American Journal Of Geriatric Psychiatry Research Articles

Improved subjective sleep quality after three months of balance learning in older adults

Improved subjective sleep quality after three months of balance learning in older adults

Enhanced memory for negative words is associated with amnestic mild cognitive impairment and in vivo cerebral amyloid‐β burden independently of depression

AbstractBackgroundEmotion dysregulation was studied as a potential risk marker for Alzheimer’s disease (AD) by assessing emotional memory in high AD‐risk groups characterized by the presence of mild cognitive impairment (MCI) or remitted major depressive disorder (rMDD) and by evaluating the relationship between emotional memory and in vivo cerebral amyloid‐β deposition.Method435 participants enrolled in the PACt‐MD clinical trial of cognitive remediation plus transcranial direct current stimulation were evaluated at baseline. The sample included 127 older adults with amnestic mild cognitive impairment (aMCI), 51 non‐amnestic MCI (naMCI), 60 rMDD without MCI, 81 rMDD+aMCI, 42 rMDD+naMCI, and 74 cognitively unimpaired older adults (CU). Diagnoses were established during a consensus conference based on psychiatric, medical, and neuropsychological assessment. Emotional memory was assessed by evaluating immediate and short‐term delayed recall of 15 personality adjectives (5 each of positive, negative and neutral words) from the Emotional Verbal Learning Test (Mah et al., 2017, American Journal of Geriatric Psychiatry, 25:1160). A subset (N = 167) completed a Positron Emission Tomography (PET) scan with carbon‐11 Pittsburgh Compound B ([11C] PIB). Valence and diagnostic group effects on recall were assessed using mixed ANOVA. Regression modelling assessed the association between emotional memory bias and amyloid‐β burden.ResultRelative to CU, both aMCI and rMDD+aMCI groups showed enhanced memory for negative words at immediate recall, which persisted after short delay in the aMCI group only (F(1, 339) = 2.66, p = .048; Figure 1). Enhanced memory for negative words at short delay was predictive of in vivo cerebral amyloid‐β deposition (standardized beta = .117, t = 1.84, p = .067), over and above the contributions of age, sex, Apolipoprotein E genotype, depression diagnosis and symptoms, and long delayed verbal recall (F(4,154) = 25.8, p<.001, R2 = .41; Figure 2).ConclusionThe association between enhanced memory for negative personality adjectives and aMCI replicates earlier work in single‐domain aMCI (Mah et al., 2017) and suggests that aMCI is characterized by a negativity bias in memory. These findings, taken together with the relationship between a negativity bias in memory and amyloid‐β burden, suggest that emotion dysregulation, in the form of enhanced memory for negative information, is a potential marker of AD risk.

Neuropsychiatric symptoms and caregiver’s burden in Colombian relatives of people with dementia

