New evidence for a biological pathway to mental health problems in dementia caregivers
Consider the case of a 62-year-old woman, Linda, whose spouse was recently diagnosed with frontotemporal dementia. In addition to the regular challenges of adjusting to post-retirement life, Linda faces a myriad of potentially stressful caregiving-related exposures. She now oversees an increasingly complex medical regime for her husband, yet only sees his decline; she often experiences intrusive thoughts about his health; she is woken at night due to her husband's problems sleeping; her relationship is strained due to his inability to recognize her emotional states; she fears he will walk off during the day and get lost; a...
Source: The American Journal of Geriatric Psychiatry - May 9, 2019 Category: Geriatrics Authors: Stephen F. Smagula Tags: Invited Perspective Source Type: research

The Challenge of Treating Depression in Dementia
Eight years ago Banerjee and colleagues published the results of the largest ever clinical trial of antidepressant treatment for depression in dementia: the Health Technology Assessment Study of the Use of Antidepressants for Depression in Dementia (HTA-SADD).1 They recruited 326 with Alzheimer's disease (AD) and randomly assigned them to double-blind treatment with placebo or up to 150 mg of sertraline or 45 mg of mirtazapine over a period of 13 weeks, after which clinicians were free to adjust the dose of the medications according to the perceived needs of participants. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 9, 2019 Category: Geriatrics Authors: Osvaldo P. Almeida Tags: Invited Perspective Source Type: research

Social Engagement and Amyloid- β-Related Cognitive Decline in Cognitively Normal Older Adults
Social relationships are integral to healthy aging. Successful aging relies on the ability to engage with others and access sources of emotional and tangible support.1,2 Social engagement is a term that describes time spent with friends and family and in other social, religious or community-based activities.3 While there appears to be wide inter-individual variability in levels and rates of change in social engagement in older adults,2,4 low social engagement3,5-7 and decline in social engagement4,8 have been associated with worsening cognition, increased risk of dementia, and earlier mortality. (Source: The American Journ...
Source: The American Journal of Geriatric Psychiatry - May 9, 2019 Category: Geriatrics Authors: Kelsey D. Biddle, Federico d'Oleire Uquillas, Heidi I.L. Jacobs, Benjamin Zide, Dylan R. Kirn, Dorene M. Rentz, Keith A. Johnson, Reisa A. Sperling, Nancy J. Donovan Tags: Regular Research Article Source Type: research

Thoughts about Electroconvulsive Therapy and New Potential Treatments for Treatment-Resistant Depression in the Elderly
Over the last year, a 75-year-old woman with several chronic illnesses, including coronary artery disease, arthritis, and type 2 diabetes, has lost 30 pounds, developed insomnia, and stopped going to church and socializing with family and friends. She is no longer interested in her hobbies of knitting, reading, and playing Sudoku. In her primary care physician's office, she is inattentive and scores a 22 on the Mini-Mental State Examination (MMSE). Six months earlier, the doctor prescribed a selective serotonin reuptake inhibitor (SSRI). (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 9, 2019 Category: Geriatrics Authors: Eugene H. Rubin Tags: Invited Perspective Source Type: research

Editorial Board
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Source Type: research

Information for Subscribers
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Source Type: research

Table of Contents
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Source Type: research

In This Issue
(Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Source Type: research

Geriatric Mental Healthcare Training: A Mini-Fellowship Approach to Interprofessional Assessment and Management of Geriatric Mental Health Issues
According to the U.S. Census Bureau, nearly 48 million Americans were aged 65 years or older in 2015, representing 14.9% of the U.S. population. This is an increase from 40 million Americans representing 13% of the U.S. population in 2010.1 By 2060, this age group is projected to increase to 98.2 million people, or 24% of U.S. population.2 The rate of growth (2010 –2015) of the population aged 65 and older has been at 21% compared with 9.7% for the general population. Despite this demographic transition, the number of providers specializing in geriatrics has been declining. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Authors: LalithKumar K. Solai, Keerthana Kumar, Elizabeth Mulvaney, Daniel Rosen, Juleen Rodakowski, Tanya Fabian, Jennifer H. Lingler, Charles F. Reynolds, Daniel Sewell Tags: Special Issue Article Source Type: research

