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International Psychogeriatric Association [keywords]
- Prevalence and Correlates of Renal Disease in Older Lithium Users: A Population-Based Study. [JOURNAL ARTICLE]
- Am J Geriatr Psychiatry 2014 Feb 2.
Lithium is an important treatment for mood disorders, but concern about its association with renal disease has contributed to its limited use, particularly in older adults. Because high-quality evidence examining renal disease in this population is lacking, this study aims to quantify the prevalence and identify clinical correlates of renal disease in geriatric lithium users.In a population-based cross-sectional study on 2,480 lithium users aged 70 or more years, the authors searched the provincial administrative health data from Ontario, Canada between April 1, 2005 and March 31, 2011. Prevalence of chronic kidney disease (CKD), acute kidney injury (AKI), and nephrogenic diabetes insipidus (NDI) was measured using International Classification of Diseases, Tenth Revision codes. Logistic regression analyses were used to identify independent correlates of renal disease.The 6-year prevalence rates of CKD, AKI, and NDI were 13.9%, 1.3%, and 3.0%, respectively. Hypertension (odds ratio [OR]: 2.05; 95% confidence interval [CI]: 1.50-2.79), diabetes mellitus (OR: 1.86; 95% CI: 1.45-2.38), ischemic heart disease (OR: 1.65; 95% CI: 1.24-2.20), NDI (OR: 2.54; 95% CI: 1.47-4.40), AKI (OR: 11.7; 95% CI: 5.26-26.1), lithium use for more than 2 years (OR: 1.71; 95% CI: 1.05-2.81), loop diuretic use (OR: 1.74; 95% CI: 1.26-2.41), hydrochlorothiazide use (OR: 1.48; 95% CI: 1.07-2.05), and atypical antipsychotic use (OR: 1.49; 95% CI: 1.17-1.89) were all independently associated with CKD.Older lithium users have high rates of CKD. Lithium use duration was independently associated with CKD. Longitudinal studies including individuals without lithium exposure will be necessary to confirm whether lithium is indeed a risk factor for CKD in older adults.
- International Psychogeriatrics and the International Psychogeriatric Association: a successful marriage turns silver. [Editorial]
- Int Psychogeriatr 2014 Jan; 26(1):1-2.
- Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach. [Journal Article, Research Support, Non-U.S. Gov't]
- Int Psychogeriatr 2014 Feb; 26(2):217-28.
Mental health professionals are frequently involved in mental capacity determinations. However, there is a lack of specific measures and well-defined procedures for these evaluations. The main purpose of this paper is to provide a review of financial and testamentary capacity evaluation procedures, including not only the traditional neuropsychological and functional assessment but also the more recently developed forensic assessment instruments (FAIs), which have been developed to provide a specialized answer to legal systems regarding civil competencies.Here the main guidelines, papers, and other references are reviewed in order to achieve a complete and comprehensive selection of instruments used in the assessment of financial and testamentary capacity.Although some specific measures for financial abilities have been developed recently, the same is not true for testamentary capacity. Here are presented several instruments or methodologies for assessing financial and testamentary capacity, including neuropsychological assessment, functional assessment scales, performance based functional assessment instruments, and specific FAIs.FAIs are the only specific instruments intended to provide a specific and direct answer to the assessment of financial capacity based on legal systems. Considering the need to move from a diagnostic to a functional approach in financial and testamentary capacity evaluations, it is essential to consider both general functional examination as well as cognitive functioning.
- Interleukin-1 alpha (rs1800587) genetic polymorphism is associated with specific cognitive functions but not depression or loneliness in elderly males without dementia. [Journal Article, Research Support, Non-U.S. Gov't]
- Neurosci Lett 2013 Nov 27.:69-72.