AbstractBackgroundNeuropsychiatric symptoms are part of the psychopathological dimension of dementias. From a psychosocial approach, the direct and indirect costs of the disease increase, generating a greater demand to the caregiver. We aim to show the relationship between neuropsychiatric symptoms and the caregiver’s burden in a group of 100 caregivers of patients with a dementia diagnosis.MethodSample of 51 caregivers of patients with Alzheimer’s disease and 49 with Fronto‐Temporal Dementia (FTD). Caregivers were patient’s relatives, mean age 58 y.o. and most of them had a college degree. To patients, we applied The Clinical Dementia Rating (CDR), The Neuropsychiatric Inventory (NPI) and a sociodemographic questionnaire. Additionally, we implemented the Zarit caregiver burden test to the caregivers.ResultCategorized three groups of caregivers: without burden (n = 42), mild burden (n = 25), and severe burden (n = 33). There were not statistical differences between caregiver’s age (p = .067), schooling (p = .429), nor how long they were caring for the patient (p = .057). Nonetheless, there’s higher burden scores when they have more economic difficulties (p<.05), more psychosomatic symptoms (p<.05), even when implementing strategies to handle stress (p<.05). Also, the burden is present the more neuropsychiatric symptoms the patients have (p<.05). Age (Beta = .021; p = .934) is not associated with burden level, however, scholarship (Beta = ‐.679; p<.05) and neuropsychiatric symptoms (Beta = 1.141; p<.001) are significantly associated.ConclusionSociodemographic caregiver’s characteristics and the symptom’s severity of the patients may establish a risk profile for caregivers. The study shows the importance of the development of support programs for caregivers.Shin, I. S., Carter, M., Masterman, D., Fairbanks, L., & Cummings, J. L. (2005). Neuropsychiatric symptoms and quality of life in Alzheimer disease. The American journal of geriatric psychiatry, 13(6), 469‐474.Hiu, S. K. W., Bigirumurame, T., Kunonga, P., Bryant, A., & Pillai, M. (2022). Neuropsychiatric Inventory domains cluster into neuropsychiatric syndromes in Alzheimer’s disease: A systematic review and meta‐analysis. Brain and Behavior, 12(9), e2734.Monfort, J. C., Lezy, A. M., Papin, A., & Du Montcel, S. T. (2020). Psychogeriatric Inventory of Disconcerting Symptoms and Syndromes (PGI‐DSS): validity and reliability of a new brief scale compared to the Neuropsychiatric Inventory for Nursing Homes (NPI‐NH). International psychogeriatrics, 32(9), 1085‐1095.

In Case You Haven't Heard…

As many as 7% of U.S. veterans were found to have a positive screen for prolonged grief disorder, reports a study in The American Journal of Geriatric Psychiatry, a American Psychiatric Association (APA) press release stated. Veterans with prolonged grief disorder were more likely than those without the disorder to also have post‐traumatic stress disorder, major depressive disorder, and generalized anxiety disorder. They were also more likely to endorse suicidal thoughts and behaviors. Prolonged grief disorder was approved by the APA board of trustees and the APA assembly for inclusion in DSM‐5 in 2020 (see “APA adds prolonged grief disorder to new text edition of DSM,” MHW, Oct. 4, 2021; https://doi.org/10.1002/mhw.32969). Of the 2,441 study participants (average age 63 years, predominantly white and non‐Hispanic), 2,339 (92.7%) reported the loss of someone close, and 158 (7.3%) screened positive for prolonged grief disorder. Factors associated with an increased risk for the disorder were being female; being Black; having served in the Marine Corps; having adverse childhood experiences; losing someone to suicide, homicide, or COVID‐19; and/or having a personal history of COVID‐19 infection.

Older Age for Every Training Stage: Confessions of a Geriatric Psychiatrist

The World Health Organization estimates that by 2050, individuals 60 or older will make up 20% of the US population, with about 15% experiencing mental disorders.(1) Unfortunately, the number of geriatric psychiatry fellows has dropped by 55% between 2022 and 2021.(2) Furthermore, the number of Black and Latinx fellows who graduate from a geriatric psychiatry program remains in the single digits.(3) This statistic is concerning given the increasing proportion of aging Black, Latinx, and Asian adults.(4) This session aims to share insights from psychiatrists of varying levels of training on strategies to improve diversity, recruitment, and retention within the field of geriatric psychiatry.Citations1. World Health Organization. (2017, December 12). Mental health of older adults. World Health Organization. Retrieved August 28, 2022, from https://www.who.int/en/news-room/fact-sheets/detail/mental-health-of-older-adults2. Conroy, M. L., Yarns, B. C., Wilkins, K. M., Lane, C. E., Zdanys, K. F., Pietrzak, R. H., Forester, B. P., & Kirwin, P. D. (2021). The AAGP Scholars Program: Predictors of Pursuing Geriatric Psychiatry Fellowship Training. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry, 29(4), 365–374. https://doi.org/10.1016/j.jagp.2020.07.0123. Accreditation Council for Graduate Medical Education data ... - ACGME. Accreditation Council for Graduate Medical Education. (n.d.). Retrieved August 27, 2022, from https://www.acgme.org/globalassets/pfassets/publicationsbooks/2020-2021_acgme_databook_document.pdf4. U.S. Census Bureau. Race and Ethnicity in the United States: 2010 Census and 2020 Census. Retrieved August 28, 2022 from https://www.census.gov/library/visualizations/interactive/race-and-ethnicity-in-the-united-state-2010-and-2020-census.html

