Abstract:
:Major depression in the elderly is often a relapsing, chronic illness with high risk for chronic invalidism, poor treatment compliance, and suicide. In most cases, maintenance treatment to prevent recurrence and to enhance the quality of life is thought to be indicated. We review recent data from our ongoing studies that support both the efficacy and the safety of pharmacotherapeutic and psychotherapeutic maintenance treatments. However, the challenges of conducting maintenance therapy research (particularly with a placebo control) with the elderly are many, involving such areas as recruitment, retention, compliance, choice of outcome measures, and informed consent. We discuss each of these challenges and our responses to them. Finally, we suggest that maintenance therapy trials should be extended in several directions: (a) long-term treatment of bipolar and delusional subtypes in the elderly, as well as depression associated with progressive neurodegenerative disorders such as Alzheimer's dementia; (b) assessment of the benefits and risks of long-term therapy with other than tricyclic and monoamine oxidase inhibitor antidepressant agents, such as selective serotonin reuptake inhibitors; and (c) development of models of long-term course, including the interaction of treatments with medical and psychosocial variables that can have a profound impact on illness onset and offset. These issues are illustrated with a discussion of a new protocol designed to test the acute and maintenance efficacy of antidepressant therapy for depressed patients with Alzheimer's disease.
journal_name
Int Psychogeriatrjournal_title
International psychogeriatricsauthors
Reynolds CF 3rd,Frank E,Perel JM,Mazumdar S,Kupfer DJdoi
10.1017/s104161029500233xsubject
Has Abstractpub_date
1995-01-01 00:00:00pages
27-39eissn
1041-6102issn
1741-203Xjournal_volume
7 Supplpub_type
杂志文章,评审abstract:OBJECTIVE:This study sought to conduct a comprehensive search for genetic risk of cognitive decline in the context of geriatric depression. DESIGN:A genome-wide association study (GWAS) analysis in the Neurocognitive Outcomes of Depression in the Elderly (NCODE) study. SETTING:Longitudinal, naturalistic follow-up stu...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610220001143
更新日期:2020-07-09 00:00:00
abstract:BACKGROUND:Neuropsychiatric symptoms (NPS) are highly prevalent among nursing home patients with dementia. Several studies have investigated subsyndromes of NPS but the stability of these subsyndromes over time has rarely been examined. We have examined the stability over time of the factor structure of the Neuropsychi...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161021100086X
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Preliminary evidence indicates that the quality of the carer-care recipient relationship predicts those carers most at risk from anxiety. Attachment style is related to higher carer burden, psychological morbidity and increased care recipient institutionalization. We tested, for the first time, the hypothesi...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S104161020700645X
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:We examine the association between leisure-time activities and the risk of developing cognitive impairment among Chinese older people, and further investigate whether the association varies by educational level. METHODS:This follow-up study included 6,586 participants (aged 79.5 ± 9.8 years, range 65-105 ye...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610216001769
更新日期:2017-05-01 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 economic cost of dementia is high and can be predicted by cognitive and neuropsychiatric profiles. The differential costs of the various subtypes of dementia are unknown in Argentina, and this study therefore aimed to compare these costs. METHODS:Patients with a diagnosis of dementia of Alzheimer-type (...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610210002012
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Identification of factors associated with quality of life (QoL) in people having dementia will help develop strategies for maintenance and improvement of patient QoL. This study examined the predictors of QoL in a community-dwelling population aged 75 years and over, with or without dementia. METHODS:This w...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610212001111
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Health services are encouraged to adopt a strong person-centered approach to the provision of care and services for older people. The aim of this project was to establish a user-friendly, psychometrically valid, and reliable measure of healthcare staff's practice, attitudes, and beliefs regarding person-cent...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000471
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Apathy, characterized by diminished motivation, is a highly prevalent neuropsychiatric symptom in dementia. However, there is a substantial knowledge gap with regard to prevalence rates, neurobiological underpinnings, and effective treatments for apathy in pre-dementia states, including mild cognitive impair...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610217000527
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Emotional distress associated with Parkinson's disease (PD) increases disease burden and decreases functioning. The literature supports the benefits of psychological interventions for amelioration of emotional distress in persons with PD. The objective of this study is to apply the Contextual Adult Lifespan ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610216000569
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The anxiety disorders are a prevalent mental health problem in older age with a considerable impact on quality of life. Until recently there have been few longitudinal studies on anxiety in this age group, consequently most of the evidence to date has been cross-sectional in nature. METHODS:We undertook a l...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610214001847
更新日期:2015-07-01 00:00:00
abstract::ABSTRACTBackground:US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmor...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610218000212
更新日期:2018-10-01 00:00:00
abstract::ABSTRACT Background: Cognitive impairment is underrecognized and misdiagnosed among community-dwelling older adults. At present, there is no consensus about which cognitive screening tool represents the "gold standard." However, one tool that shows promise is the Brief Cognitive Assessment Tool (BCAT), which was origi...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610214001458
更新日期:2014-08-13 00:00:00
abstract::ABSTRACTBackground:Evidence suggests that semantic interference may be a sensitive indicator of early dementia. We examined the utility of the Semantic Interference Test (SIT), a cognitive stress memory paradigm which taps proactive and retroactive semantic interference, for predicting progression from mild cognitive ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610217002666
更新日期:2018-10-01 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:BACKGROUND:The Charles Bonnet syndrome (CBS) is characterized by distinct visual hallucinations and ocularpathology causing visual impairment in patients with insight and the absence of psychiatric comorbidity. The number of reported cases of CBS is expanding as the population ages and the prevalence of vision disorder...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213000719
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The field of geriatric medicine has identified a need for an evaluative tool that can rapidly quantify global cognitive ability and accurately monitor change over time in patients with a wide range of impairments. We hypothesized that the development of an adaptive test approach to cognitive measurement woul...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610211000615
更新日期:2011-09-01 00:00:00
abstract::Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benefits in this variably progressive syndrome is complex and difficult. This consensus statement was generated by an international group representing caregivers, organizations and professionals with expertise in dementia. We r...
