Do Antidepressants Increase the Risk of Dementia?
Authors: Solomonov N, Alexopoulos GS PMID: 31320244 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 21, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Beyond Cross-Sectional Snapshots: Charting the Course of Burden in Caregivers of Family Members With Mild Cognitive Impairment.
Authors: Dew MA, Garand L PMID: 31320245 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 21, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Molecular Senescence Is Associated With White Matter Microstructural Damage in Late-Life Depression.
CONCLUSIONS: Our data suggest that, in the context of late-life depression, SASP proteins are associated with microstructural abnormalities in white matter tracts in brain and worse executive function performance. PMID: 31320246 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 21, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Particulate Air Pollutants and Trajectories of Depressive Symptoms in Older Women.
CONCLUSION: Long-term exposure to ambient fine particles was associated with increased depressive symptoms among older women without prior depression or cognitive impairment. PMID: 31311712 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Editorial Board
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Source Type: research

Information for Subscribers
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Source Type: research

Table of Contents
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Source Type: research

In This Issue
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Source Type: research

Relationships between executive control circuit activity, amyloid burden, and education in cognitively healthy older adults
Amyloid-beta (A β) protein is a key marker in the pathology of Alzheimer's disease (AD) and is associated with atrophy, decreases in glucose metabolism, worsening cognitive function, and changes in brain activation and connectivity.1-4 Previous studies have shown an accumulation of Aβ in pre-clinical AD and may r eflect early manifestation of AD pathology.5,6 A three-stage model for AD has been described: initial Aβ deposition, followed by neurodegeneration (including synaptic degeneration, neural atrophy, hypometabolism, and changes in connectivity), and finally progressive cognitive dysfunction. (Source: T...
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Authors: Helmet T Karim, Dana L Tudorascu, Ann Cohen, Julie C Price, Brian Lopresti, Chester Mathis, William Klunk, Beth E. Snitz, Howard J Aizenstein Tags: Regular Research Article Source Type: research

Regional grey matter volume links rest-activity rhythm fragmentation with past cognitive decline
Human activity follows 24-hour cycles known as the rest-activity rhythm (RAR). Early research found greater RAR fragmentation in people with dementia1. Since RARs are measured non-invasively and are potentially modifiable, understanding the neurobiology of their relationship with cognition is a step towards biologically-informed screening and prevention. Neurodegenerative (amyloid-related2) and cerebrovascular3 processes have been implicated. However, to our knowledge, no prior studies have evaluated whether grey matter and/or cerebrovascular measures explain statistical correlations between RAR fragmentation and cognition...
Source: The American Journal of Geriatric Psychiatry - July 19, 2019 Category: Geriatrics Authors: Stephen F. Smagula, Lana Chahine, Andrea Metti, Anusha Rangarajan, Howard J. Aizenstein, Qu Tian, Caterina Rosano Tags: Brief Report Source Type: research

Depression Symptoms Declining Among Older Adults: Birth Cohort Analyses From the Rust Belt.
CONCLUSION: Reduced rates of depression symptoms observed in successive birth cohorts of older adults may reflect compression of morbidity or other secular trends. PMID: 31300193 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 15, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Effects of Testosterone Supplementation on Separate Cognitive Domains in Cognitively Healthy Older Men: A Meta-analysis of Current Randomized Clinical Trials.
CONCLUSION: Overall, our findings support the potential for TS as a preventative measure against cognitive decline, although the effect sizes were small. These findings warrant further observational studies and clinical trials of good methodological quality, to elucidate the effect of TS on cognition. PMID: 31296441 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 14, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