Drug Deaths Among Older Adults Rising

Drug Deaths Among Older Adults Rising

Suicide‐attempt traits in seniors, younger adults examined

While subjective suicidal intent was higher compared to a young group, older adults who are suicidal were less likely to fulfill criteria for major depression and several other mental disorders, compared to younger adults, according to new research published Aug. 9 in the American Journal of Geriatric Psychiatry.

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

American Journal of Geriatric Psychiatry: Translating Research Evidence into Clinical Geriatric Mental Health Practice

This symposium will describe the role of the American Journal of Geriatric Psychiatry in translating research evidence into clinical practice. The publishing team will provide an overview of defining impact and the methodology for measuring impact. The members of the AJGP editorial board will describe metrics used to evaluate the impact of research evidence on the readership of the journal and the field of geriatric mental health. The Editor-in-Chief and three Associate Editors will describe the top three papers in the areas of translational research, clinical interventions, and epidemiological studies with the highest impact in the last year.

How to Peer Review a Paper

At the beginning of a career in academic psychiatry, new attending psychiatrists do not have all the skills necessary to advance towards promotion. For instance, attendings are most likely well versed in reading and perhaps in writing medical literature, but may not have the knowledge, skills or attitudes to provide a meaningful peer review to a publication. Aside from providing an important, meaningful service to medical science, reviewing articles prior to publication can allow novice researchers and writers to gain important skills in writing for publication and critical thinking. It also allows one to keep up to date on the latest science, and build your CV. This interactive workshop will give participants the opportunity to work in small groups to review an article, present their evaluation and compare their findings with experts.Dr. Nery Diaz and Dr. Paroma Mitra will discuss the basic process of peer review, why participants should accept requests to review articles and provide a “how to” guide. Then, participants will form small groups and group review a section of an article using the guidelines discussed previously. After, the groups will report out their findings. The results from the official review of the article will be shared so that participants can compare findings. Dr. Jordan Karp will provide insights into the process of publication from the viewpoint of a member of the editorial board of the American Journal of Geriatric Psychiatry. Finally, Dr. Popeo will provide a brief summary.

Pandemic Takes Toll on Those Who Grieve

Pandemic Takes Toll on Those Who Grieve

Ethical Dilemmas in Inpatient Psychiatry During the Pandemic

Ethical Dilemmas in Inpatient Psychiatry During the Pandemic

AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY: TRANSLATING RESEARCH EVIDENCE INTO CLINICAL GERIATRIC MENTAL HEALTH PRACTICE

This symposium will describe the role of the American Journal of Geriatric Psychiatry in translating research evidence into clinical practice. The publishing team will provide an overview of defining impact and the methodology for measuring impact. The members of the AJGP editorial board will describe metrics used to evaluate the impact of research evidence on the readership of the journal and the field of geriatric mental health. The Editor-in-Chief and three Associate Editors will describe the top three papers in the areas of translational research, clinical interventions, and epidemiological studies with the highest impact in the last year.

