scholarly journals Education of Caregivers and Veterans to Improve the Care of the Geriatric Psychiatric Patient

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 496-496
Author(s):  
Maritza Buenaver
Keyword(s):  
Mental Illness ◽  
Cognitive Impairment ◽  
Outpatient Clinic ◽  
Early Identification ◽  
Psychological Symptoms ◽  
The Elderly ◽  
Psychiatric Clinic ◽  
Beers Criteria ◽  
Emergency Room Visits ◽  
Behavioral And Psychological Symptoms

Abstract The geriatric psychiatry outpatient clinic provides assessment of the elderly Veteran with mental illness and behavioral and psychological symptoms of dementia. I will describe strategies developed and implemented in this setting to provide education to the caregiver (family) to improve early identification of delirium, depression and cognitive impairment. This education proved to reduce the number of pharmacological treatment and increase the use of nonpharmacological interventions based on "what matters to the patient" and following the BEERS criteria guidelines. One of the most important outcomes of the education and evaluation in the geriatric psychiatric clinic was a decrease in number of emergency room visits of elderly, specifically those with dementia.

scholarly journals Floods in 2007 and older adult services: lessons learnt

2009 ◽  
Vol 33 (9) ◽  
pp. 332-336 ◽  
Author(s):  
Joseph Hayes ◽  
Julian Mason ◽  
Fay Brown ◽  
Rebecca Mather
Keyword(s):  
Mental Illness ◽  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Direct Consequence ◽  
The Elderly ◽  
Illness Management ◽  
Mental Health Team ◽  
Adult Services ◽  
Evacuation Plans ◽  
Flood Effects

Aims and MethodTo review the clinical and managerial impact of flooding on a community mental health team (CMHT) for older adults by prospectively recording all flooding related events met by the CMHT.ResultsOf 348 individuals known to the CMHT, 87 lived in flood affected areas. In nine patients symptoms deteriorated. There were two new referrals as a direct consequence of the flooding. Flood effects can be grouped into: new mental illness, management problems, CMHT workload, and secondary benefits.Clinical ImplicationsThe immediate and delayed problems caused by flooding to the elderly with mental illness and dementia include unmasking cognitive impairment and provoking exacerbations in depressive and anxiety disorders. Personal evacuation plans should be used when moving individuals with marked cognitive impairment to avoid difficulties with identification. Overcrowding of care homes used to temporarily accommodate additional residents can contribute to behavioural changes and psychological symptoms in those with pre-existing dementia.

Caregiver-Reported Sleep Disturbances Are Associated With Behavioral and Psychological Symptoms in an Asian Elderly Cohort With Cognitive Impairment-No Dementia

2018 ◽  
Vol 31 (2) ◽  
pp. 70-75
Author(s):  
Xin Xu ◽  
Cheuk Ni Kan ◽  
Tien Yin Wong ◽  
Ching-Yu Cheng ◽  
M. Kamran Ikram ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Risk Of Progression ◽  
Elderly Cohort ◽  
Anxiety Depression ◽  
Behavioral And Psychological Symptoms ◽  
Asian Sample ◽  
Cognitive Impairment No Dementia

Objective: Sleep disturbances were found to be associated with more behavioral and psychological symptoms (BPS) in early patients with Alzheimer's disease (AD). However, data on preclinical stages of dementia are lacking. Hence, the present study sought to investigate the association between sleep disturbances and BPS in dementia-free elderly with varying severity of cognitive impairment in an Asian sample. Methods: Community-living elderly were recruited and administered a comprehensive cognitive battery (vascular dementia battery [VDB]) and the Neuropsychiatric Inventory to assess symptoms of sleep disturbances and BPS. Severity of cognitive impairment was diagnosed and classified as no cognitive impairment (NCI), cognitive impairment-no dementia (CIND) -mild (1-2 impaired domains on the VDB), and CIND-moderate (≥3 impaired domains on the VDB). Analysis of variance was conducted to assess the associations between the presence of sleep disturbances and BPS scores in each diagnostic group. Logistic regression was used to examine whether the coexistence of sleep disturbances and other BPS was associated with CIND-moderate, which is known to carry a higher risk of progression to AD. Results: Among 839 elderly, 79 (9.4%) reported sleep disturbances. Participants with sleep disturbances had higher total BPS burden than those without among CIND participants but not in NCIs. Furthermore, CIND-moderate participants with sleep disturbances had more delusions, hallucinations, anxiety, depression, irritability, aberrant motor behavior, and appetite change ( P < .05). The presence of both sleep disturbances and other BPS was associated with CIND-moderate (odds ratio: 2.5, 95% confidence interval: 1.1-5.5). Conclusions: Sleep disturbances are associated with higher total BPS burden and specific BPS among elderly patients with cognitive impairment, particularly those with CIND moderate, which carries higher risk of developing dementia.

