American Journal of Geriatric Psychiatry最新文献

{"title":"13. OPTIMIZING THE DESIGN AND MEASUREMENT OF A MULTI-MODULE GROUP INTERVENTION TO IMPROVE WELL-BEING IN OLDER ADULTS","authors":"Ira Yenko , Feng Vankee Lin , Christine Gould , Ryan Pate , Maryam Makowski , Oceanna Li , Vanessa Silva , Dolores Gallagher-Thompsom , Erin Cassidy-Eagle","doi":"10.1016/j.jagp.2025.04.016","DOIUrl":"10.1016/j.jagp.2025.04.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Well-being is defined broadly, but typically includes promoting a combination of health, resilience, quality of life and connection. Positive psychological interventions move beyond the goal of simply decreasing symptoms and disorder rates and gravitate towards life enhancing and skill development. This psychological wellness group focuses on improving quality of life and skill development that aim to build resilience to life’s challenges, increase motivation to engage in positive self-care and drive to find purpose in engaging with and helping others. Our multi-modal well-being group targets a broad range of well-being dimensions including cognitive, behavioral, emotional, social, and physical health parameters. Group interventions harness the power of social connection while offering a cost effective and efficient means to reach a broad range of older patients that might otherwise be unable to access care. The overall aim of this project is to utilize an iterative process to continually improve and innovate a rotating psychological wellness group for older adults.</div></div><div><h3>Methods</h3><div>This program includes a psychological wellness group offering for older adults with 8 modules covering a collection of topics that support optimal psychological wellness and promote health and resilience (i.e. digital tools and mobile apps, value-based behavioral activation to improve your mood, eating for a healthy brain, caring for the caregiver, introduction to mindfulness, improving your sleep, physical activity and strategies for managing anxiety) that are held weekly, ranging in duration from 2-4 weeks, over a 7 month period. Well-being is broadly defined, including the existence of over 100 self-report measures to date, and our shift in measurement aims to provide clarity in definition and impact of our intervention. Having tried various well-being, loneliness, affect based, depression, anxiety, coping and resilience-based surveys, the team has worked to identify evidenced based measures that will capture our variables of interest and reflect change within the duration of the intervention. Evidence-based and lifestyle interventions target skill development, create opportunities for practice and provide expert feedback within the context of a socially engaged and supportive peer environment. Participants were referred from outpatient psychiatry clinics, geriatric medicine providers in medical centers and local community organizations servicing older adults. Inclusion criteria: Participants must be 65+ years old, English speaking, absent a diagnosis of dementia and open to group treatment.</div></div><div><h3>Results</h3><div>Older adults (N=19) were enrolled in the second wave of the psychological wellness group, including 9 males and 10 females with a mean age of 71. Summarized in Table One, the baseline (T1) and follow-up measures collected for T2 (6 weeks), T3 (12 weeks), T4 (18 weeks) and T5 (23 weeks) inclu","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S10"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24. CHALLENGES FACING CAREGIVERS OF INDIVIDUALS DIAGNOSED WITH FRONTOTEMPORAL DEMENTIA IN THE UNITED STATES","authors":"Grace Mausisa ,&nbsp;Annick de Bruin ,&nbsp;Devon Chenette ,&nbsp;Susan Gorky ,&nbsp;Tiffany Chow","doi":"10.1016/j.jagp.2025.04.026","DOIUrl":"10.1016/j.jagp.2025.04.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Caregivers or care partners often experience challenges while caring for persons diagnosed with FTD. We surveyed caregivers to better understand their specific challenges and identify gaps in existing services.</div></div><div><h3>Methods</h3><div>Alector developed the FTD Caregiver Survey, an online self-administered questionnaire, consisting of informed consent, eligibility screening, and questions regarding caregiver burden and strains. The survey was distributed with support from patient groups, individual advocates and an FTD website community. Eligible responders were adults who could read and write in English, reside in the United States, and who have been an unpaid primary caregiver for a person diagnosed with FTD. The first 90 surveys, completed from May to June 2024, were analyzed.