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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 351, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 238, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 353, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 325, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 405, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 235, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 57, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 161, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Geriatric Psychiatry
  [SJR: 1.653]   [H-I: 93]   [15 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1064-7481 - ISSN (Online) 1545-7214
   Published by Elsevier Homepage  [3043 journals]
  • Development of Geriatric Mental Health Learning Objectives for Medical
           Students: A Response to the Institute of Medicine 2012 Report
    • Authors: Susan W. Lehmann; William B. Brooks; Dennis Popeo; Kirsten M. Wilkins; Mary C. Blazek
      Pages: 1041 - 1047
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Susan W. Lehmann, William B. Brooks, Dennis Popeo, Kirsten M. Wilkins, Mary C. Blazek
      America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students. The authors describe the development of a set of such learning objectives that all medical students should achieve by graduation. The iterative process included initial drafting by content experts from five medical schools with input and feedback from a wider group of geriatric psychiatrists, geriatricians, internists, and medical educators. The final document builds upon previously published work and includes specific knowledge, attitudes and skills in six key domains: Normal Aging, Mental Health Assessment of the Geriatric Patient, Psychopharmacology, Delirium, Depression, and Dementia. These objectives address a pressing need, providing a framework for national standards and curriculum development.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.05.006
       
  • MRI Markers of Neurodegenerative and Neurovascular Changes in Relation to
           Postoperative Delirium and Postoperative Cognitive Decline
    • Authors: Ilse M.J. Kant; Jeroen de Bresser; Simone J.T. van Montfort; Arjen J.C. Slooter; Jeroen Hendrikse
      Pages: 1048 - 1061
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Ilse M.J. Kant, Jeroen de Bresser, Simone J.T. van Montfort, Arjen J.C. Slooter, Jeroen Hendrikse
      Postoperative delirium (POD) and postoperative cognitive decline (POCD) are common in elderly patients. The aim of the present review was to explore the association of neurodegenerative and neurovascular changes with the occurrence of POD and POCD. Fifteen MRI studies were identified by combining multiple search terms for POD, POCD, and brain imaging. These studies described a total of 1,422 patients and were all observational in design. Neurodegenerative changes (global and regional brain volumes) did not show a consistent association with the occurrence of POD (four studies) or POCD (two studies). In contrast, neurovascular changes (white matter hyperintensities and cerebral infarcts) were more consistently associated with the occurrence of POD (seven studies) and POCD (five studies). In conclusion, neurovascular changes appear to be consistently associated with the occurrence of POD and POCD, and may identify patients at increased risk of these conditions. Larger prospective studies are needed to study the consistency of these findings and to unravel the underlying pathophysiological mechanisms.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.06.016
       
  • State of the Art and Promise of Structural Neuroimaging in Postoperative
           Delirium and Postoperative Cognitive Decline
    • Authors: Michele Cavallari; Charles R.G. Guttmann; Sharon K. Inouye; David C. Alsop
      Pages: 1062 - 1063
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Michele Cavallari, Charles R.G. Guttmann, Sharon K. Inouye, David C. Alsop


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.07.009
       
  • Clinical Features Associated with Delirium Motor Subtypes in Older
           Inpatients: Results of a Multicenter Study
    • Authors: Alessandro Morandi; Simona G. Di Santo; Antonio Cherubini; Enrico Mossello; David Meagher; Andrea Mazzone; Angelo Bianchetti; Nicola Ferrara; Alberto Ferrari; Massimo Musicco; Marco Trabucchi; Giuseppe Bellelli; Stefano Boffelli; Fabio Di Stefano; Francesco De Filippi; Fabio Guerini; Erik Bertoletti; Albert March; Alessandro Margiotta; Patrizia Mecocci; Desireè Addesi; Fausto Fantò; Gianluca Isaia; Babette Dijik; Paola Porrino; Antonino Maria Cotroneo; Giovanni Galli; Amalia Cecilia Bruni; Bruno Bernardini; Carla Corsini; Annachiara Cagnin; Amedeo Zurlo; Giuseppe Barbagallo; Maria Lia Lunardelli; Emilio Martini; Giuseppe Battaglia; Raffaele Latella; Donatella Petritola; Elena Sinforiani; Alberto Cester; Marino Formilan; Pasqualina Carbone; Ildebrando Appollonio; Diletta Cereda; Lucio Tremolizzo; Edo Bottacchi; Lucio Lucchetti; Claudio Mariani; Piero Rapazzini; Giuseppe Romanelli; Alessandra Marengoni; Giovanni Zuliani; Lara Bianchi; Teresa Suardi; Ettore Muti; Renato Bottura; Giovanni Sgrò; Antonella Mandas; Luca Serchisu; Patrizia Crippa; Claudio Ivaldi; Andrea Ungar; Daniele Villani; Clara Raimondi; Chiara Mussi; Giancarlo Isaia; Giuseppe Provenzano; Daniela Mari; Patrizio Odetti; Fiammetta Monacelli; Raffaele Antonelli Incalzi; Alice Pluderi; Claudio Bellamoli; Luciano Terranova; Elio Scarpini; Ferdinando D'Amico; Maria Chiara Cavallini; Gianbattista Guerrini; Anna Maria Scotuzzi; Antonino Chiarello; Alberto Pilotto; Sara Tognini; Giuseppina Dell'Aquila; Gabriele Toigo; Giuliano Ceschia; Maristella Piccinini; Andrea Fabbo; Marco Zoli; Paola Forti; Christian Wenter; Giorgio Basile; Anna Lasagni; Alessandro Padovani; Luca Rozzini; Maria Cottino; Silvia Vitali; Gabriele Tripi; Stefano Avanzi; Simona Umidi; Daniela Moretti; Giovanni Ruotolo; Federica Boschi; Paolo Bonino; Niccolò Marchionni; Maria C. Cavallini; Sara Fascendini; Gabriele Noro; Renato Turco; Maria C. Ubezio; Carlo Serrati; Maria Infante; Simona Gentile; Luigi M. Pernigotti; Carlo A. Biagini; Enzo Canonico; Pietro Bonati; Pietro Gareri; Paolo Caffarra; Arcangelo Ceretti; Rosanna Castiglia; Carlo Gabelli; Mario Lo Storto; Paolo Putzu; Giuseppe Bellelli; Alessandro Morandi; Simona Di Santo; Andrea Mazzone; Renzo Rozzini; Ermellina Zanetti; Angelo Bianchetti; Mario Bo; Enrico Mossello; Antonio Cherubini; Nicola Ferrara; Alberto Ferrari; Massimo Musicco; Marco Trabucchi
      Pages: 1064 - 1071
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Alessandro Morandi, Simona G. Di Santo, Antonio Cherubini, Enrico Mossello, David Meagher, Andrea Mazzone, Angelo Bianchetti, Nicola Ferrara, Alberto Ferrari, Massimo Musicco, Marco Trabucchi, Giuseppe Bellelli
      Objective To date motor subtypes of delirium have been evaluated in single-center studies with a limited examination of the relationship between predisposing factors and motor profile of delirium. We sought to report the prevalence and clinical profile of subtypes of delirium in a multicenter study. Methods This is a point prevalence study nested in the “Delirium Day 2015”, which included 108 acute and 12 rehabilitation wards in Italy. Delirium was detected using the 4-AT and motor subtypes were measured with the Delirium Motor Subtype Scale (DMSS). A multinomial logistic regression was used to determine the factors associated with delirium subtypes. Results Of 429 patients with delirium, the DMSS was completed in 275 (64%), classifying 21.5% of the patients with hyperactive delirium, 38.5% with hypoactive, 27.3% with mixed and 12.7% with the non-motor subtype. The 4-AT score was higher in the hyperactive subtype, similar in the hypoactive, mixed subtypes, while it was lowest in the non-motor subtype. Dementia was associated with all three delirium motor subtypes (hyperactive, OR 3.3, 95% CI: 1.2-8.7; hypoactive, OR 2.8, 95% CI: 1.2-6.5; mixed OR 2.6, 95% CI: 1.1-6.2). Atypical antipsychotics were associated with hypoactive delirium (OR 0.23, 95% CI: 0.1-0.7), while intravenous lines were associated with mixed delirium (OR 2.9, 95% CI: 1.2-6.9). Conclusions The study shows that hypoactive delirium is the most common subtype among hospitalized older patients. Specific clinical features were associated with different delirium subtypes. The use of standardized instruments can help to characterize the phenomenology of different motor subtypes of delirium.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.05.003
       