When and How to Treat Agitation in Alzheimer's Disease Dementia With Citalopram and Escitalopram.
Authors: Aga VM Abstract Agitation is a common neuropsychiatric symptom (NPS) in the early and middle stages of Alzheimer's disease (AD) dementia, which is difficult to treat and causes much distress. The U.S. Food and Drug Administration (U.S. FDA) issued black box warnings against the use of antipsychotics in dementia in 2005 and 2008 due to the increased risk of morbidity and mortality, resulting in the reduction in antipsychotic use for treating dementia-related NPS and spurring the quest for safer and more effective pharmacological options. The data favoring the use of citalopram for treating agitation in AD d...
Source: The American Journal of Geriatric Psychiatry - July 12, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Molecular and Cellular Evidence for Age by Disease Interactions: Updates and Path Forward.
Authors: Shukla R, Oh H, Sibille E Abstract Characterization of age-associated gene expression changes shows that the brain engages a specific set of genes and biologic pathways along a continuous life-long trajectory and that these genes and pathways overlap with those associated with brain-related disorders. Based on this correlative observation, we have suggested a model of age-by-disease interaction by which brain ageing promotes biologic changes associated with diseases and where deviations from expected age-related trajectories, due to biologic and environmental factors, contribute to defining disease risk or...
Source: The American Journal of Geriatric Psychiatry - July 11, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

New Evidence for a Biological Pathway to Mental Health Problems in Dementia Caregivers: Invited Commentary on the Article by Wells et al. (AMGP-1247).
Authors: Smagula SF PMID: 31285154 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 11, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Care Transitions in the Psychiatric Hospital: Focus on Older Adults
A care transition is defined as the transfer of a patient between care settings, such as between a skilled nursing facility (SNF) to an emergency department (ED) or from the general medical ward to the inpatient psychiatric unit.1 The processes of care that occur during such transfers is defined as transitional care.2 These processes include reconciliation of medication orders, transmission of important medical information, and communication among patients, families, and care providers. Lack of continuity and coordination of medical services while providing transitional care negatively impacts quality of care, diminishes p...
Source: The American Journal of Geriatric Psychiatry - July 11, 2019 Category: Geriatrics Authors: Matthew Conlon, James Tew, LalithKumar K Solai, Priya Gopalan, Pierre Azzam, Jordan F. Karp Tags: Treatment in Geriatric Mental Health: Research in Action Source Type: research

Commentary: Depression and Incidence of Frailty in Older People From Six Latin American Countries by Prina et al. AJGP, in Press.
Authors: Brown PJ PMID: 31278010 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 8, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Working Memory Training for Older Adults After Major Surgery: Benefits to Cognitive and Emotional Functioning.
CONCLUSION: The results of this pilot study suggest that cognitive training targeting working memory administered in the postoperative period after major surgery can sustain older adults' cognitive and emotional functioning, and especially their mood. PMID: 31278011 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 8, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Animal Models of Psychosis in Alzheimer Disease.
Authors: Krivinko JM, Koppel J, Savonenko A, Sweet RA Abstract Psychosis in Alzheimer Disease (AD) represents a distinct clinicopathologic variant associated with increased cognitive and functional morbidity and an accelerated disease course. To date, extant treatments offer modest benefits with significant risks. The development of new pharmacologic treatments for psychosis in AD would be facilitated by validated preclinical models with which to test candidate interventions. The current review provides a brief summary of the process of validating animal models of human disease together with a critical analysis of ...
Source: The American Journal of Geriatric Psychiatry - July 8, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Reproductive history and cognitive aging: The Bogalusa Heart Study
Although it has become increasingly clear that pregnancy experience and pregnancy-related health predict later-life cardiometabolic health, the relationship between reproductive history and cognitive health is much less studied. Short-term, pregnancy produces changes in memory, with diminished verbal recall memory (but not recognition or working memory).1 Alzheimer's neuropathology has been found in women with more children,2,3 but not in men,4 and women with more pregnancies were found to demonstrate a younger age of onset of Alzheimer's in one case series. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 5, 2019 Category: Geriatrics Authors: Emily W. Harville, Jack Guralnik, Maryellen Romero, Lydia A. Bazzano Tags: Regular Research Article Source Type: research