</div></div><div><h3>Results</h3><div>Of all respondents, 47% self-identified as a sole caregiver. Over one third of all respondents spent over 40 hours per week providing direct care. Many respondents (41%) also provided care for other family members, with a majority (92%) reporting difficulty managing those responsibilities. Most caregivers reported difficulty attending to their own healthcare.</div><div>Respite services, in-home care, or adult day care were identified as the most needed and the most difficult to access amongst a list of services. Care planning and symptom management were highlighted as areas of need. FTD-specific websites or organizations were identified as being the most helpful source of assistance and information.</div></div><div><h3>Conclusions</h3><div>Patient organizations and healthcare professionals can help address the need for strategies to overcome barriers and expand on FTD-specific support, ranging from caregiver support groups to financial assistance and additional support in the day-to-day caregiving at home.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S18"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"31. THE BURDEN OF TARDIVE DYSKINESIA IN LONG-TERM CARE SETTINGS: RESULTS FROM A REAL-WORLD STUDY OF UNITED STATES CLAIMS DATA","authors":"Morgan Bron ,&nbsp;Gideon Aweh ,&nbsp;Darlene Salas ,&nbsp;Eric Jen ,&nbsp;Amita Patel","doi":"10.1016/j.jagp.2025.04.033","DOIUrl":"10.1016/j.jagp.2025.04.033","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure, can have disabling impacts on social, physical, and emotional functioning. Older adults have a higher risk for TD and may be particularly vulnerable to its physical impacts (e.g., difficulty swallowing), potentially complicating clinical management in long-term care (LTC) settings. However, data on the prevalence and burden of TD in LTC settings are limited. Therefore, a real-world study was conducted using United States (US) claims data to characterize patients with TD in LTC settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The STATinMED Real-World Data Insights Database, which captures 80% of US claims data, was used for analysis. The study period was defined as Jan 2016-Dec 2022 (inclusive). Patients with ≥1 LTC stay and an ICD-10 code indicative of TD (G24.01) during the study period were identified and analyzed descriptively by LTC setting for each LTC stay during the study period. Additional analyses related to comorbidities, medication use, and healthcare visits were analyzed descriptively in a subpopulation of patients who met a more stringent set of inclusion criteria: ≥1 LTC stay from Jan 2017 to Dec 2021 (identification period), with “index stay” defined as the first LTC stay; ICD-10 code of G24.01 on or before the index stay; and continuous capture of medical and pharmacy benefits for 1 year pre-index stay and 1 year post-index stay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;20,183 patients had an ICD-10 code indicative of TD and ≥1 LTC stay during the study period. Skilled nursing facilities were the most common type of LTC stay, with 14,235 (70.5%) patients having ≥1 skilled nursing facility stay during the study period. LTC stays in nursing homes (55.2%) and assisted living facilities (20.4%) were also common. Among 2,294 patients who met the criteria for additional analysis, 1,483 (64.6%) were ≥65 years and 1,544 (67.3%) were female. The mean (±SD) Charlson Comorbidity Index (CCI) score was 3.72 (±4.2), and 753 (32.8%) had a CCI score ≥4, indicating high comorbidity burden and increased mortality risk. Common comorbidities included mood disorders (66.1%), schizophrenia (38.8%), sleep disorders (35.0%), substance abuse (28.4%), urinary tract infections (26.7%), and dysphagia (18.5%). The use of antidepressants (56.1%), anticonvulsants (52.3%), antipsychotics (50.4%), and anticholinergics (50.0%) was common. Moreover, polypharmacy was common, with 47.9% of patients being prescribed ≥3 medications that may increase risk of falls or cognitive impairment in elderly adults (e.g., anticholinergics, anticonvulsants, antihistamines, benzodiazepines, sedative-hypnotics). Within 1 year after the index LTC stay, 1,085 (47.3%) patients had ≥1 emergency department (ED) visit, with a median of 2 visits/patient and median time to first visit of 143 days. Additional longitudinal