The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Oct 2009
Self-reported pain in persons with dementia predicts subsequent decreased psychosocial functioning.
Pain self-report is the assessment gold standard in cognitively intact populations but has been discouraged in persons with dementia because of significant evidence that pain intensity is often underreported by persons with dementia. However, most community-dwelling persons with dementia are cared for in primary care settings where a more in depth pain assessment is unlikely. Therefore, it is vital to know the clinical predictive value of self-report pain assessment in this population. Psychosocial functioning is a meaningful focus for clinical prediction, because psychosocial constructs are integrally related to quality of life, physical functioning, and one's ability to function in the presence of pain. The purpose of this study was to investigate the degree to which answers to simple self-report pain questions can predict changes in psychosocial functioning 4 months later in community-dwelling older adults with dementia. ⋯ Our results suggest that persons with dementia who affirmatively respond to pain questions are at higher risk for developing negative psychosocial states.
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Am J Geriatr Psychiatry · Sep 2009
Comparative StudyComorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey-replication.
To identify age differences in the 12-month and lifetime comorbidity of depressive and anxiety disorders for adults (18-64 years) compared with older adults (65 years and older) in a nationally representative sample of community-dwelling adults in the United States. ⋯ Depressive and anxiety disorders frequently cooccurred in this representative sample of community-dwelling adults. Older adults experienced comorbidity to a similar extent as younger adults, suggesting high rates of comorbidity across the lifespan.
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Am J Geriatr Psychiatry · Sep 2009
Comparative StudyGeriatric ward hospitalization reduced incidence delirium among older medical inpatients.
Most strategies for delirium prevention in older hospitalized patients are common good clinical geriatric care. We investigated whether acute geriatric ward (AGW) hospitalization, compared with acute general medical ward (AGMW) hospitalization,is associated with reduced incident delirium in older medical inpatients. ⋯ AGW hospitalization is associated with less incident delirium among older medical inpatients. Despite inherent limitations of observational studies, these hypothesis-generating findings add to previous evidence of potential benefit in delirium prevention from geriatric consultation in several hospital settings.
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Am J Geriatr Psychiatry · Mar 2009
Spousal suffering and partner's depression and cardiovascular disease: the Cardiovascular Health Study.
To assess the effects of suffering in a spouse on prevalent and incident psychiatric (depression) and physical morbidity (cardiovascular disease [CVD]) in their partner, controlling for known risk factors for depression and CVD. ⋯ Exposure to spousal suffering is an independent and unique source of distress in married couples that contributes to psychiatric and physical morbidity. More attention should be paid to the interpersonal effects of suffering in married couples and to its role in contributing to morbidity.
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Am J Geriatr Psychiatry · Feb 2009
Randomized Controlled TrialMelatonin fails to improve sleep or agitation in double-blind randomized placebo-controlled trial of institutionalized patients with Alzheimer disease.
Patients with Alzheimer dementia often display both agitated behavior and poor sleep. Given that the disease is often associated with low endogenous levels of melatonin, exogenous melatonin administration may lead to improvements in sleep and agitation. ⋯ : This study failed to find a beneficial effect of exogenous melatonin, consistent with a number of other studies. The lack of efficacy may be related to the absence of a true treatment effect or to the superphysiologic dose of melatonin used.