact on the risk of obesity in individuals with Down syndrome (DS). However, in the absence of national nutritional guidelines in individuals with DS, further work is needed to understand their dietary and physical activity patterns. In this work we retrieved caregivers’ responses on those aspects. Methods: We analyzed data from a cross-sectional online survey of caregivers of individuals with DS conducted as part of the GO-DS21 project and reported in the accompanying paper (nutrients-4216283) (n = 764). We explored physical activity patterns, dietary habits, beliefs around weight-loss interventions and caregiver confidence that family members with DS would engage in a healthier lifestyle. Associations were examined using correlation analysis, and cumulative and binary logistic regression models. Results: Caregivers reported that most individuals with DS exercised 1–3 times per week, with frequency declining with age. Males were more likely to exercise daily than females. Caregiver exercise frequency was positively correlated with that of their DS family member (ρ = 0.521, p < 0.001), suggesting clustering of shared health behaviors within households. In adjusted models, caregivers who exercised regularly had up to thirteen-fold higher odds of having a physically active family member with DS (aOR = 13.02, 95% CI: 7.40–24.06, p < 0.001). Fried food consumption and higher snack frequency were independently associated with perceived obesity status, while sugar-sweetened beverage consumption was not. Caregivers favored exercise as a weight-loss strategy, while anti-obesity drugs were endorsed by only 11% of caregivers primarily and were more likely to be endorsed when obesity was perceived (aOR = 4.21, 95% CI: 2.44–7.39, p < 0.001). Finally, caregiver confidence that their family member with DS would engage in healthier behaviors was associated with perceived obesity status and strongly associated with higher physical activity levels (aOR 14.68, 95% CI: 6.59–33.40, p < 0.001). Conclusions: In this large European caregiver survey, reported consumption of selected energy-dense foods was generally low, although fried food intake and higher snack frequency were associated with perceived obesity. Physical activity patterns were closely aligned between caregivers and individuals with DS, suggesting shared household health behaviors. These findings highlight the importance of involving caregivers and family environments in lifestyle interventions aimed at supporting physical activity and weight management in individuals with DS. Full article

Background and Objectives: Acetabular fracture surgery is associated with substantial perioperative blood loss and prolonged operative time. Routine preoperative pelvic computed tomography (CT) carries information about body composition that is not currently exploited for risk stratification. We tested whether (i) CT-defined pelvic sarcopenia is associated with lower preoperative haemoglobin and (ii) preoperative subcutaneous fat cross-sectional area (CSA) is independently associated with operative time, after adjustment for surgical approach, age, fracture complexity and sarcopenia status. Materials and Methods: In this single-centre retrospective cohort study, 48 adults (37 men, 11 women; mean age 40.2 ± 16.5 years) who underwent open reduction and internal fixation (ORIF) for unilateral acetabular fractures between 2016 and 2024 were included. Pelvic muscle and subcutaneous fat CSAs were measured on the contralateral side of preoperative CT images using ImageJ. Sarcopenia was defined as an internal, cohort-relative classification based on the sex-specific bottom tertile of psoas CSA. Normality was assessed by Shapiro–Wilk testing; Pearson or Spearman correlation was used accordingly, and the 36 pairwise correlations were controlled with the Benjamini–Hochberg false-discovery-rate procedure. The multivariable model used ordinary least squares regression with heteroscedasticity-consistent (HC3) standard errors and a median quantile-regression robustness check. Results: Sarcopenic patients (n = 17) had significantly lower preoperative haemoglobin (12.63 ± 1.24 vs. 14.00 ± 1.53 g/dL; p = 0.002; Cohen’s d = 0.96). The absolute perioperative haemoglobin drop was numerically smaller in the sarcopenic group (ΔHb 1.64 ± 0.91 vs. 2.46 ± 1.87 g/dL) but did not reach statistical significance (p = 0.079); estimated blood loss (p = 0.258) and transfusion requirement (p = 0.567) did not differ between groups. Pelvic muscle CSAs correlated positively with preoperative haemoglobin (all q < 0.05 after Benjamini–Hochberg correction). In the multivariable model (F[6, 41] = 3.71, p = 0.005; adjusted R² = 0.26; all variance inflation factors 1.06–1.26), subcutaneous fat CSA (B = +0.25 min/cm², p = 0.004) and the modified Stoppa approach (vs. Kocher–Langenbeck; +65 min, p = 0.001) were independently associated with operative time. Conclusions: In this exploratory retrospective cohort, routine preoperative pelvic CT contained two body-composition signals that may warrant prospective evaluation: pelvic sarcopenia, which was associated with lower baseline haemoglobin, and subcutaneous adiposity, which was associated with longer operative time in the primary regression model. Both signals require confirmation—the sarcopenia–bleeding relationship was not statistically significant, and the subcutaneous fat association was attenuated under robust inference. These findings are hypothesis-generating; prospective multicentre validation with height-normalised sarcopenia thresholds and body mass index is required before clinical implementation. Full article

