The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Apr 2018
Baseline Mobility is Not Associated with Decline in Cognitive Function in Healthy Community-Dwelling Older Adults: Findings From The Irish Longitudinal Study on Ageing (TILDA).
Few studies examine the relationship between Timed Up-and-Go (TUG), a commonly used clinical test, and cognitive decline. This study examines whether TUG, usual gait speed (UGS), and dual-task gait speed (DTGS) predict decline in global cognition, executive function, processing speed, memory, and attention with follow-up of up to 5.9 years. ⋯ These mobility tasks are not sensitive predictors of cognitive decline in this high-functioning, community-dwelling sample; nonetheless, limited decline in cognitive function was observed during follow-up. Further work with longer follow-up and/or analysis of more specific and comprehensive measures associated with gait is required.
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The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Caring for an Aging America". In this commentary we summarize key findings and recommendations most relevant to clinicians and researchers in geriatric psychiatry and related disciplines. The report notes the growing prevalence of family caregiving in the United States, especially those caring for high-need patients with multiple chronic conditions, disability, and/or cognitive impairment. ⋯ We also need research to identify how to best implement, maintain, and evaluate caregiver support programs within clinical and community settings. The Centers for Medicare and Medicaid Services should be charged with developing, testing, and implementing provider payment reforms that motivate providers to engage and support family caregivers. Payment reforms should include clearly articulated performance standards that hold providers accountable for caregiver engagement, training, and support by explicitly including caregiver outcomes in quality measures.
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Am J Geriatr Psychiatry · Feb 2018
ReviewAging and Post-Intensive Care Syndrome: A Critical Need for Geriatric Psychiatry.
Because of the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments because of critical illness, known as post-intensive care syndrome (PICS). This article focuses on PICS-related cognitive, psychological, and physical impairments and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS and what roles geriatric psychiatrists could play in the future of this rapidly growing population.
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Am J Geriatr Psychiatry · Feb 2018
Case Reports¡HOLA, Amigos! Toward Preventing Anxiety and Depression in Older Latinos.
Given the prevalence and morbidity of depression and anxiety in later life, the inadequacies of current treatment approaches for averting years living with disability, the disparities in access to the mental healthcare delivery system, and the workforce shortages to meet the mental health needs of older Latinos, development and testing of innovative strategies to prevent depression and anxiety are of great public health significance and have the potential to change practice. Although impediments to good depression and anxiety outcomes exist for all older adults, they are even more pronounced for older Latinos, who tend to have fewer socioeconomic resources. ⋯ The diverse needs and circumstances of older Latinos (highly sedentary, culture-specific health beliefs, service disparities) were incorporated into the design of HOLA to reduce risk factors and improve health-related outcomes associated with common mental disorders in this group. The authors describe HOLA (highlighted in this case example) and why health promotion interventions like HOLA may hold promise as effective, practical, and nonstigmatizing interventions for preventing common mental disorders in older Latinos who are at risk for developing these disorders.
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Am J Geriatr Psychiatry · Dec 2017
Use of Complementary and Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-Boomers.
To compare use of complementary and alternative medicine (CAM) across age cohorts. ⋯ Age cohort plays a significant role in shaping individual healthcare behaviors and service use and may influence future trends in the use of CAM for behavioral health. Healthcare providers need to be aware of patient use of CAM and communicate with them about the pros and cons of alternative therapies.