The Promise and Challenges of Using Combined Moderator Methods to Personalize Mental Health Treatment
Personalized medicine approaches depend on identifying moderators. In a randomized clinical trial (RCT), a moderator is a pre-treatment characteristic that provides information about who is likely to have a favorable outcome with which treatment. (In contrast, a non-specific predictor is a pre-treatment characteristic that provides information about who is likely to have a favorable outcome, regardless of treatment.) To illustrate, a recent RCT found that set-shifting performance moderated the effect of aripirazole (versus placebo) on remission in older adults with venlafaxine-resistant major depression (1). (Source: The A...
Source: The American Journal of Geriatric Psychiatry - April 24, 2018 Category: Geriatrics Authors: Meredith L. Wallace, Stephen H. Smagula Tags: Invited Perspective Source Type: research

Symptomatic and Functional Recovery From Major Depressive Disorder in the Ibadan Study of Ageing
The article by Ojagbemi et  al.1 that appears in this issue of the American Journal of Geriatric Psychiatry represents the 26th publication reporting results from the Ibadan Study of Ageing (ISA). The study, which began in 2003 with a cross-sectional household survey and was then followed, beginning in 2007, with three annua l waves of data collection (http://www.who.int/healthinfo/09_IbadanStudyAgeing_Gureje.pdf), has produced a wealth of information about aging and well-being among community-dwelling Nigerians aged ≥ 65 years. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2018 Category: Geriatrics Authors: Alex Cohen Tags: Invited Perspective Source Type: research

Commentary: Symptomatic and Functional Recovery From Major Depressive Disorder in the Ibadan Study of Ageing
The paper by Akin Ojagbemi and colleagues (1) that appears in this issue of AJGP represents the 26th publication reporting results from the Ibadan Study of Ageing (ISA). The study, which began in 2003 with a cross-sectional household survey, and was then followed, beginning in 2007, with three annual waves of data collection (http://www.who.int/healthinfo/09_IbadanStudyAgeing_Gureje.pdf) has produced a wealth of information about ageing and well-being among community-dwelling Nigerians 65 years and older. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2018 Category: Geriatrics Authors: Alex Cohen Tags: Invited Perspective Source Type: research

Resilience and White Matter Integrity in Geriatric Depression
• White matter integrity in the Genu of the corpus callosum and cingulum was associated with the Grit factor of resilience in geriatric depression.• No white matter integrity correlates were found for the other resilience factors (Active Coping Self-efficacy, Accommodative Coping Self-efficacy, and Spirituality).• These results provide further support for the conceptualization of resilience as a complex dynamic system comprised of multiple factors with distinct underlying neurobiology. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2018 Category: Geriatrics Authors: Roza M. Vlasova, Prabha Siddarth, Beatrix Krause, Amber M. Leaver, Kelsey T. Laird, Natalie St. Cyr, Katherine L. Narr, Helen Lavretsky Tags: Regular Research Articles Source Type: research

Commentary: Symptomatic and Functional Recovery From Major Depressive Disorder in the Ibadan Study of Ageing
The paper by Akin Ojagbemi and colleagues (1) that appears in this issue of AJGP represents the 26th publication reporting results from the Ibadan Study of Ageing (ISA). The study, which began in 2003 with a cross-sectional household survey, and was then followed, beginning in 2007, with three annual waves of data collection (http://www.who.int/healthinfo/09_IbadanStudyAgeing_Gureje.pdf) has produced a wealth of information about ageing and well-being among community-dwelling Nigerians 65 years and older. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2018 Category: Geriatrics Authors: Alex Cohen Tags: Invited Perspective Source Type: research

Resilience and White Matter Integrity in Geriatric Depression
• White matter integrity in the Genu of the corpus callosum and cingulum was associated with the Grit factor of resilience in geriatric depression.• No white matter integrity correlates were found for the other resilience factors (Active Coping Self-efficacy, Accommodative Coping Self-efficacy, and Spirituality).• These results provide further support for the conceptualization of resilience as a complex dynamic system comprised of multiple factors with distinct underlying neurobiology. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2018 Category: Geriatrics Authors: Roza M. Vlasova, Prabha Siddarth, Beatrix Krause, Amber M. Leaver, Kelsey T. Laird, Natalie St. Cyr, Katherine L. Narr, Helen Lavretsky Tags: Regular Research Articles Source Type: research

