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Geriatric bipolar

Andrew W Bodrogi, Robert Sciortino, David A Fitch, Wade Gofton
BACKGROUND: Femoral neck fractures are common injuries in the geriatric population associated with high morbidity and mortality rates. Studies have shown outcomes can be positively influenced by early postoperative mobilization. The supercapsular percutaneously assisted total hip (SuperPath) surgical technique has been shown to lead to early mobilization for osteoarthritic total hip replacement patients and as such has the potential to provide similar benefits in fracture patients. This manuscript provides a detailed description of this technique using hemiarthroplasty to treat femoral neck fractures and presents the first case series of this application...
October 12, 2016: Journal of Orthopaedic Surgery and Research
Leandro da Costa Lane Valiengo, Florindo Stella, Orestes Vicente Forlenza
Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors...
2016: Neuropsychiatric Disease and Treatment
Adriana P Hermida, A Umair Janjua, Oliver M Glass, Camille P Vaughan, Felicia Goldstein, Lynn Marie Trotti, Stewart A Factor
Lithium is a mood stabilizer rarely associated with drug-induced parkinsonism (DIP). We present a case of an elderly woman with bipolar disorder who developed parkinsonian symptoms after chronic lithium administration despite therapeutic serum levels. Upon evaluation, classic parkinsonian signs of muscle rigidity, tremor, bradykinesia, freezing of gait, and cognitive decline were observed. Initially, she was diagnosed with Parkinson's disease (PD); however, DaTscan SPECT imaging clarified the diagnosis as DIP...
August 12, 2016: International Psychogeriatrics
Anjana Sahu, Indirani H Kumar
A 70-year-old female patient, known case of hypertension and incomplete Left bundle branch block (LBBB), posted for bipolar hemiarthroplasty. A geriatric patient with LBBB and systemic hypertension is a fatal combination; it may precipitate into complete AV dissociation during anaesthesia and surgical stress. We are reporting this interesting case as our patient had developed complete Atrioventricular (AV) dissociation when scheduled earlier for surgery and got postponed. We had given combined spinal epidural anaesthesia and managed successfully without any complication...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Annemiek Dols, Lars Vedel Kessing, Sergio A Strejilevich, Soham Rej, Shang-Ying Tsai, Ariel G Gildengers, Osvaldo P Almeida, Kenneth I Shulman, Martha Sajatovic
OBJECTIVE: Older adults with bipolar disorder (OABD) are a growing segment of patients with bipolar disorder (BD) for which specific guidelines are warranted. Although, OABD are frequently excluded from randomized controlled trials due to their age or somatic comorbidity, more treatment data from a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world...
July 21, 2016: International Journal of Geriatric Psychiatry
Aline T Soares, Ana C Andreazza, Soham Rej, Tarek K Rajji, Ariel G Gildengers, Beny Lafer, L Trevor Young, Benoit H Mulsant
OBJECTIVES: Decreased levels of brain derived neurotrophic factor (BDNF) have been found in adult patients with bipolar disorder (BD) compared with a comparison group, yet there are no data specifically examining this in geriatric patients. The objective of this study was to examine whether euthymic late-life BD patients have lower BDNF levels than healthy comparators. DESIGN: Cross-sectional study. SETTING: Clinics at the University of Pittsburgh and the Centre for Addiction and Mental Health (Toronto)...
August 2016: American Journal of Geriatric Psychiatry
Ching Yu, Jean-Daniel Sylvestre, Marilyn Segal, Karl J Looper, Soham Rej
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. The main outcome was psychiatric re-hospitalization in 5-year follow-up post-discharge (e...
November 2015: International Journal of Geriatric Psychiatry
Martha Sajatovic, Sergio A Strejilevich, Ariel G Gildengers, Annemiek Dols, Rayan K Al Jurdi, Brent P Forester, Lars Vedel Kessing, John Beyer, Facundo Manes, Soham Rej, Adriane R Rosa, Sigfried Ntm Schouws, Shang-Ying Tsai, Robert C Young, Kenneth I Shulman
OBJECTIVES: In the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older-Age Bipolar Disorder (OABD). METHODS: This task force report addresses the unique aspects of OABD including epidemiology and clinical features, neuropathology and biomarkers, physical health, cognition, and care approaches...
November 2015: Bipolar Disorders
Perminder S Sachdev, Adith Mohan, Lauren Taylor, Dilip V Jeste
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the changes in DSM-5 relative to earlier versions.• Evaluate the implications of the DSM-5 for practicing geriatric psychiatrists. ABSTRACT: About every 20 years, the American Psychiatric Association revises its official classification of mental disorders. The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, prompting considerable commentary, debate, and criticism...
September 2015: Harvard Review of Psychiatry
Tor Magne Bjølseth, Knut Engedal, Jūratė Šaltytė Benth, Gro Strømnes Dybedal, Torfinn Lødøen Gaarden, Lars Tanum
BACKGROUND: No prior study has investigated whether impairment of specific cognitive functions at baseline may predict the short-term treatment outcome of electroconvulsive therapy (ECT) in elderly non-demented patients with major depression (MD). METHODS: This longitudinal cohort study included 65 elderly patients with unipolar or bipolar MD, aged 60-85 years, treated with formula-based ECT. Treatment outcome was assessed using the 17-item Hamilton Rating Scale for Depression (HRSD17)...
October 1, 2015: Journal of Affective Disorders
Igor Aedo, Jaime Santander, Christian Weiss, Ximena Fuentes
INTRODUCTION: It is estimated that Chilean geriatric population (=65 years) will hit 16% in the year 2030. Psychiatric longer stays have been described for those equal 65 years vs. less than 65 years. We aim to describe the characteristics associated with lengths of stay in our psychiatric unit. MATERIAL AND METHODS: Retrospective review of 3112 admissions between July 2001 and June 2010 to the general psychiatric service of the Pontific Catholic University of Chile...
