Abstract:
:ABSTRACTObjectives:Behavioral and psychological symptoms of dementia (BPSD) are nearly universal in dementia, a condition occurring in more than 40 million people worldwide. BPSD present a considerable treatment challenge for prescribers and healthcare professionals. Our purpose was to prioritize existing and emerging treatments for BPSD in Alzheimer's disease (AD) overall, as well as specifically for agitation and psychosis. DESIGN:International Delphi consensus process. Two rounds of feedback were conducted, followed by an in-person meeting to ratify the outcome of the electronic process. SETTINGS:2015 International Psychogeriatric Association meeting. PARTICIPANTS:Expert panel comprised of 11 international members with clinical and research expertise in BPSD management. RESULTS:Consensus outcomes showed a clear preference for an escalating approach to the management of BPSD in AD commencing with the identification of underlying causes. For BPSD overall and for agitation, caregiver training, environmental adaptations, person-centered care, and tailored activities were identified as first-line approaches prior to any pharmacologic approaches. If pharmacologic strategies were needed, citalopram and analgesia were prioritized ahead of antipsychotics. In contrast, for psychosis, pharmacologic options, and in particular, risperidone, were prioritized following the assessment of underlying causes. Two tailored non-drug approaches (DICE and music therapy) were agreed upon as the most promising non-pharmacologic treatment approaches for BPSD overall and agitation, with dextromethorphan/quinidine as a promising potential pharmacologic candidate for agitation. Regarding future treatments for psychosis, the greatest priority was placed on pimavanserin. CONCLUSIONS:This international consensus panel provided clear suggestions for potential refinement of current treatment criteria and prioritization of emerging therapies.
journal_name
Int Psychogeriatrjournal_title
International psychogeriatricsauthors
Kales HC,Lyketsos CG,Miller EM,Ballard Cdoi
10.1017/S1041610218000534subject
Has Abstractpub_date
2019-01-01 00:00:00pages
83-90issue
1eissn
1041-6102issn
1741-203Xpii
S1041610218000534journal_volume
31pub_type
杂志文章abstract:BACKGROUND:The ability to manage everyday technology (ET), such as computers and microwave ovens, is increasingly required in the performance of everyday activities and participation in society. This study aimed to identify aspects that influence the ability to manage ET among older adults with and without cognitive im...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211002092
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Nearly half of care home residents with advanced dementia have clinically significant agitation. Little is known about costs associated with these symptoms toward the end of life. We calculated monetary costs associated with agitation from UK National Health Service, personal social services, and societal per...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610219002059
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Despite the high consistency of evidence in favor of person-centered care, little information is available on how person-centered and family-centered interventions are actually provided. The aim of this study is to gain insight into the provision of the effective New York University Caregiver Intervention (N...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210000050
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Olfactory dysfunction, impaired smell identification in particular, is known as a diagnostic and a marker of conversion in Alzheimer's disease (AD). We aimed to evaluate the associations of olfactory identification impairments with cognition, illness severity, and progression in AD patients. METHODS:Fifty-s...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000446
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk fac...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211000263
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:There is suggestion that self-reported depressive syndromes can independently manifest in the general population as cognitive/affective or somatic/vegetative. The Beck Depression Inventory, 2nd edition (BDI-II), a self-report measure of depressive symptoms, has been shown to support this two-factor structure...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610212001676
更新日期:2013-03-01 00:00:00
abstract::ABSTRACTBackground:Cognitive decline is an important complication of joint replacement surgeries in senior people. METHODS:We determined incidence rates of dementia diagnosis following endoprosthetic joint replacement surgery (upper and lower extremities). The observation period covered up to 28 quarters using German...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610217002976
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The use of benzodiazepines is associated with increased risk of fall-related injuries in the elderly. However, it is unclear if the risks vary across the products and how they depend on the pattern of use and dosage. Specifically, the possibility of cumulative effects of past benzodiazepine use has not been ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211002031
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that the verbal fluency test (VFT) is a sensitive measure of cognitive dysfunction in Alzheimer's disease (AD). However, other studies have shown that the performances were significantly influenced by education in the normal elderly population. In order to examine the utility of t...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210000839
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The impact of spousal bereavement on mental health varies among the widowed. More information is needed on factors influencing bereavement outcome. METHOD:We conducted a cross-sectional study on a sample of 216 widowed individuals. Initial non-response was high, with only 8% of all approached persons partic...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610206004248
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Little is known about the prevalence of, or associations with behavioral and psychological symptoms of dementia (BPSD) in developing countries. METHODS:Individuals diagnosed as having dementia according to DSM-IV criteria (mild and moderate cases as defined by the Clinical Dementia Rating scale only), toget...