  • Delirium Phenomenology and Beyond
    • Authors: Karin Neufeld
      Pages: 1072 - 1073
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Karin Neufeld


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.07.001
       
  • Distress Associated with Dementia-Related Psychosis and Agitation in
           Relation to Healthcare Utilization and Costs
    • Authors: Donovan T. Maust; Helen C. Kales; Ryan J. McCammon; Frederic C. Blow; Amanda Leggett; Kenneth M. Langa
      Pages: 1074 - 1082
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Donovan T. Maust, Helen C. Kales, Ryan J. McCammon, Frederic C. Blow, Amanda Leggett, Kenneth M. Langa
      Objectives Explore the relationship between behavioral and psychological symptoms of dementia (BPSD; specifically, delusions, hallucinations, and agitation/aggression) and associated caregiver distress with emergency department (ED) utilization, inpatient hospitalization, and expenditures for direct medical care. Design/Setting/Participants Retrospective cross-sectional cohort of participants with dementia (N = 332) and informants from the Aging, Demographics, and Memory Study, a nationally representative survey of U.S. adults >70 years old. Measurements BPSD of interest and associated informant distress (trichotomized as none/low/high) were assessed using the Neuropsychiatric Inventory (NPI). Outcomes were determined from one year of Medicare claims and examined according to presence of BPSD and associated informant distress, adjusting for participant demographics, dementia severity, and comorbidity. Results Fifty-eight (15%) participants with dementia had clinically significant delusions, hallucinations, or agitation/aggression. ED visits, inpatient admissions, and costs were not significantly higher among the group with significant BPSD. In fully adjusted models, a high level of informant distress was associated with all outcomes: ED visit incident rate ratio (IRR) 3.03 (95% CI: 1.98–4.63; p < 0.001), hospitalization IRR 2.78 (95% CI: 1.73–4.46; p < 0.001), and relative cost ratio 2.00 (95% CI: 1.12–3.59; p = 0.02). Conclusions A high level of informant distress related to participant BPSD, rather than the symptoms themselves, was associated with increased healthcare utilization and costs. Effectively identifying, educating, and supporting distressed caregivers may help reduce excess healthcare utilization for the growing number of older adults with dementia.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.02.025
       
  • The Best Value in Dementia Care
    • Authors: Robert Roca
      Pages: 1083 - 1084
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Robert Roca


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.03.010
       
  • Medical Care Activities Among Spouses of Older Adults With Functional
           Disability: Implications for Caregiving Difficulties and Gains
    • Authors: Courtney A. Polenick; Amanda N. Leggett; Helen C. Kales
      Pages: 1085 - 1093
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Courtney A. Polenick, Amanda N. Leggett, Helen C. Kales
      Objectives Spouses of older adults with functional disability often provide help with their partner's medical care. Yet little is known about the implications of these activities for spouses' caregiving experiences. We examined how spouses' medical care activities are linked to both positive and negative aspects of caregiving (difficulties and gains), and whether these associations vary by their age, gender, or education. Design Retrospective analysis of data from the 2011 National Health and Aging Trends Study and National Study of Caregiving cross-sectional studies. Setting Caregivers and care recipients/proxies were interviewed by telephone at home. Participants Nationally representative U.S. sample of 345 spousal caregivers and their community-dwelling care recipients aged 65 years and older. Measurements Caregivers' self-reported sociodemographics, care activities, health conditions, well-being, and support resources. Care recipients (or proxies) reported on their health conditions and dementia status. Results A higher number of health system interaction tasks (e.g., making appointments) were significantly associated with greater emotional caregiving difficulties, whereas a higher number of medical/nursing tasks (e.g., giving shots/injections) were significantly linked to greater caregiving gains. A higher number of medical/nursing tasks were also significantly associated with greater physical difficulties for caregiving wives and spouses with less education. Conclusions Medical care activities may have both positive and negative consequences for spousal caregivers, which depend partly on sociodemographics. This study underscores the importance of ensuring that spouses have the resources and support needed to provide complex care to their partners.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.05.001
       