Geriatric Mental Healthcare Training: Development of a Learning Collaborative ( “ Mini-Fellowship”) in Interprofessional Assessment and Clinical Management
According to the U.S. Census Bureau, nearly 48 million Americans were aged 65 years or older in 2015, representing 14.9% of the U.S. population. This is an increase from 40 million Americans representing 13% of the U.S. population in 2010.1 By 2060, this age group is projected to increase to 98.2 million people, or 24% of U.S. population.2 The rate of growth (2010-2015) of the 65+ population has been at 21% as compared to 9.7% for the general population. Despite this demographic transition, the number of providers specializing in geriatrics has been declining. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 8, 2019 Category: Geriatrics Authors: LalithKumar K. Solai, Keerthana Kumar, Elizabeth Mulvaney, Daniel Rosen, Juleen Rodakowski, Tanya Fabian, Jennifer H. Lingler, Charles F. Reynolds, Daniel Sewell Source Type: research

Randomized Placebo-Controlled Trial of Nabilone for Agitation in Alzheimer's Disease
Agitation, seen in 20% –50% of those with moderate-to-severe Alzheimer's disease (AD),1,2 is particularly common in long-term care facility residents3,4 and a challenging neuropsychiatric symptom (NPS) to treat. Agitation is associated with decreased quality of life, increased caregiver burden, and higher rates of insti tutionalization and mortality.3,5 Nonpharmacologic interventions are considered first-line therapy for the management of agitation in AD. However, with severe agitation, when nonresponsive to nonpharmacologic interventions, judicious use of pharmacologic interventions is recommended. (Source: The Amer...
Source: The American Journal of Geriatric Psychiatry - May 7, 2019 Category: Geriatrics Authors: Nathan Herrmann, Myuri Ruthirakuhan, Damien Gallagher, Nicolaas Paul L.G. Verhoeff, Alex Kiss, Sandra E. Black, Krista L. Lanct ôt Tags: Regular Research Article Source Type: research

Randomized placebo controlled trial of nabilone for agitation in Alzheimer's disease
Agitation, seen in 20-50% of those with moderate-to-severe Alzheimer's disease (AD),1,2 is particularly common in long-term care facility residents3,4 and a challenging neuropsychiatric symptom (NPS) to treat. Agitation is associated with decreased quality of life, increased caregiver burden, and higher rates of institutionalization and mortality.3,5 Nonpharmacological interventions are considered first-line therapy for the management of agitation in AD. However, with severe agitation, when nonresponsive to nonpharmacological interventions, judicious use of pharmacological interventions is recommended. (Source: The America...
Source: The American Journal of Geriatric Psychiatry - May 7, 2019 Category: Geriatrics Authors: Nathan Herrmann, Myuri Ruthirakuhan, Damien Gallagher, Nicolaas Paul LG Verhoeff, Alex Kiss, Sandra E Black, Krista L Lanct ôt Tags: Regular Research Article Source Type: research

Taking physical activity interventions outside of the lab: A commentary on “Changes in moderate intensity physical activity are associated with better cognition in the Multilevel Intervention for Physical Activity in Retirement Communities (MIPARC) study”
Unprecedented increases in life expectancy and the resulting rapid growth in the proportion of older adults compared to other age groups across the globe have led to international interest the promotion of healthier aging. Declines in cognitive functioning are a normal and a widespread consequence of normal aging, and so it is not surprising that an aging society also brings with it an increased prevalence of cognitive impairment. In the absence of promising drug treatments for reducing cognitive declines once diagnosed, the field of cognitive aging has turned to non-pharmacologic treatments that could prevent or delay cog...
Source: The American Journal of Geriatric Psychiatry - May 6, 2019 Category: Geriatrics Authors: Chelsea Stillman Tags: Invited Perspective Source Type: research