This study examines how decision uncertainty shapes consumers’ Fear of Better Options (FOBO), and subsequently is associated with ditto consumption, while assessing FOBO’s mediating role and the moderating effects of emotional state (Fear of Missing Out, FOMO/Joy of Missing Out, JOMO) and cultural differences (China/Korea). Using survey data from 682 new energy vehicle consumers in China and Korea, structural equation modeling was applied to test the proposed framework. The results reveal that choice overload and price fluctuation significantly increase both FOBO and ditto consumption, while obsolescence risk does not show a significant direct effect. Notably, time pressure negatively influences FOBO but positively affects ditto consumption, suggesting a dual-path mechanism in decision-making under time constraints. FOBO partially mediates the effects of choice overload and price fluctuation on ditto consumption. Moreover, emotional state and cultural differences moderate these relationships: FOMO amplifies, whereas JOMO mitigates the transmission effect of FOBO. Chinese consumers display stronger overall effects compared with their Korean counterparts. This study expands upon uncertainty avoidance theory by incorporating FOBO into consumer decision-making models, providing insights into how decision uncertainty, along with cultural and emotional factors, can inform marketing strategies. Full article

Background: Mild Cognitive Impairment (MCI) is an early stage of cognitive decline and a major risk factor for dementia, typically diagnosed using neuropsychological assessments such as memory and executive function tests. While EEG-based detection has been widely explored, most approaches rely on raw signal analysis and computationally intensive deep learning models. In contrast, wearable devices use indirect behavioral proxies (e.g., activity patterns or sleep–wake patterns), limiting diagnostic specificity. Although substantial clinical evidence indicates altered sleep architecture in MCI, the use of sleep stage dynamics for MCI classification remains largely unexplored. Methods: We propose a lightweight and physiologically interpretable framework using novel features based on hypnogram-derived sleep dynamics. The method was evaluated on the MASS SS1 dataset (36 healthy, 17 MCI subjects) using five classifiers—Logistic Regression, Random Forest, XGBoost, Linear SVM, and RBF SVM—with leave-one-subject-out validation and threshold optimization. Results: RBF SVM achieved the best performance (accuracy: 77.4%, balanced accuracy: 78.7%, sensitivity: 82.4%, specificity: 75.0%, ROC AUC: 0.778), followed by Random Forest (accuracy: 77.4%, balanced accuracy: 77.1%) and XGBoost (accuracy: 71.7%, balanced accuracy: 73.0%). Conclusions: This proof-of-concept study demonstrates that features extracted from sleep stage dynamics are effective, non-invasive, and interpretable biomarkers for early MCI detection, with strong potential for integration into wearable sleep monitoring systems. Full article

