A Pilot Randomized Trial of Engage Psychotherapy to Increase Social Connection and Reduce Suicide Risk in Later Life
This study examines acceptability, feasibility, and efficacy of Engage Psychotherapy to improve subjective disconnection (target mechanisms: low belonging and perceived burden), and improve clinical and functional outcomes (depression, suicide ideation, quality of life).METHODS: Pilot randomized trial with adults age 60 and older who reported feeling lonely and/or like a burden. Participants were randomly assigned to 10 sessions of 'Social Engage' (S-ENG; n = 32) or care-as-usual (CAU; n = 30), with follow-up assessments at 3 weeks, 6 weeks, and 10 weeks.RESULTS: S-ENG is feasible to deliver over 10 sessions and acceptable...
Source: The American Journal of Geriatric Psychiatry - May 6, 2021 Category: Psychiatry Authors: Kimberly A Van Orden Patricia A Are án Yeates Conwell Source Type: research

The Role of Spirituality in Conceptualizations of Health Maintenance and Healthy Aging Among Latin American Immigrants
As societies around the globe see impressive advances in the medical sciences, longevity is increasing, leading to a heightened focus on the health and wellbeing of the growing population of older adults. One crucial consideration in this population is brain health. In the United States, there are currently an estimated 6 million adults living with dementia1, a clinical disorder that is characterized by neurocognitive decline severe enough to impede independent living. Furthermore, this number is projected to reach nearly 14 million by 2060 1, highlighting the importance of identifying strategies that may help reduce the b...
Source: The American Journal of Geriatric Psychiatry - May 4, 2021 Category: Geriatrics Authors: Sophia Weiner-Light, Katherine P. Rankin, Serggio Lanata, Katherine L. Possin, Daniel Dohan, Alissa Bernstein Sideman Source Type: research

Improving social connections to reduce suicide risk: A promising intervention target?
Invited commentary on: “A Pilot Randomized Trial of Engage Psychotherapy to Increase Social Connection and Reduce Suicide Risk in Later Life” Kimberly Van Orden, Ph.D., Patricia Areán, Ph.D.,& Yeates Conwell, M.D. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 4, 2021 Category: Geriatrics Authors: Katalin Szanto, Kathrine Whitman Tags: Editorial Source Type: research

The role of decreased cortical thickness and volume of medial temporal lobe structures in predicting incident psychosis in patients with Alzheimer's disease: a prospective longitudinal MRI study
Psychotic symptoms are among the most common non-cognitive neuropsychiatric symptoms seen in Alzheimer's disease (AD) and have been reported to occur in approximately 25-41 % of patients with AD.1-3 The presence of psychotic symptoms in AD portends a more severe course of cognitive decline,4 increases the burden on the caregiver,5 and often results in early institutionalization6 of patients with AD. Given the limited efficacy over placebo7 and high incidence of adverse effects8 of antipsychotic drugs prescribed for AD, identifying the underlying neurobiological mechanism is critical for early diagnosis and prediction of th...
Source: The American Journal of Geriatric Psychiatry - April 29, 2021 Category: Geriatrics Authors: Young-Min Lee, Je-Min Park, Byung-Dae Lee, Eunsoo Moon, Hee-Jeong Jeong, Soo Yeon Kim, Kang Yoon Lee, Hwagyu Suh, Hak-Jin Kim, Kyongjune Pak, Kyung-Un Choi, Young-In Chung Tags: Regular Research Article Source Type: research

Psychological Resilience to the Challenges of Physical Aging in Older U.S. Veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study
As life expectancy increases globally, identifying factors that contribute to improved health and well-being in late-life is of growing importance, especially since healthy, disease-free lifespan has not increased as quickly as life expectancy (1). Physical health conditions are associated with increased risk for mental health difficulties, which can in turn negatively impact functioning and overall quality of life (2). To date, however, scarce research has examined factors that may help promote psychological resilience to aging-related physical health challenges. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 28, 2021 Category: Geriatrics Authors: Ruth H. Asch, Lorig Kachadourian, Steven M. Southwick, Irina Esterlis, Robert H. Pietrzak Tags: Brief Report Source Type: research

Resilience: Taking Its Measure Across the Life Span
The study of resilience is not new, and it is hard to approach the older literature on stressors, response to stress, ego strength, social support, hardiness, coping and the “neurotic constitution”, for instance, without acknowledging that, to some extent, such studies embrace the footprint of personal resilience. When the topic of resilience entered the psychiatric literature directly, it was mainly driven by the contributions of experts in child and developmental psychology, and took time before penetrating into everyday psychiatry. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 26, 2021 Category: Geriatrics Authors: Jonathan Davidson Tags: Editorial Source Type: research