  • In Sickness and in Health: Spousal Caregivers and The Correlates of
           Caregiver Outcomes
    • Authors: Mijung Park
      Pages: 1094 - 1096
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Mijung Park


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.07.004
       
  • Childhood Stress and Adversity is Associated with Late-Life Dementia in
           Aboriginal Australians
    • Authors: Kylie Radford; Kim Delbaere; Brian Draper; Holly A. Mack; Gail Daylight; Robert Cumming; Simon Chalkley; Cecilia Minogue; Gerald A. Broe
      Pages: 1097 - 1106
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Kylie Radford, Kim Delbaere, Brian Draper, Holly A. Mack, Gail Daylight, Robert Cumming, Simon Chalkley, Cecilia Minogue, Gerald A. Broe
      Objectives High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. Design A cross-sectional study with a representative sample of community-dwelling older Aboriginal Australians. Setting Urban and regional communities in New South Wales, Australia. Participants 336 Aboriginal and/or Torres Strait Islander Australians aged 60–92 years, of whom 296 were included in the current analyses. Measurements Participants completed a life course survey of health, well-being, cognition, and social history including the Childhood Trauma Questionnaire (CTQ), with consensus diagnosis of dementia and Alzheimer disease. Results CTQ scores ranged from 25–117 (median: 29) and were associated with several adverse childhood indicators including separation from family, poor childhood health, frequent relocation, and growing up in a major city. Controlling for age, higher CTQ scores were associated with depression, anxiety, suicide attempt, dementia diagnosis, and, specifically, Alzheimer disease. The association between CTQ scores and dementia remained significant after controlling for depression and anxiety variables (OR: 1.61, 95% CI: 1.05–2.45). In contrast, there were no significant associations between CTQ scores and smoking, alcohol abuse, diabetes, or cardiovascular risk factors. Conclusions Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.05.008
       
  • Childhood Stress and Adversity is Associated with Late-Life Dementia in
           Aboriginal Australians
    • Authors: Sharon L. Naismith; Robert M. Parker
      Pages: 1107 - 1108
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Sharon L. Naismith, Robert M. Parker


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.07.003
       
  • Harnessing Peer Support in an Online Intervention for Older Adults with
           Depression
    • Authors: Kathryn N. Tomasino; Emily G. Lattie; Joyce Ho; Hannah L. Palac; Susan M. Kaiser; David C. Mohr
      Pages: 1109 - 1119
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Kathryn N. Tomasino, Emily G. Lattie, Joyce Ho, Hannah L. Palac, Susan M. Kaiser, David C. Mohr
      Objective This pilot study evaluated the feasibility and efficacy of two methods of delivering a cognitive behaviorally informed Internet intervention for depression for adults 65 years and older. Methods Forty-seven participants were enrolled and assigned to receive one of two versions of the Internet intervention, either delivered individually (III) or with peer support (II+PS), or to a wait list control group (WLC). Primary outcomes included change in depressive symptoms from baseline to post-intervention (week 8), site use, self-reported usability, and coach time. Secondary outcomes included measures of social support and isolation and anxiety. Results Follow-up data were provided by 85.1% (40 of 47) of enrolled participants. There were significant differences in depression change across groups (F(2,37) = 3.81, p = 0.03). Greater reductions in depressive symptoms were found for the III (p = 0.02) and II+PS (p = 0.03) compared with WLC, and significantly less coach time was required in the II+PS (p = 0.003). Conclusions These results highlight the potential of cognitive-behaviorally informed Internet interventions for older adults with depression, and indicate that peer-supported programs are both acceptable and equivalent to individually delivered Internet interventions. Including peer support may be a viable and potentially more cost-effective option for disseminating online treatments for depression for older adults.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.04.015
       
  • Internet Delivery and Peer Support: New Venues for Psychosocial
           Interventions of Late-Life Depression
    • Authors: Dimitris N. Kiosses
      Pages: 1120 - 1122
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Dimitris N. Kiosses


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.06.024
       
  • Longitudinal Cognitive Outcomes of Clinical Phenotypes of Late-Life
           Depression
    • Authors: Meghan Riddle; Guy G. Potter; Douglas R. McQuoid; David C. Steffens; John L. Beyer; Warren D. Taylor
      Pages: 1123 - 1134
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Meghan Riddle, Guy G. Potter, Douglas R. McQuoid, David C. Steffens, John L. Beyer, Warren D. Taylor
      Objective Late-life depression is associated with cognitive deficits and increased risk for cognitive decline. The purpose of the study was to determine whether clinical characteristics could serve as phenotypes informative of subsequent cognitive decline. Age at depression onset and antidepressant remission at 3 months (acute response) and 12 months (chronic response) were examined. Methods In a longitudinal study of late-life depression in an academic center, 273 depressed and 164 never-depressed community-dwelling elders aged 60 years or older were followed on average for over 5 years. Participants completed annual neuropsychological testing. Neuropsychological measures were converted to z-scores derived from the baseline performance of all participants. Cognitive domain scores at each time were then created by averaging z-scores across tests, grouped into domains of episodic memory, attention-working memory, verbal fluency, and executive function. Results Depressed participants exhibited poorer performance at baseline and greater subsequent decline in all domains. Early-onset depressed individuals exhibited a greater decline in all domains than late-onset or nondepressed groups. For remission, remitters and nonremitters at both 3 and 12 month exhibited greater decline in episodic memory and attention-working memory than nondepressed subjects. Three-month remitters also exhibited a greater decline in verbal fluency and executive function, whereas 12-month nonremitters exhibited greater decline in executive function than other groups. Conclusion Consistent with past studies, depressed elders exhibit greater cognitive decline than nondepressed subjects, particularly individuals with early depression onset, supporting the theory that repeated depressive episodes may contribute to decline. Clinical remission is not associated with less cognitive decline.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.03.016
       