Finding Disparities in the Stars: Using the Nursing Home Five-Star Quality Rating System to Identify Disparities in Nursing Home Quality for Older Adults with Severe Mental Illness
The new study by Temkin-Greener and colleagues1 contributes to a growing body of literature establishing that older adults with severe mental illness (SMI) are more likely to receive care from lower quality nursing homes, compared with older adults without mental illness. Temkin-Greener et  al. used data from Center for Medicare and Medicaid Services (CMS) Nursing Home Five-Star Quality Rating System to highlight this disparity in novel manner. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 20, 2018 Category: Geriatrics Authors: Ivy Benjenk, Jie Chen Tags: Invited Perspective Source Type: research

Odorant Item Specific Olfactory Identification Deficit May Differentiate Alzheimer Disease From Aging
AD is the most common form of dementia leading to progressive cognitive decline. Due to its high prevalence, accessible and feasible screening and prognostic tools are needed. AD is a disease superimposed on normal aging; thus, biomarker development has been challenging in separating the disease and aging signals.1 Olfactory identification deficit (OID) is an attractive candidate, being cost effective and easy to administer without the need for specific training.2,3 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 19, 2018 Category: Geriatrics Authors: Matthew R. Woodward, Muhammad Ubaid Hafeez, Qianya Qi, Ahmed Riaz, Ralph H.B. Benedict, Li Yan, Kinga Szigeti, Texas Alzheimer's Research, Care Consortium Tags: Regular Research Articles Source Type: research

Odorant Item Specific Olfactory Identification Deficit May Differentiate Alzheimer's Disease From Aging
• Screening for amnestic disorder must differentiate from changes associated with normal aging.• Using an odorant identification test, we identified specific odorants which failure to identify best predicts amnestic disorder vs. normal aging. The identified odorants were validated with performan ce on neuropsychological testing and prediction of conversion from amnestic mild cognitive impairment to Alzheimer's disease.• Olfactory identification impairment was associated with poor performance in numerous cognitive domains and was predictive of progression of mild cognitive impairment. (Source: The American Jo...
Source: The American Journal of Geriatric Psychiatry - April 19, 2018 Category: Geriatrics Authors: Matthew R. Woodward, Muhammad Ubaid Hafeez, Qianya Qi, Ahmed Riaz, Ralph H.B. Benedict, Li Yan, Kinga Szigeti, Texas Alzheimer's Research and Care Consortium Tags: Regular Research Articles Source Type: research

Age-Related Hearing Loss and Its Association with Depression in Later Life
This study contributes to the theory that ARHL may place older adults at risk for developing depressive symptoms• Future studies should investigate whether treatment of ARHL may be an effective prevention and/or therapeutic strategy for depre ssive symptoms. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 13, 2018 Category: Geriatrics Authors: Katharine K. Brewster, Adam Ciarleglio, Patrick J. Brown, Chen Chen, Hae-Ok Kim, Steven P. Roose, Justin S. Golub, Bret R. Rutherford Tags: Regular Research Articles Source Type: research

Integrated Exposure Therapy and Exercise Reduces Fear of Falling and Avoidance in Older Adults: a Randomized Pilot Study
• An 8-week intervention integrating cognitive-behavioral therapy and exercise reduced fear of falling and avoidance in older adults with disproportionate fear of falling relative to in-home fall prevention education.• The intervention did not increase fall risk.• Effects on fear and avoidance tended to erode over a six-month follow-up period. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 12, 2018 Category: Geriatrics Authors: Julie Loebach Wetherell, Emily S. Bower, Kristen Johnson, Douglas G. Chang, Samuel R. Ward, Andrew J. Petkus Tags: Regular Research Articles Source Type: research