real-world analyses on anticholinergic use, the pre","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S22"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"33. USING NOVEL WEARABLES AND ECOLOGICAL MOMENTARY ASSESSMENT TO TRACK PHYSIOLOGICAL BIOMARKERS IN PSYCHOTHERAPY FOR LATE-LIFE DEPRESSION","authors":"Parhesh Kumar ,&nbsp;Joohyun Kang ,&nbsp;Jordan Serrano-Guedea ,&nbsp;Faith Gunning ,&nbsp;Oded Bein ,&nbsp;Nili Solomonov","doi":"10.1016/j.jagp.2025.04.035","DOIUrl":"10.1016/j.jagp.2025.04.035","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Late-life depression is common, debilitating, and linked with poor mental health and medical outcomes. Individuals with depression experience high baseline heart rates and sleep disturbances, including fluctuations in circadian rhythm and sleep cycles. Depression is typically measured using weekly or periodic interviewer-rated or self-reported measures. These scales are limited by recall bias and low time sensitivity and accuracy, especially among older adults. Novel wearable devices and real-time mood scales measured multiple times a day (ecological momentary assessments; EMAs) can improve the precision and accuracy of depression severity measurement. There is little work on the application of these methods in the aging population, with only a few studies examining changes during treatment for late-life depression. We aimed to examine whether wearables and EMAs are feasible and can track precisely the changes across multiple domains during psychotherapy for late-life depression&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We implemented a novel wearable biometric ring (Oura Ring) and EMAs (measured twice daily) in an ongoing randomized controlled trial of psychotherapies for late-life suicidality. Three patients with major depression and suicidality completed 9 weeks of psychotherapy while wearing the Oura Ring and completing two EMA surveys a day (afternoon and evening surveys). Oura Ring data collected daily measures of average heart rate (beats per minute), heart rate variability, and hours of sleep. EMAs measured number of hours they slept, negative affect (stress, anxiety, irritability, depression, and loneliness), and positive affect (energy, motivation, excitement, interest, and satisfaction).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Our preliminary results show that all three participants experienced a reduction in negative affect and an increase in positive affect during psychotherapy. There was variability in trajectories of positive affect: Patients A and C showed a pronounced increase in positive affect, while Patient B showed an initial increase followed by a decrease. Further, for all three participants, hours slept (measured by Oura Ring) and self-reported hours slept followed a similar pattern over time, indicating these two measures may be linked. Finally, Patients A and C showed a consistent increase in heart rate variability, while patient B experienced a decrease over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our preliminary case studies suggest that integrating wearables with daily EMA self-reports can provide a feasible, precise, and granular assessment of daily changes in affect and biometrics, such as sleep and heart rate, during psychotherapy for late-life depression. The strong alignment between wearable-measured and self-reported sleep data, along with observable trends in heart rate variability and negative valence mood responses, highlights the powerful potential of these methods. This potenti","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S23"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"42. POSITIVE PSYCHOLOGICAL CORRELATES OF SUCCESSFUL AGING: A CROSS-SECTIONAL STUDY OF MENTAL, PHYSICAL, COGNITIVE, AND SOCIAL FUNCTIONING AMONG COMMUNITY-DWELLING OLDER ADULTS.","authors":"Nikki Bloch ,&nbsp;Stephanie Ibrahim ,&nbsp;Elizabeth W. Twamley ,&nbsp;Colin Depp ,&nbsp;Ellen Lee","doi":"10.1016/j.jagp.2025.04.044","DOIUrl":"10.1016/j.jagp.2025.04.044","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;While successful aging remains nebulously defined, research definitions commonly include domains of mental health, physical health, cognitive health, and social functioning. Positive psychological factors such as self-compassion and resilience have been shown to be important predictors of these same successful aging domains. However, the literature is mixed regarding which predictors impact which successful aging domains. Discerning