Brain vascular disease is a major contributor to cognitive decline and to mood disorders in late-life. The role of brain vascular disease has been studied mainly by structural magnetic resonance imaging (MRI) methods to measure white matter hyperintensities (that reflect vascular and neurodegenerative processes) and strokes. A major advance to understanding underlying cerebral hemodynamic mechanisms has been the development of arterial spin labelling (ASL) perfusion MRI that provides a noninvasive, quantitative measure of cerebral blood flow (CBF) by using magnetically labeled blood as an endogenous CBF tracer.
Category: American Journal of Geriatric Psychiatry
American Journal of Geriatric Psychiatry
Chronic pain remains a serious healthcare challenge, particularly for older adults who suffer substantial disability and are susceptible to serious risks from pain medications and invasive procedures. Psychotherapy is a promising option for older adults with chronic pain, since it does not contribute to medical or surgical risks. However, standard psychotherapies for chronic pain, including cognitive-behavioral therapy (CBT), acceptance and commitment therapy, and mindfulness-based interventions, produce only modest and time-limited benefits for older adults.
In their comprehensive review and call to action, Jimenez and colleagues define a central challenge in psychiatry: how to remove the pernicious effect of racism from the diagnosis and treatment of vulnerable minority populations when institutional psychiatry, from diagnostic algorithms to care models, is built on the legacy of racism. Their review clearly identifies the sources and ramifying effects of racism on the mental health of older African Americans, Asians, and Latinos. Because the authors have developed and tested mental health interventions for minority populations, they are also in a good position to advise on strategies to combat such racism.
Neurocognitive disorders, such as Alzheimer’s disease (AD), Lewy body dementia (LBD), and frontotemporal dementia (FTD), are complex, multifaceted disorders. Beyond the significant and progressive disease-defining cognitive deficits, neuropsychiatric symptoms and behavioral manifestations are prevalent over the course of these neurocognitive disorders. [1,2] The majority of patients with a neurocognitive disorder will exhibit neuropsychiatry symptoms over the course of the disease, especially at the major neurocognitive stage.
Remotely Administered Resilience- and Wisdom-focused Intervention to Reduce Perceived Stress and Loneliness: Pilot Controlled Clinical Trial in Older Adults
Stress and loneliness are biologically toxic factors with adverse effects on mental and physical health. The 2018 Gallup World Poll found a 25% to 40% increase in stress, worry, and anger in the US from 2008 to 2018 (1). Loneliness is associated with considerable distress (2), and older adults are vulnerable to loneliness due to losses, physical decline, and social isolation. The COVID-19 pandemic led to increased social isolation, though some older adults with higher levels of resilience and wisdom faced the pandemic with greater fortitude than younger adults (3).