Older adults utilize less efficient postural adaptations when they are uncertain about the magnitude of a perturbation.

People frequently experience perturbations while standing or walking in crowded areas or when interacting with external objects. Balance maintenance in response to a perturbation is affected by the predictability of the magnitude of a body disturbance. The aim of this quasi-experimental study was to investigate the role of aging in maintenance of standing balance in response to perturbations of varying magnitudes. Twelve older adults and twelve young adults received a series of frontal perturbations of small or large magnitudes induced to their upper body by a pendulum impact while standing. The perturbation sequence included 10 trials of small, 15 trials of large, and 10 more trials of small magnitudes. The participants were exposed to either repetitive perturbations of known (predictable) magnitude or perturbations of unknown (unpredictable) magnitude as they were not told which of the perturbation magnitude (small, large) to expect. Electromyographic activity of six leg and trunk muscles and displacements of the center of pressure were recorded and analyzed during anticipatory (APAs) and compensatory (CPAs) phases of postural control. When exposed to both, repetitive perturbations of known magnitude and perturbations of unpredictable magnitude, older adults, compared to young adults, demonstrated delayed and smaller anticipatory and compensatory postural adaptations. Older adults also required more trials to modify postural adjustments, as compared to young adults. The findings imply that the ability to predict magnitudes of frontal perturbations is declined in older adults.

The Emerging Role of Pimavanserin in the Management of Parkinson's Disease Psychosis.

A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life. The panel reviewed current practices and formulated recommendations on moving forward in the treatment of PDP. DISCLOSURES: This project and manuscript was funded by ACADIA Pharmaceuticals and developed by Magellan Rx Management. Lopes and Farnum are employees of Magellan Rx Management. Kremens has received consulting/speaker fees from Teva Pharmaceuticals, UCB, Sunovion, Impax, Lundbeck, ACADIA, USWorldMeds, Merz, Acorda, Kyowa, Neurocrine, and GE Healthcare. Pagan reports consulting/speaker fees from Teva Nanoscience, AbbVie, Impax, ACADIA, Medtronic, USWorldMeds, Merz, and Cynapsus and research and educational grants from USWorldMeds, Teva, and Medtronic. Patel has received consultant/speaker fees from ACADIA, Allergen, and Avanir. Alva reports research support from Accera, Allergan, Axovant, Eisai, Neurotrope, Genentech, Intra Cellular, Janssen, Lundbeck, Neurim, Novartis, Otsuka, Roche, Suven, and Trans Tech and consultant/speaker fees from ACADIA, Alkermes, Allergan, Avanir, Janssen, Lundbeck, Merck, Nestle, Otsuka, Sunovion, Takeda, and Vanda. The other authors report no potential conflicts of interest, financial or otherwise.