the specific positive psychological factors that influence certain domains may allow for more targeted, individualized interventions. Our study aimed to understand the associations of positive psychological factors (e.g., resilience, self-compassion) with successful aging domains. We hypothesized that self-compassion and resilience would be associated with better mental health outcomes, physical health outcomes, social functioning, and cognitive functioning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a cross-sectional, retrospective study of prospectively collected registry data of independent-living older adults in a continuing care senior housing community in San Diego County. Inclusion criteria were: English speaking, age ³65, no known diagnosis of dementia or disabling illness, and ability to complete study assessments. Positive psychological factors were assessed using validated scales: Neff Self-Compassion Scale and Connor-Davidson Resilience Scale. Outcome measures were assessed through validated self-administered and clinician administered instruments for: depression (Patient Health Questionnaire); physical health: frailty (Fried Frailty Index), comorbidities (Cumulative Illness Rating Scale), mobility (Timed Up and Go test), subjective physical well-being (Medical Outcomes Survey); cognitive health: overall (Montreal Cognitive Assessment), executive functioning (Delis-Kaplan Executive Function System); social functioning: social support (Social Support Index), Emotional Support (Perceived Support Scale, PSS), Instrumental Support (PSS), negative social interactions (PSS), loneliness (UCLA Loneliness Scale 8-item); and overall successful aging (Self Rated Successful Aging Scale, SRSA).&lt;/div&gt;&lt;div&gt;The dataset was limited to the first visit from individuals who completed the SRSA. Statistical analyses were conducted using SPSS software. Descriptive statistics characterizing the sample were calculated with means and standard deviations for numerical variables and percentages for categorical variables. General Linear Models were used to assess associations of positive psychological factors to successful aging domains and covaried for age, sex, years of education, and relationship status.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The sample included 118 participants with mean age of 82.92 (range 66-98). The majority were female (66.9%), white (90.7%), and unpartnered (59.3%). Self-compassion was positively associated with better mental health (p &lt; 0.05) and was not associated with phy","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S30-S31"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"91. TELEHEALTH IN WAR: THE STATE OF GERIATRIC MENTAL HEALTH IN UKRAINE","authors":"Christian Schmutz ,&nbsp;Julia Mikevitch","doi":"10.1016/j.jagp.2025.04.093","DOIUrl":"10.1016/j.jagp.2025.04.093","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;In February 2022 the Russian Federation invaded Ukraine. The ongoing conflict, including 1682 verified attacks on healthcare infrastructure, strained the Ukrainian healthcare system. TeleHelp Ukraine (THU), a nonprofit organization based in the United States, intervened to provide free telemedicine services to individuals living in Ukraine, including areas of active conflict and occupied territories. This paper addresses how age, gender, geographic location, and significant wartime events affect psychiatric symptoms and mental healthcare utilization in older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data extraction:&lt;/div&gt;&lt;div&gt;Data was extracted from Cliniko, a secure telemedicine platform utilized by THU. 618 patient visits for all medical specialties were extracted from 8/12/2022-6/27/2023 containing the following variables: date of visit, geographic location, age, sex, chief complaint. A subset of 394 mental health visits with recorded patient ages was isolated. These visits were divided into 2 groups for comparison, patients age 50 or older (31 visits) and patients younger than age 49 or younger (363 visits).&lt;/div&gt;&lt;div&gt;Data analysis:&lt;/div&gt;&lt;div&gt;The Wilcoxon rank sum test was used to compare median ages between older and younger patients. Fisher exact test was used to compare reported sexes. Simple statistics described the geographic distribution of older adult visits.&lt;/div&gt;&lt;div&gt;The number of psychiatric symptoms or “chief complaints” (CCs) recorded for each visit ranged from 0 to 6. 