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Alzheimer's Disease (AD)
Published in Charles Theisler, Adjuvant Medical Care, 2023
B Vitamins: B vitamins lower homocysteine, which directly leads to a decrease in gray matter atrophy, thereby slowing cognitive decline. In a study in the International Journal of Geriatric Psychiatry, researchers established that vitamin B supplementation, in particular vitamins B6, B9, and B12, significantly improved cognition and memory function of older adults with mild cognitive impairment.8 Taking vitamins B6 (20 mg), B12 (500 mcg), and folic acid (800 mcg) in medicinal quantities reduced the overall shrinkage of a person’s brain by 30% over the course of the two-year study.9,10
Those old blues
Published in Patrick Rabbitt, The Aging Mind, 2019
A central theme in geriatric psychiatry has been whether depression becomes more common in old age. Some clinicians comment that depression may be a realistic response to life at any age, and that depressed patients are often in closer touch with uncomfortable realities than are the naïvely optimistic “normal”. Depression and anxiety may, indeed, be apt responses to inevitable changes. As we lose youth and the illusions that once gift-wrapped our lives, does realistic depression become the penalty for keeping our wits about our condition?
Psychosocial Assessment
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
In terms of additional psychological factors, the older adult may have pre-existing psychological disorders or substance abuse issues that can impact the course of their medical diagnoses as well as their understanding of and response to medical conditions. There is a relatively high prevalence rate for depression and other mental health disorders in the older adult population. The American Association for Geriatric Psychiatry51 has estimated that 20% of adults aged 55 and older have a mental health disorder (e.g., mood disorder, anxiety, or cognitive impairment) that is not part of normal aging. According to the Geriatric Mental Health Foundation (GMHF),52 an estimated 15%–20% of adults older than 65 in the United States have experienced depression. The GMHF also estimates that approximately 25% of those with chronic illness are affected by depression, most commonly observed in patients with ischemic heart disease, stroke, cancer, chronic lung disease, arthritis, Alzheimer disease, and Parkinson disease.
Effects of Client-Centered Occupational Therapy on Behavioral Psychological Symptoms, Social Interaction, Occupational Performance, Quality of Life, and Caregiver Burden among the Individuals with Dementia
Published in Occupational Therapy In Health Care, 2023
In general, people with dementia living in local communities are younger, have higher education and overall health levels, and have lower medical service requirements compared to those in nursing facilities (Gitlin et al., 2013). A recent study on therapeutic approaches for people with dementia has revealed more participation using leisure activities, quality of life, and maintenance of occupational performance skills, unlike previously when only the treatment of the disease itself was considered important (Korean Association for Geriatric Psychiatry, 2003). Therefore, it is necessary to develop and apply systematically, an intervention that reflects the characteristics of individuals in order to maintain the function of people with dementia in the community as long as possible (Burgener et al., 1998; Gitlin et al., 2001).
Unmet needs in the diagnosis and treatment of Parkinson’s disease psychosis and dementia-related psychosis
Published in International Journal of Psychiatry in Clinical Practice, 2023
Marwan Sabbagh, Gary W. Small, Stuart H. Isaacson, Yasar Torres-Yaghi, Fernando Pagan, Rajesh Pahwa
There are various national and international societies that have issued limited guidance for the treatment of patients with DRP (Table 2), including the American Psychiatric Association Guidelines for the Treatment of Patients with Alzheimer’s Disease and Other Dementias (Rabins et al., 2017); the American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia (Reus et al., 2020); the retired American Academy of Neurology Guidelines on the Management of Dementia (Doody et al., 2001) (developed in 2001; retired in 2012; updated guidelines are currently in development); and the American Association of Geriatric Psychiatry Position Statements (developed in 2006) (American Association for Geriatric Psychiatry, 2006, 2012). Despite the mentioned treatment guidelines, there remains an unmet need for a standardised, comprehensive, and updated guidance regarding the treatment of DRP.
Evaluating pimavanserin as a treatment for psychiatric disorders: A pharmacological property in search of an indication
Published in Expert Opinion on Pharmacotherapy, 2021
John Davis, Daisy Zamora, Mark Horowitz, Stefan Leucht
Geriatric psychiatry has assumed that geriatric patients have the same disorders as adults. The finding that 5-HT2A upregulation occurs in some elderly patients with dementia or Parkinson’s disease and can be successfully treated by a specific 5-HT2A antagonist/partial agonist suggests there is potential for unique drugs to treat mental illnesses associated with advanced age. However, both in vivo and in vitro studies have also reported a reduction of 5-HT2A receptors in some aging populations [46]. It would be helpful to establish which symptoms or characteristics might predict a favorable response to pimavanserin based on the completed clinical trials (e.g. presence of visual hallucinations). Then another RCT can establish, based on this entrance criteria, the efficacy of pimavanserin over placebo.