Depression in the elderly is an eminently treatable disease. It may masquerade as a pseudo dement... more Depression in the elderly is an eminently treatable disease. It may masquerade as a pseudo dementia--a reversible condition with proper treatment. The need for an eclectic approach to management is emphasised and the special needs of the elderly outlined.
... Tress and Patricia Desmond 1 (b) Magnetic resonance imaging 23 Patricia Desmond and Brian Tre... more ... Tress and Patricia Desmond 1 (b) Magnetic resonance imaging 23 Patricia Desmond and Brian Tress 1 (c) Single photon and positron emission tomography 43 Basil Shepstone and Kim Jobst 1 (d) Electroencephalography and magnetoencephalography Andrew Leuchter and ...
Journal of Neuropsychiatry and Clinical Neurosciences, Jul 1, 2020
Objective: Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, c... more Objective: Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, cognitive, psychiatric, and behavioral impairments that eventually affect work-role functioning. There is limited research regarding predictors of workplace disability in HD. The authors examined predictors of work impairment and disability in a cross-sectional cohort of employed persons with symptomatic HD participating in the worldwide Enroll-HD study. Methods: The study sample (N=316) comprised individuals with manifest HD and a CAG repeat length range between 39 and 60 and were currently engaged in paid full-or parttime employment. Univariate and multivariate logistic regression analyses identified predictors and the effect of all predictors in a fully adjusted model. Results: Of the sample, 20.3% reported missing work due to HD, 60.1% reported experiencing impairment while working due to HD, 79.1% reported having work-related activity impairment due to HD, and 60.8% reported impairment in overall work productivity due to HD. Individuals had 25% higher odds of missing work time if they had a higher level of functional impairment (odds ratio=0.76, 95% CI=0.64, 0.91) and had three times greater odds of missing work if they were current alcohol drinkers, compared with nondrinkers (odds ratio52.86, 95% CI51.62, 5.03). Individuals with lower self-perceived mental health were also 5% more likely to experience impairment at work due to HD. Motor impairment was not a strong predictor of workplace disability. Conclusions: These findings provide important new knowledge that can inform the development of strategies or targeted intervention trials to support persons with symptomatic HD to maintain their work roles.
This paper provides an overview of the literature on depression in the elderly, and draws the att... more This paper provides an overview of the literature on depression in the elderly, and draws the attention of the readers to some, but not all, important issues related to this condition, which is still awaiting further exploration in its clinical presentation, epidemiology, treatment and ...
; 13:30; Debate topic : Dementia with Lewy bodies and Parkinson's disease dementia are the same d... more ; 13:30; Debate topic : Dementia with Lewy bodies and Parkinson's disease dementia are the same disease. Joseph Friedman Yes; Francesc Valldereola-No Congress Proceedings Dementia with Lewy Bodies (DLB) and Parkinson's Disease with Dementia (PDD) are different diseases, until they're not.
Psychiatric disorders are common in the elderly. Antidepressants are probably underprescribed. In... more Psychiatric disorders are common in the elderly. Antidepressants are probably underprescribed. In recurrent depression, lifelong prophylaxis may be required. Benzodiazepines can aggravate cognitive impairment and cause falls; they should not be used for chronic insomnia. Antipsychotic drugs are useful for the treatment of delusions and hallucinations but are less effective for disturbed behaviour in dementia sufferers. There are no satisfactory drugs for treating dementia at present, but promising palliative treatments for Alzheimer's disease are under trial.
International Journal of Geriatric Psychiatry, Jun 1, 1997
Aggressive behavior among the elderly is a neglected area of research. An 18-week prospective stu... more Aggressive behavior among the elderly is a neglected area of research. An 18-week prospective study of aggressive behavior on a continuing-care psychogeriatric ward provided data to examine the relationship between two aggression scales (WAS and RAGE). There was a strong and significant correlation between the SOAS and RAGE scales for the total and the subscale scores. Both these scales appear useful in measuring aggressive behavior among continuing-care psychogeriatric inpatients. Also, the nursing staff can be trained to complete these scales effectively.
The vast experiences from the community mental health care models in the Asia-Pacific region can ... more The vast experiences from the community mental health care models in the Asia-Pacific region can serve as valuable lessons and inspiration for future development. For positive change to occur, it is clear that innovative, culturally sensitive and economically sustainable pathways for community treatment models need to be explored and developed. The Asia-Pacific Community Mental Health Development (APCMHD) project has been established to explore diverse leading models or approaches to community mental health service delivery in the Asia-Pacific region. It aims to illustrate and promote best practice in mental health care in the community through use of information exchange, current evidence and practical experience in the region. The project is based on the work of an emerging network of mental health leaders from 14 countries or regions in the Asia-Pacific, working to build culturally appropriate mental health policy frameworks and workforce in the implementation of community mental health services. Some of the key guiding principles of developing community mental health care in the region are highlighted. Such collaborative exchange based on local practices will help enhance regional solutions to challenges in building capacity and structures for community-based mental health systems in the future.