HOW TO PEER REVIEW A PAPER

At the beginning of a career in academic psychiatry, new attending psychiatrists do not have all the skills necessary to advance towards promotion. For instance, attendings are most likely well versed in reading and perhaps in writing medical literature, but may not have the knowledge, skills or attitudes to provide a meaningful peer review to a publication. Aside from providing an important, meaningful service to medical science, reviewing articles prior to publication can allow novice researchers and writers to gain important skills in writing for publication and critical thinking. It also allows one to keep up to date on the latest science, and build your CV. This interactive workshop will give participants the opportunity to work in small groups to review an article, present their evaluation and compare their findings with experts.Dr. Nery Diaz and Dr. Paroma Mitra will discuss the basic process of peer review, why participants should accept requests to review articles and provide a “how to” guide. Then, participants will form small groups and group review a section of an article using the guidelines discussed previously. After, the groups will report out their findings. The results from the official review of the article will be shared so that participants can compare findings. Dr. Jordan Karp will provide insights into the process of publication from the viewpoint of a member of the editorial board of the American Journal of Geriatric Psychiatry. Finally, Dr. Popeo will provide a brief summary.

Disclosure of Competing Interests for 2019

The American Journal of Geriatric Psychiatry has implemented a policy requiring its editorial board to disclose any potential competing interests in the amount of $5,000 or more and occurring within the past 24 months, including consultation fees from pharmaceutical companies or honoraria and travel expenses from them. At the time this issue went to press, the following board members had reported their competing interests during the 24 months:

Elderly see little overall benefit from intranasal esketamine with antidepressant

Elderly patients with treatment‐resistant depression did not see overall improvement in depression symptoms over 28 days with use of esketamine nasal spray plus an oral antidepressant, a placebo‐controlled Phase 3 study has found. A younger subgroup of the overall study sample, as well as patients with earlier onset of depression, showed some improvement with esketamine, the researchers reported. Study results were published online Oct. 17, 2019, in the American Journal of Geriatric Psychiatry.

Visual versus Verbal Working Memory in Statistically Determined Patients with Mild Cognitive Impairment: On behalf of the Consortium for Clinical and Epidemiological Neuropsychological Data Analysis (CENDA).

Previous research in mild cognitive impairment (MCI) suggests that visual episodic memory impairment may emerge before analogous verbal episodic memory impairment. The current study examined working memory (WM) test performance in MCI to assess whether patients present with greater visual versus verbal WM impairment. WM performance was also assessed in relation to hippocampal occupancy (HO), a ratio of hippocampal volume to ventricular dilation adjusted for demographic variables and intracranial volume. Jak etal. (2009) (The American Journal of Geriatric Psychiatry, 17, 368-375) and Edmonds, Delano-Wood, Galasko, Salmon, & Bondi (2015) (Journal of Alzheimer's Disease,47(1), 231-242) criteria classify patients into four groups: little to no cognitive impairment (non-MCI); subtle cognitive impairment (SCI); amnestic MCI (aMCI); and a combined mixed/dysexecutive MCI (mixed/dys MCI). WM was assessed using co-normed Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span Backwards and Wechsler Memory Scale-IV (WMS-IV) Symbol Span Z-scores. Between-group analyses found worse WMS-IV Symbol Span and WAIS-IV Digit Span Backwards performance for mixed/dys MCI compared to non-MCI patients. Within-group analyses found no differences for non-MCI patients; however, all other groups scored lower on WMS-IV Symbol Span than WAIS-IV Digit Span Backwards. Regression analysis with HO as the dependent variable was statistically significant for WMS-IV Symbol Span performance. WAIS-IV Digit Span Backwards performance failed to reach statistical significance. Worse WMS-IV Symbol Span performance was observed in patient groups with measurable neuropsychological impairment and better WMS-IV Symbol Span performance was associated with higher HO ratios. These results suggest that visual WM may be particularly sensitive to emergent illness compared to analogous verbal WM tests.