Inflammatory process is considered to be a pathway that results in neurodegeneration, and numerous plasma cytokines have been examined for their association with cognitive function and depression. Interleukin-1 alpha (IL-1A) genetic polymorphism (rs1800587) has been found to be associated with Alzheimer's disease susceptibility. The aim of this study was to investigate the effect of IL-1A rs1800587 genetic effects on cognitive functions, loneliness and depression severity in elderly males without dementia or major depression. 192 non-demented Chinese elderly male were recruited and underwent Cognitive Abilities Screening Instrument (CASI), Wechsler Digit Span Task, Geriatric Depression Scale-short form, and UCLA Loneliness Scale assessment. IL-1A rs1800587 is a C to T transition at position -889. Compared to the C/C carriers, the T allele carriers had significantly overall higher CASI score (p=0.017) after using age and total education years as co-variates. This was especially true in the four distinct domains of long-term memory (p<0.001), orientation (p=0.017), visual construction (p=0.003), and list-generating fluency (p=0.020). This polymorphism is not associated with Geriatric Depression Scale-short form or UCLA Loneliness Scale. Our data supports that the T allele of IL-1A rs1800587 genetic polymorphism is associated with better cognitive function in the elderly. Further research will be needed to better understand the molecular mechanism for IL-1A genetic effects on cognitive function in the elderly.
- The 2013 International Psychogeriatric Association Junior Research Awards in Psychogeriatrics. [Editorial]
- Int Psychogeriatr 2013 Dec; 25(12):1915-6.
- The association of poor economic condition and family relations in childhood with late-life depression. [Journal Article]
- Psychiatr Danub 2013 Sep; 25(3):241-7.
Late-life depression encompasses both patients with late-life onset of depression (>60 years) and older adults with a prior and current history of depression. The aim of the study was to analyze the impact of the economic condition and family relations in childhood as risk factors for late-life depression.This was an analytical cross-sectional study comprising 120 subjects, 60 patients with unipolar depression and 60 subjects without depressive disorders, diagnosed in accordance with the 10-th International Classification of Mental and Behavioural Disorders. All participants in the study were above the age of 60 and there was no significant statistical difference in the sex proportion in both groups (p>0.05). Data for the examination were taken from a self-reported questionnaire designed for our aim. The Geriatric Depression Scale was used to measure depressive symptoms.Our results have shown that severe financial difficulties are important events in childhood and are risk factors for depression in the elderly (Chi-square=12.68, df=2, p=0.0018). Our investigation has found the association of family relations with late-life depression. In fact, conflictual relations in the family were more common in the experimental group than in the control group (Chi-square=14.32, df=3, p=0.0025). Furthermore, father's addiction to alcohol in childhood was associated with depression in later life (p=0.013). The difference in childhood emotional neglect and unequal treatment between siblings in both groups was insufficient to be confirmed statistically, but the examinees with this trauma had a threefold higher chance of having depression later in life (Odds ratio=3.04, 95% CL0.92 < OR<10.65; Yates chi-square=3.2, df=1, p=0.07). Subjects who have estimated their mother (p=0.019) or father (p=0.046) having negative personal character traits had a significantly greater risk for development of late-life depression.Negative socio-economic circumstances as well as family conflicts during childhood are associated with late-life depression. Father's addiction to alcohol and parents' negative personal character traits are associated with depression in the elderly.
- Prevalence and Gender Differences in Late-Life Depression: A Population-Based Study. [Journal Article]
- Am J Geriatr Psychiatry 2014 Apr; 22(4):370-80.