Innovations and Challenges of Training in Geriatric Mental Health
This thematic issue represents the joint efforts of early-career members of the 2018-19 Editorial Board of the American Journal of Geriatric Psychiatry, under the mentorship and support of the Editor-in-Chief, Dr. Reynolds. The early-career editorial board provides a unique avenue for researchers and clinicians to become involved in the journal in a variety of ways: reviewing manuscripts, serving as triage editor, and proposing thematic issues. During our first meeting, we discussed the varied issues affecting training in geriatric mental health which felt particularly pertinent given the early stages of our careers and de...
Source: The American Journal of Geriatric Psychiatry - May 6, 2019 Category: Geriatrics Authors: Ellen E. Lee, Meera Balasubramaniam, Jin Hui Joo, Kevin Manning, Gregory M. Pontone, Julia Kirkham Source Type: research

Exercise and cognitive training to improve neurocognitive outcomes in patients with heart failure: can cardiac rehabilitation deliver?
Heart failure (HF) affects approximately 6.6 million Americans with over 660,000 newly diagnosed cases and 280,000 deaths annually. It is also the leading cause for hospitalization among Medicare patients and remains the only major cardiovascular disease whose mortality rate has remained essentially unchanged over the past decade.1 Frequently contributing to the significant clinical burden of the disease is mild to moderate cognitive impairment (MCI), which is estimated to be present in over one-quarter of community-dwelling HF patients. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 6, 2019 Category: Geriatrics Authors: Bruce L. Rollman Tags: Invited Perspective Source Type: research

Imagining a Role for Psychedelics in Dementia Care.
Authors: George DR, Hanson R PMID: 31047789 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 5, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Improving Patient Reported Outcomes and Preventing Depression and Anxiety in Older Adults With Knee Osteoarthritis: Results of a Sequenced Multiple Assignment Randomized Trial (SMART) Study.
CONCLUSION: As response rates were similar for PT-PT and CBT-CBT, it may be dose and not type of these interventions that are necessary for clinical benefit. For non-responders, this finding may guide providers to stay the clinical course for up to 12 weeks before switching. These results support future trials of SMART designs in late-life depression prevention. PMID: 31047790 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 5, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Establishing a Link Between Mitochondrial Dysfunction and Late-Life Depression
Psychiatric disorders, in general, and depression, in particular, appear to be the consequence of multiple interacting biological factors. These factors may be apparent not only in brain, but also in peripheral tissues. Considering that brain function is difficult to study in life, there is a long history of attempts, as in the work of Brown et al.1 in the current issue of the American Journal of Geriatric Oncology, to find peripheral measures of function that might be correlated with brain abnormalities that underlie depression or other psychiatric conditions. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 4, 2019 Category: Geriatrics Authors: Brent P. Forester, Emily Mellen, Bruce M. Cohen Tags: Invited Perspective Source Type: research

Establishing a Link between Mitochondrial Dysfunction and Late Life Depression
Psychiatric disorders, in general, and depression, in particular, appear to be the consequence of multiple interacting biological factors. These factors may be apparent not only in brain, but also in peripheral tissues. Since brain function is difficult to study in life, there is a long history of attempts, as in the work of Brown et al in the current issue of the Journal,1 to find peripheral measures of function that might be correlated with brain abnormalities that underlie depression or other psychiatric conditions. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 4, 2019 Category: Geriatrics Authors: Brent P. Forester, Emily Mellen, Bruce M. Cohen Tags: Invited Perspective Source Type: research

