International psychogeriatrics
-
Comment
Success at 100 is easier said than done--comments on Araújo et al: successful aging at 100 years.
Few would argue that achieving the age of 100 years is extraordinary, but what about the quality of life at this extreme age? Is it worth it to live to 100 and beyond? The study by Araújo, Ribero, Teixeira, and Paúl (2015) in three ways provided an answer to this question substantiating and complementing recent findings about successful aging in extreme old age (Poon and Perls, 2007; Martin et al., 2015). First, the study joined other investigators in asking whether the criteria for successful aging posed by Rowe and Kahn (1997) are applicable for older adults at the end stage of a very long life. ⋯ Pruchno et al., 2010; Cho et al., 2012). Finally, the study provided additional data on psychological, social, and economic resources that enhance the needed ingredients of successful aging at the century mark.
-
People with dementia may benefit from palliative care which specifically addresses the needs of patients and families affected by this life-limiting disease. On behalf of the European Association for Palliative Care (EAPC), we recently performed a Delphi study to define domains for palliative care in dementia and to provide recommendations for optimal care. An international panel of experts in palliative care, dementia care or both, achieved consensus on almost all domains and recommendations, but the domain concerning the applicability of palliative care to dementia required revision. ⋯ Benefits of palliative care in dementia are acknowledged by experts worldwide, but there is some controversy around its early introduction. Further studies should weigh concerns expressed around care receiving a "palliative" label versus the benefits of applying palliative care early.
-
Randomized Controlled Trial
Change in agitation in Alzheimer's disease in the placebo arm of a nine-week controlled trial.
Placebo responses raise significant challenges for the design of clinical trials. We report changes in agitation outcomes in the placebo arm of a recent trial of citalopram for agitation in Alzheimer's disease (CitAD). ⋯ We observed significant placebo response which may be due to regression to the mean, response to a psychosocial intervention, natural course of symptoms, or nonspecific benefits of participation in a trial.
-
Cognitive and functional impairment increase risk for post-coronary artery bypass graft (CABG) surgery delirium (PCD), but how much impairment is necessary to increase PCD risk remains unclear. ⋯ MCI predicts post-operative delirium and delirium severity, but MCI definition alters these relationships. Cognitive and functional impairment independently predict post-operative delirium and delirium severity.
-
Multicenter Study
Sleep and agitation in nursing home residents with and without dementia.
The prevalence of dementia in Australian nursing homes is high. A large proportion of residents express themselves through agitated behaviors, with substantial interpersonal and day-to-day variance. One factor that may increase agitation is poor sleep. The current study aimed to determine if sleep influences symptoms of agitation in nursing home residents, and whether this effect differed by dementia status. As benzodiazepines are used widely as hypnotic medication, their impact was also considered. ⋯ These results suggest that sleep could play an important role in explaining agitation, but more research is needed to explore the relationship between sleep and benzodiazepines in nursing home residents.