The worldwide phenomenon of an aging population combined with the increasing prevalence of depression in late life are issues that need to be addressed. This study aims to estimate the frequency of depression and subthreshold depression occurring in a sample of cognitively well-functioning, community-dwelling, older Italian adults and to investigate sociodemographic and clinical correlates of depression, exploring gender differences.We used a cross-sectional analyses of survivors in a population-based study (the Faenza Project) that included 359 subjects aged 74 years and older (49.3% women). A modified version of Cambridge Examination for Mental Disorders of Elderly Persons-Revised was administered to all participants. Prevalence rates of depression and 95% confidence intervals (CIs) were estimated according to International Classification of Diseases, Tenth Revision criteria. Statistical analyses were implemented to describe sociodemographic and clinical features associated with depression. Odds ratios were estimated by multivariate logistic regression, and the dependant variable was any type of depression.Overall prevalence of depression was 25.1% (95% CI: 20.6-29.6), with no evidence of gender difference. Prevalence of mild, moderate, and severe depression was 16.4% (95% CI: 12.6-20.2), 7.5% (95% CI: 4.8-10.2), and 1.1 (95% CI: -0.4-2.6), respectively. A rate of 5.6% of the population complained of subthreshold depressive symptoms. After age 81, depression occurrence decreased as age increased. The association between depression and functional measures, such as primary activity, mobility, and disability in performing household chores, were stronger in men than in women. Similarly, severely disabling conditions like stroke were more strongly associated with depression in men than in women.Our data suggest a disparity between men and women regarding the impact of depression on everyday life. Specific gender differences need to be taken into account for the evaluation of the depression-related burden in late life.
- Anxiety, depression, and fall-related psychological concerns in community-dwelling older people. [Journal Article]
- Am J Geriatr Psychiatry 2013 Dec; 21(12):1287-91.
Establish the association between affect and fall-related psychological concerns (fear of falling, fall-related self-efficacy, balance confidence, and outcome expectancy).A total of 205 community-dwelling older people (mean age 81, SD 7.5 years) completed the Geriatric Depression Scale-15, Geriatric Anxiety Inventory, Modified Survey of Activities and Fear of Falling, Falls-Efficacy Scale- International, Activity-Specific Balance Confidence Scale, and the Consequences of Falling Scale.Hierarchical regression models showed that anxiety was independently associated with all fall-related psychological concerns; depression was only associated with falls efficacy. Associations between fall-related psychological concerns and age, gender, accommodation,medications, self-rated physical health, falls history, mobility, and sensory aids are also discussed.This is the first study that investigates the association between affect and the four fall-related psychological concerns. Anxiety was a significant factor associated with all four, whereas depression was only associated with activity avoidance. Implications for healthcare providers are discussed.
- Association between depressive symptoms and metabolic syndrome in Japanese community-dwelling older people: a cross-sectional analysis from the baseline results of the Fujiwara-kyo prospective cohort study. [Journal Article, Research Support, Non-U.S. Gov't]
- Int J Geriatr Psychiatry 2013 Dec; 28(12):1251-9.
Metabolic syndrome contains many risks for medical diseases such as cardiovascular disease and diabetes, which might precipitate depressive symptoms in the older people. However, the association between depressive symptoms and metabolic syndrome in Japanese community-dwelling older people is unclear. This study was performed to answer this important question.Cross-sectional analyses were performed on 3796 community-dwelling independent older people (≥ 65 years, 1911 men and 1885 women) from the 2007-2008 baseline examination of the Fujiwara-kyo study, a prospective cohort study on successful aging. Depressive symptoms were assessed using the 15-item short form of the Geriatric Depression Scale and metabolic syndrome was defined according to the 2005 International Diabetes Federation. Covariates were social supports, negative life events, health behavior, education, cognitive function, anthropometric status, and others. Multiple logistic regression analyses were performed to determine the relationships between depressive symptoms and these variables.The prevalence of depressive symptoms (Geriatric Depression Scale-15 ≥ 6) and metabolic syndrome were 14.8% and 16.6%, respectively. Significant protective factors against depressive symptoms were higher education, more opportunity for drinking of alcohol, better social supports, and more walking daily. Metabolic syndrome was statistically associated with depressive symptoms (adjusted odds ratio = \ 1.32, 95% confidence interval = 1.03-1.68). Other risk factors significantly associated with depressive symptoms were sleep disturbance, visual or hearing impairment, and negative life events.The present study showed an association between metabolic syndrome and depressive symptoms in ambulatory Japanese older people, as in western countries.
- Anxiety, Depression, and Fall-Related Psychological Concerns in Community-Dwelling Older People. [JOURNAL ARTICLE]
- Am J Geriatr Psychiatry 2012 Aug 22.