Financial Risk Aversion and Incipient Dementia.
Authors: Chapman BP, Phillips C PMID: 31036373 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 2, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Echocardiogram.
Authors: Shepherd JB PMID: 31036374 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 2, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Social support and depression related to older adults ’ hypertension control in rural china
Hypertension (HTN) is one of the most common chronic diseases worldwide, contributing to two-thirds of all strokes and half of all coronary disease, and thus representing as a major risk factor for cardiovascular morbidity and mortality.1 –3 One-quarter of the world's adult population exhibits HTN, and HTN prevalence is estimated to reach 29% by 2025.4 Almost 75% of people with HTN live in developing countries, where people have limited health resources, low awareness about HTN prevention, and consequently poor blood pressure (BP) control. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - May 2, 2019 Category: Geriatrics Authors: Tingfei Zhu, Jiang Xue, Yuxing Jiang, Jiayu Wang, Wenqi Weng, Shulin Chen Tags: Regular Research Article Source Type: research

The Future of Caregiver Efficacy Research: Commentary on "Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers".
The Future of Caregiver Efficacy Research: Commentary on "Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers". Am J Geriatr Psychiatry. 2019 Apr 10;: Authors: Schulz R PMID: 31031074 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 30, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Aequanimitas: A Goal to Strive For
I am privileged to have observed and been a part of the emergence of geriatric psychiatry. I hope that by reflecting on some of my experiences, it may guide those who are early in their careers or are in a position to begin mentoring others. Several key factors had an influence in shaping my career: consistent and generous mentoring, the ability to pursue answers to clinical problems I noticed in practice, and the good fortune to work in a highly collaborative field. In some ways, I have come full circle, as I am now Vice President of Research at the Centre for Addiction and Mental Health (CAMH), the hospital where I train...
Source: The American Journal of Geriatric Psychiatry - April 29, 2019 Category: Geriatrics Authors: Bruce G. Pollock Tags: Scientific Autobiography Source Type: research

Depression and incidence of frailty in older people from six Latin American countries
Frailty is an age-related biological syndrome resulting in decreased physiological reserve and increased susceptibility to stressor during the ageing process1,2 and ultimately in increased disability and mortality.3,4 A meta-analysis estimated the prevalence of frailty to be 11% in community-dwelling older people but range was wide across studies (4-59%).5 A multicentre cohort study in five Latin American cities reported relatively high estimates in both men (21-35%) and women (30-48%).6 (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 29, 2019 Category: Geriatrics Authors: A. Matthew Prina, Brendon Stubbs, Nicola Veronese, Mariella Guerra, Carolina Kralj, Juan J Llibre Rodriguez, Martin Prince, Yu-Tzu Wu Tags: Regular Research Article Source Type: research

Neurodegenerative Disease Caregivers ’ 5-HTTLPR Genotype Moderates the Effect of Patients’ Empathic Accuracy Deficits on Caregivers’ Well-Being
Neurodegenerative diseases are incurable, debilitating conditions that result in deficits in cognitive, emotional, and motor functioning. With increasing incidence of these diseases, the number of close loved ones serving as caregivers is rising dramatically.1 Compared to non-caregiving adults and nondementia caregivers, caregivers of patients with dementia have considerably lower well-being.2,3 Not all caregivers experience similar declines in well-being. Thus, it is important to identify the factors accounting for caregivers ’ vulnerability and resilience. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 29, 2019 Category: Geriatrics Authors: Jenna L. Wells, Casey L. Brown, Alice Y. Hua, Peter D. Soyster, Kuan-Hua Chen, Deepika R. Dokuru, Giovanni Coppola, Claudia M. Haase, Robert W. Levenson Tags: Regular Research Article Source Type: research