journal_title:International psychogeriatrics
pub_type: 共识发展会议,杂志文章
doi:10.1017/S1041610207005145
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:This review presents an overview of the published literature on the effectiveness of continuing professional education (CPE), which includes continuing medical education (CME) of different health care professionals in healthcare settings, for improving patient management and patient outcomes. This review sum...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610209008746
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countries and professionals ...
journal_title:International psychogeriatrics
pub_type: 杂志文章,评审
doi:10.1017/S1041610210000736
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to examine the impact of residential respite care on disruptive behavior displayed by older people, particularly those with dementia. METHODS:A quasi-experimental, repeated-measures, single-group design was used. The participants were a consecutive series of 100 older people with a...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610205002553
更新日期:2006-03-01 00:00:00
abstract::The focus of this report is the treatment of persons with dementia who are of a non-English-speaking background (NESB). Noisemaking is one behavioral manifestation associated with severe dementia. It can have devastating effects on persons with dementia by limiting their access to activity programs and social interact...
journal_title:International psychogeriatrics
pub_type: 临床试验,杂志文章
doi:10.1017/s1041610299005864
更新日期:1999-09-01 00:00:00
abstract::This article reviews the evidence available from natural history studies and randomized clinical trials (RCT) concerning what is now coined as amnestic MCI and vascular MCI and will answer the question about the similarity and difference of their progression toward dementia. The issues to be resolved prior to the use ...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610203009293
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Young-onset dementia (YOD) is defined as dementia that develops before the age of 65 years. The prevalence and type of neuropsychiatric symptoms (NPS) in YOD differ from patients with late onset dementia. NPS in dementia patients are often treated with psychotropic drugs. The aim of this study was to investi...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610213002330
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Workforce shortages to meet the mental health needs of the world's aging population are well documented. Within the field of professional geropsychology in the U.S.A., a national conference was convened in 2006 to delineate competencies for psychological practice with older adults and a training model for th...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209991736
更新日期:2010-09-01 00:00:00
abstract::Alzheimer´s disease (AD) is a severe neurodegenerative brain disorder characterized by beta-amyloid plaques, Tau pathology, inflammation, neurodegeneration, and cerebrovascular dysfunction. Besides that, alterations in monocytes and platelets have been reported in the blood of Alzheimer patients. In the present study,...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610217001612
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:There is increasing interest in identifying novel cognitive paradigms to help detect preclinical dementia. Promising results have been found in clinical settings using the Semantic Interference Test (SIT), a modification of an existing episodic memory test (Fuld Object Memory Evaluation) that exploits vulner...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209991657
更新日期:2010-08-01 00:00:00
abstract::I read with great interest the study of Petrazzuoli et al. (2017) on exploring dementia management attitudes in primary care. The authors made a laudable effort to evaluate this important issue, which certainly needs timely attention. The high response rate from 25 member countries of the European General Practice Res...
journal_title:International psychogeriatrics
pub_type: 评论,信件
doi:10.1017/S1041610217003003
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The elderly are at high risk of developing tuberculosis. The prevalence and incidence of depression and anxiety are higher in those with tuberculosis than in the general population. A positive correlation between national suicide rates and rates of mortality due to tuberculosis has been reported. METHODS:Th...
journal_title:International psychogeriatrics
pub_type: 杂志文章
doi:10.1017/S1041610209990378
更新日期:2009-12-01 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