The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
-
Am J Geriatr Psychiatry · Mar 2017
Impact of Delirium After Hip Fracture Surgery on One-Year Mortality in Patients With or Without Dementia: A Case of Effect Modification.
We evaluated whether delirium after hip fracture repair modifies the relationship between baseline dementia and one-year mortality after surgery. ⋯ Delirium after hip fracture repair surgery in patients with preoperative dementia modifies the risk of mortality over the first postoperative year. Patients with DSD have a nearly two-fold greater odds of one-year mortality than those without dementia or delirium.
-
Am J Geriatr Psychiatry · Feb 2017
A Multimodal Structural and Functional Neuroimaging Study of Amnestic Mild Cognitive Impairment.
Examination of brain structural and functional abnormalities in amnestic mild cognitive impairment (aMCI) has the potential to enhance our understanding of the initial pathophysiological changes in dementia. We examined gray matter volumes and white matter microstructural integrity, as well as resting state functional connectivity (rsFC) in patients with aMCI (N = 48) in comparison to elderly cognitively healthy comparison subjects (N = 48). Brain volumetric comparisons were carried out using voxel-based morphometric analysis of T1-weighted images using the FMRIB Software Library. ⋯ Additionally, reduced rsFC in the anterior subdivision of the default mode network (DMN) and increased rsFC in the executive network were noted in the absence of demonstrable impairment of white matter microstructural integrity. We conclude that the demonstrable neuroimaging findings in aMCI include significant gray matter volumetric reductions in the fronto-temporo-parietal structures as well as resting state functional connectivity disturbances in DMN and executive network. These findings differentiate aMCI from healthy aging and could constitute the earliest demonstrable neuroimaging findings of incipient dementia.
-
Am J Geriatr Psychiatry · Nov 2016
Review Meta AnalysisEfficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression.
Generalized anxiety disorder (GAD) is a common disorder in older adults producing functional impairment, and psychotherapy is the preferred treatment option. Meta-analytic methods sought to determine the efficacy of outpatient cognitive behavioral therapy (CBT) with respect to the hallmark feature of GAD-uncontrolled and excessive worry. In order to optimize clinical applicability, variables associated with GAD treatment outcomes were also examined. ⋯ CBT is more helpful than having no treatment for GAD in later life. Nevertheless, whether CBT shows long-term durability, or is superior to other commonly available treatments (such as supportive psychotherapy), remains to be tested. The relationship between treatment effects for GAD and depression following CBT warrants further research.
-
Am J Geriatr Psychiatry · Nov 2016
Development and Validation of a Short Version of the Cornell Scale for Depression in Dementia for Screening Residents in Nursing Homes.
To develop and validate a short version of the Cornell Scale for Depression in Dementia (CSDD-19) for routine detection of depression in nursing homes. ⋯ The CSDD-4 is valid for routine screening of depression in nursing homes. Its adoption is feasible and practical for nursing home staff, and may facilitate more comprehensive assessment and management of depression in nursing home residents.
-
Am J Geriatr Psychiatry · Nov 2016
Agitation in Alzheimer Disease as a Qualifying Condition for Medical Marijuana in the United States.
To determine the extent to which states and localities include dementia as a qualifying condition for medical marijuana and how common this indication is. ⋯ Dementia is somewhat commonly listed as a potential qualifying condition for medical marijuana. Currently, few applicants for medical marijuana list dementia as the reason for seeking certification. However, given increasingly open attitudes toward recreational and medical marijuana use, providers should be aware that dementia is a potential indication for licensing, despite lack of evidence for its efficacy.