  • Negative Affectivity, Aging, and Depression: Results From the Neurobiology
           of Late-Life Depression (NBOLD) Study
    • Authors: David C. Steffens; Lihong Wang; Kevin J. Manning; Godfrey D. Pearlson
      Pages: 1135 - 1149
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): David C. Steffens, Lihong Wang, Kevin J. Manning, Godfrey D. Pearlson
      Objective Neuroticism is a common yet understudied condition in older adults. We hypothesized that presence of high negativity affectivity (NA), a key feature of neuroticism, would be associated with different prefrontal cortex (PFC) activity and connectivity patterns in depressed and never-depressed older adults. Methods This is a baseline cross-sectional analysis of a cohort study of 52 depressed and 36 never-depressed older adults. Assessments included NA scores from the Type D Scale-14 and Montgomery-Åsberg Depression Rating Scale scores. All subjects had a 3T brain functional magnetic resonance imaging resting scan, neuronal activity determined by amplitude of low-frequency fluctuations (ALFFs) were obtained, and resting state functional connectivity (FC) analyses were performed. Analyses of covariance were conducted on ALFFs and FC to examine significant differences between groups. Results In the ALFF analyses there were clearly different patterns between depressed and comparison groups in the correlation of ALFFs and NA. The correlation differences between the two groups were significant in the dorsomedial PFC, insula, amygdala, and posterior cingulate cortex (PCC). FC analyses revealed different between-group connectivity patterns. Significantly higher ventromedial PFC–amygdala FC with NA correlation was found in the depressed group than that in the never-depressed group. Conclusion This study confirms differential activity of the dorsal and ventral regions of the medial PFC in individuals with high neuroticism. Our findings suggest increased rostral medial PFC activity may be a marker of resilience to depression in the elderly and decreased anterior ventromedial PFC, PCC, and amygdala activity may be a result of successful emotion regulation in never-depressed higher NA individuals.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.03.017
       
  • Challenging Assumptions About African American Participation in Alzheimer
           Disease Trials
    • Authors: Richard E. Kennedy; Gary R. Cutter; Guoqiao Wang; Lon S. Schneider
      Pages: 1150 - 1159
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Richard E. Kennedy, Gary R. Cutter, Guoqiao Wang, Lon S. Schneider
      Objective The authors investigated potential effects of increased African American participation in Alzheimer disease (AD) and mild cognitive impairment (MCI) clinical trials by examining differences in comorbid conditions and treatment outcome affecting trial design. Methods Using a meta-database of 18 studies from the Alzheimer's Disease Cooperative Study and the Alzheimer's Disease Neuroimaging Initiative, a cohort of 5,164 subjects were included for whom there were baseline demographic data and information on comorbid disorders, grouped by organ system. Meta-analysis was used to compare prevalence of comorbidities, dropouts, and rates of change on the cognitive subscale of the Alzheimer's Disease Assessment Scale by race. Clinical trial scenarios similar to recent therapeutic trials were simulated to determine effects of increased African American participation on statistical power. Results Approximately 7% of AD, 4% of MCI, and 11% of normal participants were African American. African American subjects had higher prevalence of cardiovascular disorders (odds ratio: 2.10; 95% confidence interval [CI]: 1.71–2.57) and higher rate of dropouts (odds ratio: 1.60; 95% CI: 1.15–2.21) compared with whites but lower rates of other disorders. There were no significant differences in rate of progression (–0.862 points/year; 95% CI: −1.89 to 0.162) by race and little effect on power in simulated trials with sample sizes similar to current AD trial designs. Conclusion Increasing African American participation in AD clinical trials will require adaptation of trial protocols to address comorbidities and dropouts. However, increased diversity is unlikely to negatively affect trial outcomes and should be encouraged to promote generalizability of trial results.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.04.013
       
  • Negative Emotional Verbal Memory Biases in Mild Cognitive Impairment and
           Late-Onset Depression
    • Authors: Linda Mah; Nicole D. Anderson; Nicolaas Paul L.G. Verhoeff; Bruce G. Pollock
      Pages: 1160 - 1170
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): Linda Mah, Nicole D. Anderson, Nicolaas Paul L.G. Verhoeff, Bruce G. Pollock
      Objective Early and preferential targeting of limbic structures by Alzheimer disease (AD)-related pathology suggests emotion dysregulation may serve as a marker of AD risk. We studied emotional verbal memory in two groups at risk for AD, amnestic mild cognitive impairment (aMCI) and late-onset depression (LOD), to test the hypothesis that aMCI and LOD would be characterized by a negative bias in emotional memory, whereas cognitively normal (CN) adults would show the “positivity effect” associated with healthy aging. Methods Participants completed a novel test of emotional verbal memory, the Emotional Verbal Learning Test (EVeLT), consisting of a 15-item list of words with positive, negative, or neutral valence. Recall as a function of group and valence was analyzed using mixed analysis of variance. Spearman's rho was used to examine associations between EVeLT, mood, and executive function. MCI and CN participants had no current or past history of mood or anxiety disorders. aMCI participants met neuropsychological criteria for single-domain aMCI (sd-aMCI). LOD developed their first episode of depression at ≥60 years of age. Results CN adults recalled more positive words, whereas sd-aMCI and LOD adults recalled more negative, relative to neutral, words on the EVeLT. Positive emotional memory and negative attitudes regarding self were inversely correlated in CN adults. Conclusion sd-aMCI and LOD groups show negative emotional memory biases, consistent with our hypothesis that emotion dysregulation is a signature of AD risk.