Behavioral Health Disorder Diagnosis Decreases Access to High-Quality Facilities

Post-acute patients diagnosed with a behavioral health disorder are more likely to enter low-quality nursing home facilities and less likely to enter high-quality facilities than those without the diagnosis, according to study results in the American Journal of Geriatric Psychiatry. “[Our findings] demonstrate that access to high-quality nursing home care is more limited for patients with behavioral health disorders than previously demonstrated,” Helena Temkin-Greener, PhD, study researcher with the University of Rochester School of Medicine and Dentistry in New York, told Caring. Dr. Temkin-Greener said that previous reports suggested nursing homes are reluctant to accept patients with behavioral health disorders. However, only one prior empirical study showed that patients with severe mental illness were more likely to be admitted to nursing homes that have a higher number of deficiency citations, which is one measure of poorer quality. “We wanted to expand on this empirical study by including patients with other behavioral health disorders, including depression which is highly prevalent,” she said, “and also by using newer measures of nursing home quality [i.e., Five-Star metrics] published by the Centers for Medicare & Medicaid Services.” For the study, the researchers used the national Minimum Data Set as well as information on the patients’ sociodemographics and their functional, cognitive, diagnostic, and therapeutic status. The analysis included 3,920,860 new post-acute Medicare nursing home admissions (age 65 years and older) from December 2011 to November 2014 [Am J Geriatr Psychiatry Feb. 28, 2018; doi:10.1016/j.jagp.2018.02.005]. The final sample size was reduced to 2,896,164 participants (78%) from 15,096 facilities due to incomplete records for all necessary covariates. Dr. Temkin-Greener and her colleagues defined the key independent variables as behavioral health diagnoses — including schizophrenia or psychosis, bipolar disorder, depression or anxiety, personality disorder, and substance abuse — based on the admission assessment. The researchers measured quality for overall and staffing domains using the CMS Five-Star Quality Rating System. Overall, 43% of admissions had a behavioral health diagnosis. Patients with schizophrenia/psychosis, bipolar or personality disorder, or substance abuse were younger and more likely to be dually eligible for Medicaid and Medicare compared with patients without a behavioral health disorder diagnosis. In a bivariate analysis, they found the patients with a behavioral health diagnosis had an increased likelihood of entering 1-Star facilities and a decreased likelihood of admittance into 5-Star facilities, as measured by both the overall quality and staffing domains. The researchers noted the distribution of 5-Star facility access during any given year was more favorable for patients without a behavioral health diagnosis than for patients with most behavioral health diagnoses. The one exception was patients with depression/anxiety, who had similar access to quality homes compared with those without any behavioral health diagnosis. “Patients with behavioral health disorders other than serious mental illness were less likely to be admitted to high quality nursing homes and more likely to be admitted to lowest quality homes,” Dr. Temkin-Greener said. Patients with behavioral health disorders and their families should be made aware that nursing home quality metrics are publicly available and should be consulted when discussing discharge plans to a nursing home. Brian Ellis is a freelance writer and editor based in NJ.

Quality Improvement in Neurology: Dementia Management Quality Measurement Set Update.

