The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Aug 2006
Multicenter StudyPredictors of complicated grief among dementia caregivers: a prospective study of bereavement.
Most family caregivers adapt well to the death of their care recipient relative; however, a sizable minority continues to experience postdeath psychiatric morbidity. The purpose of this study was to better understand why some caregivers manifest clinical levels of complicated grief postdeath. This is the first study to prospectively assess predictors of complicated grief among family caregivers of patients with dementia who experience the death of their care recipient. ⋯ This study identifies predictors of complicated grief for which interventions could be developed to not only ease caregiver distress, but also serve as preventive interventions for bereavement. Reducing the burden of active caregiving, treating depression before the death of the loved one and providing supportive psychosocial and skills training caregiver interventions can prevent the emergence of postdeath psychiatric morbidity.
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Am J Geriatr Psychiatry · Aug 2006
Multicenter StudyWhy doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?
The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. ⋯ These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.
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Am J Geriatr Psychiatry · Aug 2006
Randomized Controlled TrialMemantine treatment in mild to moderate Alzheimer disease: a 24-week randomized, controlled trial.
The objective of this study was to compare the efficacy and safety of the moderate-affinity, uncompetitive N-methyl-d-aspartate receptor antagonist, memantine, versus placebo in patients with mild to moderate Alzheimer disease (AD). ⋯ These results support the safety and efficacy of memantine for the treatment of mild to moderate AD.
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Am J Geriatr Psychiatry · Aug 2006
Dementia severity of the care receiver predicts procoagulant response in Alzheimer caregivers.
The procoagulant factor D-dimer has been shown to be associated with thrombus formation and degradation as seen with conditions such as myocardial infarction and unstable angina. Research has demonstrated that spousal dementia caregivers have elevated levels of D-dimer relative to their non-caregiving peers. ⋯ Dementia severity of the care recipient was associated with increasing hypercoagulability among elderly caregivers. Effect size estimates suggest that such D-dimer increases may have clinical implications, particularly among late-stage caregivers.