Addressing Mistreatment by Patients in Geriatric Subspecialties: A New Framework
An 80-year-old patient presents for follow up at an outpatient geriatric psychiatry clinic. His son accompanies him for the first time to meet the patient's geriatric psychiatry fellow and attending. Upon introducing his son to the geriatric psychiatry fellow, the patient states, “See, son, what did I tell you? She's beautiful! She makes me want to go home and kiss my wife!” The son replies with a smile, “Aww. Now she's blushing.” The patient then adds, “And her English is so good, you would never guess she's not American.” (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 26, 2021 Category: Geriatrics Authors: Kirsten M. Wilkins, Matthew N. Goldenberg, Kali D. Cyrus, Marilise Hyacinth, Michelle L. Conroy Tags: Special Article Source Type: research

Resilience through the Holocaust and Soviet Labor Camps: My grandfather, Henry Glass (Szpigielglas)
Henry Glass (Szpigielglas) – April 22, 1920 (some documents note April 4, 1920) to October 30, 2002 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 26, 2021 Category: Geriatrics Authors: Oliver Mathew Glass Source Type: research

Monitoring Behaviors of Patients with Late-stage Dementia Using Passive Environmental Sensing Approaches: A  Case Series
Behavioral and Psychological Symptoms of Dementia (BPSD), also called neuropsychiatric symptoms, are the wide range of non-cognitive symptoms and behaviors experienced by persons with dementia (PwD). BPSD can occur in all types of dementia and they include symptoms such as agitation, aggression, anxiety, apathy, depression, and sleep disturbances1. BPSD often progresses over time, and they correlate with institutional placement, more rapid progression of dementia, and earlier mortality. Some of the symptoms, such as agitation and aggression, can also endanger patients themselves and/or their caregivers. (Source: The Americ...
Source: The American Journal of Geriatric Psychiatry - April 22, 2021 Category: Geriatrics Authors: Wan-Tai M. Au-Yeung, Lyndsey Miller, Zachary Beattie, Rose May, Hailey V Cray, Zachary Kabelac, Dina Katabi, Jeffrey Kaye, Ipsit V. Vahia Tags: Regular Research Article Source Type: research

White Matter Abnormalities in Late Onset First Episode Mania: A Diffusion Tensor Imaging Study
CONCLUSIONS: Patients with first episode mania in late life have relevant white matter abnormalities not explained by age, affecting interhemispheric and fronto-limbic networks probably related to executive functioning and emotional processing, at the level of the corpus callosum and the uncinate fasciculus. The etiology of this white matter loss of integrity in patients with late-onset mania is yet to be explored.PMID:33879344 | DOI:10.1016/j.jagp.2021.03.007 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 21, 2021 Category: Psychiatry Authors: Jesus Ram írez-Bermúdez Oscar Marrufo-Melendez Cecilia Berlanga-Flores Adilia Guadamuz Carmen Atriano Roger Carrillo-Mezo Patricia Alvarado Rafael Favila Jesus Taboada Camilo Rios Maria Yoldi-Negrete Ramiro Ruiz-Garcia Mauricio Tohen Source Type: research

A useless old doctor
I just got the retirement watch. Check.(But who needs a watch in retirement?)And I received the congratulationsFrom all of my patients. Check.I haven't quite figured out my health care thoughSo no check there, not yet.Retirement asks more questionsThan it provides answers.After a lifetime of being a doctor,Can I ever be anything else?If I cannot be a doctor any more,Then what good am I?If I can no longer spend every waking moment(and a lot of sleepless moments too)Caring desperately about other people's lives,Then who am I?I don't know but will soon have to faceThe soul-sucking, existential fear of being useless,Of living ...
Source: The American Journal of Geriatric Psychiatry - April 21, 2021 Category: Geriatrics Authors: David L. Coulter Tags: Poem Source Type: research

Addressing Loneliness in Older Adults During the COVID-19 Pandemic
The importance of loneliness and social isolation for health have become increasingly salient since the start of the COVID-19 pandemic and need for physical distancing to prevent spread of the virus.1 While the impacts of loneliness and social isolation on health, well-being, and longevity are well-documented,2 the importance of social connection for health is often under-appreciated by clinicians and patients alike. However, this may be changing as public discourse increasingly focuses on how restricted social opportunities can lead to depression, anxiety, and suicidal thoughts in some individuals. (Source: The American J...
Source: The American Journal of Geriatric Psychiatry - April 21, 2021 Category: Geriatrics Authors: Kimberly A. Van Orden Tags: Editorial Source Type: research

Factors Associated With Sleep Disturbances Related to the COVID-19 Pandemic Among Older Adults With Chronic Conditions
CONCLUSIONS: These findings identify factors that may heighten risk of sleep problems since the COVID-19 pandemic in an especially vulnerable subgroup of older adults.PMID:33867223 | DOI:10.1016/j.jagp.2021.03.003 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2021 Category: Psychiatry Authors: Courtney A Polenick Nikita R Daniel Emily A Perbix Source Type: research

