International Journal of Geriatric Psychiatry

doi: 10.1002/gps.2399pmid: N/A

In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Reviews; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

van Vliet, Deliane; de Vugt, Marjolein E.; Bakker, Christian; Koopmans, Raymond T. C. M.; Verhey, Frans R. J.

doi: 10.1002/gps.2439pmid: 20957692

Objective When it comes to dementia, caregiving can have adverse effects on the psychological and physical health of the informal caregiver. As yet, little is known about the impact of caring for a young dementia patient. This review provides an overview of the literature concerning the impact of early onset dementia (EOD) on informal caregivers and on children of EOD patients. The available literature comparing the impact on EOD and late onset dementia (LOD) caregivers will also be provided. Methods PubMed, Psychinfo, and Cinahl were searched for articles that considered the psychological or psychosocial impact of EOD on informal caregivers and children. The methodological quality of the studies was assessed in order to make better judgments about the value of each article. Results Seventeen articles were included, of which the overall methodological quality was limited. The results showed that EOD caregivers experienced high levels of burden, stress, and depression. When compared with LOD caregivers, results were inconclusive. Furthermore, the caregivers of EOD patients experienced a variety of psychosocial problems, including relational problems, family conflict, problems with employment, financial difficulties, and problems concerning diagnosis. Conclusions Whether there is a difference in impact between EOD and LOD on caregivers is still unclear. The studies conducted are methodologically too limited to answer this question. Nevertheless, it is clear that EOD caregivers do seem to experience high levels of psychological suffering and specific problems related to their phase in life. Copyright © 2010 John Wiley & Sons, Ltd.

Raue, Patrick J.; Schulberg, Herbert C.; Lewis‐Fernandez, Roberto; Boutin‐Foster, Carla; Hoffman, Amy S.; Bruce, Martha L.

doi: 10.1002/gps.2444pmid: 19946872

Objective We suggest that clinicians consider models of shared decision‐making (SDM) for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. Methods We explore the characteristics and techniques of patient–clinician SDM, with particular emphasis on this model's relevance to the unique treatment concerns of depressed older adults. Results We describe a SDM intervention to engage older adults in depression treatment in the primary care sector. Conclusions It is timely to examine SDM models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes. Copyright © 2009 John Wiley & Sons, Ltd.

Mitford, Emma; Reay, Robert; McCabe, Kate; Paxton, Roger; Turkington, Douglas

doi: 10.1002/gps.2437pmid: 20029820

Objective To consider the characteristics of first episode psychosis in older adults in a county in North East England. Method/Design The present study used a naturalistic design to compare individuals aged 65 years and over with those under 65, with a first episode psychosis. Data were collected on demographics, diagnosis at presentation and hospital admissions in the first year. Results Almost a quarter of all patients were aged 65 years or older. The older group were admitted later on after presentation, but with longer average hospital stays (p < 0.01), compared to the younger group, with no difference in the use of the Mental Health Act. Late onset schizophrenia (40–59 years) and very late onset schizophrenia‐like psychosis (60 + years) formed a considerable proportion of patients. Conclusions There is a substantial proportion of older people with first episode psychosis, with a significant use of hospital bed days. There are large gaps in services for this group who often do not have the same access to those offered to younger people, e.g. Assertive Outreach or crisis teams, access to Clozapine and CBT. Ageism exists in all forms; the elderly are doubly disadvantaged in view of their age and mental illness. In view of the Age Discrimination Act (2006) the elderly functionally ill group of patients should be entitled to the same level of care and equal access to services as younger people. More attention and interventions need to be focused on this overlooked group. © Crown copyright 2009. Reproduced with the permission of Her Majesty's Stationery Office. Published by John Wiley & Sons, Ltd.

Archer, H. A.; Kennedy, J.; Barnes, J.; Pepple, T.; Boyes, R.; Randlesome, K.; Clegg, S.; Leung, K. K.; Ourselin, S.; Frost, C.; Rossor, M. N.; Fox, N. C.

doi: 10.1002/gps.2440

Chen, Shulin; Chiu, Helen; Xu, Baihua; Ma, Yan; Jin, Tao; Wu, Manhua; Conwell, Yeates

doi: 10.1002/gps.2442pmid: 20029795

Objective The aim of this study was to examine the reliability and validation of the 9‐item Patient Health Questionnaire (PHQ‐9) for late‐life depression in Chinese primary care. Methods In the primary care clinics (PCCs) of Hangzhou city, we recruited 364 older patients (aged ≥ 60) for the PHQ‐9 screening. Then 77 of them were further interviewed with Structured Clinical Interview for DSM Disorders (SCID) for the diagnosis of major depression in late life. Statistic strategies for the feasibility, reliability, validity, and receiver operating characteristic curve were performed. Results The mean administration time was 7.5 min, and the Cronbach's α was 0.91. The optimal cut‐off score of PHQ‐9 ≥ 9 revealed a sensitivity of 0.86, specificity of 0.77, and positive likelihood ratio of 5.73. The area under the curve (AUC) in this study was 0.92 (SD = 0.02, 95% CI 0.88–0.96). The PHQ‐2 also revealed good sensitivity (0.84) and specificity (0.90) at the cut‐off point≥ 3. Conclusions The PHQ‐9 performs well and has acceptable psychometric properties for screening of patients with late‐life depression in Chinese primary care settings. Copyright © 2009 John Wiley & Sons, Ltd.

