Mind, Mood, Mobility: Supporting Independence Among Rural Older Adults at Risk for Functional Decline.

Rural communities need access to effective interventions that can prevent functional decline among a growing population of older adults. We describe the conceptual framework and rationale for a multicomponent intervention ("Mind, Mood, Mobility") delivered by Area Agency on Aging staff for rural older adults at risk for functional decline due to early impairments in cognition, mood, or mobility. Our proposed model utilizes primary care to identify at-risk older adults, combines evidence-based interventions that address multiple risk factors simultaneously, and leverages a community-based aging services workforce for intervention delivery.

Promoting or Undermining Quality Decision Making? A Qualitative Content Analysis of Patient Decision Aids Comparing Surgical and Medication Abortion.

Objectives: To understand, describe, and compare the content of patient decision aids on surgical and medication abortion, including 1) attributes used to describe each method, 2) approaches to clarify patients' values, 3) language used to describe each method, and 4) language used to frame women's decision-making role.

Study Design: We analyzed 49 decision aids identified through a previous systematic review and environmental scan. We used summative content analysis for objectives 1 and 2 and directed content analysis for objectives 3 and 4.

Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies.

The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity.

Spontaneous Coronary Artery Dissection (SCAD): FEMALE SURVIVORS' EXPERIENCES OF STRESS AND SUPPORT.

Purpose: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women without typical risk factors for heart disease. Few investigations have examined psychosocial variables in this population and none have looked at patient perceptions of the experience and stresses associated with having a SCAD event or the resources currently available to SCAD survivors. This investigation describes survivors' subjective experiences of SCAD.

Methadone Maintenance Treatment for Older Adults: Cost and Logistical Considerations.

In a demographic shift, older adults now comprise an increasing proportion of those receiving methadone maintenance treatment (MMT) for opioid use disorder. A study of MMT recipients in New York City suggests that 13% of the population is over 60 years of age. Adults ages 50-59 are among the largest age demographic, evidence that the number of older adults receiving MMT will continue to increase.

Feasibility Study of Increasing Social Support to Enhance a Healthy Lifestyle Intervention for Individuals with Serious Mental Illness.

Objective: Healthy lifestyle interventions addressing obesity in people with serious mental illness (SMI) lead to modest weight losses that tend not to be sustained over time. By augmenting lifestyle interventions with family and peer support targeting health behavior change, greater weight loss might be obtained and sustained in this population. The purpose of this study was to assess the feasibility of increasing support from family and friends to enhance a healthy lifestyle intervention (In SHAPE) adapted for individuals with SMI.

Systematic Review of Integrated General Medical and Psychiatric Self-Management Interventions for Adults With Serious Mental Illness.

Objective: Adults with serious mental illness are disproportionately affected by general medical comorbidity, earlier onset of disease, and premature mortality. Integrated self-management interventions have been developed to address both general medical and psychiatric illnesses. This systematic review examined evidence about the effect of self-management interventions that target both general medical and psychiatric illnesses and evaluated the potential for implementation.

Qualitative Analysis of Resources and Barriers Related to Treatment of Borderline Personality Disorder in the United States.

Objective: Resources and treatment for individuals with borderline personality disorder (BPD) are limited and often difficult to obtain. This article aimed to identify key resources for and barriers to obtaining supportive and treatment services for BPD from the perspective of individuals seeking information or services related to BPD ("BPD care seekers").

Methods: Data came from transcripts of resource requests to the Borderline Personality Disorder Resource Center from January 2008 to December 2015 (N=6,253).

A Multi-Stakeholder Process to Transform a Community-based Screening and Referral Program to Implement Evidence-Based Depression Care.

Background: Screening and referral for geriatric depression by service agencies is associated with poor treatment engagement indicating the need to transform services to directly provide depression care.

Objective: To describe a multi-organization workgroup implementation planning process used to transform a community-based screening and referral program to provide a brief evidence-based intervention for older adults with depressive symptoms.

Methods: An iterative implementation procedure used by a multi-stakeholder group that selected an evidence-based practice, planned implementation rollout, planned counselor training, and designed an implementation evaluation.

Dementia grief: A theoretical model of a unique grief experience.

Previous literature reveals a high prevalence of grief in dementia caregivers before physical death of the person with dementia that is associated with stress, burden, and depression. To date, theoretical models and therapeutic interventions with grief in caregivers have not adequately considered the grief process, but instead have focused on grief as a symptom that manifests within the process of caregiving. The Dementia Grief Model explicates the unique process of pre-death grief in dementia caregivers.

The Paradox of Scarcity in a Land of Plenty: Meeting the Needs of Older Adults with Mental Health and Substance Use Disorders.

Between the ACA, innovative strategies to create a new type of workforce, and technology, we have a chance to redesign healthcare to adequately address physical and mental health.

New Hampshire REAPs Results: Tailored Outreach Program Assists Older Adults at Risk for Mental Health Conditions and Substance Misuse.

A model community-based outreach program overcomes barriers to screening and case identification of vulnerable older adults in psychiatric distress.