Changes in moderate intensity physical activity are associated with better cognition in the Multilevel Intervention for Physical Activity in Retirement Communities (MIPARC) study
Given an aging population expected to more than double in the United States by the year 2050,1 developing interventions to promote cognitive health and prevent dementia is an important public health goal. Epidemiologic studies have indicated that midlife physical activity is associated with lower risk of cognitive decline and dementia later in life.2,3 Similarly, a meta-analysis of randomized controlled trials of exercise found that aerobic exercise was associated with modest improvements in attention and processing speed, executive function, and memory performance,4 although this was not always the case. (Source: The Amer...
Source: The American Journal of Geriatric Psychiatry - April 29, 2019 Category: Geriatrics Authors: Zvinka Z. Zlatar, Suneeta Godbole, Michelle Takemoto, Katie Crist, Cynthia M. Castro Sweet, Jacqueline Kerr, Dori E. Rosenberg Tags: Regular Research Article Source Type: research

Aequanimitas1: A goal to strive for
I am privileged to have observed and been part of the emergence of geriatric psychiatry. I hope that by reflecting on some of my experiences, it may guide those who are early in their careers or are in a position to begin mentoring others. Several key factors had an influence in shaping my career: consistent and generous mentoring, the ability to pursue answers to clinical problems I noticed in practice, and the good fortune to work in a highly collaborative field. In some ways I have come full circle, as I am now Vice President of Research at the Centre for Addiction and Mental Health (CAMH), the hospital where I trained ...
Source: The American Journal of Geriatric Psychiatry - April 29, 2019 Category: Geriatrics Authors: Bruce G. Pollock Tags: Scientific Autobiography Source Type: research

Psychological and Psychosocial Interventions for Depression and Anxiety in Patients With Age-Related Macular Degeneration: A Systematic Review.
CONCLUSION: Clinical practice with patients with AMD can rely on some tailored cognitive-behavioral therapeutic protocols to improve patients' mental health, but further clinical trials will generate the necessary evidence-based knowledge to improve those therapeutic techniques and offer additional tailored interventions for patients with AMD. PMID: 31005495 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Delirium: Medical Students' Knowledge and Effectiveness of Different Teaching Methods.
CONCLUSION: Teaching about delirium to medical students with a video resulted in better knowledge transfer and recall. Most medical students, particularly men, overestimated their knowledge about delirium. PMID: 31005497 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

The Neuropsychiatry of Parkinson Disease: A Perfect Storm.
Authors: Weintraub D, Mamikonyan E Abstract Affective disorders, cognitive decline, and psychosis have long been recognized as common in Parkinson disease (PD), and other psychiatric disorders include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their frequent occurrence, there is incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically multimorbid, and there is great intra- and i...
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM): Study Design and Treatment Characteristics of the First 396 Participants Randomized
A challenge in the care of older adults with major depressive disorder is failure to respond to first-line pharmacotherapy: one-half to two-thirds of these older adults fail to remit with a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI).1 Late-life treatment-resistant depression (LLTRD) worsens medical outcomes,2 increases disability,3 hastens cognitive decline, and increases risk of dementia.4 The societal toll of unremitted depression is high: it is strongly associated with suicide,2 it carries the highest loss of quality of life, and has the highest mortality among ...
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Pilar Cristancho, Emily Lenard, Eric J. Lenze, J. Philip Miller, Patrick J. Brown, Steven P. Roose, Carolina Montes-Garcia, Daniel M. Blumberger, Benoit H. Mulsant, Helen Lavretsky, Bruce L. Rollman, Charles F. Reynolds, Jordan F. Karp Tags: Regular Research Article Source Type: research

MMSE Changes During and After ECT in Late-Life Depression: A  Prospective Study
Late-life depression (LLD) is associated with an increased risk for developing physical morbidity and disability.1,2 The burden of depression on older patients, their caregivers, health services, and society is high.3,4 Electroconvulsive therapy (ECT) is an effective and well-established treatment for LLD. An older age predicts a better outcome with this treatment modality, and remission rates go up to 90% in patients over 65 years of age.5,6 However, there is ongoing concern about the possible impact of ECT on cognition, especially in the presence of pre-existing cognitive impairment and increasing age, implying that olde...
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Jasmien Obbels, Kristof Vansteelandt, Esm ée Verwijk, Annemieke Dols, Filip Bouckaert, Mardien L. Oudega, Mathieu Vandenbulcke, Max Stek, Pascal Sienaert Source Type: research

Sensor-Based Assessment of Neuropsychiatric Symptoms in Dementia: Time to Go Beyond Actigraphy?
Knuff et al.1 present very interesting results on wrist-actigraphy measurement of agitated symptoms in patients suffering from dementia. Quantifying neuropsychiatric symptoms (NPS) is a highly relevant and desirable goal, especially in dementia care. The use of technological approaches in geriatric psychiatry promises advances in the objective assessment, that could allow to derive and evaluate personalized pharmacological and non-pharmacological interventions.2 Picking up the results by Knuff et al.,1 we want to discuss the measurement approaches and clinical relevance of their analyses. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Tim Fleiner, Sabato Mellone, Peter Haussermann, Wiebren Zijlstra Source Type: research

Optimizing Outcomes of Treatment Resistant Depression in Older Adults (OPTIMUM): Study Design and Treatment Characteristics of the First 396 Participants Randomized
A challenge in the care of older adults with major depressive disorder is failure to respond to first-line pharmacotherapy: Half to two-thirds of these older adults fail to remit with a selective serotonin reuptake inhibitor (SSRI) or a serotonin –norepinephrine reuptake inhibitor (SNRI).1 Late-life treatment-resistant depression (LLTRD) worsens medical outcomes,2 increases disability,3 hastens cognitive decline, and increases risk of dementia.4 The societal toll of unremitted depression is high: it is strongly associated with suicide,2 it carries the highest loss of quality of life and the highest mortality among ch...
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Pilar Cristancho, Emily Lenard, Eric J Lenze, J. Philip Miller, Patrick J. Brown, Steven P. Roose, Carolina Montes-Garcia, Daniel M. Blumberger, Benoit H. Mulsant, Helen Lavretsky, Bruce L. Rollman, Charles F. Reynolds III, Jordan F. Karp Tags: Regular Research Article Source Type: research

MMSE changes during and after ECT in late-life depression: a prospective study
Late-life depression (LLD) is associated with an increased risk for developing physical morbidity and disability.1,2 The burden of depression on older patients, their caregivers, health services and society is high.3,4 Electroconvulsive therapy (ECT) is an effective and well-established treatment for LLD. An older age predicts a better outcome and remission rates go up to 90 % in patients over 65 years of age.5,6 However, there is ongoing concern about the possible impact on cognition, especially in the presence of pre-existing cognitive impairment and increasing age, implying that older patients might be more vulnerable t...
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Jasmien Obbels, Kristof Vansteelandt, Esm ée Verwijk, Annemieke Dols, Filip Bouckaert, Mardien L Oudega, Mathieu Vandenbulcke, Max Stek, Pascal Sienaert Tags: Regular Research Article Source Type: research

Sensor-based assessment of neuropsychiatric symptoms in dementia – time to go beyond actigraphy?
The group of Knuff et al.1 presents very interesting results on wrist-actigraphy measurement of agitated symptoms in patients suffering from dementia. Quantifying neuropsychiatric symptoms (NPS) is a highly relevant and desirable goal, especially in dementia care. The use of technological approaches in geriatric psychiatry promises advances in the objective assessment, that could allow to derive and evaluate personalized pharmacological and non-pharmacological interventions2. Picking up the results by Knuff et al. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 23, 2019 Category: Geriatrics Authors: Tim Fleiner, Sabato Mellone, Peter Haussermann, Wiebren Zijlstra Tags: Letter to the editor Source Type: research