Serum 25-Hydroxyvitamin D Levels and Depression in Older Adults: A Dose-Response Meta-Analysis of Prospective Cohort Studies.
Authors: Li H, Sun D, Wang A, Pan H, Feng W, Ng CH, Ungvari GS, Tao L, Li X, Wang W, Xiang YT, Guo X Abstract OBJECTIVE: The association between serum vitamin D and risk of depression in older adults is controversial. We performed a dose-response meta-analysis of prospective cohort studies to examine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of depression in older population. METHODS: Studies published before February 2018 in the PubMed, Cochrane Library, Web of Science, PsycINFO, and EMBASE databases were systematically searched. Prospective cohort studies that exa...
Source: The American Journal of Geriatric Psychiatry - July 4, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Vitamin D and Psychosis in Alzheimer Disease: New Insights From Pharmacogenomics Research.
Authors: Vyas CM, Okereke OI PMID: 31262684 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 4, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

What Are the Appropriate Boundaries of Imagination?
Authors: Ellison JM, Kyomen HH PMID: 31262685 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 4, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Sleep Duration and Cognition in a Nationally Representative Sample of U.S. Older Adults
A growing body of literature has highlighted the critical role sleep plays in the cognitive and general health in older adults.1,2 While there are numerous metrics of sleep quality and quantity, sleep duration is of particular interest given its conceptual accessibility to community-dwelling older adults and the relative ease with which it can be queried in large epidemiologic samples. The recommended sleep duration for adults aged 65 years and older, per National Sleep Foundation guidelines, is 7 to 8 hours per night. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 4, 2019 Category: Geriatrics Authors: Dominique V. Low, Mark N. Wu, Adam P. Spira Tags: Regular Research Article Source Type: research

Digging deeper into delusion circuitry in Alzheimer's disease
Clinical significance of psychotic symptoms in Alzheimer's disease (AD) is emphasized by its association with rapid progression of AD, higher risk of death and greater caregiver burden. Likewise, pathophysiological significance is underscored by their potential to be the endophenotypes for rapid progression of AD. Despite clinical challenges in phenomenologically characterizing delusions in individuals with global cognitive decline, investigation of AD with psychotic symptoms (AD+P) has made significant progress. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 3, 2019 Category: Geriatrics Authors: Konasale Prasad Tags: Invited Perspective Source Type: research

Thoughts About Electroconvulsive Therapy and New Potential Treatments for Treatment-Resistant Depression in the Elderly.
Authors: Rubin EH PMID: 31255468 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 2, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Beyond depression: Estimating 12-months prevalence of passive suicidal ideation in mid- and late-life in the Health and Retirement Study
Suicide is the 10th leading cause of death in the US. Incidence of suicide is highest among older adults,1 and rates have increased steadily over the past decade.2 Suicidal behavior is often considered primarily in relation to mental disorders such as depression; however, several recent meta-analyses have concluded that depression only modestly predicts risk of completed suicide in the general population.3,4 The links between depression and suicidal behavior may be even more nuanced among older adults. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 2, 2019 Category: Geriatrics Authors: Liming Dong, Viktoryia Kalesnikava, Richard Gonzalez, Briana Mezuk Tags: Regular Research Article Source Type: research

The Construction and Evaluation of Executive Attention Training to Improve Selective Attention, Focused Attention, and Divided Attention for Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial.
CONCLUSION: The executive attention training significantly improved selective attention and divided attention performance. Future studies should identify transfer effects of attention training, and that can employ early screening to provide integrated attention training, and decrease its relevant risks on competency in performing daily activities, such as falling and driving. PMID: 31248769 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 1, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Social Engagement and Amyloid- β-Related Cognitive Decline in Cognitively Normal Older Adults.
CONCLUSIONS: Low social engagement may be a marker of neurocognitive vulnerability in older adults who are cognitively normal but have evidence of AD pathophysiologic change. Understanding changes in social engagement in older adults may lead to earlier diagnosis of AD and advances in evidence-based prevention and treatment. PMID: 31248770 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - July 1, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Exposure to Antidepressant Medication and the Risk of Incident Dementia.
CONCLUSION: In this study, monotherapeutic antidepressant exposure in old age was associated with increased incident dementia. Clinicians, caregivers, and patients may wish to consider this potentially negative consequence of antidepressant exposure and aim to balance the costs and benefits of treatment. PMID: 31235427 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 28, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Apolipoprotein E ε4 allele is associated with plasma amyloid beta and amyloid beta transporter levels: a cross-sectional study in a rural area of Xi'an, China
Insoluble extracellular senile plaques, the pathological  hallmark of Alzheimer's disease (AD), are mainly composed of amyloid beta40 (Aβ40) and amyloid beta42 (Aβ42).1 Transporting from the central nervous system (CNS) into blood through the blood–brain barrier (BBB) is the mainly clearance pathway of Aβ.2,3 Soluble low-density lipoprotein receptor -related protein-1 (sLRP1) in plasma binds 70-90% of peripheral Aβ and prevents it from flowing into the brain.4,5 At the same time, soluble receptor of advanced glycation end products (sRAGE), as a decoy receptor for plasma Aβ, can prevent i...
Source: The American Journal of Geriatric Psychiatry - June 28, 2019 Category: Geriatrics Authors: Shan Wei, Ling Gao, Yu Jiang, Suhang Shang, Chen Chen, Liangjun Dang, Beiyu Zhao, Juanli Zhang, Jin Wang, Kang Huo, Jingyi Wang, Rong Zhang, Qiumin Qu Tags: Regular Research Article Source Type: research