      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.05.005
       
  • Whistling Past the Graveyard
    • Authors: David L. Coulter
      First page: 1171
      Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10
      Author(s): David L. Coulter


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.06.013
       
  • Locked in and Growing Old: the Psychiatric, Forensic, and Cognitive
           Correlates of 30 Years of Psychiatric Hospitalization
    • Authors: Frederick Hives; Kenny A. Karyadi; Steve Nitch; Dominique Kinney
      Abstract: Publication date: Available online 12 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Frederick Hives, Kenny A. Karyadi, Steve Nitch, Dominique Kinney
      As the number of older adults in the United States continues to grow, the population of older adults with severe mental illness in institutional settings (OASIS) is expected to place a significant demand on healthcare resources. This study presents an update to research regarding the clinical characteristics of OASIS inpatients with histories of extensive hospitalization through the use of a newly developed psychiatric measure: the Clinician-Rated Dimension of Psychosis Symptom Severity (CRDPSS). We investigated an OASIS sample (n = 55) with an average of nearly 30 continuous years of hospitalization at a forensic state psychiatric hospital. The average OASIS patient exhibited the most prominent psychiatric symptoms via delusions and negative symptoms, received psychotropic medications at substantially higher doses than recommended therapeutic levels, rarely committed acts of institutional violence (IV), and performed more than two standard deviations below the normative mean on cognitive testing. More severe hallucination symptoms were associated with higher psychotropic medication dosage, and more severe depressive symptoms were associated with more IV incidents. OASIS inpatients performed moderately worse than general psychiatric inpatients in the areas of overall cognition, immediate memory, and delayed memory; older age was associated with poorer language and attention. No psychiatric or cognitive factors predicted IV incidents. These results highlight the continued importance of understanding the psychiatric, forensic, and cognitive factors associated with aging in an institutional setting and how these factors among OASIS inpatients may vary from general psychiatric inpatients.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.10.003
       
  • Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life
           and Prevalence According to Age, Gender and Country.
    • Authors: Aartjan T.F. Beekman
      Abstract: Publication date: Available online 12 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Aartjan T.F. Beekman


      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.10.004
       
  • Safety and Effectiveness of Long-Term Treatment with Lurasidone in Older
           Adults with Bipolar Depression: Post-Hoc Analysis of a 6 Month, Open-Label
           Study
    • Authors: Brent P. Forester; Martha Sajatovic; Joyce Tsai; Andrei Pikalov; Josephine Cucchiaro; Antony Loebel
      Abstract: Publication date: Available online 10 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Brent P. Forester, Martha Sajatovic, Joyce Tsai, Andrei Pikalov, Josephine Cucchiaro, Antony Loebel
      Objective To evaluate the safety and effectiveness of 6 months of treatment with lurasidone in older adults with a diagnosis of bipolar I depression. Design Post-hoc analysis of a multicenter, 6-month, open-label extension study. Setting Outpatient. Participants Patients 55-75 years with a DSM-IV-TR diagnosis of bipolar I depression who had completed 6 weeks of double-blind, placebo-controlled treatment with either lurasidone monotherapy (1 study) or adjunctive therapy with lithium or valproate (2 studies). Intervention Flexible doses of lurasidone, 20-120 mg/d, either as monotherapy, or adjunctive with lithium or valproate. Measurements Effectiveness was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS; change from open-label-baseline to month-6, observed case analysis). Results A total of 141 older adults entered the extension study (monotherapy, n=55; 39%; adjunctive therapy, n=86; 61%). At the end of 6 months of open-label treatment with lurasidone, as monotherapy or adjunctive therapy, minimal changes were observed in the older adult sample in mean weight (-1.0 kg and -0.4 kg, respectively); and median total cholesterol (-2.0 mg/dL and +6.0 md/dL, respectively), triglycerides (+2.5 mg/dL and +6.0 mg/dL, respectively), and HbA1c (0.0% and -0.1%, respectively). Patients treated with 6 months of lurasidone showed a mean change on the MADRS in both the monotherapy (-6.2) and adjunctive therapy (-6.7) groups. Conclusions Results of these post-hoc analyses found that up to 7.5 months of lurasidone treatment for bipolar depression in older adults was associated with minimal effects on weight and metabolic parameters, with low rates of switching to hypomania or mania, and was well-tolerated. The antidepressant effectiveness of lurasidone in this age group was maintained over the 6-month treatment period.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.08.013
       
  • Two Interventions for Patients with Major Depression and Severe COPD:
           Impact on Dyspnea Related Disability
    • Authors: George S. Alexopoulos; Jo Anne Sirey; Samprit Banerjee; Danielle S. Jackson; Dimitris N. Kiosses; Cristina Pollari; Richard S. Novitch; Amanda Artis; Patrick J. Raue
      Abstract: Publication date: Available online 10 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): George S. Alexopoulos, Jo Anne Sirey, Samprit Banerjee, Danielle S. Jackson, Dimitris N. Kiosses, Cristina Pollari, Richard S. Novitch, Amanda Artis, Patrick J. Raue
      Objective Personalized Intervention for Depressed Patients with COPD (PID-C) is an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that Problem Solving-Adherence (PSA) intervention, which integrates problem solving into adherence enhancement procedures, reduces dyspnea related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea related disability trajectories and to compare their clinical profiles. Design Randomized controlled trial. Setting Acute inpatient rehabilitation and community. Participants 101 diagnosed with COPD and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation. Intervention 14 sessions of PID-C vs. PSA over 26 weeks. Measurements Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M). Results The study hypothesis was not supported. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea related disability improved had more severe disability and less sense of control over their condition at baseline. Conclusions Improvement or no worsening of disability was noted in both treatment groups. This is a favorable course for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs, and after further testing in the community, it can be integrated in the care of depressed COPD patients.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.10.002
       