Background and Objectives: Pathological upstaging from non-muscle-invasive bladder cancer (NMIBC) to muscle-invasive disease (MIBC) at radical cystectomy (RC) compromises preoperative risk stratification and may deprive patients of the survival benefit conferred by neoadjuvant chemotherapy. This study aimed to define the frequency and independent predictors of pathological upstaging in a contemporary single-institution cohort, and to characterise its impact on recurrence-free, disease-specific, and overall survival. Materials and Methods: We conducted a retrospective review of a prospectively maintained database of all patients who underwent RC and pelvic lymphadenectomy for urothelial bladder cancer at our institution between January 2009 and December 2023. Upstaging was defined as the final pathological stage ≥ pT2 or pN+ from a clinical stage of <T2N0M0. Clinicopathological factors were evaluated for their association with upstaging using chi-squared, Fisher’s exact, and logistic regression analyses. Survival outcomes—recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS)—were estimated by the Kaplan–Meier method and compared using the log-rank test. Multivariable Cox proportional hazards regression identified independent prognostic factors. Results: Of 1002 patients who underwent RC during the study period, complete clinicopathological data were available for 826. Primary clinical stage at presentation was MIBC (≥T2) in 448 (54.2%) and NMIBC (<T2) in 378 (45.8%). Among NMIBC patients, 102 (27.0%) were upstaged to MIBC at final pathology. Multivariable logistic regression identified concomitant carcinoma in situ (CIS) (p = 0.042), variant histology—predominantly squamous differentiation (p = 0.003)—and urethral involvement (p = 0.003) as independent predictors of upstaging. Upstaged patients had significantly worse 5-year RFS (p < 0.001), DSS (p = 0.01), and OS (p < 0.001) compared with patients who remained NMIBC. No statistically significant difference in survival was observed between patients upstaged at RC and those presenting with primary MIBC. Conclusions: Pathological upstaging occurs in more than a quarter of patients undergoing RC for NMIBC and confers a survival penalty equivalent to that of primary MIBC. Concomitant CIS, variant histology, and urethral involvement identify those at highest risk. These patients warrant aggressive preoperative counselling, expedited surgical planning, and consideration of perioperative systemic therapy. Full article

More than one million adults in Mississippi have hypertension. We examined the association between a summary measure of social determinants of health (SDOH) and health equity (SDOH/HE) and hypertension prevalence among Mississippi adults. Using data from 3867 respondents to the 2023 Mississippi Behavioral Risk Factor Surveillance System SDOH/HE Module, we performed multivariable logistic regression analyses to examine the association between hypertension prevalence and a summary SDOH/HE measure. The SDOH/HE summary measure score was created using responses to 10 questions assessing employment/economic and housing stability, receipt of food assistance, access to quality food and transportation, utilities security, social isolation, social and emotional support, life satisfaction, and mental well-being of the participants. The likelihood of experiencing 0, 1, 2, 3, or 4 or more SDOH/HE risk factors was 38.6, 22.9%, 13.7%, 7.9%, and 16.8%, respectively. Mississippi adults experiencing one (adjusted odds ratio, AOR, 1.47) and four or more (AOR, 2.62) of SDOH/HE risk factors had higher odds of hypertension compared to those experiencing no SDOH/HE risk factors. Associations between presence of two or three SDOH/HE risk factors and hypertension were not significant. Mississippi adults with one and at least four SDOH/HE risk factors had significantly higher odds of hypertension risk than those with no SDOH/HE risk factors. These findings highlight an association between SDOH/HE factors and the burden of hypertension and underscore the need for targeted inventions among Mississippi adults with multiple SDOH/HE risk factors. Full article

