Impact of Mild Behavioral Impairment on Longitudinal Changes in Cognition.

Background: To examine cross-sectional differences and longitudinal changes in cognitive performance based on the presence of mild behavioral impairment (MBI) among older adults who are cognitively healthy or have mild cognitive impairment (MCI).

Methods: Secondary data analysis of participants (n = 17 291) who were cognitively healthy (n = 11 771) or diagnosed with MCI (n = 5 520) from the National Alzheimer's Coordinating Center database. Overall, 24.

Cognitive and Functional Status of Persons Newly Enrolled at Dementia-Specific Adult Day Centers and Burden of Their Caregivers.

Background And Objectives: Recognizing the important role that dementia-specific adult day centers have in maintaining persons with a neurocognitive disorder in their home, this article examines three critical indicators at the time when people first enroll in such a center: cognitive and functional impairment of the enrollee, and burden reported by their family caregivers. We also considered variations in these 3 indicators by race/ethnicity and by the relationship of caregiver to the new enrollee.

Research Design And Methods: We conducted a secondary analysis of data collected by a nonprofit organization operating 11 dementia-specific adult day centers located on the east coast of Florida.

Come, join, lead: Attracting students to careers in aging and promoting involvement in gerontological societies.

Geriatric educators face the challenge of attracting more clinicians, scientists, and educators into geriatrics and gerontology, and promoting involvement in gerontological societies. A survey of psychologists (N = 100) examined factors that attract students in clinical/counseling psychology to practice with older adults, as well as experiences in organizational service. For 58%, interest in aging began at the undergraduate level, but for others interest developed later.

Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

Purpose: To understand the needs and challenges encountered by older homeless veterans.

Methods: We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers.

Results: Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs.

Reasons for psychiatric medication prescription for new nursing home residents.

Objectives: This article focuses on justification of psychoactive medication prescription for NH residents during their first three months post-admission.

Method: We extracted data from 73 charts drawn from a convenience sample of individuals who were residents of seven nursing homes (NHs) for at least three months during 2009. Six focus groups with NH staff were conducted to explore rationales for psychoactive medication usage.

Longitudinal investigation of wandering behavior in Department of Veterans Affairs nursing home care units.

Objectives: To explore the extent of and factors associated with male residents who change wandering status post nursing home admission.

Design: Longitudinal design with secondary data analyses. Admissions over a 4-year period were examined using repeat assessments with the Minimum Data Set (MDS) to formulate a model understanding the development of wandering behavior.

The aging physician with cognitive impairment: approaches to oversight, prevention, and remediation.

There are many important unanswered issues regarding the occurrence of cognitive impairment in physicians, such as detection of deficits, remediation efforts, policy implications for safe medical practice, and the need to safeguard quality patient care. The authors review existing literature on these complex issues and derive heuristic formulations regarding how to help manage the professional needs of the aging physician with dementia. To ensure safe standards of medical care while also protecting the needs of physicians and their families, state regulatory or licensing agencies in collaboration with state medical associations and academic medical centers should generate evaluation guidelines to assure continued high levels of functioning.

Serious mental illness in Florida nursing homes: need for training.

This study examined how the mental health needs of nursing home (NH) residents with serious mental illness (SMI) are addressed. Data were collected from three sources: interviews with 84 SMI stakeholders; surveys of 206 NH staff members; and focus groups at two psychiatry specialty NHs. Four common themes emerged: placement of older adults with SMI was a significant problem for discharge planners and NH admission coordinators; NH staff reported being uneasy with SMI residents and were concerned over aggressive behavior; staff in NHs with psychiatry specialty units appeared more comfortable serving SMI residents; and SMI training was a consistent recommendation of all SMI stakeholders and NH staff.

Wanderers with cognitive impairment in Department of Veterans Affairs nursing home care units.

Objectives: To explore the extent of and factors associated with male nursing home residents who wander.

Design: Cross-sectional design with secondary data analyses.

Setting: One hundred thirty-four nursing home facilities operated by the Department of Veterans Affairs.

Factors affecting deficit awareness in persons with dementia.

Objective: This study examined factors affecting deficit awareness (DA) and the effects of diagnostic status (dementia and depression), measurement method and DA dimension on these relationships.

Methods: One hundred and twenty-one participants (66 persons with dementia and 55 persons without dementia, matched for depression diagnosis) were enrolled, each with a family informant. Participant DA (clinician and informant rated), cognitive impairment, physical illness, functional disability and caregiver burden were assessed.

Accuracy of self-reported depression in persons with dementia.

Objectives: To investigate the reliability and validity of self-reported depression in demented elderly patients.

Design: This is the first study to combine the use of multiple depression criteria with dementia and depression control groups.

Setting: Houston Veterans Affairs nursing home and geropsychiatric inpatient unit and outpatient clinic, Baylor College of Medicine's Alzheimer's Disease Research Center.

Dementia Deficits Scale. Rating self-awareness of deficits.

Impaired deficit awareness is important to detect because of its clinical implications; for example, patients with impaired awareness are more likely to engage in potentially dangerous activities, such as operating the stove. This study evaluated the reliability and validity of the Dementia Deficits Scale (DDS), a new multidimensional instrument for the assessment of self-awareness of cognitive, emotional, and functional deficits associated with dementia. Three parallel forms of the DDS were independently completed by the patient, clinician, and informant.

Health care utilization in dementia patients with psychiatric comorbidity.

Purpose: The purpose of this research was to determine if differences in service use exist between dementia patients with and without psychiatric comorbidity.

Design And Methods: A retrospective cohort study was conducted on all Veterans Affairs (VA) beneficiaries seen at the Houston Veterans Affairs Medical Center with a VA Outpatient Clinic File diagnosis of dementia in 1997. The primary dependent measure was amount of Houston VA health service use from study entry until the end of fiscal year 1999 or until death.