Association of Hippocampal Substructure Resting-State Functional Connectivity with Memory Performance in Older Adults.
CONCLUSIONS: Rather than global hyper-connectivity of the medial temporal lobe, left dentate-lingual connectivity may provide a specific assay of medial temporal lobe hyper-connectivity relevant to memory in aging. PMID: 29628321 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 11, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Vitamin D Status and Depressive Symptoms in Older Adults: A Role for Physical Functioning?
CONCLUSIONS: Older women showed an inverse relationship between 25(OH)D and depressive symptoms over time, which may partially be explained by declining physical functioning. Replication of these findings by future studies is needed. PMID: 29628322 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 11, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Moving the Dementia-Related Stigma Dial among Chinese Americans.
Authors: Woo BKP, Chung JOP PMID: 29627191 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Why Do the Very Old Self-Harm? A Qualitative Study.
CONCLUSIONS: Self-harm may communicate a need that cannot otherwise be expressed. An individualized person-centered approach is required to respond to self-harm, including a combination of practical, medical, and psychological approaches as indicated. Involvement of families in the process of understanding the meaning of and responding to self-harm through education and family therapy, as well as education of healthcare professionals beyond risk factor notation may be indicated. PMID: 29627192 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 9, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Prevalence of Mental Health Disorders in Geriatric U.S. Military Veterans.
Authors: Little JT PMID: 29609900 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 5, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Perceived Treatment Status of Fluctuations in Parkinson Disease Impacts Suicidality.
Authors: Hinkle JT, Perepezko K, Mari Z, Marsh L, Pontone GM Abstract OBJECTIVE: On/off motor fluctuations in Parkinson disease (PD) can be associated with extreme mood fluctuations and severe dysphoria. The impact of these affective symptoms may be overlooked in the treatment of motor fluctuations. Our goal was to examine the relationship between motor fluctuations, their treatment status, and suicidality in PD participants. METHODS: We analyzed data from the Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study of 223 individuals with PD. Suicidality was measured using items from four...
Source: The American Journal of Geriatric Psychiatry - April 5, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

People's Beliefs and Expectations About How Cognitive Skills Change with Age: Evidence From a U.K.-Wide Aging Survey
Provision for the rising number of people living with dementia is a major challenge for public healthcare worldwide. Currently, around 850,000 people are living with dementia in the United Kingdom.1 However, not everyone develops dementia or experiences cognitive decline, and the risk of cognitive decline can be reduced.2 For example, although genetic factors are partially responsible for cognitive variability throughout life,3 research has identified a number of potentially modifiable lifestyle and behavioral factors such as physical activity,4 diet,5 and social interaction. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 4, 2018 Category: Geriatrics Authors: Eleftheria Vaportzis, Alan J. Gow Tags: Regular Research Articles Source Type: research

People's Beliefs and Expectations About How Cognitive Skills Change with Age: Evidence From a UK-Wide Aging Survey
• This is the first UK-wide survey collecting information from adults over 40 years on their beliefs, fears, perceptions and attitudes to cognitive aging.• Having a purpose in life, healthy eating, challenging the mind, sleep, and physical activity were perceived as important for maintaining or improving cognitive skills.• Older respondents expected cognitive skills to begin to decline about 10-15 years later than younger respondents.• Most respondents believed that it is possible to maintain or improve cognitive skills; however, 41.1% were unsure or did not know how to keep their brai n healthy. (Sourc...
Source: The American Journal of Geriatric Psychiatry - April 4, 2018 Category: Geriatrics Authors: Eleftheria Vaportzis, Alan J. Gow Tags: Regular Research Articles Source Type: research

In This Issue
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 1, 2018 Category: Geriatrics Source Type: research

Table of Contents
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 1, 2018 Category: Geriatrics Source Type: research

Information for Subscribers
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 1, 2018 Category: Geriatrics Source Type: research

Editorial Board
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 1, 2018 Category: Geriatrics Source Type: research

Effect of Problem-Solving Therapy Versus Supportive Management in Older Adults with Low Back Pain and Depression While on Antidepressant Pharmacotherapy
Most older adults seek treatment for depression and pain in primary care. Twelve percent of primary care elderly are depressed,1 and the prevalence of chronic low back pain (CLBP) in later life is also 12%.2 Both conditions are risk factors for the other's onset,3 interfere with the others' treatment response,4 mutually amplify disability, and mutually slow rates of remission.5 In our own work we have observed that CLBP is the most common pain problem for which older adults are referred from primary care to a pain clinic,6)indicating how therapeutically challenging these patients are for primary care physicians. (Source: T...
Source: The American Journal of Geriatric Psychiatry - March 30, 2018 Category: Geriatrics Authors: Jordan F. Karp, Xiaotian Gao, Abdus S. Wahed, Jennifer Q. Morse, Bruce L. Rollman, Debra K. Weiner, Charles F. Reynolds Tags: Regular Research Articles Source Type: research

