April 22nd 2024
What is the efficacy of ECT for the treatment of dementia?
Introduction: Dementia, Delirium, Depression, Drugs, and Driving
July 28th 2012Of the 3 informative articles included in this special geriatric collection, 1 offers a perspective on the treatment of depression that does not focus on somatotherapy. The others remind us of 2 additional geriatric Ds of importance: drugs and driving.
Read More
Brain Aging and Dementia: Practical Tips From Clinical Research
June 29th 2012Age is a major risk factor for the development of Alzheimer disease and other dementias. New technologies in brain imaging represent major advances in our ability to diagnose age-related cognitive and behavioral disorders.
Read More
Video: Delaying Symptom Deterioration in Alzheimer Dementia
December 17th 2011Anton Porsteinsson, MD, discusses some specifics for fine-tuning the care of patients with Alzheimer disease. Here: optimizing physical health and mental stimulation and promoting a brain-healthy diet and aerobic exercise.
Read More
As I lie in my hospital bed, attempting to breathe through my trach tube at a normal rate, waiting for my morning medication, and hoping to hear good, or at least manageable, results from my doctors when they come to me on rounds, my mind wanders. Despite the precariousness of my situation, I can’t help but smile as I think of my now monthly psychotherapy sessions.
Read More
DSM-5: Continuing the Confusion about Aging, Alzheimer’s and Dementia
July 15th 2010Since the early twentieth century, when Alois Alzheimer and Emil Kraepelin constructed it as a unified clinical-pathological entity, Alzheimer’s disease has been both one of the most stable and one of the most problematic neuropsychiatric entities.
Read More
One Step Closer to Getting a Handle on Alzheimer Disease
June 24th 2010The causes of Alzheimer disease and attempts to predict who is at risk for it have been confounding the medical profession ever since Dr Alzheimer first described the disorder in 1906. Finally, a breakthrough in dye and imaging technology may be the key to solving the puzzle.
Read More
Medical Decision-Making Capacity of Patients With Dementia
December 14th 2009The United States Census Bureau projects that by 2010 nearly 13% of the US population will be over the age of 65. The elderly are one of the most rapidly growing segments of the US population and are expected to account for more than 20% of the total population by 2050.1 In 2001, the prevalence of dementia in North America was 6.4%. A 49% increase in the number of people with dementia is expected by 2020, and a 172% increase by 2040.2 Patients with dementia may lack the capacity to consent to treatment. The need to evaluate capacity to consent to treatment will therefore increase as the aging population grows.
Read More
Comorbidity: Psychiatric Comorbidity in Persons With Dementia
April 16th 2009The assessment and treatment of psychiatric symptoms in persons with cognitive dysfunction are becoming increasingly important. Prevalence estimates of dementia in the United States range from 5% in those aged 71 to 79 years to 25% to 50% in those 90 or older.
Read More
Evaluating Capacity to Make a WillPsychological Autopsy and Assessment of Testamentary Capacity
December 2nd 2008It is an ancient practice to state instructions for distributing one’s property after death. In Genesis 48, Jacob verbally bequeaths his property to Joseph, Joseph’s siblings, and Joseph’s 2 sons. Wills existed in ancient Greece and Rome, with restrictions.
Read More
The Dementias: Neuropsychiatric Syndromes of the 21st Century
October 1st 2008In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.
Read More
Antipsychotics in Dementia: Evidence of Risk Mounts
October 1st 2008The use of antipsychotics to quiet agitated older adults with dementia has come under increasing fire. After a Canadian study demonstrated an increased risk of adverse events or death with these agents,1 the FDA expanded its earlier warning to physicians.
Read More
Parkinson Disease: Phenomenology and Treatment of the Most Common Psychiatric Symptoms
March 1st 2008Parkinson disease (PD) is a progressive neurodegenerative disorder that is characterized by its motor signs, including resting tremor, rigidity, bradykinesia, and postural instability. PD is more common in the elderly, and there is usually no family history of the disease.
Read More
Agitation in Dementia: Update and Prospectus
February 1st 2008On a hypothetical morning, you've arrived early at your office to answer e-mails and respond to prescription requests without interruptions. The following voice mail, left for you much earlier that day, awaits your attention: "Doctor, I need to discuss my mother's behavior with you. The medications she's taking might be calming her down during the days, but she's not okay at night."
Read More
Medications for Agitation in Dementia: Seeking Efficacy With Safety References
January 1st 2008Almost 3 years after the FDA warned of increased mortality in elderly patients who received atypical antipsychotics off-label for neuropsychiatric syndromes of dementia, no medication has been approved as safe and effective for this increasingly challenging problem. Recent publications, however, including a white paper from the American College of Neuropsychopharmacology (ACNP), indicate that clinical investigators are wrestling with the dilemma and considering potential alternatives to antipsychotics.
Read More
Recognition of Apathy as Marker for Dementia Growing
October 1st 2007A recent 4-year study linked apathy to a hastened decline in persons with Alzheimer disease (AD). Another recent study found that persons with mild cognitive impairment (MCI) were more likely to convert to AD a year later if they also had apathy.
Read More
Cognitive Complaints: Their Role in Detecting MCI and Dementia
October 1st 2007Short of mass screening of the elderly using a neuropsychological test or some yet-to-be-determined biomarker, persons with cognitive disorders come to the attention of the health care system only when symptoms are recognized. Occasionally, physicians identify cognitive deficit on routine examination or when they notice patients having trouble following instructions (eg, taking medications properly)
Read More