  • A Systematic Review of Practice Guidelines and Recommendations for
           Discontinuation of Cholinesterase Inhibitors in Dementia
    • Authors: Brenna N. Renn; Ali Abbas Asghar-Ali; Stephen Thielke; Angela Catic; Sharyl R. Martini; Brian G. Mitchell; Mark E. Kunik
      Abstract: Publication date: Available online 10 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Brenna N. Renn, Ali Abbas Asghar-Ali, Stephen Thielke, Angela Catic, Sharyl R. Martini, Brian G. Mitchell, Mark E. Kunik
      Cholinesterase inhibitors (ChEI) are the primary pharmacological treatment for symptom management of Alzheimer's disease (AD), but they carry known risks during long-term use, and do not guarantee clinical effects over time. The balance of risks and benefits may warrant discontinuation at different points during the disease course. Indeed, while there is limited scientific study of deprescribing ChEI, clinicians routinely face practical decisions about whether to continue or stop medications. This review examined published practice recommendations for discontinuation of ChEI in AD. To characterize the scientific basis for recommendations, we first summarized randomized controlled trials of ChEI discontinuation. We then identified practice guidelines by professional societies and in textbooks and classified them according to (1) whether they made a recommendation about discontinuation, (2) what the recommendation was, and (3) the proposed grounds for discontinuation. There was no consensus in guidelines and textbooks about discontinuation. Most recommended individualized discontinuation decisions, but there was essentially no agreement about what findings or situations would warrant discontinuation, or even about what domains to consider in this process. The only relevant domain identified by most guidelines and textbooks was a lack of response or a loss of effectiveness, both of which can be difficult to ascertain in the course of a progressive condition. Well-designed, long-term studies of discontinuation have not been conducted; such evidence is needed to provide a scientific basis for practice guidelines. It seems reasonable to apply an individualized approach to discontinuation while engaging patients and families in treatment decisions.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.09.027
       
  • Enhancing Quality of Life and Caregiver Interactions for Persons with
           Dementia Using TimeSlips Group Storytelling: a Six-Month Longitudinal
           Study
    • Authors: Alyssa A. Vigliotti; Vernon M. Chinchilli; Daniel R. George
      Abstract: Publication date: Available online 9 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Alyssa A. Vigliotti, Vernon M. Chinchilli, Daniel R. George


      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.10.001
       
  • Assessing Responsiveness of Health Systems to Drug Safety Warnings
    • Authors: Lauren B. Gerlach; Hyungjin Myra Kim; Matheos Yosef; Anne E. Sales; Claire Stano; Helen C. Kales; Kara Zivin
      Abstract: Publication date: Available online 28 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Lauren B. Gerlach, Hyungjin Myra Kim, Matheos Yosef, Anne E. Sales, Claire Stano, Helen C. Kales, Kara Zivin
      Objectives In 2011-2012, the FDA issued safety announcements cautioning providers against prescribing high doses of citalopram given concerns for QT prolongation. The authors evaluated Veterans Affairs (VA) national trends in citalopram use and dose compared to alternative antidepressants following the FDA warnings. Design Time-series analyses estimated the effect of the FDA warnings on citalopram and other antidepressant across three periods: prior to the first FDA warning in 8/2011, post-2011 FDA warning until the second warning in 3/2012, and post-2012 FDA warning. Setting National VA health system. Participants Adult VA outpatients prescribed citalopram or alternative antidepressants from 2/2010 to 9/2013. Measurements Outpatient use of high dose citalopram (>40 mg or >20 mg daily in adults >60 years old) including proportion of patients prescribed citalopram and difference between study periods. Results Between the first and second FDA warnings, among patients 18-60, high dose citalopram use decreased by 2.0% per month (p<0.001) and by 1.9% per month (p<0.001) for older adults. After the second FDA warning in 2012, 30.7% of older patients remained on doses higher than the newly recommended dose of 20 mg. Reductions in overall use of citalopram were accompanied by significant increases in prescriptions of alternative antidepressants, with sertraline being most widely prescribed. Conclusion While trends in high dose citalopram use declined following the 2011-2012 FDA warnings, roughly a third of older adults still remained on higher than recommended doses. Concomitant increases in sertraline and other antidepressant prescriptions suggest potential substitution of these medications for citalopram.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.09.024
       
  • A Systematic Review of Dementia-Related Stigma Research: Can We Move the
           Stigma Dial'
    • Authors: Lynn K. Herrmann; Elisabeth Welter; James Leverenz; Alan J. Lerner; Nancy Udelson; Cheryl Kanetsky; Martha Sajatovic
      Abstract: Publication date: Available online 12 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Lynn K. Herrmann, Elisabeth Welter, James Leverenz, Alan J. Lerner, Nancy Udelson, Cheryl Kanetsky, Martha Sajatovic
      Stigma negatively affects individuals with cognitive impairment and dementia. This literature review examined the past decade (January 2004-December 2015) of world-wide research on dementia-related stigma. Using standard systematic review methodology, original research reports were identified and assessed for inclusion based on defined criteria. Initial database searches yielded 516 articles. After removing duplicates and articles that did not fit inclusion criteria (419), 97 articles were reviewed, yielding a leaving a final total of 51 publications, mainly originating in the U.S. and Europe. Studies were assessed for date, geographic region, sample description, methodology and key findings. Reports were evaluated on; 1) how stigmatizing attitudes may present in various sub-groups, including in racial or ethnic minorities, 2) stigma assessment tools and, 3) prospective or experimental approaches to assess or manage stigma. Stigma impedes help-seeking and treatment, and occurs broadly and world-wide. Stigmatizing attitudes appear worse among those with limited disease knowledge, with little contact with people with dementia, in men, in younger individuals, and in the context of ethnicity and culture. In some cases, health providers may have stigmatizing attitudes. In research studies, there does not appear to be consensus on how to best evaluate stigma, and there are few evidence-based stigma reduction approaches. Given the projected increase in persons with dementia globally, there is a critical need for research that better identifies and measures stigma and tests new approaches that can reduce stigmatizing attitudes.

      PubDate: 2017-10-14T04:31:45Z
      DOI: 10.1016/j.jagp.2017.09.006
       
  • Depression and Functional Impairment: a Pernicious Pairing in Older Adults
    • Authors: Eric Lenze; Peggy Barco Marghuretta Bland
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Eric J. Lenze, Peggy P. Barco, Marghuretta D. Bland


      PubDate: 2017-10-09T03:44:20Z
       
  • Vignettes and Viewpoints From a Professional Autobiography
    • Authors: Jeffrey M. Lyness
      Abstract: Publication date: Available online 4 October 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Jeffrey M. Lyness
      In this professional autobiography, the author describes factors contributing to important decisions in his academic geriatric psychiatry career. Major inflection points included embarking on clinical research and later deciding to focus more on leadership roles in education and in faculty affairs. The discussion then examines themes that have emerged in reviewing this career arc, including the value of: the variety and social connectedness inherent in the academic life; cultivation of interpersonal relationships and best efforts as much as possible; an open mind ready to (collegially) seize new opportunities; and family, friends, and avocational pursuits as complements to one's profession. The author hopes that this public life review is of help to others planning or reflecting on their own career paths.