Lamotrigine Therapy and Biomarkers of Cerebral Energy Metabolism in Older Age Bipolar Depression.
CONCLUSION: Group differences in NAA suggest evidence for a deficit in cerebral energy metabolism in OABD. PMID: 31000323 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 20, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Commentary on "The Neuropsychiatry of Parkinson's Disease: A Perfect Storm".
Commentary on "The Neuropsychiatry of Parkinson's Disease: A Perfect Storm". Am J Geriatr Psychiatry. 2019 Mar 20;: Authors: Friedman JH PMID: 30987802 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 18, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Mechanisms Linking White Matter Lesions, Tract Integrity, and Depression in Alzheimer Disease
Late-life depression is one of the most common mental illnesses in the aging population and its prevalence is exacerbated in those with dementia.1 Onset of depressive symptoms in late life is precipitated by risk factors including cerebrovascular disease, old age, vulnerable genotypes, low socioeconomic status, and stressful life events.2 –4 Of these risks, the most studied has been cerebrovascular disease, which has been proposed by the vascular depression hypothesis to predispose, precipitate, and perpetuate late-life depression by altering cerebral white matter. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 18, 2019 Category: Geriatrics Authors: Chathuri Yatawara, Daryl Lee, Kok Pin Ng, Russell Chander, Debby Ng, Fang Ji, Hee Youn Shim, Saima Hilal, Narayanaswamy Venketasubramanian, Christopher Chen, Juan Zhou, Nagaendran Kandiah Tags: Regular Research Article Source Type: research

Understanding Aging in Bipolar Disorder by Integrating Archival Clinical Research Datasets
While 25% of BD patients are over 60 years old,1 research on older age bipolar disorder (OABD) is limited. The International Society for Bipolar Disorders (ISBD) convened a global panel that summarized the existing evidence base on OABD,2 and noted many important gaps such as a clear understanding of mood symptom evolution and medical comorbidity characterization. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 18, 2019 Category: Geriatrics Authors: Lisa T. Eyler, Michelle E. Aebi, Rebecca E. Daly, Kristen Hansen, Curtis Tatsuoka, Robert C. Young, Martha Sajatovic Tags: Regular Research Article Source Type: research

Mechanisms Linking White Matter Lesions, Tract Integrity and Depression in Alzheimer's Disease
Late-life depression is one of the most common mental illnesses in the aging population and its prevalence is exacerbated in those with dementia.1 Onset of depressive symptoms in late-life is precipitated by risk factors including cerebrovascular disease, old age, vulnerable genotypes, low socioeconomic status and stressful life events.2-4 Of these risks, the most studied has been cerebrovascular disease, which has been proposed by the vascular depression hypothesis to predispose, precipitate and perpetuate late-life depression by altering cerebral white matter. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 18, 2019 Category: Geriatrics Authors: Chathuri Yatawara, Daryl Lee, Kok Pin Ng, Russell Chander, Debby Ng, Fang Ji, Hee Youn Shim, Saima Hilal, Narayanaswamy Venketasubramanian, Christopher Chen, Juan Zhou, Nagaendran Kandiah Tags: Regular Research Article Source Type: research

Deterioration of Brain Neural Tracts in Elderly Women with Sarcopenia.
CONCLUSION: The authors found that the neural tracts in elderly women with sarcopenia were extensively deteriorated, and their hand-grip power and memory function were associated with related neural tracts. The DTT seems to be a useful tool for evaluating structural changes in the brains of people with sarcopenia. PMID: 30981430 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 16, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Risk Aversion and Alzheimer Disease in Old Age.
Authors: Wilson RS, Yu L, Schneider JA, Bennett DA, Boyle PA Abstract OBJECTIVE: To test the hypothesis that late-life risk aversion is partly a prodromal sign of dementia. METHODS: The authors' design was a longitudinal clinical-pathologic cohort study. The setting included participants' residences in the Chicago area, and a total of 874 older persons without dementia were enrolled. At baseline, risk aversion was assessed with questions involving choices between certain smaller rewards and uncertain larger rewards. At annual intervals thereafter, participants underwent evaluations that included cognitive testi...
Source: The American Journal of Geriatric Psychiatry - April 16, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

