Does the geriatric depression scale have utility for measuring depression severity?

The prevalence of major depression ranges from 1% to 16% among elderly living in private households or in institutions, and in similar settings "patients" with clinically relevant depressive symptoms vary between 7.2% and 49% (Djernes, 2006). Community studies looking at point prevalence of depression in older people suggest rates between 10% and 20% depending on cultural situations (Rodda et al., 2011).

Medication adherence and knowledge in older patients.

OBJECTIVES: To assess the degree to which a sample of older individuals - who are engaged with psychiatric services - are knowledgeable about their medication and the reason for its prescription; to assess the degree to which these patients adhere to what is prescribed. METHODS: Convenience sample of 24 patients over 65 years old, under the care of psychiatric services for Later Life, included. Patients who scored < 23 on Mini-mental State Examination were excluded. A questionnaire was administered which evaluated patients' knowledge of the names of, and reasons for, all prescription medications. Adherence rates were measured. Comparisons were made regarding to self-reported adherence rates and medication knowledge. These were based on diagnosis, age, number of medications prescribed and the presence or absence of sensory impairment. RESULTS: The median percentage of medication names recalled was 60%. A total of 25% of patients reported having some problem with adherence. No patient with a diagnosis of dementia was able to recall the names of, or reasons for, all medications prescribed. Patients with depression and dementia were as likely to be fully adherent as the total sample. Patients (a) aged 78 years or more and (b) those who were on more than six medications - were less knowledgeable about and less likely to adhere to prescribed drug regimens. We did not identify an association between reduced visual acuity and reduced medication adherence Conclusion: Patients require ongoing education concerning all aspects of medication, especially the reasons for prescription. Older patients and those receiving more complex regimens may be at particular risk of adherence problems.

Memory-related EEG power and coherence reductions in mild Alzheimer's disease.

OBJECTIVES: To examine memory-related EEG power and coherence over temporal and central recording sites in patients with early Alzheimer's disease (AD) and normal controls. METHOD: EEG was recorded from central (Fz, Cz and Pz) and temporal (T3 and T4) electrodes while ten very mild AD patients and ten controls performed a Sternberg-type memory scanning task with three levels of working memory load. Spectral power in delta (0-3 Hz), theta (3-5 Hz), lower alpha1 (5-7 Hz), lower alpha2 (7-9 Hz), upper alpha (9-11 Hz) and beta (15-30 Hz) was averaged for temporal and central electrodes. Coherence was averaged between central electrodes, between central and right temporal electrodes and between central and left temporal electrodes. RESULTS: While behavioral performance of very mild AD patients did not differ significantly from that of normal controls, findings suggest that normal controls but not AD patients respond to memory demands by increasing upper alpha power over temporal cortex. When compared with normal controls, AD patients had reduced upper alpha coherence between central and right temporal cortex. DISCUSSION: Results are consistent with previous research on the role of upper alpha in semantic memory and suggest that very mild AD may inhibit selective synchronization of upper alpha in temporal lobes. Reduced coherence between central and temporal cortex is discussed in light of a neurological model of AD that hypothesizes reduced electrocortical efficiency and a breakdown of neural network communication to temporal lobes possibly resulting from temporal lobe atrophy.