Effect of Problem Solving Therapy Versus Supportive Management in Older Adults with Low Back Pain and Depression While on Antidepressant Pharmacotherapy
In late-life, depression and low-back pain: 1) are risk factors for the other's onset; 2) interfere with each others' treatment response; 3) mutually amplify disability; and 4) mutually slow rates of remission.We tested a stepped care intervention using venlafaxine with and without Problem Solving Therapy for Depression and Pain (PST-DP).While PST-DP is not needed to augment response, over the course of 20 weeks, up to 60% of patients have improvement in both depression and pain when treated with algorithmic antidepressant pharmacotherapy. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 30, 2018 Category: Geriatrics Authors: Jordan F. Karp, Xiaotian Gao, Abdus S. Wahed, Jennifer Q. Morse, Bruce L. Rollman, Debra K. Weiner, Charles F. Reynolds Tags: Regular Research Articles Source Type: research

Curcumin for Neuroprotection: Taking a Second Look at Results
In an 18-month randomized, placebo-controlled trial, Small et  al. explored the effects of 180 mg of curcumin (Theracurmin) on verbal memory, visual memory, attention, and mood in elderly subjects without dementia.1 They also examined FDDNP brain PET scan binding in predefined regions of interest. They found that curcumin was superior to placebo on (only) o ne measure of verbal memory and on the attentional task, and that curcumin was associated with lower FDDNP binding than placebo in only the hypothalamus and not in any of seven other brain areas studied. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 30, 2018 Category: Geriatrics Authors: Migita Michael Dcruz, Spoorthy Sai Mamidipalli, Abha Thakurdesai, Chittaranjan Andrade Source Type: research

Effect of Problem Solving Therapy Versus Supportive Management in Older Adults with Low Back Pain and Depression While on Antidepressant Pharmacotherapy
In late-life, depression and low-back pain: 1) are risk factors for the other's onset; 2) interfere with each others' treatment response; 3) mutually amplify disability; and 4) mutually slow rates of remission.We tested a stepped care intervention using venlafaxine with and without Problem Solving Therapy for Depression and Pain (PST-DP).While PST-DP is not needed to augment response, over the course of 20 weeks, up to 60% of patients have improvement in both depression and pain when treated with algorithmic antidepressant pharmacotherapy. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 30, 2018 Category: Geriatrics Authors: Jordan F. Karp, Xiaotian Gao, Abdus S. Wahed, Jennifer Q. Morse, Bruce L. Rollman, Debra K. Weiner, Charles F. Reynolds Tags: Regular Research Articles Source Type: research

Curcumin for Neuroprotection: Taking a Second Look at Results
In an 18-month randomized, placebo-controlled trial, Small et  al (2018) explored the effects of 180 mg of curcumin (Theracurmin®) on verbal memory, visual memory, attention, and mood in elderly subjects without dementia (1). They also examined FDDNP brain PET scan binding in predefined regions of interest (ROIs). They found that curcumin was superior to pla cebo on (only) one measure of verbal memory and on the attentional task, and that curcumin was associated with lower FDDNP binding than placebo in only the hypothalamus and not in any of 7 other brain areas studied. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 30, 2018 Category: Geriatrics Authors: Migita Michael Dcruz, Spoorthy Sai Mamidipalli, Abha Thakurdesai, Chittaranjan Andrade Source Type: research

Aging Affects Us All: Aging Physicians and Screening for Impaired Professional Proficiency
In 1959 the U.S. Federal Aviation Administration set an age limit for pilots engaged in certain operations. Since then, forced retirement of pilots has been under attack because it has been perceived as discriminatory and ageist. Physicians are not pilots, but many of the arguments relevant to balancing the security interests of airline travel and the “fair treatment of experienced pilots” are also relevant to medicine.1 In this issue Soonsawat et al.2 have reviewed what is currently known about this delicate issue and the way in which healthcare systems have gone about dealing with it. (Source: The Americ...
Source: The American Journal of Geriatric Psychiatry - March 29, 2018 Category: Geriatrics Authors: Aartjan T.F. Beekman Tags: Invited Perspective Source Type: research