Reynolds, Charles F.; Dew, Mary Amanda; Martire, Lynn M.; Miller, Mark D.; Cyranowski, Jill M.; Lenze, Eric; Whyte, Ellen M.; Mulsant, Benoit H.; Pollock, Bruce G.; Karp, Jordan F.; Gildengers, Ariel; Szanto, Katalin; Dombrovski, Alexandre Y.; Andreescu, Carmen;

Vercambre, Marie‐Noël; Cuvelier, Hélène; Gayon, Yasemin Atakuman; Hardy‐Léger, Isabelle; Berr, Claudine; Trivalle, Christophe; Boutron‐Ruault, Marie‐Christine; Clavel‐Chapelon, Françoise

doi: 10.1002/gps.2447pmid: 20054838

Woo, Benjamin K. P.; Harwood, Dylan G.; Melrose, Rebecca J.; Mandelkern, Mark A.; Campa, Olivia M.; Walston, Amy; Sultzer, David L.

doi: 10.1002/gps.2452pmid: 20069587

Objective Executive deficits are common in patients with Alzheimer's disease (AD), contribute prominently to clinical disability, and may be associated with frontal lobe pathology. This study examined regional brain hypometabolism associated with executive dysfunction in patients with AD. Methods Forty‐one patients with probable AD underwent (18F) fluorodeoxyglucose positron emission tomography (FDG‐PET) imaging at rest. Neuropsychological measures of executive control included the Conceptualization (Conc) and Initiation/Perseveration (I/P) subscales of the Mattis Dementia Rating Scale (DRS), the Wechsler Adult Intelligence Scale (WAIS) Similarities subtest, the Tower test, and the Ruff Figural Fluency test (Ruff). Voxel‐based analyses were conducted using statistical parametric mapping (SPM2) to measure the correlation between regional cerebral metabolism and executive measures. Correlations independent of global cognitive impairment were identified by including Mini‐Mental State Examination (MMSE) score as a covariate in the model. Results Executive deficits, as measured by poor performances on the DRS I/P and Conc subscales, were associated with hypometabolism in the bilateral mid‐dorsolateral frontal region. Activity in posterior cortical regions also contributed uniquely to some aspects of executive functioning, as lower resting metabolism in parietal or temporal cortex was correlated with poor performance on four of the five executive measures. After controlling for global cognitive score, there were significant extra‐frontal correlations with hypometabolism in insula, occipital lobe, and temporal cortex. Conclusions Some but not all executive deficits in AD are associated with neural activity in the dorsolateral frontal cortex. Activities in distributed neural systems that include parietal and temporal cortex also contribute to some executive abilities. The pathophysiology of executive dysfunction is complex and includes abnormalities not limited to a single region. Copyright © 2010 John Wiley & Sons, Ltd.

Weyerer, Siegfried; Schäufele, Martina; Hendlmeier, Ingrid

doi: 10.1002/gps.2455pmid: 20054837

Objective Two‐thirds of all residents in nursing homes in Germany suffer from some type of dementia. We investigated whether or not dementia patients receiving special (segregated or partially segregated) care exhibited a better quality of life than their counterparts residing in traditional nursing homes. Methods In a cross‐sectional study in 28 special dementia care facilities in the city of Hamburg (admission criterion: mobile dementia patients with behaviour problems) 594 residents were compared to a group of nursing home residents with dementia (n = 573) in 11 randomly selected nursing homes who were receiving traditional integrative care. Primary features such as cognitive and functional impairment, and behaviour problems were assessed by qualified nursing staff. Results Controlling for confounding variables, for dementia patients in special care units as compared to a reference group in traditional integrative care, the level of volunteer caregiver involvement was higher and there was more social contact to staff, fewer physical restraints, more involvement in home activities, and more frequent use of psychiatrists. There was no significant difference between the two care settings with regard to overall use of psychotropic drugs, however, residents in special dementia care used antipsychotics significantly less often and antidepressants more often. Conclusions Significant differences for a number of indicators of the quality of life point in favour of special dementia care. Future evaluation studies ought to examine not only the general efficacy of types of care designed especially for dementia patients but also the efficacy of the respective individual components (i.e. caregiver ratio). Copyright © 2010 John Wiley & Sons, Ltd.