Psychological Research-psychologische Forschung, Jun 1, 1993
A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an... more A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an indication of the motor functions of the basal ganglia. Basal-ganglia diseases affect voluntary movement and can cause involuntary movement. Deficits are often manifested during the coordination of fine multi-joint movements (e. g., handwriting). The disturbances of motor control (e. g. akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data suggest that the basal ganglia play an important role in the automatic execution of serially ordered complex movements.
Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benef... more Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benefits in this variably progressive syndrome is complex and difficult. This consensus statement was generated by an international group representing caregivers, organizations and professionals with expertise in dementia.
ABSTRACT We secured a grant from the Legal Services Board of Victoria to fund a follow-on project... more ABSTRACT We secured a grant from the Legal Services Board of Victoria to fund a follow-on project from RESPOND-HD to analyze and explore the Australian experience of genetic discrimination (GD), using HD as a case model. The objectives are 1) improving knowledge of laws related to GD, 2) improved legal services, and 3) development of easily accessible resources (brochure, website) informing consumers of their rights. Results Of 60 participants (65% female; 35% male; 60% HD gene positive; 40% gene negative), aged between 20 and 69 years, 32% reported experiencing GD, with mean number of incidences 3.17 (±3.35). Participants experienced discrimination in employment, social, and insurance domains. For example, 17% of respondents had been refused insurance coverage, 20% offered coverage only at a higher premium, 55% told because of family history they could get only limited coverage, and 36% told that due to test results they could get only limited coverage. Responses to Discrimination 1Action—getting involved in activities2Inaction—do nothing, react with positivity, feel surprised by discrimination3Involvement—information provision, research involvement4Advice—regarding event or potential for event5Advocacy—to reduce stereotyping, providing education Awareness of Legislation Victoria's anti-discrimination laws are contained in the Equal Opportunity Act 1995, Disability Discrimination Act 1992, and Human Rights and Equal Opportunity Commission Act 1986. Regarding GD, 17% of participants knew where to make a complaint; 27% knew of laws preventing employers from unfairly using genetic information; 15% knew of laws preventing health insurance companies from accessing or requiring genetic information about an insured person; and 10% knew of laws preventing these companies from using genetic information to deny insurance. We aim to increase these percentages. We are funded to hold focus groups to discuss results and clarify issues with several cohorts (gene-negative participants, gene-positive participants, family members, case workers, health professionals, and researchers), and also for a public launch of the above-mentioned resources.
Depression in the elderly is an eminently treatable disease. It may masquerade as a pseudo dement... more Depression in the elderly is an eminently treatable disease. It may masquerade as a pseudo dementia--a reversible condition with proper treatment. The need for an eclectic approach to management is emphasised and the special needs of the elderly outlined.
... Tress and Patricia Desmond 1 (b) Magnetic resonance imaging 23 Patricia Desmond and Brian Tre... more ... Tress and Patricia Desmond 1 (b) Magnetic resonance imaging 23 Patricia Desmond and Brian Tress 1 (c) Single photon and positron emission tomography 43 Basil Shepstone and Kim Jobst 1 (d) Electroencephalography and magnetoencephalography Andrew Leuchter and ...
Journal of Neuropsychiatry and Clinical Neurosciences, Jul 1, 2020
Objective: Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, c... more Objective: Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, cognitive, psychiatric, and behavioral impairments that eventually affect work-role functioning. There is limited research regarding predictors of workplace disability in HD. The authors examined predictors of work impairment and disability in a cross-sectional cohort of employed persons with symptomatic HD participating in the worldwide Enroll-HD study. Methods: The study sample (N=316) comprised individuals with manifest HD and a CAG repeat length range between 39 and 60 and were currently engaged in paid full-or parttime employment. Univariate and multivariate logistic regression analyses identified predictors and the effect of all predictors in a fully adjusted model. Results: Of the sample, 20.3% reported missing work due to HD, 60.1% reported experiencing impairment while working due to HD, 79.1% reported having work-related activity impairment due to HD, and 60.8% reported impairment in overall work productivity due to HD. Individuals had 25% higher odds of missing work time if they had a higher level of functional impairment (odds ratio=0.76, 95% CI=0.64, 0.91) and had three times greater odds of missing work if they were current alcohol drinkers, compared with nondrinkers (odds ratio52.86, 95% CI51.62, 5.03). Individuals with lower self-perceived mental health were also 5% more likely to experience impairment at work due to HD. Motor impairment was not a strong predictor of workplace disability. Conclusions: These findings provide important new knowledge that can inform the development of strategies or targeted intervention trials to support persons with symptomatic HD to maintain their work roles.
