Digital Therapeutics for Geriatric Psychiatry: From Laboratory to Clinic
Despite recent advances in medication treatment for abnormal brain aging such as depression and dementia, it has become increasingly clear that pharmaceutical – based therapeutic strategies have significant limitations in the percentage of patients that benefit, the degree of clinical improvement, the durability of that improvement, the risk of side effects, and cost. Patients who suffer from age-related cognitive deficits have few, if any, efficacious treatment options. Advances in computer science, programming, and portable technology have begun to offer the opportunity for development of digital therapeutics, leveragi...
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Paul Newhouse, Shizuko Morimoto, Jennifer Vega, Kevin Manning, Alexander Conley Source Type: research

Dementia with Aggressive Behavior and an Adverse Outcome in a Memory Disorders Facility; A Mock Trial
Memory disorder residential facilities typically house people with later stage dementing disorders who cannot be managed in less restrictive settings. The frequency of behavioral dyscontrol tends to increase as the dementia worsen. A certain percentage of such individuals will have aggressive behaviors, which may result in patient on patient or patient on staff aggressive acting-out that can have problematic or even catastrophic outcomes. When this occurs, the incident may become the focus of legal action taken against the facility and/or the care providers. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Elliott Stein, Sanford Finkel, Jay Luxenberg, Karen Reimers, David Trader Source Type: research

The Optimization of Pharmacological and Non-pharmacological Interventions in a Case of Parkinson's Psychosis
Mr. L is a 64 y.o. male with a history of Parkinson's disease s/p bilateral DBS who initially presented to the emergency room from an assisted living facility for altered mental status and increased combativeness with staff. Patient was found to be experiencing symptoms of Parkinson's Psychosis and had uncontrol behavioral disturbance. Psychiatry was consulted for recommendations for agitation and hallucinations. Mr. L was hospitalized for over a year due to the need for higher level of care, inability to obtain guardianship, and inability to obtain subsequent placement. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Toni Carter Source Type: research

Psychosis in Later Life: The Case of a 66 y/o Hispanic Female with Depression and New Onset Visual Hallucinations
Intro: Psychosis in later life (age> 65 y/o) can be difficult to diagnose and treat given complex relationships between biological, psychological, and social factors that can interact and affect an individual's function and well-being. Understanding etiologies for psychotic symptoms is crucial. Differentiation between primary and secondary psychotic disorders can be a good first step in elucidating diagnosis and treatment. Treatment often consists of eliminating probable causes of secondary symptoms, judicious, short-term use of antipsychotics in some cases and combination of psychosocial modalities, such as behavioral the...
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Catherine Gonzalez Source Type: research

Understanding the Nuances of Managing PTSD and Cognitive Impairment in Aging Adults Living with HIV
During the advent of the HIV epidemic in the 1980s, AIDS was an illness that disproportionately affected younger people, particularly young gay cisgender men, as without the availability of antiretroviral therapy (ART), those who acquired HIV had a very short life expectancy. With the development of highly effective ART, the landscape of living with HIV has changed and we are now seeing a growing population of aging adults living with HIV, particularly those who identify across the LGBTQ+ spectrum. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: William Smith Source Type: research

Disentangling the Diagnoses of Psychotic Depression, Catatonia, Neurocognitive Disorders, and Delirium: A Multidisciplinary Approach
An ambiguous clinical presentation can create diagnostic uncertainty, leading to delays in effective interventions and increasing the likelihood of adverse clinical outcomes. Unfortunately, many psychiatric conditions share overlapping clinical symptoms. Psychotic depression, catatonia, neurocognitive disorders, and delirium are all examples of distinct clinical conditions with overlapping symptomatology, and all require decidedly different therapeutic interventions. While much literature is devoted to the diagnostic criteria and management of these clinical conditions, little is dedicated to the challenge of disentangling...
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Vinay Kotamarti Source Type: research

Cognitive Decline in Older Adults with Schizophrenia-Bipolar Spectrum Disorder
Mr. S is a 67-year-old man with psychiatric history of an unspecified psychotic disorder (schizophrenia vs schizoaffective disorder vs bipolar I disorder) and medical history of hypertension and hyperlipidemia who presented to the emergency department (ED) for inability to care for self after being picked up by emergency medical services (EMS) while wandering outside. Psychiatry was consulted due to a chart history of bipolar I disorder with concern for active mania given disorganization and agitation. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Evelina Sterina Source Type: research

Behavioral Variant Frontotemporal Dementia-like Syndrome –Atypical Presentation of Intracranial Hypotension.
We present the case of a 56 yo Male with postural headache and behavioral symptoms, initially diagnosed with bvFTD. On re-evaluation in our clinic imaging revealed caudal displacement of the midline structures suggestive of CSF hypotension. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Kasia Gustaw Rothenberg Source Type: research