journal_title:International psychogeriatrics
pub_type: 杂志文章,多中心研究
doi:10.1017/s1041610204000833
更新日期:2004-12-01 00:00:00
abstract::ABSTRACTObjectives:The objectives of the study were to examine the trajectory of spirituality among older adults, to investigate the roles of gender and religion on the developmental trajectory of spirituality, and to explore whether the linear growth of spirituality accelerated or decelerated at time points at which ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218000029
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:There is currently a lack of consensus on the definition of successful aging (SA) and existing implementations have omitted constructs associated with SA. We used empirical methods to develop a dimensional model of SA that incorporates a wider range of associated variables, and we examined the relationship a...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211002055
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:This article analyzes the natural history of wandering behavior throughout the course of dementia. DESIGN:Prospective, 10-year, longitudinal study of wandering behavior in dementia, with autopsy follow-up. SETTING:Participants with dementia, living at home with a carer. All lived in Oxfordshire, UK. PARTIC...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610201007542
更新日期:2001-06-01 00:00:00
abstract::Positive psychiatry is the science and practice of psychiatry that focuses on psycho-bio-social study and promotion of well-being and health through enhancement of positive psychosocial factors (such as resilience, optimism, wisdom, and social support) in people with illnesses or disabilities as well as the in communi...
journal_title:International psychogeriatrics
pub_type: 社论
doi:10.1017/S1041610218002211
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Research shows that lipid levels may be associated with cognitive function, particularly among women. We aimed to examine total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL), and HDL/LDL ratio in relation to cognitive performance, measured w...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610215000320
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:To examine the effects of complex cognitive (mahjong) and physical (Tai Chi) activities on dementia severity in nursing home residents with dementia. METHODS:Cluster-randomized open-label controlled design. 110 residents were randomized by nursing home into three conditions: mahjong, Tai Chi, and simple han...
journal_title:International psychogeriatrics
pub_type: 杂志文章,随机对照试验
doi:10.1017/S1041610213002524
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to examine and test the sensitivity, specificity, and threshold scores of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) and determine those that best correspond to a clinical diagnosis of dementia with Lewy bodies (DLB). METHODS:Sixty-seven A...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213001245
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Patient and carer participation in old age psychiatry is less developed than in other areas of mental health. What can we learn from the historical context about increasing participation and how can it be conceptualized? METHODS:The historical and policy context of patient and carer participation in the Nat...
journal_title:International psychogeriatrics
pub_type: 历史文章,杂志文章,评审
doi:10.1017/S1041610211001864
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Studies indicate that diet may be related to the occurrence of brain lesions. The cross-sectional association between food intake and brain lesion volumes in late-life depression was examined in a cohort of elderly individuals with current or prior depression. METHODS:Food intake was assessed in 54 elderly ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610206004431
更新日期:2007-04-01 00:00:00
abstract::Delirium significantly increases morbidity and mortality in older people, especially those affected by other organic disorders, notably dementia (Siddiqi et al., 2006; Davis et al., 2012; Martins and Fernandes, 2012). Both delirium and dementia are characterized by cognitive decline through disintegration of brain fun...
journal_title:International psychogeriatrics
pub_type: 评论,杂志文章
doi:10.1017/S1041610216001988
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Whilst previous surveys of mental health literacy of general practitioners (GPs) have shown high rates of recognition of common mental disorders, few studies have been carried out into GPs' understanding of presentations in late life. This study aims to determine GPs' recognition of mental disorders in older...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610208008235
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:A careful characterization of behavioral abnormalities in corticobasal degeneration syndrome (CBDS) and progressive supranuclear palsy (PSP) by reliable tools is still lacking. Literature data provided evidence of the usefulness of the Frontal Behavioral Inventory (FBI) to operationalize such disturbances, p...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209008862
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:A consequence of pressure on hospitals to accommodate care needs of older patients is "boarding" or out-lying from their home ward. This may have greater adverse effects on older inpatients who are frail. METHODS:A retrospective matched cohort study was conducted in an outer metropolitan general hospital. R...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610216001605
更新日期:2017-02-01 00:00:00
abstract::Written records have been describing extreme states of emotions since ancient Greece (Angst and Marneros, 2001), but Aretaeus of Cappadocia (which is geographically located in modern Turkey) was probably the first to outline the close relationship between depression and mania nearly 2000 years ago: "I think that melan...
journal_title:International psychogeriatrics
pub_type: 社论
doi:10.1017/S1041610216001423
更新日期:2016-11-01 00:00:00
abstract::ABSTRACTBackground:The number of elderly individuals living in China is increasing rapidly. The aim of this study was to examine the potential risk factors of geriatric depression in rural areas. METHODS:A repeated cross-sectional study was conducted between January 2015 and October 2016 in rural China. Nine hundred ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218000030
更新日期:2018-10-01 00:00:00
abstract::Noisemaking is one of the most disturbing behavior disorders associated with dementia. Standard management practices, including pharmacological interventions, are not very successful in treating the behavior. Very little research has been carried out to evaluate innovative treatments or to determine the etiology of no...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610297004547
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. METHODS:Demographic and clinical da...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610217000308
更新日期:2017-08-01 00:00:00
abstract::Many nursing home residents are candidates for antipsychotic pharmacotherapy for dementia-related behavioral disturbances that include physical agitation and aggression, verbal outbursts, anxiety, and depression. These patients are often resistant to or intolerant of standard neuroleptics and are usually receiving mul...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/s1041610297004213
更新日期:1997-03-01 00:00:00
abstract::ABSTRACTObjectives:Centenarians have survived into very late life, but whether they reach very old age in good health remains unclear. The purpose of this study was to compare the cardiovascular health status and cognitive functioning of centenarians in the United States with centenarians in Japan. DESIGN, SETTING, A...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218001813
更新日期:2019-04-01 00:00:00