      PubDate: 2017-10-09T03:44:20Z
      DOI: 10.1016/j.jagp.2017.08.008
       
  • Baseline Vascular Cognitive Impairment Predicts the Course of Apathetic
           Symptoms after Stroke: the CASPER Study
    • Authors: Elles Douven; Sebastian Köhler; Syenna Schievink; Robert J. van Oostenbrugge; Julie Staals; Frans R.J. Verhey; Pauline Aalten
      Abstract: Publication date: Available online 28 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Elles Douven, Sebastian Köhler, Syenna Schievink, Robert J. van Oostenbrugge, Julie Staals, Frans R.J. Verhey, Pauline Aalten
      Objective - To examine the influence of VCI on the course of post-stroke depression (PSD) and post-stroke apathy (PSA). Methods - We included 250 stroke patients, who underwent neuropsychological and neuropsychiatric assessment 3 months after stroke (baseline), and at 6- and 12-month follow-up after baseline. Linear mixed models tested the influence of VCI in at least 1 cognitive domain (any VCI) or multi-domain VCI (VCI in multiple cognitive domains) at baseline, as well as domain-specific VCI at baseline on levels of depression and apathy over time, with random effects for intercept and slope. Results - Almost half of the patients showed any VCI at baseline, and any VCI was associated with increasing apathy levels from baseline to 12-month follow-up. Patients with multi-domain VCI had higher apathy scores at 6- and 12-month follow-up compared with patients with VCI in a single cognitive domain. Domain-specific analyses showed that impaired executive function and slowed information processing speed went together with increasing apathy levels from baseline to 6- and 12-month follow-up. None of the cognitive variables predicted the course of depressive symptoms. Conclusion - Baseline VCI is associated with increasing apathy levels from baseline to the chronic stroke phase, while no association was found between baseline VCI and the course of depressive symptoms. Health professionals should be aware that apathy might be absent early after stroke, but may evolve over time in patients with VCI.

      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.022
       
  • Commentary re: “TIME - Targeted Interdisciplinary Model for Evaluation
           and Treatment of Neuropsychiatric Symptoms” in the context of Emerging
           Evidence regarding Training Interventions for dementia in Nursing Homes
    • Authors: Clive Ballard; Ingelin Testad
      Abstract: Publication date: Available online 28 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Clive Ballard, Ingelin Testad


      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.021
       
  • The Two Sides of Bipolar Disorder in Nursing Homes: Mental Health Care and
           Quality Indicators
    • Authors: Julia G. Kirkham; Dallas P. Seitz
      Abstract: Publication date: Available online 28 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Julia G. Kirkham, Dallas P. Seitz


      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.020
       
  • End-of-Life Care Preferences in Patients with Severe and Persistent Mental
           Illness and Chronic Medical Conditions: a Comparative Cross-Sectional
           Study
    • Authors: Dominique Elie; Amanda Marino; Susana G. Torres-Platas; Saeid Noohi; Trent Semeniuk; Marilyn Segal; Karl J. Looper; Soham Rej
      Abstract: Publication date: Available online 25 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Dominique Elie, Amanda Marino, Susana G. Torres-Platas, Saeid Noohi, Trent Semeniuk, Marilyn Segal, Karl J. Looper, Soham Rej
      Objectives: Physicians rarely engage severe and persistent mental illness (SPMI) patients in end-of-life care discussion despite an increased risk of debilitating medical illnesses and mortality. Whereas access to quality palliative care and medical assistance in dying (MAID) has become a priority in Canada and many jurisdictions, we 1) compared SPMI and chronic medically-ill (CMI) patients' end-of-life care preferences and comfort level with end-of-life care discussion, and 2) identified potential predictors of interest in MAID. Design: Comparative cross-sectional study. Setting: Hospital-based. Participants: We recruited 106 SPMI and 95 CMI patients at the Jewish General Hospital, Canada. Patients aged ≥40 years, without severe cognitive impairment, able to communicate in English or French, and provide written informed consent were included. Measurements: Attitudes towards pain management, palliative sedation, MAID, and artificial life support were collected with the Health Care Preferences Questionnaire. Adjusted odd ratios were calculated for each end-of-life care intervention. Comfort with discussion was rated on a Likert scale. A step-wise regression analysis was performed to identify predictors of interest in MAID. Results: SPMI was not correlated to any end-of-life care intervention, except for MAID where SPMI patients were less likely to support its use (aOR = 0.48, CI 95% 0.25-0.94, p = 0.03). Religiosity was also correlated with interest in MAID (aOR = 0.14, CI 95% 0.06-0.31, p<0.001). Patients in both groups were comfortable talking about end-of-life care. Conclusions: SPMI patients are able to voice their end-of-life care preferences, and contrary to some fears, do not want MAID more than CMI patients.

