Michelle Brandt, Felipe de Oliveira Silva, José Pedro Simões Neto, Maria Alice Tourinho Baptista, Tatiana Belfort, Isabel Barbeito Lacerda, Marcia Cristina Nascimento Dourado
{"title":"Facial Expression Recognition of Emotional Situations in Mild and Moderate Alzheimer's Disease.","authors":"Michelle Brandt, Felipe de Oliveira Silva, José Pedro Simões Neto, Maria Alice Tourinho Baptista, Tatiana Belfort, Isabel Barbeito Lacerda, Marcia Cristina Nascimento Dourado","doi":"10.1177/08919887231175432","DOIUrl":"10.1177/08919887231175432","url":null,"abstract":"<p><p><b>Background:</b> Recognizing emotional situations may be impaired in people with Alzheimer's disease (AD). <b>Purpose:</b> We examined differences in the comprehension of an emotional situation in healthy older controls (HOC) and individuals with mild and moderate AD. <b>Research Design:</b> cross-sectional study. <b>Study Sample:</b> We assessed a convenience sample of 115 participants in 3 contexts: understanding the situation, ability to name the congruent emotion, and choice of the correct face in 4 emotional situations (sadness, surprise, anger, happiness). <b>Data Colection:</b> Chi-square and Mann-Whitney U tests were used for comparison between groups separated by CDR 1 and 2. Chi-square and Kruskal-Wallis tests were also used for comparison between groups separated by CDR 0, 1, and 2, with a pairwise comparisons analysis. <b>Results:</b> We found that the ability to understand, name, and choose the proper emotion is not linked and depends on the portrayed emotion. <b>Conclusions:</b> The findings suggest an interaction between emotional processing and cognitive functioning. Therefore, knowledge of an emotional condition and the connection to a specific facial choice most likely involve 2 degraded areas of knowledge, resulting in even higher odds of inaccuracy.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"73-83"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9432322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deepal Shah-Zamora, Sharlet Anderson, Brandon Barton, Jori E Fleisher
{"title":"Virtual Group Music Therapy for Apathy in Parkinson's Disease: A Pilot Study.","authors":"Deepal Shah-Zamora, Sharlet Anderson, Brandon Barton, Jori E Fleisher","doi":"10.1177/08919887231176755","DOIUrl":"10.1177/08919887231176755","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of virtual group music therapy on apathy in people with Parkinson's disease (PD).</p><p><strong>Introduction: </strong>Apathy affects 40% of people with PD, lacks effective therapies, and independently predicts poorer quality of life and greater caregiver burden. Music therapy is the clinical application of music to address a person's physical or emotional needs and is effective in treating apathy in dementia.</p><p><strong>Methods: </strong>People with idiopathic PD and apathy (Movement Disorders Society-Unified Parkinson's Disease Rating Scale, apathy item <u>≥</u> 2) and their caregivers participated in twelve, weekly virtual group music therapy sessions, with session attendance signifying adherence. Participants completed pre- and post-intervention assessments of apathy (Apathy Scale (AS)), quality of life (Parkinson's Disease Questionnaire-short form), functional ability (Schwab & England Activities of Daily Living Scale), depression (Beck Depression Inventory (BDI-II)), and cognition (Montreal Cognitive Assessment-Blind). Among secondary outcomes, we assessed caregiver burden (Zarit Burden Interview-short form) and strain (Multidimensional Caregiver Strain Index).</p><p><strong>Results: </strong>Sixteen PD participants (93.8% men, mean age 68.3 <u>±</u> 8.4 years, median 6 years PD duration) and their caregivers (93.8% women, mean age 62.6 <u>±</u> 11 years) completed the study. All PD participants and 88% of caregivers were >70% adherent to the intervention. Apathy (AS, effect size = 0.767, <i>P</i> = 0.002) and depression (BDI-II, effect size = 0.542, <i>P</i> = 0.03) improved, with no change in caregiver measures.</p><p><strong>Conclusion: </strong>Group music therapy is an effective treatment for apathy in PD and may improve mood. The virtual format is a feasible alternative to in-person sessions with high adherence and satisfaction.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"49-60"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Late-Life High Blood Pressure and Enlarged Perivascular Spaces in the Putaminal Regions of Community-Dwelling Japanese Older Persons.","authors":"Ayumi Tachibana, Jun-Ichi Iga, Yasuko Tatewaki, Benjamin Thyreau, Hongkun Chen, Tomoki Ozaki, Taku Yoshida, Yuta Yoshino, Hideaki Shimizu, Takaaki Mori, Yoshihiko Furuta, Mao Shibata, Tomoyuki Ohara, Jun Hata, Yasuyuki Taki, Shigeyuki Nakaji, Tetsuya Maeda, Kenjiro Ono, Masaru Mimura, Kenji Nakashima, Minoru Takebayashi, Toshiharu Ninomiya, Shu-Ichi Ueno","doi":"10.1177/08919887231195235","DOIUrl":"10.1177/08919887231195235","url":null,"abstract":"<p><strong>Background: </strong>Enlarged perivascular spaces (EPVS) of the brain may be involved in dementia, such as Alzheimer's disease and cerebral small vessel disease (CSVD). Hypertension has been reported to be a risk factor for dementia and CSVD, but the association between blood pressure (BP) and perivascular spaces is still unclear. The aim of this study was to determine the association between BP and EPVS volumes and to examine the interactions of relevant factors.