Discussion 3

2000 ◽  
Vol 12 (S1) ◽  
pp. 171-174
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Psychological Symptoms ◽  
Cognitively Impaired ◽  
Visual Hallucinations ◽  
Close Relationship ◽  
State Examination ◽  
Behavioral And Psychological Symptoms

Dr. Förstl was impressed by Dr. Reisberg's data showing a close relationship between cognitive impairment and behavioral and psychological symptoms of dementia (BPSD). Yet he questioned Dr. Reisberg's conclusion that cognitive impairment is necessary for developing hallucinations or delusions. Dr. Reisberg responded that although there is no correlation between scores on the Mini-Mental State Examination (MMSE) and BPSD, it does not mean that cognition is not involved in these symptoms. By definition, BPSD are behavioral and psychological. There is a psychological, or cognitive, element to all BPSD, said Dr. Reisberg. As an example, he noted that a patient with cataracts is more likely to experience visual hallucinations. A person who is not cognitively impaired will be able to censor those experiences and not discuss them with others. Patients with dementia do not censor this information, and tell others about their visual hallucinations. Dr. Reisberg noted, however, that visual hallucinations among patients with Alzheimer's disease (AD) are not common, occurring in about 20% of patients, with a peak occurrence just before the final stages of the disease. Dr. Shah commented that BPSD in patients in the final stages of AD may be difficult to detect because techniques for identifying these symptoms in severely cognitively impaired patients are lacking.

Comparison of behavioral and psychological symptoms of dementia and psychotropic drug treatments among old people in geriatric care in 2000 and 2007

2011 ◽  
Vol 23 (10) ◽  
pp. 1616-1622 ◽  
Author(s):  
Hugo Lövheim ◽  
Yngve Gustafson ◽  
Stig Karlsson ◽  
Per-Olof Sandman
Keyword(s):  
Cognitive Impairment ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Antidepressant Drug ◽  
Geriatric Care ◽  
Psychotic Symptoms ◽  
Aggressive Behaviors ◽  
People With Dementia ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground: Behavioral and psychological symptoms, such as verbal or physical aggression, aberrant motor behaviors, psychotic symptoms, anxiety, depressive symptoms and apathy are common among people with dementia. The aim of the present study was to compare the one-week prevalence of behavioral and psychological symptoms and psychotropic drug treatment among people with cognitive impairment living in institutional care, in two large, comparable samples from 2000 and 2007.Methods: A comparison was made between two cross-sectional samples, collected in 2000 and 2007, comprising 4054 participants with cognitive impairment living in geriatric care units in the county of Västerbotten, Sweden. The Multi-Dimensional Dementia Assessment Scale (MDDAS) was used to assess cognitive impairment and behavioral and psychological symptoms. The use of psychotropic drugs was recorded.Results: Between 2000 and 2007, 15 out of 39 behavioral or psychological symptoms had become less common and no symptoms had become more common, after controlling for demographic changes. Four out of six behaviors within the cluster of aggressive behaviors had declined in prevalence. Patients prescribed anti-dementia drugs increased from 5.1% to 18.0% and antidepressant drug use increased from 43.2% to 49.1%, while anxiolytic, hypnotic, sedative and antipsychotic drug use remained largely unchanged.Conclusion: The prevalence of many behavioral symptoms had declined from 2000 to 2007, and among these changes, the decline in aggressive behaviors probably has the greatest clinical impact.

Behavioral and Psychological Symptoms of Dementia: Factor Analysis and Relationship with Cognitive Impairment

2013 ◽  
Vol 69 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Michele Poletti ◽  
Angelo Nuti ◽  
Gabriele Cipriani ◽  
Ubaldo Bonuccelli
Keyword(s):  
Factor Analysis ◽  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Behavioral And Psychological Symptoms

scholarly journals Correlation of Frontal Atrophy and CSF Tau Levels With Neuropsychiatric Symptoms in Patients With Cognitive Impairment: A Memory Clinic Experience

2021 ◽  
Vol 13 ◽  
Author(s):  
Matteo Cotta Ramusino ◽  
Giulia Perini ◽  
Gloria Vaghi ◽  
Beatrice Dal Fabbro ◽  
Marco Capelli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Body Disease ◽  
Cortical Atrophy ◽  
Psychotic Symptoms ◽  
Memory Clinic ◽  
Neuropsychiatric Inventory ◽  
Clinic Experience ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are a distressful condition. We aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy.Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium.Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups (p &lt; 0.05, p &lt; 0.001, and p &lt; 0.05), with LBD patients showing higher scores for hallucinations (vs. MCI, p &lt; 0.001, and AD, p &lt; 0.05) and psychosis cluster (vs. MCI, p &lt; 0.05). In primary dementias, we found a negative correlation between NPI total score and tau levels (p = 0.08), confirmed by beta regression (p &lt; 0.01), while a positive non-significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy (p &lt; 0.05, on both hemispheres) and hallucinations (left: p &lt; 0.01, right: p &lt; 0.05). GCA-F scores were positively correlated with psychosis cluster (right: p &lt; 0.05), and agitation/aggression (left: p &lt; 0.05). Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores (left: p &lt; 0.01; right: p &lt; 0.05).Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.

Sign in / Sign up

Export Citation Format

Share Document