The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · May 2002
Suppression of catatonia-like signs by lorazepam in nonconvulsive status epilepticus without seizure termination.
Nonconvulsive status epilepticus (NCSE) cannot be reliably distinguished from catatonia by signs or symptoms. The authors report on a 68-year-old man with endogenous major depression who displayed catatonia-like psychopathology, which temporarily disappeared with lorazepam. ⋯ When lorazepam was stopped, the catatonia-like delirium returned; it disappeared again with valproate administration. This case illustrates that the reduction of signs consistent with catatonia by benzodiazepines does not by itself confirm catatonia, even in patients with endogenous depression.
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Am J Geriatr Psychiatry · Mar 2002
ReviewCurrent state of research on decision-making competence of cognitively impaired elderly persons.
As the number of cognitively impaired elderly persons increases, the need for evidence-based assessments of their capacity to consent to medical treatment and research participation will grow. The authors conducted an electronic and manual literature search for all English-language articles examining the decision-making capacity of elderly persons with dementia or cognitive impairment, reviewing articles in relation to key areas of methodological, clinical, and policy importance. The 32 relevant studies identified were highly heterogeneous, even in their definitions and measurements of decisional capacity. ⋯ The use of expert judgment-based methods may mitigate the problem of a lack of a criterion standard for competence. Research into the decision-making competence of cognitively impaired elderly persons is a growing field. It is beginning to yield findings with practical implications for preserving the autonomy and welfare of this group of vulnerable elderly patients.
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Am J Geriatr Psychiatry · Mar 2002
Randomized Controlled Trial Clinical TrialOndansetron in the treatment of cognitive decline in Alzheimer dementia.
The authors performed a multicenter, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of ondansetron (20 microg/day and 100 microg/ day) in treating cognitive decline in 185 patients with Alzheimer disease. Although ondansetron was well tolerated without any serious drug-related side effects, the study failed to demonstrate any significant cognitive improvement.
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Am J Geriatr Psychiatry · Jan 2001
Severity and course of delirium in medically hospitalized nursing facility residents.
Delirium is a common and serious complication of medical illness in frail elderly patients. The authors report on a series of nursing facility delirium patients followed for 3 months during and after acute medical hospitalization. Delirium was persistent to time of death or hospital discharge in 72%. ⋯ A purely hypoactive delirium vs. a hyperactive or mixed was associated with delirium persistence. Delirium is associated with high mortality and frequent persistence. Additional research is needed to clarify who is at risk for delirium with associated persistence and/or mortality.
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Am J Geriatr Psychiatry · Jan 2001
ReviewGeriatric mental health services research: Strategic Plan for an Aging Population: Report of the Health Services Work Group of the American Association for Geriatric Psychiatry.
In November 1999, a working group of the American Association for Geriatric Psychiatry (AAGP) convened to consider strategic recommendations for developing geriatric mental health services research as a scientific discipline. The resulting consensus statement summarizes the principles guiding mental health services research on late-life mental disorders, presents timely and topical priorities for investigation with the potential to benefit the lives of older adults and their families, and articulates a systematic program for expanding the supply of well-trained geriatric mental health services researchers. The agenda presented here is designed to address critical questions in provision of effective mental health care to an aging population and the health policies that govern its delivery.