ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Using data from the 1996 National Survey of Psychiatric Practice from the American Psychiatric Association (APA), the authors updated information on psychiatrists who are high geriatric providers (HGPs). In 1996, HGPs comprised 18% of the sample. Only 23% reported no geriatric patients in their practice, a 51% reduction from 1988–89; the proportion of HGPs is increasing. HGPs were more often male, minority, international medical school graduates, certified in geriatric psychiatry, and not medical school-affiliated. HGPs worked longer hours/week in direct patient care, had more patient visits/week, and saw more new patients/month, spending more time in hospitals and nursing homes and less time in office-based practice, and seeing more patients with mood disorders, psychotic disorders, and other disorders. Medicare was a proportionally higher payment source. Older psychiatrists were likely to have more patients over age 65. Tracking practice activities of HGPs may help inform policy discussion regarding staffing needs for geriatric patients with late-life mental disorders.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Age-related patterns of symptom presentation may complicate the recognition of suicide risk. The authors sought to determine whether there is a relationship between age and reported suicidal ideation in depressed suicide attempters (DSAs) and depressed nonattempters (DNs) 50 years of age and over. Regression analyses revealed that increasing age is significantly associated with the absence of suicidal ideation in both DSAs and DNs. Because of their lower rates of depressed mood and suicidal ideation, the depressions of older adults may more readily escape detection. Preventive or treatment measures initiated after the onset of the suicidal state may be insufficient, and other preventive strategies ought to be considered.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Although state Medicaid programs may bear a large portion of the costs of Alzheimer's disease (AD), current information on spending is not available. Using a health insurance claims database for a 10% random sample of California Medicaid (“Medi-Cal”) recipients 60+ years of age, the authors estimated the excess cost of AD to Medi-Cal in 1995 as the difference in expenditures between an AD cohort (those with AD or related dementias) and an age- and sex-matched cohort without AD. Among 62,450 recipients, 2,575 (4.1%) were found to have AD or related dementias, and their average payments were approximately $7,700 higher (P<0.01) than those for the comparison group. These estimates suggest that Medi-Cal spends about $200 million on AD and related dementias annually, a burden that represents nearly 10% of state spending on elderly patients.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors conducted a 6-year follow-up of 16 patients with late-life depression to evaluate the relationships between clinical and neuroradiologic variables and disease outcome. Patients had a comprehensive neuropsychiatric evaluation and magnetic resonance imaging (MRI) at baseline and follow-up. Eight of the 16 developed a chronic course of unremitting major depression sufficient to cause significant psychosocial impairment. Six patients with a chronic course and four patients with a non-chronic course of depression had white matter hyperintensities (WMH) on MRI at baseline. Four patients whose WMH increased in size over time developed a chronic unremitting course of depression. No patients with non-chronic depression had large areas of WMH at baseline or exhibited increased WMH size over time. Chronic depression was associated with severity of cerebrovascular risk factors, apathy, and poor quality of life. Treatment and prevention of cerebrovascular disease may improve the outcome of late-life depression.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors explored cognitive functioning and suicidal behavior in older depressed patients. Inpatients age 50 years or older (N=103) with major depression, 45 of whom had attempted suicide, were evaluated within 1 week of their hospital admission. Measures of suicidal behavior included suicide attempter status, the Suicide Intent Scale (SIS), ratings of method used (violent/nonviolent), and seriousness of injuries sustained (lethality). The Mini-Mental State Exam (MMSE) score measured cognitive impairment; covariates were age, gender, and living arrangement. The MMSE score was not associated with suicide attempter status, but for attempters, MMSE score showed a positive association with SIS score, but not method or lethality. Findings suggest that although cognitive disturbance may be associated with less-deliberate acts among older depressed suicide attempters, it does not appear to influence the potential lethality of their behavior.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

To examine whether informant-based assessments of patients with Alzheimer's disease (AD) can be used longitudinally to track patient functioning, the authors followed AD patients (N=153) and their caregivers over 1 year with the Relative's Assessment of Global Symptomatology–Elderly (RAGS–E) and the Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADASc). Factor analysis of the RAGS–E yielded two subscales, Cognitive Functioning and Mood Disturbance. The cognitive subscale and ADASc correlated at all visits, whereas the mood subscale did not. After 12 months (n=62), the cognitive scale worsened at a rate similar to the ADASc, suggesting concurrent validity. Therefore, informant-based measures appear to be reliable and valid methods of identifying cognitive change in AD patients.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Serum alpha1-acid glycoprotein (AAG) reportedly can increase with age in the normal population, especially among women. In 33 patients with unipolar major depression or bipolar disorder, serum AAG was measured by age. The authors noted a positive association with age, particularly in depressed female patients (n=18; rs=0.61; P<0.01). The authors discuss implications for drug pharmacokinetics. Investigation of AAG in mood disorders needs to take age and sex into consideration.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors assessed the usefulness of event-related potentials (ERP) and flash visual evoked potentials (FVEP) as prognostic markers in a sample of 25 subjects with probable Alzheimer's disease (AD). ERP and FVEP recordings were obtained from 21 and 23 subjects, respectively. Ranking of the annual rate of change in cognitive scales vs. baseline ERP/FVEP latencies was compared, and those with longer FVEP N2component latencies showed slower subsequent rates of decline (τ=0.32; z=2.16; P=0.015), suggesting that further study of FVEP responses as prognostic markers in AD is warranted.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID