AAGP position statement: disaster preparedness for older Americans: critical issues for the preservation of mental health.

The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.

The use of the Minimum Data Set to identify depression in the elderly.

OBJECTIVE: To determine whether depression in the elderly in institutionalized settings could be identified using the mood indicators in the Minimum Data Set (MDS) 2.0 (Section E1, Items A-P). DESIGN: Descriptive study. SETTING: Three nursing homes in the southeastern part of the country. PARTICIPANTS: Residents aged 65 and above. MEASUREMENTS: The items in "Indicators of Depression, Anxiety and Sad Mood" on the MDS 2.0 were used to identify observable features of depression in the elderly. The Cornell Scale for Depression in Dementia (CSDD) was used to validate the MDS indicators. Consensus analysis, which controls raters' bias, raters' ability, and item difficulty, was used to analyze data. RESULTS: No depressive patterns were detected using the MDS indicators. On the CSDD, distinct depressive features were identified: anxiety, sadness, lack of reaction to pleasant events, irritability, agitation, multiple physical complaints, loss of interest, appetite loss, and lack of energy. CONCLUSION: The incongruent findings on the MDS indicators the CSDD may be reflective of the assessment process used with the MDS rather than its ability to identify features of elderly depression. The practice of allowing nondirect caregivers to complete the MDS may have serious implications for the accuracy of the data collected.

Effects of Buspirone on Agitation Associated With Dementia.

Ten patients with probable Alzheimer's disease participated in an open-label study of buspirone for agitation. The starting dose of 15 mg/day was increased by 5 mg every week until maximal improvement or 60 mg/day was reached. A significant decrease in agitation scores occurred at an average dose of 35 mg/day.