Understanding Psychological Distress and Protective Factors Amongst Older Adults During the COVID-19 Pandemic
CONCLUSIONS: Even after prolonged social distancing, older adults in this study did not report greater psychological distress compared to earlier studies of older adults during COVID-19. Older adults with lower SES, worse physical health, and less resiliency, were more likely to report more loneliness. It is this group that should be the focus of intervention.PMID:33867224 | DOI:10.1016/j.jagp.2021.03.005 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2021 Category: Psychiatry Authors: Nichole Sams Dylan M Fisher Felicia Mata-Greve Morgan Johnson Michael D Pullmann Patrick J Raue Brenna N Renn Jaden Duffy Doyanne Darnell Isabell Griffith Fillipo Ryan Allred Kathy Huynh Emily Friedman Patricia A Are án Source Type: research

Factors Associated With Sleep Disturbances Related to the COVID-19 Pandemic Among Older Adults With Chronic Conditions
CONCLUSIONS: These findings identify factors that may heighten risk of sleep problems since the COVID-19 pandemic in an especially vulnerable subgroup of older adults.PMID:33867223 | DOI:10.1016/j.jagp.2021.03.003 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2021 Category: Psychiatry Authors: Courtney A Polenick Nikita R Daniel Emily A Perbix Source Type: research

Understanding Psychological Distress and Protective Factors Amongst Older Adults During the COVID-19 Pandemic
CONCLUSIONS: Even after prolonged social distancing, older adults in this study did not report greater psychological distress compared to earlier studies of older adults during COVID-19. Older adults with lower SES, worse physical health, and less resiliency, were more likely to report more loneliness. It is this group that should be the focus of intervention.PMID:33867224 | DOI:10.1016/j.jagp.2021.03.005 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2021 Category: Psychiatry Authors: Nichole Sams Dylan M Fisher Felicia Mata-Greve Morgan Johnson Michael D Pullmann Patrick J Raue Brenna N Renn Jaden Duffy Doyanne Darnell Isabell Griffith Fillipo Ryan Allred Kathy Huynh Emily Friedman Patricia A Are án Source Type: research

Daily News
Forgot my pocket radio and ear buds this morningas I took off for the necessary dog walkalong the bluffs beside the shore.So I missed the very latest, all that breaking news –This Just In..! – that breaks and tears so muchof what I stand for, what I care for.Caught, instead, the sounding of the surffrom last night's storm, the breakers crashand crumple as they rolled ashore reportingon the deepest state of things,reminding me that they will still be singing herewhen all my news has fled like so much sea sprayon these stark, primeval rocks. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2021 Category: Geriatrics Authors: J. Barrie Shepherd Tags: Poem Source Type: research

Relationships Between a New Cultured Cell-Based Serum Anticholinergic Activity Assay and Anticholinergic Burden Scales or Cognitive Performance in Older Adults
CONCLUSIONS: These results support the use of the cSAA assay as a laboratory measure of anticholinergic burden.PMID:33846084 | DOI:10.1016/j.jagp.2021.03.002 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 13, 2021 Category: Psychiatry Authors: Susmita Chandramouleeshwaran Naba Ahsan Roger Raymond Jose N Nobrega Wei Wang Corinne E Fischer Alastair J Flint Nathan Herrmann Sanjeev Kumar Krista Lanct ôt Linda Mah Benoit H Mulsant Bruce G Pollock Tarek K Rajji Source Type: research

Diagnostic Precision in the Detection of Mild Cognitive Impairment: A Comparison of Two Approaches
Accurate classification of early cognitive decline is needed to inform intervention efforts to prevent or delay progression to dementia. Multiple diagnostic classification systems for detecting cognitive decline have been developed, contributing to variability in the operationalization of early cognitive decline. The term Mild Cognitive Impairment (MCI) has commonly been used to describe the intermediary stage between normal cognitive aging and dementia. Current research criteria for a clinical diagnosis of MCI are based on the 2011 National Institute of Aging and Alzheimer's Association (NIA-AA) workgroup guidelines 1. (S...
Source: The American Journal of Geriatric Psychiatry - April 13, 2021 Category: Geriatrics Authors: Andrea M. Weinstein, Swathi Gujral, Meryl A. Butters, Christopher Bowie, Corinne E. Fischer, Alastair J. Flint, Nathan Herrmann, James L. Kennedy, Linda Mah, Shima Ovaysikia, Bruce G. Pollock, Tarek K. Rajji, Benoit H. Mulsant, for the PACt-MD Study Group Tags: Regular Research Article Source Type: research