Dementia is a neurologic condition manifested by a substantial decline in multiple cognitive abilities that collectively render a person unable to function at expected levels and progressively impede independent ability to perform everyday activities. For decades, public health officials have warned of the coming tsunami of Alzheimer disease (AD), and dementia has even been characterized as the dominant scourge of modern times, replacing cancer.1 Recently, hopeful signs have appeared, including reports from some longitudinal research studies that incidence of dementia is declining,2 and from the federal government that research funding for AD and other dementias will approach $1 billion USD in 2017.3 The authors thank all the Dementia Management Update Quality Measurement Set Work Group members for their dedication, time, energy, contributions and work that supported the development of this manuscript: Amy E. Sanders, MD, MS, FAAN (American Academy of Neurology); Robert Roca, MD (American Psychiatric Association); Piero Antuono, MD (American Academy of Neurology); Kelly Sullivan, PhD (American Academy of Neurology); Karl Goodkin, MD, PhD, DFAPA (American Psychiatric Association); Donovan Maust, MD, MS (American Psychiatric Association); Michael Lubin, MD, MACP (American College of Physicians); Sam Fazio, PhD (Alzheimer's Association); Ann Knutson (Alzheimer's Association); Robert O'Keefe, MA (Alzheimer's Association); Eric Tangalos, MD, FACP, AGSF, CMD (AMDA–The Society for Post-Acute and Long-Term Care Medicine); Glenn Smith, PhD (American Academy of Clinical Neuropsychology and American Psychological Association); Brian Unwin, MD, FAAFP (American Academy of Family Physicians); Joseph Shega, MD (American Academy of Hospice and Palliative Medicine); Dale Strasser, MD (American Academy of Physical Medicine and Rehabilitation); Michele Grigaitis, DNP, FNP-BC, CNRN (American Association of Neuroscience Nurses); Jerry Johnson, MD (American Geriatric Society); Mary Kathleen Owens, RN MSN, C-NE, RAC-CT (American Health Care Association and Gerontological Advanced Practice Nurses Association); Catherine Piersol, PhD, OTR, FAOTA (American Occupational Therapy Association); Lise McCarthy, PT, DPT, GCS (American Physical Therapy Association); Kathleen Welsh-Bohmer, PhD, ABPP (American Psychological Association); David Webster, MD, MBA (Humana); James Galvin, MD, MPH, FANA (Lewy Body Dementia Association); Daniel Marson, PhD, JD (National Academy of Neuropsychology); Richard Fortinsky, PhD (The Gerontological Society of America); Marsden McGuire, MD (Veteran's Affairs); John Absher, MD (American Academy of Neurology Facilitator); James Nininger, MD (American Psychiatric Association Facilitator); Amy Bennett, JD (American Academy of Neurology Staff); Gina Gjorvad (American Academy of Neurology Staff); Erin Hagen (American Academy of Neurology Staff); Becky Schierman, MPH (American Academy of Neurology Staff); Samantha Shugarman, MS (American Psychiatric Association Staff); and Kristin Kroeger (American Psychiatric Association Staff). The authors also thank Jean O'Keefe for participation and the individuals and organizations who offered public comments.

Corticosteroid-Induced Psychiatric Symptoms #323.

Journal of Palliative MedicineVol. 20, No. 3 Fast Facts and ConceptsCorticosteroid-Induced Psychiatric Symptoms #323Rebecca Campbell, Laura Tycon, and Jennifer PruskowskiRebecca CampbellSearch for more papers by this author, Laura TyconSearch for more papers by this author, and Jennifer PruskowskiSearch for more papers by this authorPublished Online:1 Mar 2017https://doi.org/10.1089/jpm.2016.0475AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Corticosteroid-Induced Psychiatric Symptoms #323." Journal of Palliative Medicine, 20(3), pp. 298–299FiguresReferencesRelatedDetailsCited byAdverse Drug Reactions and Comorbidities in Patient Treated for COVID-1923 November 2021 | Asian Journal of Research in Chemistry, Vol. 14, No. 1Mood disorder induced by prednisolone – an easily overlooked complication29 January 2021 | Current Problems of Psychiatry, Vol. 21, No. 3Association of Megestrol Use With the Development of New Psychiatric DiagnosesThe American Journal of Geriatric Psychiatry, Vol. 28, No. 6Commonly Used Drugs for Medical Illness and the Nervous SystemCONTINUUM: Lifelong Learning in Neurology, Vol. 26, No. 3 Major Neurologic Adverse Drug Reactions, Potential Drug–Drug Interactions and Pharmacokinetic Aspects of Drugs Used in COVID-19 Patients with Stroke: A Narrative Review 1 June 2020 | Therapeutics and Clinical Risk Management, Vol. Volume 16 Volume 20Issue 3Mar 2017 InformationCopyright 2017, Mary Ann Liebert, Inc.To cite this article:Rebecca Campbell, Laura Tycon, and Jennifer Pruskowski.Corticosteroid-Induced Psychiatric Symptoms #323.Journal of Palliative Medicine.Mar 2017.298-299.http://doi.org/10.1089/jpm.2016.0475Published in Volume: 20 Issue 3: March 1, 2017Online Ahead of Print:November 22, 2016PDF download