Exercise for geriatric psychiatry outpatients: Results from a clinic intervention.

Background: Exercise is a non-pharmacological intervention that may benefit elderly patients with depression, but the effects of an exercise intervention in geriatric psychiatry outpatients have yet to be tested.

Method: Outpatients in a geriatric psychiatry clinic participated in a structured exercise intervention of 50 minutes, twice-weekly, over twelve weeks. Depressive symptoms were assessed at baseline and post-intervention using the Patient Health Questionnaire-9 (PHQ-9).

Management of Agitation in Dementia and Effects on Inpatient Length of Stay.

Background: Agitation associated with dementia impacts delivery of medical care and is a major reason for institutionalization in dementia patients. This study examines the association of medication use and other clinical factors with patients' 'dischargeability' (i.e.

Early Clinical Exposure to Geriatric Psychiatry and Medical Students' Interest in Caring for Older Adults: A Randomized Controlled Trial.

Objective: In the next 25 years, the population aged 65 and older will nearly double in many countries, with few new doctors wishing to care for older adults. The authors hypothesize that early clinical exposure to elderly patient care could increase student interest in caring for older adults during their future career.

Methods: The authors conducted a pragmatic medical education randomized controlled trial (RCT) at the Jewish General Hospital and the Douglas Mental Health Institute, McGill University, in Montreal, Canada.

Mind-Body Interventions in Late-Life Mental Illnesses and Cognitive Disorders: A Narrative Review.

Background: Current pharmacological treatments and psychotherapeutic approaches often have adverse effects or are ineffective in late-life cognitive and mental illnesses. Mind-body interventions offer a holistic approach and are of interest because of potential patient acceptability and scalability.

Objective: To synthesize current evidence on mind-body interventions in treating or preventing mental illnesses and cognitive disorders in older adults.

End-of-Life Care Preferences in Patients with Severe and Persistent Mental Illness and Chronic Medical Conditions: A Comparative Cross-Sectional Study.

Objectives: Physicians rarely engage severe and persistent mental illness (SPMI) patients in end-of-life care discussion despite an increased risk of debilitating medical illnesses and mortality. Access to quality palliative care and medical assistance in dying (MAID) has become a priority in Canada and many jurisdictions. In this study, we compared SPMI and chronic medically ill (CMI) patients' end-of-life care preferences and comfort level with end-of-life care discussion, and identified potential predictors of interest in MAID.

Brief Mindfulness Meditation for Depression and Anxiety Symptoms in Patients Undergoing Hemodialysis: A Pilot Feasibility Study.

Background And Objectives: Up to 50% of patients undergoing hemodialysis suffer from symptoms of depression and/or anxiety. Access to traditional pharmacotherapies and psychotherapies for depression or anxiety in this patient population has been inadequate. The objective of this study was to investigate the feasibility and effectiveness of brief mindfulness meditation intervention for patients on hemodialysis with depression and anxiety symptoms.

Can Geriatric Psychiatry Patients Complete Symptoms Self-Reports Using Tablets? A Randomized Study.

Background: With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection.

Methods: This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs.

Mobile Health Technology in Late-Life Mental Illness: A Focused Literature Review.

Objective: In an era of rising geriatric mental health care needs worldwide, technological advances can help address care needs in a cost-effective fashion. Our objective in this review was to assess whether mobile health technology, such as tablets and smartphones, are feasible to use in patients with late-life mental and cognitive disorders, as well as whether they were generally reliable modes of mental health/cognitive assessment.

Methods: We performed a focused literature review of MEDLINE, PsychInfo, and Embase databases, including papers specifically assessing the implementation of mobile health technologies: electronic tablets (e.

Tolerability and suitability of brief group mindfulness-oriented interventions in psychiatric inpatients: a pilot study.

Objective: Mindfulness-oriented therapies have a positive impact on patients' overall well-being and alleviate many psychiatric conditions. However, little is known about their use in people with severe mental illness. We aimed to identify which clinical and sociodemographic factors are associated with suitability/tolerability of a brief group mindfulness-oriented therapy.

Does lower urine-specific gravity predict decline in renal function and hypernatremia in older adults exposed to psychotropic medications? An exploratory analysis.

Background: Exposure to psychotropic agents, including lithium, antipsychotics and antidepressants, has been associated with nephrogenic diabetes insipidus (NDI). This is especially concerning in older adults already at risk of developing chronic kidney disease (CKD) and hypernatremia with advanced aging. This study investigates whether commonly performed random urine-specific gravity (USG) tests can predict adverse NDI outcomes (CKD and hypernatremia) in psychotropic-exposed older adults.

Selective Serotonin Re-Uptake Inhibitors and Hyponatremia in Acutely Medically-Ill Inpatients.

Background: Selective Serotonin Reuptake Inhibitors (SSRIs) have become the mainstay of treatment for depression, anxiety, and many other conditions. However, they have been associated with an increased risk of hyponatremia. Little is known about the risk of SSRI-associated hyponatremia in certain potentially at-risk populations, such as patients with acute medical illnesses.

Health Canada Warning on Citalopram and Escitalopram--Its Effects on Prescribing in Consultation-Liaison Psychiatry.

Background: Reports have suggested that citalopram and escitalopram may prolong the QTc interval, leading Health Canada to issue a warning to limit their dosages in 2012. Little is known about the effects of this warning and similar ones (e.g.

Predictors of psychiatric re-hospitalization in older adults with severe mental illness.

Objective: Many patients with severe recurrent mental illness are approaching late life; however, little is known about psychiatric re-hospitalization in this population. Our objective was to identify predictors of psychiatric re-hospitalization.

Methods: This was a retrospective cohort study of all 226 geriatric patients (age ≥65 years) admitted to a tertiary care Canadian inpatient psychiatric unit between 2003 and 2008.

Chronic kidney disease in lithium-treated older adults: a review of epidemiology, mechanisms, and implications for the treatment of late-life mood disorders.

Lithium is an important medication in the treatment of mood disorders. However, clinicians are hesitant to use lithium in older adults for fear of its medical effects, particularly kidney disease. This review describes the current understanding of the epidemiology and mechanisms underlying chronic kidney disease (CKD) in older lithium users, with recommendations for using lithium safely in late life.

Diabetes mellitus onset in geriatric patients: does long-term atypical antipsychotic exposure increase risk?

Background: Diabetes mellitus (DM) in common in adults using psychotropic medications. However, it remains largely unknown whether there is an additional risk of diabetes mellitus (DM) in elderly psychiatric outpatients, particularly those with long-term exposure to atypical antipsychotics (AP).

Methods: In this retrospective longitudinal study, 61 atypical AP-exposed and 64 atypical AP-unexposed geriatric psychiatric patients were compared to a group of 200 psychotropic-naïve controls.

Lithium dosing and serum concentrations across the age spectrum: from early adulthood to the tenth decade of life.

Objectives: Little is known about how lithium should be dosed to achieve therapeutic but safe serum concentrations in older adults. In this paper, we investigate how the lithium dose-concentration ratio changes across the lifespan.

Methods: This was a cross-sectional analysis of 63 current lithium users aged 20-95 years using data from McGLIDICS (the McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study).