Aging Affects Us All. Commentary Regarding: Cognitively Impaired Physicians: How Do We Detect Them? How Do We Assist Them? (Soonsawat et  al Am J Ger Psychiatry 2018)
Aging affects us all: aging physicians and screening for impaired professional proficiency (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 29, 2018 Category: Geriatrics Authors: Aartjan T.F. Beekman Tags: Invited Perspective Source Type: research

Response to Letter About Memory and Brain Effects of Curcumin
Considerable disagreement exists on the necessity and extent of adjustment for multiple comparisons.1 Although many articles have discussed when and how to control for inflation of Type I errors (i.e., finding a difference between groups when none exists), there is no consensus in the literature regarding this issue.2 –4 It has been pointed out, however, that adjustment is not required when the research is addressing novel or exploratory hypotheses—that is, when one also needs to consider the risk of making a Type II error (i.e., finding no difference when one exists). (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 29, 2018 Category: Geriatrics Authors: Prabha Siddarth, Jorge R. Barrio, Gary W. Small Source Type: research

Aging Affects Us All. Commentary Regarding: Cognitively Impaired Physicians: How Do We Detect Them? How Do We Assist Them? (Soonsawat et  al Am J Ger Psychiatry 2018)
Aging affects us all: aging physicians and screening for impaired professional proficiency (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 29, 2018 Category: Geriatrics Authors: Aartjan T.F. Beekman Tags: Invited Perspective Source Type: research

Response to Letter About Memory and Brain Effects of Curcumin
Considerable disagreement exists on the necessity and extent of adjustment for multiple comparisons (1). Although many articles have discussed when and how to control for inflation of Type 1 errors (i.e., finding a difference between groups when none exists), there is no consensus in the literature regarding this issue (2-4). However, it has been pointed out that adjustment is not required when the research is addressing novel or exploratory hypotheses, when one also needs to consider the risk of making a Type 2 error (i.e., finding no difference when one exists) (2, 5). (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 29, 2018 Category: Geriatrics Authors: Prabha Siddarth, Jorge R. Barrio, Gary W. Small Source Type: research

When Post-Traumatic Stress Disorder and Charles Bonnet Syndrome Become Lewy Body Dementia
We report the case of a 71-year-old Vietnam veteran with chronic post-traumatic stress disorder (PTSD) and recurrent major depression who had been treated with prolonged exposure therapy and 150  mg/day of sertraline with improvement. His cognition appeared intact, and he was generally functioning well. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Eileen Ahearn, Art Walaszek Source Type: research

Childhood Adversities and Thriving Skills: Sample Case of Older Swiss Former Indentured Child Laborers
Advancing age is still predominantly associated with declining functional abilities and health, especially in individuals who experienced extended life strains.1 However, research on “successful aging” is dedicated to understanding the potential pathways to good health in older adulthood. The most widely applied definition is the one proposed by Rowe and Kahn, which defines successful aging as a multidimensional construct encompassing “…low probability of disease and dis ease-related disability (including risk-factors for disease), high cognitive and physical functional capacity, and active engagem...
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Jan H öltge, Shauna L. McGee, Andreas Maercker, Myriam V. Thoma Tags: Regular Research Articles Source Type: research

Childhood Adversities and Thriving Skills: the Sample Case of Older Swiss Former Indentured Child Laborers
• The current study investigated which and how positively-evaluated resources for successful aging could develop in response to childhood adversity.• Interviews were conducted with a sample of successfully-aged former indentured child laborers in Switzerland.• The following resources for succe ssful aging were reported as a result of the experienced adversities: ‘lightheartedness’, ‘social purpose’, and a lifelong motivation for ‘self-enhancement’.• Therefore, under certain circumstances, early and prolonged adversity can also initiate the development of resources for...
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Jan H öltge, Shauna L. Mc Gee, Andreas Maercker, Myriam V. Thoma Tags: Regular Research Articles Source Type: research

When PTSD and Charles Bonnet Syndrome Become Lewy Body Dementia
We report the case of a 71 year old Vietnam veteran with chronic PTSD and recurrent major depression who had been treated with Prolonged Exposure therapy and 150 mg/day of sertraline with improvement. His cognition appeared intact and he was generally functioning well. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Eileen Ahearn, Art Walaszek Source Type: research