      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.018
       
  • Electroconvulsive Therapy for Agitation and Aggression in Dementia –
           a Systematic Review
    • Authors: Julia F. van den Berg; Henk C. Kruithof; Rob M. Kok; Esmée Verwijk; Harm-Pieter Spaans
      Abstract: Publication date: Available online 25 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Julia F. van den Berg, Henk C. Kruithof, Rob M. Kok, Esmée Verwijk, Harm-Pieter Spaans
      Objectives Many patients with dementia develop agitation or aggression in the course of their disease. In some severe cases, behavioral, environmental, and pharmacological interventions are not sufficient to alleviate these potentially life-threatening symptoms. It has been suggested that in those cases, electroconvulsive therapy (ECT) could be an option. This review summarizes the scientific literature on ECT for agitation and aggression in dementia. Methods We performed a systematic review in accordance with PRISMA guidelines. A search was conducted in Ovid MEDLINE, EMBASE, and PsycINFO. Two reviewers extracted the following data from the retrieved articles: number of patients and their age, gender, diagnoses, types of problem behavior, treatments tried before ECT, specifications of the ECT treatment, use of rating scales, treatment results, follow-up data, and adverse effects. Results The initial search yielded 264 articles, 17 of which fulfilled the inclusion criteria. Of these studies, one was a prospective cohort study, one was a case-control study, and the others were retrospective chart reviews, case series, or case reports. Clinically significant improvement was observed in the majority (88%) of the 122 patients described, often early in the treatment course. Adverse effects were most commonly mild, transient, or not reported. Conclusion The reviewed articles suggest that ECT could be an effective treatment for severe and treatment-refractory agitation and aggression in dementia, with few adverse consequences. However, because of the substantial risk of selection bias, the designs of the studies reviewed and their small number, further prospective studies are needed to substantiate these preliminary positive results.

      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.023
       
  • Blood Pressure's Role in Alzheimer's Disease Pathology
    • Authors: Timothy M. Hughes; Samuel N. Lockhart; Stephen F. Smagula
      Abstract: Publication date: Available online 25 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Timothy M. Hughes, Samuel N. Lockhart, Stephen F. Smagula


      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.019
       
  • The Multi-Faceted Relationship between White Matter Lesions and Late-Life
           Depression
    • Authors: Minjie Wu; Howard J. Aizenstein
      Abstract: Publication date: Available online 21 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Minjie Wu, Howard J. Aizenstein


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.017
       
  • Relationship among Depression, Gait Disturbance, Disability, and
           Neurobiological Abnormalities
    • Authors: Juleen Rodakowski
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Juleen Rodakowski


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.016
       
  • University Museum
    • Authors: J. Barrie Shepherd
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): J. Barrie Shepherd


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.013
       
  • Commentary: Discrimination and Risk for Suicide in Later Life
    • Authors: Yeates Conwell
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Yeates Conwell


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.014
       
  • Cancer-Related Cognitive Impairment: Considering Risk Factors, Approaching
           Assessment, and Contemplating Treatment
    • Authors: Robin E. Valpey
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Robin E. Valpey


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.015
       
  • Caring for Nursing Home Residents with Agitation Continues to be Very
           Challenging
    • Authors: David K. Conn
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): David K. Conn


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.009
       
  • Wake-Up Call
    • Authors: J. Barrie Shepherd
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): J. Barrie Shepherd


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.09.011
       
  • Worldly Wisdom'
    • Authors: Barrie Shepherd
      Abstract: Publication date: Available online 20 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): J. Barrie Shepherd


      PubDate: 2017-09-24T02:28:42Z
       
  • Response to: Measuring Loneliness: are There Method Factors'
    • Authors: Joonyup Lee; John G. Cagle
      Abstract: Publication date: Available online 17 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Joonyup Lee, John G. Cagle


      PubDate: 2017-09-24T02:28:42Z
      DOI: 10.1016/j.jagp.2017.07.014
       
  • In vivo brain plaque and tangle burden mediates the association between
           
    • Authors: Florence F. Roussotte; Prabha Siddarth; David A. Merrill; Katherine L. Narr; Linda M. Ercoli; Jacqueline Martinez; Natacha D. Emerson; Jorge R. Barrio; Gary W. Small
      Abstract: Publication date: Available online 15 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Florence F. Roussotte, Prabha Siddarth, David A. Merrill, Katherine L. Narr, Linda M. Ercoli, Jacqueline Martinez, Natacha D. Emerson, Jorge R. Barrio, Gary W. Small
      Objective Growing evidence supports an association between increased blood pressure and: (a) poor cognitive performance in older adults, and (b) various biomarkers of increased Alzheimer's disease (AD) neuropathology. The objective of this study was to determine whether systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly associated with cognitive functioning in non-demented adults, and to examine in vivo AD pathology as a possible mediator of this association. Methods Positron emission tomography (PET) scans with 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile (FDDNP) provide in vivo measurements of plaque and tangle burden. A total of 101 non-demented older subjects with blood pressure data and FDDNP-PET scans were drawn from a larger study of predictors of cognitive decline. A neuropsychological test battery was used to compute “global cognitive scores” (averaged across five key domains), which served as an index of general cognitive functioning. Results Higher DBP (but not SBP) was significantly associated with lower cognitive scores, controlling for age, sex, antihypertensive medication use, and ApoE genotype (η2 = 0.06). However, this relationship was no longer significant after introducing FDDNP-PET binding as an additional covariate in the statistical models. In vivo plaque and tangle burden accounted for over 30% of the observed association between higher DBP and poorer cognitive performance. Conclusions By suggesting a mediation of the relationship between DBP and cognitive functioning by FDDNP-PET binding, this study advances our understanding of some potential predictors of cognitive decline in non-demented adults, and underscores the importance of devising early multimodal interventions to more effectively combat degenerative brain disorders.

      PubDate: 2017-09-18T02:03:23Z
      DOI: 10.1016/j.jagp.2017.09.001
       
  • Nature, Nurture, Personality and Behavior: What's the Formula for
           Survival'
    • Authors: Marc E. Agronin
      Abstract: Publication date: Available online 12 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Marc E. Agronin


      PubDate: 2017-09-18T02:03:23Z
      DOI: 10.1016/j.jagp.2017.09.008
       
  • Information for Subscribers
    • Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10


      PubDate: 2017-09-12T01:40:15Z
       
  • In This Issue
    • Abstract: Publication date: October 2017
      Source:The American Journal of Geriatric Psychiatry, Volume 25, Issue 10


      PubDate: 2017-09-12T01:40:15Z
       
  • Lurasidone: a New Option for Older Adults with Bipolar Disorder'
    • Authors: Soham Rej
      Abstract: Publication date: Available online 11 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Soham Rej


      PubDate: 2017-09-12T01:40:15Z
      DOI: 10.1016/j.jagp.2017.09.003
       
 
 
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