The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Jan 2008
Randomized Controlled Trial Multicenter StudySafety and tolerability of oral paliperidone extended-release tablets in elderly patients with schizophrenia: a double-blind, placebo-controlled study with six-month open-label extension.
The objective of this multicenter, international study was to evaluate safety and tolerability of paliperidone extended-release (ER) tablets in elderly (age > or =65 years) patients with schizophrenia. The authors conducted a 6-week, double-blind, randomized, placebo-controlled, optional 24-week open-label extension study. Interventions consisted of flexible, once-daily doses of paliperidone ER (3-12 mg/day; 6-mg starting dose, adjusted in 3-mg dose increments) or placebo (2:1) during double-blind treatment and paliperidone ER only during open-label treatment. Measurements included adverse events, laboratory tests, physical examinations, 12-lead electrocardiograms, movement disorder rating scales, Positive and Negative Syndrome Scale, and Clinical Global Impression scale. The study was not powered to show statistical differences. ⋯ Paliperidone ER (3-12 mg/day) treatment over a 30-week period was generally well-tolerated and may improve symptom severity in elderly patients with schizophrenia.
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Am J Geriatr Psychiatry · Nov 2007
Randomized Controlled Trial Multicenter Study Comparative StudyAripiprazole for the treatment of psychoses in institutionalized patients with Alzheimer dementia: a multicenter, randomized, double-blind, placebo-controlled assessment of three fixed doses.
To assess the efficacy and safety of aripiprazole for psychosis associated with Alzheimer dementia (AD). ⋯ Aripiprazole 10 mg/day was efficacious and safe for psychosis associated with AD, significantly improving psychotic symptoms, agitation, and clinical global impression. However, clinicians should be aware of the safety considerations of atypical antipsychotic uses in this population.
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Am J Geriatr Psychiatry · Aug 2007
Randomized Controlled Trial Multicenter StudyPain limits the effectiveness of collaborative care for depression.
To ascertain the effects of baseline pain on depression outcomes in a collaborative care treatment trial of depression for older adults. ⋯ A collaborative care intervention was significantly more successful in older adults with less pain. Pain may be an important barrier to improvement of depression and attending to pain might produce better depression outcomes.
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Am J Geriatr Psychiatry · Aug 2006
Multicenter StudyPredictors of complicated grief among dementia caregivers: a prospective study of bereavement.
Most family caregivers adapt well to the death of their care recipient relative; however, a sizable minority continues to experience postdeath psychiatric morbidity. The purpose of this study was to better understand why some caregivers manifest clinical levels of complicated grief postdeath. This is the first study to prospectively assess predictors of complicated grief among family caregivers of patients with dementia who experience the death of their care recipient. ⋯ This study identifies predictors of complicated grief for which interventions could be developed to not only ease caregiver distress, but also serve as preventive interventions for bereavement. Reducing the burden of active caregiving, treating depression before the death of the loved one and providing supportive psychosocial and skills training caregiver interventions can prevent the emergence of postdeath psychiatric morbidity.
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Am J Geriatr Psychiatry · Aug 2006
Multicenter StudyWhy doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?
The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. ⋯ These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.