628 and 53 CCs were reported for the younger and older age groups respectively. The large number of unique CCs made meaningful comparisons unrealistic, so CCs were reclassified into categories for comparison: depressive, anxious, PTSD, nonspecific symptoms, psychosocial stress, and other. CCs were compared between groups for each individual category using a Chi Square test. The resulting p-values were adjusted using a Benjamini-Yakutieli correction for multiple testing.&lt;/div&gt;&lt;div&gt;Significant war events were identified using sources from government and news media. These events were mapped onto the number of patient visits each week over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Demographics: The median age of the younger and older groups was 33 and 68, respectively (p &lt; 0.0001). Only 3% of visits in the older group were for male-identifying patients, versus 39% in the younger group (p &lt; 0.0001). Geographically, visits in the older adult group were approximately evenly distributed between Kyiv, the occupied territories, and undisclosed locations (35%, 32%, and 29% respectively).&lt;/div&gt;&lt;div&gt;Chief complaint: Non-specific mood symptoms were more likely in older patient visits than in younger patient visits (26% and 8% respectively; p = 0.001).&lt;/div&gt;&lt;div&gt;War Events: There was an apparent increase in telemental health utilization around the time of the Russian Bakhmut offensive. There was an apparent decrease in utilization around th","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S67-S68"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"83. SUPPORTING THE SAFETY OF ANTI-AMYLOID MONOCLONAL ANTIBODY THERAPY FOR EARLY ALZHEIMER'S DISEASE IN UNITED STATES VETERANS","authors":"Alexandra Fortunato ,&nbsp;Alison O'Donnell ,&nbsp;Brittany Spitznogle ,&nbsp;Naveen Reddy ,&nbsp;Shaye Kerper ,&nbsp;Steven Handler","doi":"10.1016/j.jagp.2025.04.085","DOIUrl":"10.1016/j.jagp.2025.04.085","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Aging United States Military Veterans are at an increased risk of developing dementia compared to the general population due to both military and non-military-related risk factors. With the Food and Drug Administration (FDA) approval of lecanemab (Leqembi ®), a monoclonal antibody therapy (mAb) directed against amyloid beta, Veterans now have access to disease modifying treatment for Alzheimer’s Disease (AD). The implementation of this novel treatment at the VA has uncovered significant education gaps and safety challenges. Specifically, there was a lack of both Veteran and clinician-facing materials for implementation and monitoring lecanemab. Thus, a variety of materials were developed by this project's authors from January 4, 2024 through August 9, 2024 and were distributed via the national VA SharePoint site. Veteran-facing materials prioritized education and safety and included information about lecanemab and its potential adverse effects. A wallet card was also developed to highlight the need for emergent evaluation and MRI brain scan if certain side effects occurred. Clinician-facing documents focused on the potential adverse effects of lecanemab, Veteran inclusion/exclusion criteria, and diagnosis of AD. To better understand the impact that these new materials have had at a national level, we developed and distributed a survey to select VA healthcare professionals. The objective of this project was to perform a gap analysis, obtain broad feedback on currently available educational materials for lecanemab, and set priorities for the development and dissemination of additional materials to support the safe use of lecanemab within the VA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a cross-sectional survey of healthcare professionals who actively participate in the national Veteran’s Health Administration (VHA) Novel AD Therapeutics Community of Practice (CoP) Workgroup. The survey was sent out on September 17, 2024 and remained open until October 4, 2024. The primary outcome was the awareness of existing lecanemab educational materials, as described above, among healthcare professionals in the CoP Workgroup involved in lecanemab implementation. Only lecanemab was evaluated since the second mAb, donanemab (Kisunla®) was not commercially available at the time of the study. Secondary outcomes focused on evaluating the effectiveness of resources necessary to: identify Veterans eligible for lecanemab, educate Veterans and caregivers on its use, determine the appropriate dosing