ABSTRACT
UNLABELLED: This study examined the prevalence of irritability and social isolation in veterans with dementia, with and without depression. Participants were diagnosed with dementia and enrolled in a dementia care-coordination and support-service intervention. Participants were interviewed and underwent assessment with the 10-item Center for Epidemiologic Studies Depression scale, a Patient Strain Measure and the Short Blessed Test. In all, of 294 participants completing interviews, 77 (26.2%) were depressed and 107 (36.4%) endorsed irritability; mean social isolation score was 1.59 ± 1.96. Irritability was significantly more likely to be present in depressed versus nondepressed participants (P < .0001), but this relationship was moderated by dementia severity. The mean social isolation score was also significantly more elevated in depressed rather than nondepressed patients (2.82 ± 1.96 vs 1.15 ± 1.76, respectively). CONCLUSIONS: Depressed persons with dementia are significantly more likely to experience irritability and social isolation than those who are not depressed.
Subject(s)
Dementia/complications , Depression/complications , Irritable Mood/physiology , Social Isolation/psychology , Aged , Aged, 80 and over , Cohort Studies , Dementia/epidemiology , Depression/epidemiology , Depression/etiology , Female , Humans , Male , Prevalence , Psychiatric Status Rating Scales , Severity of Illness Index , United States/epidemiology , Veterans/psychologyABSTRACT
The purpose of this study was to systematically review the literature to determine whether aggression is linked to psychosis in persons with dementia. An electronic search using PubMed for articles in English focusing on psychosis and aggression or agitation in adults aged 65+ with dementia. Cross-sectional, longitudinal, and randomized controlled treatment studies examining the outcomes of aggression and psychosis were eligible for inclusion. Eighteen articles were selected for final analysis. Of the seven cross-sectional and two longitudinal studies directly examining the correlation of aggression and psychosis, most showed a positive association. Outcome data from the nine treatment studies was more mixed. Limited data link psychosis with aggression in persons with dementia. Prospectively designed studies looking at the temporal relationship of these variables are needed to make a stronger causal argument.
Subject(s)
Aggression/psychology , Dementia/psychology , Psychotic Disorders/psychology , Aged , Cross-Sectional Studies , Dementia/complications , Humans , Longitudinal Studies , Psychotic Disorders/complications , Randomized Controlled Trials as TopicABSTRACT
The prevalence of insomnia increases with age and affects up to 35% of community-dwelling adults with dementia. Sleep disturbances and associated cognitive and behavioral symptoms in this patient population can be a significant contributor to morbidity, mortality, and caregiver burden. Despite the frequency with which sleep disorders are encountered in primary care, few evidence-based guidelines are available to guide physician treatment plans. Sedative-hypnotic medications are commonly prescribed but are associated with significant adverse effects and have limited efficacy data. Non-pharmacologic treatments can be safe and effective adjuncts or alternatives to medications but are often underused in clinical practice. This article reviews practical applications of modalities such as light therapy, exercise, and sleep-hygiene modification in treating insomnia in persons with dementia.