Introduction
Am J Geriatr Psychiatry. 2021 May;29(5):513. doi: 10.1016/j.jagp.2021.03.006.NO ABSTRACTPMID:33840422 | DOI:10.1016/j.jagp.2021.03.006 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 12, 2021 Category: Psychiatry Authors: Nancy R Davison Source Type: research

Commentary on "Cannabinoids for Agitation in Alzheimer's Disease"
Am J Geriatr Psychiatry. 2021 Mar 19:S1064-7481(21)00262-1. doi: 10.1016/j.jagp.2021.03.004. Online ahead of print.NO ABSTRACTPMID:33839012 | DOI:10.1016/j.jagp.2021.03.004 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 11, 2021 Category: Psychiatry Authors: Joseph S Goveas Source Type: research

Editorial Board
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Source Type: research

Information for Subscribers
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Source Type: research

Table of Contents
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Source Type: research

In This Issue
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Source Type: research

Introduction
Two reactions to the COVID lockdown. Choices, written in the first week, is a response to life in isolation. Waking Dream, written in July, sees open spaces, endless horizons blocked by an irrational barrier, a clanging alarm. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Authors: Nancy R. Davison Source Type: research

The elusive ‘white whale’ of treatment response prediction: Leveraging the curse of heterogeneity in late-life depression
One of the basic principles of modern medicine is that "no two patients are alike." But truly understanding how the variability among patients contributes to variability within treatment is the foundation of modern personalized medicine. The Canadian physician (and “Father of Modern Medicine"), Dr. William Osler, once said, “Medicine is a science of uncertainty and an art of probability.” With this in mind, we start to understand that variability can be used to our advantage. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Authors: Helmet T. Karim Tags: Editorial Source Type: research

Improving Sleep Quality of Dementia Family Caregivers: Benefit-Finding as a Strategy?
Sleep disturbance, often in the form of fragmentation, is very prevalent among family caregivers of relatives with dementia and is a major contributor to exhaustion and depression in caregivers.1 Estimates suggest that two-thirds of dementia caregivers experience some form of sleep disturbance in the course of providing care to the relative.2 Such sleep problems may even persist after death of the care-recipient and cessation of the caregiving role.3 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Authors: Resa Gersdorf Tags: Letter to the Editor Source Type: research

Benefit-Finding Intervention May Alleviate Caregiver Insomnia, But More Data Are Needed
Sleep disturbance is a very common problem among caregivers of relatives with dementia, with complex causes involving personal, care-recipient, and environmental factors.1 It is no doubt a contributor to depression in caregivers but the relationship between sleep disturbance and depression is likely bidirectional.2 Given its prevalence among dementia family caregivers, it has been suggested that sleep problem should be assessed more often as an outcome in intervention studies.3 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2021 Category: Geriatrics Authors: Sheung-Tak Cheng Tags: Letter to the Editor Source Type: research

Directional Effects of Social Isolation and Quality of Life on Anxiety Levels Among Community-dwelling Older Adults During a COVID-19 Lockdown
Coronavirus disease (COVID-19) is a global health crisis that has taken many lives and pushed countries to introduce lockdowns to curb its spread. Singapore was placed under lockdown from 7th April to 1st June. All non-essential workplaces, schools, and food establishments were closed while social gatherings were prohibited. From 2nd to 19th June, some workplaces reopened and restricted visitations to parent's or grandparent's houses were allowed. The present study was conducted from 11th May to 19th June. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 8, 2021 Category: Geriatrics Authors: Savannah Kiah Hui Siew, Rathi Mahendran, Junhong Yu Tags: Brief Report Source Type: research

Medication Beliefs and Depression in African Americans with Diabetes
In older blacks with diabetes, medication adherence is influenced by health literacy, health beliefs, depression, and social determinants.1 Identifying interrelationships among these variables can target interventions to optimize health in the context of sociocultural factors. We investigated these interrelationships in a cross-sectional analysis of baseline data from a clinical trial testing the efficacy of a behavioral intervention to prevent emergency department visits in 200 older blacks with diabetes. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 8, 2021 Category: Geriatrics Authors: Barry W. Rovner, Robin. J. Casten Tags: Letter to the Editor Source Type: research

Can (or Should) We Treat Depression and Anxiety in Parkinson's Disease Algorithmically?
Am J Geriatr Psychiatry. 2021 Mar 14:S1064-7481(21)00259-1. doi: 10.1016/j.jagp.2021.03.001. Online ahead of print.NO ABSTRACTPMID:33824056 | DOI:10.1016/j.jagp.2021.03.001 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 7, 2021 Category: Psychiatry Authors: Michael R Martyna Nicholas T Trapp Ian H Kratter Source Type: research