schedule, establish monitoring protocols, and manage potential side effects effectively. Outcomes were measured using Microsoft Forms web-based survey software and were reported on a 5-point Likert scale, ranging from “strongly disagree” to “strongly agree”. The two positive responses (“agree” and “strongly agree”) and the two negative responses (“disagree” and “strongly disagree”) were combined to make positive and negative response gr","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S61"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"11. MIRTAZAPINE INDUCED TARDIVE DYSKINESIA IN AN OLDER ADULT","authors":"Amin Syed ,&nbsp;Karishma Soni ,&nbsp;Azziza Bankole ,&nbsp;Badr Ratnakaran","doi":"10.1016/j.jagp.2025.04.014","DOIUrl":"10.1016/j.jagp.2025.04.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Mirtazapine, first sold in the United States as Remeron in 1996, is a noradrenergic and specific serotonergic antidepressant FDA-approved for major depressive disorder. Its mechanism of action is referred to as NaSSA due to its alpha-2, 5-HT2, and 5-HT3 antagonism. It has also been used off-label as a third-line treatment option for akathisia, appetite stimulation, and SSRI-induced sexual dysfunction. Incidents of hyperkinetic movement disorders caused by mirtazapine have been reported, but even more infrequent for cases involving tardive dyskinesia (TD). The aim of this presentation is to highlight a case of TD with the use of mirtazapine in an older adult and search for more literature involving mirtazapine-induced tardive dyskinesia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This case involved an older adult with a history of major neurocognitive disorder with behavioral disturbance and stroke in 2012 who was initially seen by geriatric medicine for a chief complaint of worsening memory loss. Prior history was noted for chronic use of amitriptyline and clonazepam, MoCA score of 8/30, medical history of Crohn’s disease (controlled), and psychiatric history of depression and anxiety. Trials of donepezil and memantine were used in the past but were discontinued due to lack of tolerance. Attempts were made to taper off amitriptyline and clonazepam with buspirone and citalopram, but this was unsuccessful. The primary care provider was eventually able to wean off clonazepam to 0.5 mg oral once daily from three times a day while amitriptyline was continued at PTA 250 mg dose at bedtime. Symptoms during that visit were noted for paranoia about strangers damaging the house, poor sleep, and poor appetite; ADLs 5/6 and IADLs 3/8; updated MoCA of 9/30. During consultation and follow-up appointments with geriatric psychiatry, medication adjustments were made, which eventually led to the development of tardive dyskinesia (TD). For this poster presentation, geriatric psychiatry and medicine department notes were chart reviewed along with the patient's profile. Informed consent was obtained for this presentation. Consensus AI, a research assistant tool that has access to millions of academic papers and accurately pulls peer-reviewed papers, was used to generate literature investigating or reporting findings of tardive dyskinesia with mirtazapine use. “Mirtazapine-induced tardive dyskinesia in older adults” was used as a search feature. All study types and countries were included, and no specific timeline was selected with regards to the publishing date.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Over the course of 6-7 months after the geriatric psychiatry consultation visit, amitriptyline was tapered off to 50 mg at bedtime while clonazepam was continued at 0.5 mg oral daily. Towards the end of the summer, risperidone was added at 0.25 mg due to worsening psychosis, while clonazepam and amitriptyline were continued. By fall, risperidone wa","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S8-S9"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"66. DATA OVERLOAD IN THE DIGITAL AGE: CAN DIGITAL PHENOTYPING CREATE LIABILITY FOR CLINICIANS?","authors":"Miranda Skurla ,&nbsp;Sara Gerke ,&nbsp;Weronika Pasciak ,&nbsp;Ipsit Vahia ,&nbsp;Carmel Shachar","doi":"10.1016/j.jagp.2025.04.068","DOIUrl":"10.1016/j.jagp.2025.04.068","url":null,"abstract":"<div><h3>Introduction</h3><div>Digital phenotyping is quickly gaining traction and more widespread availability. This emerging technology has the potential for collecting large amounts of precise, temporal patient data, ultimately leading to enhanced monitoring, detection, and personalization of healthcare. However, this firehose of data generated by digital phenotyping may create a dilemma for clinicians already inundated with information.