</p><p><strong>Methods: </strong>A total of 9296 community-dwelling subjects aged ≥65 years participated in a brain magnetic resonance imaging and health status screening examination. Perivascular volume was measured using a software package based on deep learning that was developed in-house. The associations between BP and EPVS volumes were examined by analysis of covariance and multiple regression analysis.</p><p><strong>Results: </strong>Mean EPVS volumes increased significantly with rising systolic and diastolic BP levels (<i>P</i> for trend = .003, <i>P</i> for trend<.001, respectively). In addition, mean EPVS volumes increased significantly for every 1-mmHg-increment in systolic and diastolic BPs (both <i>P</i> values <.001). These significant associations were still observed in the sensitivity analysis after excluding subjects with dementia.</p><p><strong>Conclusions: </strong>The present data suggest that higher systolic and diastolic BP levels are associated with greater EPVS volumes in cognitively normal older people.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"61-72"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9924968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luke R Miller, Christopher Reed, Ross Divers, Matthew Calamia
{"title":"Baseline Differences in Driving Frequency as a Predictor of Cognitive Decline and Alzheimer's Disease.","authors":"Luke R Miller, Christopher Reed, Ross Divers, Matthew Calamia","doi":"10.1177/08919887231175436","DOIUrl":"10.1177/08919887231175436","url":null,"abstract":"<p><strong>Objective: </strong>To extend prior research by examining daily driving frequency as a predictor of cognitive decline and later diagnosis of Alzheimer's disease.</p><p><strong>Methods: </strong>1,426 older adults completed batteries of questionnaires and neuropsychological tests at baseline and yearly follow-ups (M = 6.8, SD = 4.9). Linear mixed effects models were estimated to examine whether daily driving frequency at baseline was predictive of cognitive decline while accounting for IADLs, mobility, depression, and demographics. Cox regression was used to examine driving frequency as a predictor of Alzheimer's disease diagnosis.</p><p><strong>Results: </strong>Less daily driving frequency was associated with greater decline in all cognitive domains over time except for working memory. Although driving frequency was associated with these changes in cognition, it did not uniquely predict the development of Alzheimer's disease when accounting for other factors (eg, other IADLs).</p><p><strong>Conclusions: </strong>Our findings extend prior research linking driving cessation to greater levels of cognitive decline. Future work might benefit from examining the utility of driving habits (especially changes in driving) as measures of everyday functioning in older adult evaluations.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"14-23"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9470988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hana Elhassan, Gregg A Robbins-Welty, Jerad Moxley, M Carrington Reid, Daniel Shalev
{"title":"Geriatric Psychiatrists' Perspectives on Palliative Care: Results From A National Survey.","authors":"Hana Elhassan, Gregg A Robbins-Welty, Jerad Moxley, M Carrington Reid, Daniel Shalev","doi":"10.1177/08919887231175435","DOIUrl":"10.1177/08919887231175435","url":null,"abstract":"<p><strong>Objectives: </strong>Older adults with psychiatric illnesses often have medical comorbidities that require symptom management and impact prognosis. Geriatric psychiatrists are uniquely positioned to meet the palliative care needs of such patients. This study aims to characterize palliative care needs of geriatric psychiatry patients and utilization of primary palliative care skills and subspecialty referral among geriatric psychiatrists.</p><p><strong>Methods: </strong>National, cross-sectional survey study of geriatrics psychiatrists in the United States.</p><p><strong>Results: </strong>Respondents (n = 397) reported high palliative care needs among their patients (46-73% of patients). Respondents reported using all domains of palliative care in their clinical practice with varied comfort. In multivariate modeling, only frequency of skill use predicted comfort with skills. Respondents identified that a third of patients would benefit from referral to specialty palliative care.</p><p><strong>Conclusions: </strong>Geriatric psychiatrists identify high palliative care needs in their patients. They meet these needs by utilizing primary palliative care skills and when available referral to subspecialty palliative care.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"3-13"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastiaan Pj van Alphen, Sanne van der Werff, Erlene Rosowsky, Daniel L Segal, Gina Rossi