The Limitations of Using Cognitive Cutoff Scores for Enrollment in Alzheimer Trials.
Authors: Patrick RE, Hobbs K, Mathias L, Harper DG, Forester BP PMID: 30982703 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 16, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Effectiveness of Shared Decision-Making for Elderly Depressed Minority Primary Care Patients.
CONCLUSION: Among untreated elderly depressed minority patients from an inner-city municipal hospital, a brief SDM intervention was associated with greater initiation and adherence to psychotherapy. However, low treatment adherence rates across both groups and the intervention's lack of impact on clinical outcomes highlight the need to provide focused and accessible mental health services to patients choosing active treatments. PMID: 30967321 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 12, 2019 Category: Psychiatry Tags: Am J Geriatr Psychiatry Source Type: research

Sertraline and mirtazapine versus placebo in subgroups of depression in dementia: findings from the hta-sadd randomised controlled trial
Depression is common in dementia with prevalence of depressive symptoms in people with dementia ranging between 10 and 62%.1 Depression in dementia is associated with reduced quality of life,2 exacerbation of cognitive and functional impairment,3 and increased stress and depression in caregivers.4 Effective treatment of depression in dementia is therefore a clinical priority. Older clinical guidelines advocate the use of antidepressants for depression in dementia such as the APA workgroup on Alzheimer's Disease and other dementia's (2007)5 and as many as 22-47% of community-dwelling persons with dementia are prescribed ant...
Source: The American Journal of Geriatric Psychiatry - April 12, 2019 Category: Geriatrics Authors: Marij Zuidersma, Kia-Chong Chua, Jennifer Hellier, Richard Oude Voshaar, Sube Banerjee, HTA-SADD investigator group Tags: Regular Research Article Source Type: research

The Future of Caregiver Efficacy Research: Commentary on “Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers”
Successful caregiver interventions accomplish two goals. One, they address the pragmatics of care provision by educating caregivers about the illness of the care recipient, associated symptoms and their progression, and available support services. Didactic training is often paired with skills training to address the needs of the care recipient, including how to assist with functional disabilities, mange problematic behaviors, and access professional support services. Two, they facilitate caregivers ’ ability to cope with the emotional challenges of caregiving inherent in watching a loved one suffer and decline, with ...
Source: The American Journal of Geriatric Psychiatry - April 10, 2019 Category: Geriatrics Authors: Richard Schulz Tags: Invited Perspective Source Type: research

TEMPORARY REMOVAL: Study of Independent Living Residents of a Continuing Care Senior Housing Community: Sociodemographic and Clinical Associations of Cognitive, Physical, and Mental Health
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - April 10, 2019 Category: Geriatrics Authors: Dilip V. Jeste, Danielle Glorioso, Ellen E. Lee, Rebecca Daly, Sarah Graham, Jinyuan Liu, Alejandra Morlett Paredes, Camille Nebeker, Xin Tu, Elizabeth W. Twamley, Ryan Van Patten, Yasunori Yamada, Colin Depp, Ho-Cheol Kim Source Type: research

The Future of Caregiver Efficacy Research: Commentary on Long-Term Outcomes of the Benefit –Finding Group Intervention for Alzheimer Caregivers
Successful caregiver interventions accomplish two goals. One, they address the pragmatics of care provision by educating caregivers about the illness of the care recipient, associated symptoms and their progression, and available support services. Didactic training is often paired with skills training to address the needs of care recipient, including how to assist with functional disabilities, mange problematic behaviors, and access professional support services. Two, they facilitate caregivers ’ ability to cope with the emotional challenges of caregiving inherent in watching a loved one suffer and decline, with litt...
Source: The American Journal of Geriatric Psychiatry - April 10, 2019 Category: Geriatrics Authors: Richard Schulz Source Type: research