November 2014: Vertex: Revista Argentina de Psiquiatriá
Young Sup Woo, Jung Goo Lee, Jong-Hyun Jeong, Moon-Doo Kim, Inki Sohn, Se-Hoon Shim, Duk-In Jon, Jeong Seok Seo, Young-Chul Shin, Kyung Joon Min, Bo-Hyun Yoon, Won-Myong Bahk
OBJECTIVE: To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014). METHODS: A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry...
2015: Neuropsychiatric Disease and Treatment
Somashekar, Sathya Vamsi Krishna, Jn Sridhara Murthy
BACKGROUND AND OBJECTIVE: Intracapsular femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty. The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients. METHODS: Forty-one patients above 60 years of age and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either unipolar or bipolar hemiarthroplasty, in the Department of Orthopaedics, between September 2009 and October 2012...
July 2013: Malaysian Orthopaedic Journal
Thomas Gregor Issac, Soundararajan Soundarya, Rita Christopher, Sadanandavalli Retnaswami Chandra
BACKGROUND: Vitamin B12 deficiency is a common condition causing neurologic, cognitive, psychiatric, and mood symptoms. With varied religious, ethnic, and socioeconomic heterogeneity among the people in India greatly influencing their dietary habits and with the high prevalence of Helicobacter pylori infection, Vitamin B12 deficiency is not uncommon, but is often under recognized due to the lack of classical symptomatic presentation. MATERIALS AND METHODS: Retrospective study on Vitamin B12 deficiency with neuropsychiatric symptoms in patients who attended neurology, psychiatry, and geriatric OPDs for a period of 1 year in a specialized neuropsychiatric institute in South India...
January 2015: Indian Journal of Psychological Medicine
Sudhir Singh, Chetan Shrivastava, Sanjiv Kumar
INTRODUCTION: Unstable inter-trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut-out of the lag screw, are the common problems of attempts to fix these fractures. Present study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty in unstable inter-trochanteric fractures in elderly patients. MATERIALS AND METHODS: This prospective study included 25 cases with unstable inter-trochanteric fracture of femur between 60 -75 y of age in whom primary Cemented Bipolar hemi - arthroplasty was performed...
October 2014: Journal of Clinical and Diagnostic Research: JCDR
Philipp Dines, Wei Hu, Martha Sajatovic
The elderly are the fastest growing segment of the global population with the number of people age 60 or older having doubled since 1980 and the number of people age 80 or older expected to increase more than 4-fold (to 395 million) by the year 2050. While depression is overall less common in older people compared to younger people, there are sub-groups of elderly, such as those with significant medical comorbidity, who are at greatly elevated risk for depression. Negative consequences of late-life depression include functional decline and disability, increased use of non-mental health services, increased mortality rates due to cardiovascular causes, increased cancer rates, and substantially greater risk for suicide...
November 2014: Psychiatria Danubina
Martha Sajatovic, Philipp Dines, Edna Fuentes-Casiano, Melanie Athey, Kristin A Cassidy, Johnny Sams, Kathleen Clegg, Joseph Locala, Susan Stagno, Curtis Tatsuoka
OBJECTIVE: In spite of growing numbers of older people, there are few treatment studies on late-life bipolar disorder (BD). This was a 12-week prospective, open-label trial to assess efficacy and tolerability of adjunct asenapine in non-demented older adults (≥ 60 years) with sub-optimal previous response to BD treatments. METHODS: Asenapine was initiated at 5 mg/day and titrated as tolerated. Effects on global psychopathology were measured with Clinical Global Impression, bipolar version (CGI-BP), and the Brief Psychiatric Rating Scale (BPRS)...
July 2015: International Journal of Geriatric Psychiatry
Ping Guo, Shikai Wang, Yiping Zhu, Xinhua Shen, Xuemin Jin, Mincai Qian, Hongyu Tang
BACKGROUND: Little is known about the risks of bone fractures in elderly patients with mental disorders in China. AIM: Assess the bone mineral density (BMD) of elderly patients with mental disorders in China and identify factors that are associated with low BMD, osteopenia and osteoporosis. METHODS: One hundred and two psychiatric inpatients 60 years of age or older (including patients with schizophrenia, depression, bipolar disorder and dementia) were randomly selected from patients in the geriatric wards of the Third People's Hospital of Huzhou...
October 2012: Shanghai Archives of Psychiatry
Erna Beers, Dineke C Moerkerken, Hubert G M Leufkens, Toine C G Egberts, Paul A F Jansen
OBJECTIVES: To investigate the inclusion of older people in clinical trials of recently authorized medicines, evaluating adherence to the 20-year-old International Conference of Harmonisation (ICH) guideline on geriatrics (E7). DESIGN: Observational. SETTING: European public assessment reports, published clinical trials, World Health Organization International Clinical Trials Registry Platform. PARTICIPANTS: Individuals aged 65 and older and 75 and older...
October 2014: Journal of the American Geriatrics Society
Egemen Ayhan, Hayrettin Kesmezacar, Ozgür Karaman, Adem Sahin, Nail Kır
BACKGROUND: The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. AIMS: THE AIMS OF THIS RETROSPECTIVE STUDY WERE: (1) to determine the factors affecting mortality of femoral neck fracture patients ≥65 years of age; (2) to compare patient mortality rates, radiological findings, and functional outcomes according to prosthesis type (unipolar or bipolar); and (3) to evaluate the persistence of inner bearing mobility of bipolar prostheses...
December 2013: Balkan Medical Journal
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