“Negress in White Hat” by the artist Vernon Ellis
The artist has chosen to depict the solemn expression of an older African American woman. The bright vibrant colors of her dress contrast with her expression and make one wonder about her state of mind. One can appreciate her frank, confrontational expression —and will not soon forget it. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 28, 2019 Category: Geriatrics Authors: Charles F. Reynolds Tags: Images in Aging Source Type: research

Digital mental health for older adults
Widespread use of digital devices has led to the emergence of mobile systems for health measurement, analysis and intervention (mHealth). Some of the digitally assessed functions are correlated with clinically meaningful measures and have implications for disease prevention. An example is a recent Framingham Heart Study, which showed that incremental light accelerometer measured physical activity was correlated with higher total brain volumes; each additional hour of activity corresponded to an average of 1.1 years of less brain aging. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 27, 2019 Category: Geriatrics Authors: George S. Alexopoulos Tags: Invited Perspective Source Type: research

Commentary on: Serum 25-hydroxyvitamin D levels and depression in older adults a dose-response meta-analysis of prospective cohort studies
The role of vitamin D and its relationship to calcium and related deficiencies in many areas of medicine, including psychiatry, has been the topic of much research and frequent disagreement.1,2 While deficiencies in vitamin D are associated with various health problems, the body of research as a whole has been limited with regard to quality of studies presented. Questions about normal prevalence ranges, what constitutes a deficiency, and what are the risks and benefits from vitamin D supplementation remain largely unanswered. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 27, 2019 Category: Geriatrics Authors: David Mischoulon, Olivia Okereke, Grace Chang Tags: Invited Perspective Source Type: research

Mild Cognitive Impairment and Caregiver Burden: A 3-Year-Longitudinal Study.
CONCLUSIONS: High levels of caregiver burden are present in a significant proportion of caregivers of people with MCI. Clinical characteristics of patients - including severity of neuropsychiatric symptoms and functional impairment - and the employment status of caregivers predict burden. Such characteristics may help identify caregivers at greater risk of burden to target for intervention. PMID: 31230914 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 25, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Eco-Psychiatry: Air Pollution is Associated With Depression in Older Adults.
Authors: Lavretsky H PMID: 31230915 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 25, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Postmortem Cortical Transcriptomics of Lewy Body Dementia Reveal Mitochondrial Dysfunction and Lack of Neuroinflammation
Lewy body dementia (LBD) is a major public health problem worldwide. Prevalence of LBD is second only to Alzheimer's disease (AD) among people with neurodegenerative dementia.1 LBD cause earlier mortality,2 earlier nursing home admissions, poorer quality-of-life, higher costs,3 more frequent falls, and more caregivers ’ burden than AD. LBD include two overlapping clinical syndromes, dementia with Lewy bodies (DLB) and Parkinson's disease (PD) dementia (PDD). They cause more frequent and more intense neuropsychiatric symptoms including visual hallucinations, delusions, agitation, and depression than AD. (Source: The A...
Source: The American Journal of Geriatric Psychiatry - June 24, 2019 Category: Geriatrics Authors: Anto P. Rajkumar, Gholamreza Bidkhori, Saeed Shoaie, Emily Clarke, Hamilton Morrin, Abdul Hye, Gareth Williams, Clive Ballard, Paul Francis, Dag Aarsland Tags: Regular Research Article Source Type: research