</div></div><div><h3>Methods</h3><div>In this study, we consider the potential risks if actionable data are missed. We provide an overview of the current legal framework for clinician liability and extrapolate its use in digital phenotyping.</div></div><div><h3>Results</h3><div>With no established best practices in digital phenotyping, we recommend that clinicians create a written notice for each patient that details how the data will be collected and monitored, as well as consider sharing the raw data with the patient when appropriate.</div></div><div><h3>Conclusions</h3><div>Guidelines for digital phenotyping must be developed now to get ahead of the eventual widespread use of digital phenotyping technology in clinical care. A proactive declaration of best practices will help guide the development of an evidence-driven and ethically sound standard of care for using digital phenotyping in clinical mental health practice and the information that should be provided to patients.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S48-S49"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"94. ACUTE FATIGUE LEVELS ARE IMPROVED BY BRIEF STANDING BREAKS IN PROLONGED SITTING AMONG OLDER POSTMENOPAUSAL WOMEN.","authors":"Vanessa Garcia ,&nbsp;Mario I. Hernandez ,&nbsp;Shannon L. Wilson ,&nbsp;Heather Anderson ,&nbsp;Jeffrey S. Patterson ,&nbsp;Ruohui Chen ,&nbsp;Lindsay Dillon ,&nbsp;Andrea Z. LaCroix ,&nbsp;Rong W. Zablocki ,&nbsp;Loki Natarajan ,&nbsp;Dorothy D. Sears","doi":"10.1016/j.jagp.2025.04.096","DOIUrl":"10.1016/j.jagp.2025.04.096","url":null,"abstract":"<div><h3>Introduction</h3><div>Fatigue is a prevalent symptom experienced in older adults. Prolonged sitting is associated with increased fatigue and adverse mental health. Emerging evidence shows that breaking up sitting time with light activity breaks or stands may reduce fatigue in sedentary workers and individuals with type 2 diabetes. However, little is known regarding the effect of breaking up sitting time on the acute fatigue levels in postmenopausal women. This study aimed to investigate the effect of interrupting sitting time with different standing interventions on the acute fatigue levels in older postmenopausal women.</div></div><div><h3>Methods</h3><div>This two-site, three-condition randomized controlled crossover trial, the Rise for Health - Lab study, enrolled postmenopausal women with overweight or obesity (n=79; mean ± SD age 67 ± 7 years and BMI 32.52 ± 5.15 kg/m2). Participants completed three 5-hr conditions in a clinical laboratory setting: frequent sit- to- stands (STS – 2-minute stand every 15 minutes), hourly standing breaks (HSB – 8-minute stand every hour), and prolonged sitting (control) in a randomized order, separated by a minimum 7-day washout period before crossover. The secondary outcome of fatigue was assessed hourly using the 18-item Lee Fatigue Scale, which yields a total fatigue score as well as fatigue and energy subscale scores. The net incremental area under the curve (iAUC) was investigated via linear mixed models to evaluate each interruption modality versus the control condition. The significance level was set as 0.025 to account for multiple comparisons (e.g., 2 intervention conditions vs. control).</div></div><div><h3>Results</h3><div>Seventy-six participants completed at least one study visit and were included in the analysis. After adjusting for site, STS significantly reduced mean iAUC fatigue subscale scores by 81% (-24.8, SE: 10.8, p=0.02) and mean iAUC total fatigue scores by 93% (-25.3, SE: 9.3, p=0.008) compared to the control. STS improved iAUC energy subscale score by 156% (26.4, SE: 10.6, p=0.01) compared to the control. The HSB condition was not associated with significant differences in the iAUC fatigue subscale score (p=0.26), iAUC energy subscale score (p=0.21), or iAUC total fatigue score (p=0.18) compared to the control condition.</div></div><div><h3>Conclusions</h3><div>Frequently breaking up prolonged sitting with brief standing breaks may reduce acute fatigue in postmenopausal women with overweight or obesity. These findings may provide geriatric practitioners and caregivers with a practical and feasible non-pharmacological option for the treatment of fatigue in older adults.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S69-S70"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}