Making Sense of Behavioral and Psychological Symptoms of Dementia
Behavioral and psychological symptoms of dementia (BPSD) are an enormous public health issue. The vast majority of persons with dementia will experience significant BPSD during the course of their illness. These diverse set of symptoms contribute not only to disability in the person living with dementia but also to the level of stress and depression in family caregivers. Difficult to treat BPSD remain one of the most challenging aspects of the clinical care of persons living with dementia. While evidence-based psychosocial interventions are available to reduce caregiver stress and strengthen their skills in managing day-to...
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Ladson Hinton Tags: Invited Perspective Source Type: research

Childhood Adversities and Thriving Skills: the Sample Case of Older Swiss Former Indentured Child Laborers
• The current study investigated which and how positively-evaluated resources for successful aging could develop in response to childhood adversity.• Interviews were conducted with a sample of successfully-aged former indentured child laborers in Switzerland.• The following resources for succe ssful aging were reported as a result of the experienced adversities: ‘lightheartedness’, ‘social purpose’, and a lifelong motivation for ‘self-enhancement’.• Therefore, under certain circumstances, early and prolonged adversity can also initiate the development of resources for...
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Jan H öltge, Shauna L. Mc Gee, Andreas Maercker, Myriam V. Thoma Tags: Regular Research Articles Source Type: research

When PTSD and Charles Bonnet Syndrome Become Lewy Body Dementia
We report the case of a 71 year old Vietnam veteran with chronic PTSD and recurrent major depression who had been treated with Prolonged Exposure therapy and 150 mg/day of sertraline with improvement. His cognition appeared intact and he was generally functioning well. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Eileen Ahearn, Art Walaszek Source Type: research

Making Sense of Behavioral and Psychological Symptoms of Dementia
Behavioral and psychological symptoms of dementia (BPSD) are an enormous public health issue. The vast majority of persons with dementia will experience significant BPSD during the course of their illness. These diverse set of symptoms contribute not only to disability in the person living with dementia but also to the level of stress and depression in family caregivers. Difficult to treat BPSD remain one of the most challenging aspects of the clinical care of persons living with dementia. While evidence-based psychosocial interventions are available to reduce caregiver stress and strengthen their skills in managing day-to...
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Geriatrics Authors: Ladson Hinton Tags: Invited Perspective Source Type: research

Are Post-Acute Patients with Behavioral Health Disorders Admitted to Lower-Quality Nursing Homes?
CONCLUSIONS: Our findings demonstrate persistence of disparities in access to high quality facilities over time and for patients with a broad range of behavioral health conditions. Further research is needed to understand the impact of these disparities on outcomes of patients with behavioral disorders. PMID: 29576229 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 28, 2018 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Subjective but Not Objective Sleep is Associated with Subsyndromal Anxiety and Depression in Community-Dwelling Older Adults
Clarifying the role of sleep in psychiatric symptoms is crucial to understanding the etiology of late-life affective disorders. Examinations of the relationship of sleep disturbance to subclinical levels of depression and anxiety may provide important clues about the pathophysiology underlying the dimensions of mood and anxiety. To date, only a few studies have conducted comprehensive assessment of objective sleep in older adults with subclinical affective symptoms rather than major clinical diagnoses of depression and anxiety, with most studies using subjective self-reports of sleep disturbance and daytime sleepiness. (So...
Source: The American Journal of Geriatric Psychiatry - March 27, 2018 Category: Geriatrics Authors: Christine E. Gould, Rosy Karna, Josh Jordan, Makoto Kawai, Rayna Hirst, Nathan Hantke, Sophia Pirog, Isabelle Cotto, Sophia Miryam Schussler-Fiorenza Rose, Sherry A. Beaudreau, Ruth O'Hara Tags: Brief Report Source Type: research

Impaired Identification of Specific Odors and Cognition in Older Adults
Impaired odor identification is a well-replicated biomarker of Alzheimer disease (AD).1,2 Of 30 published studies, all showed odor identification deficits in AD compared with healthy control subjects.3 These deficits are known to predict the transition to a clinical diagnosis of AD and also to predict cognitive decline in cognitively intact older adults.1 In autopsy studies neurofibrillary tangles, and to a lesser extent amyloid plaques, are seen in the olfactory bulb in the early stages of the disease process. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 27, 2018 Category: Geriatrics Authors: D.P. Devanand Tags: Invited Perspective Source Type: research