Background/Objectives: Clostridioides difficile infection (CDI) is the leading cause of colitis and hospital-acquired diarrhea. Patients with Chronic Obstructive Pulmonary Disease (COPD) frequently have infectious exacerbations requiring treatment with antibiotics, which may be predisposing them to CDI. This study examines the prevalence and in-hospital outcomes of CDI in patients with COPD. Methods: Data for hospitalized patients with CDI was extracted from the National Inpatient Sample database for the years 2016 through 2020. Baseline risk factors were identified using the International Classification of Diseases codes. Patients were stratified into two groups: with COPD and without COPD. The primary outcome was in-hospital mortality. The secondary outcomes were septic shock, hypovolemic shock, AKI, cardiac arrest, need for intensive care unit (ICU) level of care and length of stay. Statistical analyses were conducted using SPSS. Results: 290,172 patients were included in this study. Patients with COPD had more comorbidities overall and higher in-hospital mortality rates compared to patients without COPD (7.7% vs. 5.9%, p < 0.001). On multivariate logistic regression analysis, patients with CDI and COPD had higher risk of in-hospital mortality (OR = 1.346, p < 0.001), septic shock (OR = 1.289, p < 0.001), hypovolemic shock (OR = 1.184, p < 0.001), cardiac arrest (OR = 1.362, p < 0.001) and required more ICU level of care. Conclusions: Patients with COPD experience frequent exacerbations, often requiring hospitalizations and broad-spectrum antibiotics, steroids, proton pump inhibitors and antacids. These factors contribute to the higher prevalence of CDI in this patient population. Patients with CDI and COPD are also more likely to require ICU level of care, shedding the light on the significant burden of CDI, long hospital stays and substantial hospital charges. Recognizing mortality outcomes is essential to guide patient-specific therapies and highlights the need for closer monitoring and targeted management of CDI in patients with COPD. Full article

Regulations of next-generation networks (NGNs) have played a central role in the transition from copper networks to broadband networks in Fiber to The Home (FTTH), also allowing for a reduction in asymmetries between incumbent operators and their competitors. Despite common European Union directives, telecom infrastructure development varies across countries due to differences in regulation, investment models, legacy networks, operators’ behavior, and public policies. This study analyzes the evolution of Very High-Capacity Networks (VHCNs), focusing on the implementation of FTTH in four European countries (Portugal, Spain, France, and Germany), and in South Korea. The latter was included as a benchmark in government-driven broadband development. The analysis considers key factors influencing FTTH development, including infrastructure regulation, fiber investment incentives, incumbent strategies, infrastructure sharing and co-investment, rural coverage plans, and demographic differences of each country. The results show that regulatory measures directly influence the pace of FTTH installation; but its effectiveness also depends on investment incentives, market competition, and demand factors. Portugal, Spain, and France have high FTTH coverage despite different regulatory and investment models. In contrast, Germany relied on xDSL over copper networks for a long time, causing significant delays, with an FTTH coverage rate of 42.5% and a penetration rate of only 12.3%, putting the European Union’s 2030 goal of universal 1 Gbps coverage at risk. South Korea shows that long-term public policies, demand-side incentives, and high digital adoption accelerate mass FTTH adoption and turn telecommunications infrastructure into a key driver of economic and technological development. Full article

Background: White matter hyperintensities (WMHs) have been implicated in late-onset psychiatric disorders, but their contribution to this clinical phenotype remains insufficiently understood. Methods: We conducted a cross-sectional transdiagnostic study of 90 consecutively admitted acute patients with schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD) meeting the predefined inclusion criteria. Patients with a late onset were compared to earlier onset (EO) psychiatric patients. Late onset was defined as the median age of the disorder onset of the sample (≥40 years). Multidimensional clinical, cognitive, psychomotor, metabolic, and neuroimaging data were evaluated (WHM burden and cerebral atrophy), and a cognitive-psychopathologic composite index was derived. Correlations and sensitivity analysis were performed. A multivariable linear regression was performed to assess the independent effects of age, vascular risk factors, and WMH severity on cognitive performance and psychiatric symptoms. Results: In patients with LO psychiatric disorders, greater WMH burden was significantly associated with poorer global cognition and specific cognitive domains, lower delusional symptoms severity, and greater suicidal thoughts/behavior intensity. These associations were markedly weaker or not present in EO patients. The regression model explained 36.5% of the variance in the cognitive-psychopathologic composite index. After adjusting for age and cumulative risk factors, Fazekas was the only significant independent predictor (β = −0.495, p = 0.001). Conclusions: WMH burden was associated with differences in clinical characteristics in LO psychiatric disorders, including cognitive and neuropsychiatric symptoms. Our findings support a possible vascular-neuropsychiatric interaction in LO phenotypes. Full article