{"title":"Assessment of Personality Disorders in Older Adults. A Practice Guide.","authors":"Sebastiaan Pj van Alphen, Sanne van der Werff, Erlene Rosowsky, Daniel L Segal, Gina Rossi","doi":"10.1177/08919887231175431","DOIUrl":"10.1177/08919887231175431","url":null,"abstract":"<p><p>Assessment of personality disorders (PDs) in older adults is a nuanced trade of its own. The aim of this practice guide is to illustrate gerontological assessment challenges using 3 case vignettes. We argue that it is important to pay extra attention to the influence of cognitive and medical (somatic) disorders on personality functioning in older adults during personality assessment. We also note that information provided by informants contributes added value to personality assessment. Personality assessment should be sufficiently age-specific to prevent overdiagnosis or underdiagnosis in older adults. Furthermore, given the reduced psychological or somatic capacity of some older adults, phased or sequential personality assessment is recommended. This should be focused on the assessment questions to be answered, for example starting with short general screening of personality functioning, followed by more in-depth exploration. Personality assessment should be kept as brief and simple as possible in terms of formulation of the items.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"470-478"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9617798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Support Needs in Carers of People With Parkinson's From Early to Later Stages: A Qualitative Study With 36 Carers in 11 European Countries.","authors":"Rowena K Merritt, Sarah Hotham, Anette Schrag","doi":"10.1177/08919887231168404","DOIUrl":"10.1177/08919887231168404","url":null,"abstract":"Background Parkinson’s Disease (PD) is associated with considerable carer burden, but there has been little qualitative research on the support needs of carers of People with Parkinson’s (PwP). Methods Semi-structured in-depth interviews with carers of PwP in 11 European countries. Results Interviews with 36 carers of PwP were analysed. At the time of diagnosis, carers often felt that they had a role in helping get a diagnosis and then in dealing with the impact of the diagnosis on the family. Information on medication was seen as particularly important for carers, and many of the carers felt that their informational needs differed from that of the PwPs. Many of the carers also felt that they needed to be present at all appointments to request referrals or ask for medication changes. Carers of those in the later stages of the disease often reported feeling isolated and not having any time for themselves. Conclusions The involvement of carers should be addressed more actively in the management of Parkinson’s.","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"505-510"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subjective Complaints are Similar in Subjective Cognitive Decline and Early-Stage Alzheimer's Disease when Assessed in a Memory Clinic Setting.","authors":"Anna E Bruus, Gunhild Waldemar, Asmus Vogel","doi":"10.1177/08919887231164352","DOIUrl":"10.1177/08919887231164352","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive complaints are generally poorly associated with objective memory functioning in older persons. Subjective cognitive decline (SCD) is a key feature in SCD and amnestic mild cognitive impairment (aMCI) which both can represent early Alzheimer's disease (AD). The aim of this study was to assess how memory clinic patients with SCD, MCI and mild AD dementia scored on 3 different complaint measures and if the format of assessment had an impact on the association with cognitive functioning, age, and depressive symptoms.</p><p><strong>Methods: </strong>We included 17 SCD patients, 17 aMCI patients, 17 patients with mild AD, and 30 controls. Complaints were assessed with the Cognitive Change Index (CCI), the Subjective Memory Complaints (SMC) scale, and the Memory Complaint Questionnaire (MAC-Q).</p><p><strong>Results: </strong>There were no significant differences between the total scores in the patient groups on the questionnaires. However, significant differences were found in the number of patients classified with impairment when using the CCI, the SMC, and the MAC-Q. Scores on all questionnaires were significantly associated with depressive symptoms, and significant associations with age, gender, and Addenbrookes Cognitive Examination score were found for the SMC. In patients with cognitive dysfunction, lower memory awareness significantly predicted fewer cognitive complaints.