Problem Adaptation Therapy for Depressed, Cognitively Impaired, Disabled Elders

2012 ◽  
Author(s):  
Dimitris Kiosses
Keyword(s):  
Cognitively Impaired

Token economy reduces aggression among cognitively impaired patients in a psychiatric hospital

2008 ◽  
Author(s):  
Dominick Dephilillis ◽  
Peter E. Quintieri ◽  
Heather K. Noble ◽  
Jose F. Reyes ◽  
Sangeeta Akundi
Keyword(s):  
Psychiatric Hospital ◽  
Token Economy ◽  
Cognitively Impaired

Nuances in Alzheimer’s Genetic Risk Reveal Differential Predictions of Non-demented Memory Aging Trajectories: Selective Patterns by APOE Genotype and Sex

2019 ◽  
Vol 16 (4) ◽  
pp. 302-315 ◽  
Author(s):  
G. Peggy McFall ◽  
Lars Bäckman ◽  
Roger A. Dixon
Keyword(s):  
Genetic Risk ◽  
Growth Models ◽  
Memory Performance ◽  
Apoe Genotype ◽  
Cognitively Impaired ◽  
Latent Growth ◽  
Latent Growth Models ◽  
Selective Protection ◽  
Underlying Mechanisms ◽  
Apoe Genotypes

Background: Apolipoprotein E (APOE) is a prominent genetic risk factor for Alzheimer’s disease (AD) and a frequent target for associations with non-demented and cognitively impaired aging. APOE offers a unique opportunity to evaluate two dichotomous comparisons and selected gradations of APOE risk. Some evidence suggests that APOE effects may differ by sex and emerge especially in interaction with other AD-related biomarkers (e.g., vascular health). Methods: Longitudinal trajectories of non-demented adults (n = 632, 67% female, Mage = 68.9) populated a 40-year band of aging. Focusing on memory performance and individualized memory trajectories, a sequence of latent growth models was tested for predictions of (moderation between) APOE and pulse pressure (PP) as stratified by sex. The analyses (1) established robust benchmark PP effects on memory trajectories, (2) compared predictions of alternative dichotomous groupings (ε4- vs ε4+, ε2- vs ε2+), and (3) examined precision-based predictions by disaggregated APOE genotypes. Results: Healthier (lower) PP was associated with better memory performance and less decline. Therefore, all subsequent analyses were conducted in the interactive context of PP effects and sex stratification. The ε4-based dichotomization produced no differential genetic predictions. The ε2-based analyses showed sex differences, including selective protection for ε2-positive females. Exploratory follow-up disaggregated APOE genotype analyses suggested selective ε2 protection effects for both homozygotic and heterozygotic females. Conclusion: Precision analyses of AD genetic risk will advance the understanding of underlying mechanisms and improve personalized implementation of interventions.

(213) Pain Reduction in Cognitively Impaired Cancer Patients Treated with Olanzapine

Pain Medicine ◽  
2001 ◽  
Vol 2 (3) ◽  
pp. 243-244
Author(s):  
Natalia Khojainova ◽  
Juan Santiago-Palma ◽  
Gilbert R. Gonzales
Keyword(s):  
Cancer Patients ◽  
Pain Reduction ◽  
Cognitively Impaired

scholarly journals Use radiography rarely, not routinely, for hip hemiarthroplasty

2021 ◽  
Author(s):  
Lucy Clare Maling ◽  
John Martin Lynch ◽  
Robert William Walker ◽  
Mark Ross Norton ◽  
Rory George Middleton
Keyword(s):  
Patient Safety ◽  
Cognitive Impairment ◽  
Limited Resources ◽  
Cognitively Impaired ◽  
Clinical Change ◽  
Index Procedure ◽  
Hip Hemiarthroplasty ◽  
Operative Care ◽  
Fluoroscopic Imaging ◽  
Retrospective Database

Abstract Purpose Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS). Methods We undertook a retrospective database review of 1563 HA procedures to assess whether the routine ordering of check radiographs played an important role in a patient’s post-operative care. Results 18 (1.2%) mechanical complications led to a return to theatre within 6 weeks of the index procedure. All were dislocations. Ten had a normal post-operative radiograph and five had documented suspicion of dislocation prior to radiography. The post-operative check radiograph was the sole identifier of dislocation in only three patients (0.2%). All three of these patients were pre-morbidly bed bound and non-communicative due to cognitive impairment (AMTS 0/10). Conclusion Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.

scholarly journals Impact of Pain and Discomfort on the Lives of Cognitively Impaired Older Adults and Their Informal Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 786-787
Author(s):  
Hyunjin Noh
Keyword(s):  
Older Adults ◽  
Cognitively Impaired ◽  
Community Settings ◽  
Adult Age ◽  
Face To Face ◽  
Disease Trajectory ◽  
Care Recipients ◽  
Home Based ◽  
The Impact ◽  
Future Program

Abstract This qualitative study explored the impact of pain and discomfort on the lives of cognitively impaired older adults and their caregivers from the caregiver perspective. Forty-three individuals of age 19+, who identified themselves as primary caregiver to a chronically or seriously ill older adult (age 50+) with cognitive impairment, such as Alzheimer’s Disease and Related Dementia, were recruited at various community settings. Individual, face-to-face interviews were conducted to ask participants how they thought their care-recipient’s pain and discomfort affected the care-recipient’s and the caregiver’s life respectively. Inductive, thematic analysis of interview transcripts revealed several key themes: compromised mobility, limited social interaction or activities, and depressive symptoms in both care-recipients and caregivers; aggravated cognitive decline in care-recipients; and poorer physical health in caregivers. Participants wanted more information on the disease trajectory and available services, particularly home-based therapies and social activities for care-recipients, which provides future program/practice implications.

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