The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
-
Am J Geriatr Psychiatry · Oct 2018
Meta AnalysisHospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness.
Delirium, defined as an acute disorder of attention and cognition with high morbidity and mortality, can be prevented by multicomponent nonpharmacological interventions. The Hospital Elder Life Program (HELP) is the original evidence-based approach targeted to delirium risk factors, which has been widely disseminated. ⋯ The Hospital Elder Life Program is effective in reducing incidence of delirium and rate of falls, with a trend toward decreasing length of stay and preventing institutionalization. With ongoing efforts in continuous program improvement, implementation, adaptations, and sustainability, HELP has emerged as a reference standard model for improving the quality and effectiveness of hospital care for older persons worldwide.
-
Am J Geriatr Psychiatry · Nov 2016
Review Meta AnalysisEfficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression.
Generalized anxiety disorder (GAD) is a common disorder in older adults producing functional impairment, and psychotherapy is the preferred treatment option. Meta-analytic methods sought to determine the efficacy of outpatient cognitive behavioral therapy (CBT) with respect to the hallmark feature of GAD-uncontrolled and excessive worry. In order to optimize clinical applicability, variables associated with GAD treatment outcomes were also examined. ⋯ CBT is more helpful than having no treatment for GAD in later life. Nevertheless, whether CBT shows long-term durability, or is superior to other commonly available treatments (such as supportive psychotherapy), remains to be tested. The relationship between treatment effects for GAD and depression following CBT warrants further research.
-
Am J Geriatr Psychiatry · Sep 2010
Meta AnalysisScreening and case-finding tools for the detection of dementia. Part II: evidence-based meta-analysis of single-domain tests.
To evaluate the diagnostic validity of single-domain cognitive tests for detecting dementia. These methods were defined as those that focus mainly on one domain of cognitive function such as orientation, memory, or executive function. ⋯ Brief single-domain methods offer diagnostic performance for detection of dementia that is surprisingly close to that offered by cognitive batteries such as the MMSE. As a method of screening or as part of a diagnostic algorithm, brief single-domain tests may be an efficient first step in identifying cognitive impairment.
-
Am J Geriatr Psychiatry · Oct 2009
Meta AnalysisThe association between delirium and the apolipoprotein E epsilon 4 allele: new study results and a meta-analysis.
To determine a possible association between Apolipoprotein E (APOE)sigma4-allele and delirium in a large cohort and combining these current data with former studies in a meta-analysis. ⋯ This study and meta-analysis suggest an association between delirium and the APOE sigma4 allele.
-
Am J Geriatr Psychiatry · Mar 2006
Meta AnalysisEfficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials.
Atypical antipsychotic medications are widely used to treat delusions, aggression, and agitation in people with Alzheimer disease (AD) and other dementia. Several clinical trials have not shown efficacy, and there have been concerns about adverse events. The objective of this study was to assess the evidence for efficacy and adverse events of atypicals for people with dementia. ⋯ Small statistical effect sizes on symptom rating scales support the evidence for the efficacy of aripiprazole and risperidone. Incomplete reporting restricts estimates of response rates and clinical significance. Dropouts and adverse events further limit effectiveness. Atypicals should be considered within the context of medical need and the efficacy and safety of alternatives. Individual patient meta-analyses are needed to better assess clinical significance and effectiveness.