</p><p><strong>Conclusions: </strong>SCD patients in a memory clinic setting report the same degree of cognitive impairment as patients with aMCI and mild dementia, and in a hospital-based cohort we extend previous findings from healthy controls, that definition of SCD may depend on the format of assessment.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"479-486"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9132739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bradley McDaniels, Gregory M Pontone, Adrienne M Keener, Indu Subramanian
{"title":"A Prescription for Wellness in Early PD: Just What the Doctor Ordered.","authors":"Bradley McDaniels, Gregory M Pontone, Adrienne M Keener, Indu Subramanian","doi":"10.1177/08919887231164358","DOIUrl":"10.1177/08919887231164358","url":null,"abstract":"<p><strong>Background: </strong>Being diagnosed with a neurodegenerative disease is a life-changing event and a critical time to help patients cope and move forward in a proactive way. Historically, the main focus of Parkinson's disease (PD) treatment has been on the motor features with limited attention given to non-motor and mental health sequelae, which have the most impact on quality of life. Although depression and anxiety have been described at the time of PD diagnosis, demoralization, intolerance of uncertainty, decreased self-efficacy, stigma and loneliness can also present and have negative effects on the trajectory of the disease. Hence, understanding the psychological impact of the diagnosis and how to provide better counselling at this critical time point may be the key to a better long-term trajectory and quality of life.</p><p><strong>Focus: </strong>There has been a paradigm shift in the treatment of chronic illness moving beyond the medical model, which focuses on fighting illness with the physician being in charge of the treatment process and the patient being the passive recipient, toward a more holistic (i.e., physical, psychological, social, and spiritual health) biopsychosocial approach that emphasizes behavioral factors with the patient being an active collaborator in their treatment. Hence, we propose that fostering resilience, social support, and psychological flexibility offer promise toward attenuating negative reactions and improving overall well-being.</p><p><strong>Conclusion: </strong>Through a proactive wellness approach incorporating lifestyle choices, people with PD (PwP) can not only achieve improved states of health, well-being, and quality of life, but actually thrive.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"461-469"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9093000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth C DeMarco, Zidong Zhang, Hunter Robinson, Leslie Hinyard
{"title":"Anxiety in Parkinson's Patients: What's Timing Got to Do with It?","authors":"Elisabeth C DeMarco, Zidong Zhang, Hunter Robinson, Leslie Hinyard","doi":"10.1177/08919887231163293","DOIUrl":"10.1177/08919887231163293","url":null,"abstract":"<p><p><b>Background:</b> Parkinson's Disease (PD) affects over 10 million people worldwide. Many PD patients experience comorbid anxiety disorders, which have been correlated with reduced quality of life and can manifest at any time during the course of PD, including prior to motor symptom onset. <b>Purpose:</b> Prior work has demonstrated that patients diagnosed with depression following a PD diagnosis are less likely to receive depression treatment, but no such study has been conducted for anxiety. <b>Research Design:</b> A cross-sectional analysis of secondary electronhic health record data was conducted. <b>Study Sample:</b> Data was obtained through Optum® de-identified Electronic Health Record dataset, using ICD-9 and ICD-10 diagnosis codes to determine PD status and comparing index date of anxiety and PD diagnoses to classify patients by relative time of diagnosis. <b>Data Analysis:</b> Multivariate logistic regression was performed to assess factors associated with receipt of mental health treatment. <b>Results:</b> Of PD patients with anxiety, 52% documented a diagnosis of anxiety prior to PD. Overall, 69% documented some treatment, with 79% of those diagnosed with anxiety prior to PD receiving some treatment compared to 59% of those diagnosed with anxiety on or after PD (<i>P</i> < 0.001). <b>Conclusion:</b> Patients with PD and subsequent anxiety diagnoses are less likely to receive treatment. Further study could explore reasons for variations in mental health care within the context of an existing PD diagnosis.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":"36 6","pages":"496-504"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}