Cocaine, Coffee, Constipation: (1) Leveraging Concrete Relatedness in Paraphrenia to Address Stimulant Use and (2) Monitoring Constipation with AIMS to Titrate Tetrabenazine
Our patient is a 75-year-old man, non-combat Army veteran ('66-'69), divorced, domiciled in his own apartment, retired from the post office, with a medical history of asthma and osteoarthritis, a psychiatric history of primary psychosis beginning in his late fifties (without affective symptoms, substance use, or cognitive decline with a MoCA 26/30), cocaine use disorder in partial remission, and depression in remission, one prior admission, without suicidality or violence, who follows with geriatric psychiatry for psychosis, tardive dyskinesia, and cocaine use. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Emily Phelps Source Type: research

Long Term Cognitive Impact of Electroconvulsive Therapy in Patients with Early Frontotemporal Lobar Degeneration
Frontotemporal lobar degeneration (FTLD) is the umbrella term to describe several overlapping neurodegenerative syndromes including progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and behavioral variant frontotemporal dementia (bvFTD). Most patients with FTLD present initially with psychiatric symptoms such as apathy, depressed mood, and fatigue (often with a mild Parkinsonism) that almost always prove refractory to medication interventions and psychotherapy. Some patients may be recommended for electroconvulsive therapy (ECT), which in our clinical experience, is not effective and potentially harmfu...
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Aaron Ritter Source Type: research

“We agreed we would both die”: Navigating Ethical Complexities in Suicide Attempts in Older Adults
Mr. Smith was an 80-year-old man admitted to the inpatient medicine service following a suicide attempt by ingestion of an unknown amount of hydrocodone-acetaminophen and alcohol. The patient was transported by ambulance, accompanied by his daughter. His daughter was also his appointed medical power of attorney and had a copy of the patient's advance directive, where he had indicated his wish not to be resuscitated (DNR) in case of a life-threatening emergency.Soon after his arrival to the hospital, a dramatic series of events unfolded. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Michael Ward Source Type: research

EMPOWER! (Brain Health Education in Minority Communities to Promote Knowledge about Early Detection of Alzheimer's Disease and Research Participation) Curriculum
An estimated 6.7 million people are living with Alzheimer's Disease and its related dementias (ADRD) with the disease being found in about 1 in 9 people (10.8%) age 65 and older. Secondary to being often uninformed regarding the risk factors, prevention measures, the importance of early detection and having lack of access to cognitive screening, Black and Hispanic older adults are disproportionality affected by ADRD. The EMPOWER curriculum serves to address this disparity by providing patient education emphasizing risk reduction strategies for older adults and improve ADRD health literacy. (Source: The American Journal of ...
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Alex Pena Garcia, Veronica Derricks, Joseph Asper, Daniela Gonzalez, Miriam Rodriguez, Patricia Garcia, Francine Epperson, Angelina Polsinelli, Andrew Saykin, Sophia Wang Tags: Poster # EI1 Source Type: research

Afternoon at the Museum: Psychosocial Wellbeing and Intergenerational Connectedness among LGBT Older Adults
Loneliness and social isolation are related yet distinct issues that negatively impact the physical health and psychosocial wellbeing of older adults (Perone et al., 2019). Social isolation among older adults is associated with adverse physical and mental health risks (Huang et al., 2023). Moreover, lack of companionship increases the risk for mental health disorders, such as anxiety, depression, and suicide (Donovan et al., 2020). In particular, LGBTQ+ older adults are at a heightened risk of both loneliness and social isolation (Perone et al., 2019). (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Xiaochen Zhong, Chloe Cheng, Nathaniel Jenkins, Peter Ureste, Tammy Duong Tags: Poster # EI2 Source Type: research

Life Story Club for Cognitively Impaired Older Adults
Creative expression programs such as storytelling have been shown to increase positive emotion in elders with cognitive impairment. The LifeStory club is a community-based social group founded to promote community building and the exchange of life stories in older adults. Our pilot study explored the feasibility, acceptability, and effectiveness of the LifeStory Club on improving the wellbeing of older adults with mild cognitive impairment (loneliness and depression) and their caregivers (caregiver burden). (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Katherine Valles, Miriam Stock, Linnea Guerin, Lily Zhou, Jessica Zwerling, Mirnova Ceide Tags: Poster # EI3 Source Type: research

Life Story Books as A Reminiscence Therapy Tool for Dementia: An Updated Review From 2018-2023
The global burden of dementia is expected to rise to 74.7 million in 2030. There has been increasing evidence that reminiscence therapy improves cognition and depressive symptoms in individuals with dementia. Digital life story books (LSB), which gather autobiographical memories into video books, have emerged as an increasingly popular tool of RT. There has been limited research into the preferences of dementia patients, the efficacy of different types of LSBs, or optimal way to implement LSBs in diverse care settings. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 18, 2024 Category: Geriatrics Authors: Monica Sadhu, Ashish Sarangi Tags: Poster # EI4 Source Type: research