Post-mortem cortical transcriptomics of Lewy body dementia reveal mitochondrial dysfunction and lack of neuroinflammation
Lewy body dementia (LBD) is a major public health problem worldwide. Prevalence of Lewy body dementia (LBD) is second only to Alzheimer's disease (AD) among people with neurodegenerative dementia.1 LBD cause earlier mortality,2 earlier nursing home admissions, poorer quality-of-life, higher costs,3 more frequent falls, and more caregivers ’ burden than AD. LBD include two overlapping clinical syndromes, dementia with Lewy bodies (DLB) and Parkinson's disease (PD) dementia (PDD). They cause more frequent and more intense neuropsychiatric symptoms including visual hallucinations, delusions, agitation, and depression th...
Source: The American Journal of Geriatric Psychiatry - June 24, 2019 Category: Geriatrics Authors: Anto P. Rajkumar, Gholamreza Bidkhori, Saeed Shoaie, Emily Clarke, Hamilton Morrin, Abdul Hye, Gareth Williams, Clive Ballard, Paul Francis, Dag Aarsland Tags: Regular Research Article Source Type: research

Do acetylcholinesterase inhibitors prevent or delay psychotropic prescribing in people with dementia? Analyses of the Swedish Dementia Registry
Behavioural and psychological symptoms of dementia (BPSD) contribute to poor quality of life, caregiver distress and admission to aged care services. BPSD may affect between 50 to 90% of people diagnosed with dementia during the course of their disease1. Symptoms include agitation, aggression, hallucinations, delusions, depression, apathy, wandering, disinhibition, and sleep disturbances2. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 24, 2019 Category: Geriatrics Authors: Edwin C.K. Tan, Kristina Johnell, J. Simon Bell, Sara Garcia-Ptacek, Johan Fastbom, Peter Nordstr öm, Maria Eriksdotter Tags: Regular Research Article Source Type: research

Effects of Socioeconomic Status on Alzheimer Disease Mortality in Taiwan
Owing to its worldwide spread, Alzheimer's disease (AD) was identified as a “global public health priority’’ by the World Health Organization in 2015.1 At that time, an estimated 47 million people were affected by AD and other dementias worldwide, a figure that is expected to reach 75 million by 2030 and 131 million by 2050. Dementia is a neurodegenerative illness who se prevalence increases with age.2 The 4.4% (3.2% in men, 5.8% in women) prevalence of dementia in 1996 in Taiwan3 increased to 6.0% as of 2010–2015. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 24, 2019 Category: Geriatrics Authors: Nai-Ching Chen, Chih-Kuang Liang, Chun-Hao Yin, Yu-Te Lin, Ching-Chih Lee, Chien-Liang Chen Source Type: research

Cognitive training for optimizing perioperative brain health
Two tsunamis are colliding: the “silver tsunami” of our aging population,1 and the “surgical tsunami” of growing numbers of surgical patients. The typical person undergoes nine surgical procedures in his or her lifetime, most after age 65.2 Optimizing perioperative brain health is a major clinical and public health concern ; it comprises mental health problems such as depression and anxiety, and cognitive health problems including delirium and cognitive impairment. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 23, 2019 Category: Geriatrics Authors: Eric J. Lenze, Christopher R. Bowie, Michael S. Avidan Tags: Invited Perspective Source Type: research

Molecular senescence is associated with white matter microstructural damage in late-life depression
Late-Life Depression (LLD) is common and associated with cognitive impairment and higher risk for dementia.1,2 The mediators of risk are not well understood, but probably involve the interaction of biological mechanisms related to aging processes, like inflammatory activation, loss of proteostasis control, increased tissue remodeling markers and reduced neurotrophic support.3 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 22, 2019 Category: Geriatrics Authors: Ana Paula Mendes-Silva, Benson Mwangi, Howard Aizenstein, Charles F. Reynolds, Meryl A. Butters, Breno S. Diniz Tags: Brief Report Source Type: research

