The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Mar 2010
Comparative StudyOutcomes of subsyndromal depression in older primary care patients.
Most older persons in primary care suffering clinically significant depressive symptoms do not meet criteria for major or minor depression. The authors tested the hypothesis that patients with subsyndromal depression (SSD) would have poorer psychiatric, medical, and functional outcomes at follow-up than nondepressed patients but not as poor as those with minor or major depression. The authors also explored the relative outcomes of three definitions of SSD to determine their relative prognostic value. ⋯ Clinicians should be vigilant in caring for patients with SSD, monitoring for persistent, or worsening depressive symptoms including suicidality, anxiety, cognitive impairment, and functional decline. Researchers may use particular SSD definitions to identify individuals at higher risk of poor outcomes, to better understand the relationships of SSD to functional disability, and to test innovative preventive and therapeutic interventions.
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Am J Geriatr Psychiatry · Feb 2010
ReviewAging, brain disease, and reserve: implications for delirium.
Cognitive and brain reserve are well studied in the context of age-associated cognitive impairment and dementia. However, there is a paucity of research that examines the role of cognitive or brain reserve in delirium. Indicators (or proxy measures) of cognitive or brain reserve (such as brain size, education, and activities) pose challenges in the context of the long prodromal phase of Alzheimer disease but are diminished in the context of delirium, which is of acute onset. ⋯ The authors highlight future research directions to move the field ahead. Reserve may be a potentially modifiable characteristic. Studying the role of reserve in delirium can advance prevention strategies for delirium and may advance knowledge of reserve and its role in aging and neuropsychiatric disease generally.
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Am J Geriatr Psychiatry · Dec 2009
Cost-related medication nonadherence among beneficiaries with depression following Medicare Part D.
Cost-related medication nonadherence (CRN) was problematic for Medicare beneficiaries with depressive symptoms before Medicare Part D. ⋯ Despite a Medicare Part D goal to improve medication adherence among mentally ill beneficiaries, the disparity in economic access to medications between beneficiaries with and without depressive symptoms did not improve after the start of Part D.
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Am J Geriatr Psychiatry · Nov 2009
Apart from nihilism and stigma: what influences general practitioners' accuracy in identifying incident dementia?
To assess the accuracy of the General Practitioner's (GP) judgment in the recognition of incident dementia cases and to explore factors associated with recognition. ⋯ GPs miss nearly half of incident dementia cases. They should be alert not to miss dementia in patients living alone. Without seeking additional information, a positive GP judgment seems not sufficient for case finding. GPs should be aware of their tendency to overestimate dementia in depressed and frail patients.
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Am J Geriatr Psychiatry · Oct 2009
Meta AnalysisThe association between delirium and the apolipoprotein E epsilon 4 allele: new study results and a meta-analysis.
To determine a possible association between Apolipoprotein E (APOE)sigma4-allele and delirium in a large cohort and combining these current data with former studies in a meta-analysis. ⋯ This study and meta-analysis suggest an association between delirium and the APOE sigma4 allele.