Do Antidepressants increase the risk of dementia?
The paper of Kodesh et al.1 in this volume reports an association between antidepressant use and later development of dementia. Its findings are based on medical records of a large sample (N=71,515) of non-demented adults aged 60 years old or older insured by a large, non-profit HMO in Israel. Individuals who had received prescriptions for one antidepressant (N=3,688) had more than 3 times higher chance to develop dementia during a 4-year follow-up period than those who had not. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 21, 2019 Category: Geriatrics Authors: Nili Solomonov, George S. Alexopoulos Tags: Invited Perspective Source Type: research

Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern
The “baby boomers” will age into the largest group of older persons heretofore in the history of the United States1. The addition of the baby boomers, who started to turn 65 in the year 2011, will swell the number of geriatric persons in the United States to approximately 72.1 million by 20302,3. Th is generation led the social upheavals of the 1960s and 1970s and pioneered dramatic increases in the use and abuse of illicit drugs4-6. Compared with previous geriatric cohorts, baby boomers have high rates of earlier life substance use1,7-11 (lifetime rates of use of illicit drug use, 47.4% versus 19.3%)11. (Sourc...
Source: The American Journal of Geriatric Psychiatry - June 21, 2019 Category: Geriatrics Authors: Stephanie Yarnell, Luming Li, Brian Mac Grory, Louis Trevisan, Paul Kirwin Source Type: research

Commentary on "When and How to Treat Agitation in Alzheimer's Disease Dementia With Citalopram and Escitalopram".
Commentary on "When and How to Treat Agitation in Alzheimer's Disease Dementia With Citalopram and Escitalopram". Am J Geriatr Psychiatry. 2019 May 27;: Authors: Pollock BG PMID: 31208921 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 19, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Beyond cross-sectional snapshots: Charting the course of burden in caregivers of family members with mild cognitive impairment
The prospect of becoming cognitively impaired provokes fear and anxiety in many older adults. Almost equally disturbing may be the possibility of a loved one developing such impairment and associated concerns over what this bodes for the future. “How will my loved one change?” “Will our relationship change?” “How will my family and I take care of him/her?” These sorts of questions typically arise when family members first learn of a diagnosis such as mild cognitive impairment (MCI) or early dementia, although they may acknowledg e that they knew something was wrong and began to have thes...
Source: The American Journal of Geriatric Psychiatry - June 19, 2019 Category: Geriatrics Authors: Mary Amanda Dew, Linda Garand Tags: INVITED PERSPECTIVE Source Type: research

Commentary on: Mechanisms Linking White Matter Lesions, Tract Integrity and Depression in Alzheimer's Disease.
Authors: Paradise DM PMID: 31201001 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 17, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

A Future Research Agenda for Digital Geriatric Mental Healthcare.
Authors: Fortuna KL, Torous J, Depp CA, Jimenez DE, Areán PA, Walker R, Ajilore O, Goldstein CM, Cosco TD, Brooks JM, Vahia IV, Bartels SJ Abstract The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances, does not rely on mental health clinics to offer real-time interventions. As technology increasingly becomes essential...
Source: The American Journal of Geriatric Psychiatry - June 15, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Tetrahydrocannabinol Has Potential for Treating Agitation in Alzheimer's Disease.
Authors: Rosenberg PB, Outen M S JD, Amjad M D M P H H, Burhanullah M D MH, Vandrey Ph D R, Monette B A PJ, Forester M D M Sc BP PMID: 31196620 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 15, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Neuropsychiatric Symptoms as Risk Factors for Cognitive Decline in Clinically Normal Older Adults: The Cache County Study.
CONCLUSION: In conclusion, among clinically normal older adults derived from this population-based study, total burden of NPS was associated with longitudinal cognitive decline. These results add to the evidence that NPS are risk factors for or clinical indicators of preclinical dementia syndrome. Our study was an exploratory study and we did not control for multiple comparisons. PMID: 31186157 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - June 14, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research