This paper provides an overview of the literature on depression in the elderly, and draws the att... more This paper provides an overview of the literature on depression in the elderly, and draws the attention of the readers to some, but not all, important issues related to this condition, which is still awaiting further exploration in its clinical presentation, epidemiology, treatment and ...
; 13:30; Debate topic : Dementia with Lewy bodies and Parkinson's disease dementia are the same d... more ; 13:30; Debate topic : Dementia with Lewy bodies and Parkinson's disease dementia are the same disease. Joseph Friedman Yes; Francesc Valldereola-No Congress Proceedings Dementia with Lewy Bodies (DLB) and Parkinson's Disease with Dementia (PDD) are different diseases, until they're not.
Psychiatric disorders are common in the elderly. Antidepressants are probably underprescribed. In... more Psychiatric disorders are common in the elderly. Antidepressants are probably underprescribed. In recurrent depression, lifelong prophylaxis may be required. Benzodiazepines can aggravate cognitive impairment and cause falls; they should not be used for chronic insomnia. Antipsychotic drugs are useful for the treatment of delusions and hallucinations but are less effective for disturbed behaviour in dementia sufferers. There are no satisfactory drugs for treating dementia at present, but promising palliative treatments for Alzheimer's disease are under trial.
International Journal of Geriatric Psychiatry, Jun 1, 1997
Aggressive behavior among the elderly is a neglected area of research. An 18-week prospective stu... more Aggressive behavior among the elderly is a neglected area of research. An 18-week prospective study of aggressive behavior on a continuing-care psychogeriatric ward provided data to examine the relationship between two aggression scales (WAS and RAGE). There was a strong and significant correlation between the SOAS and RAGE scales for the total and the subscale scores. Both these scales appear useful in measuring aggressive behavior among continuing-care psychogeriatric inpatients. Also, the nursing staff can be trained to complete these scales effectively.
The vast experiences from the community mental health care models in the Asia-Pacific region can ... more The vast experiences from the community mental health care models in the Asia-Pacific region can serve as valuable lessons and inspiration for future development. For positive change to occur, it is clear that innovative, culturally sensitive and economically sustainable pathways for community treatment models need to be explored and developed. The Asia-Pacific Community Mental Health Development (APCMHD) project has been established to explore diverse leading models or approaches to community mental health service delivery in the Asia-Pacific region. It aims to illustrate and promote best practice in mental health care in the community through use of information exchange, current evidence and practical experience in the region. The project is based on the work of an emerging network of mental health leaders from 14 countries or regions in the Asia-Pacific, working to build culturally appropriate mental health policy frameworks and workforce in the implementation of community mental health services. Some of the key guiding principles of developing community mental health care in the region are highlighted. Such collaborative exchange based on local practices will help enhance regional solutions to challenges in building capacity and structures for community-based mental health systems in the future.
Psychological Research-psychologische Forschung, Jun 1, 1993
A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an... more A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an indication of the motor functions of the basal ganglia. Basal-ganglia diseases affect voluntary movement and can cause involuntary movement. Deficits are often manifested during the coordination of fine multi-joint movements (e. g., handwriting). The disturbances of motor control (e. g. akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data suggest that the basal ganglia play an important role in the automatic execution of serially ordered complex movements.
Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benef... more Current symptomatic treatments for dementia have only modest efficacy. Assessing meaningful benefits in this variably progressive syndrome is complex and difficult. This consensus statement was generated by an international group representing caregivers, organizations and professionals with expertise in dementia.
ABSTRACT We secured a grant from the Legal Services Board of Victoria to fund a follow-on project... more ABSTRACT We secured a grant from the Legal Services Board of Victoria to fund a follow-on project from RESPOND-HD to analyze and explore the Australian experience of genetic discrimination (GD), using HD as a case model. The objectives are 1) improving knowledge of laws related to GD, 2) improved legal services, and 3) development of easily accessible resources (brochure, website) informing consumers of their rights. Results Of 60 participants (65% female; 35% male; 60% HD gene positive; 40% gene negative), aged between 20 and 69 years, 32% reported experiencing GD, with mean number of incidences 3.17 (±3.35). Participants experienced discrimination in employment, social, and insurance domains. For example, 17% of respondents had been refused insurance coverage, 20% offered coverage only at a higher premium, 55% told because of family history they could get only limited coverage, and 36% told that due to test results they could get only limited coverage. Responses to Discrimination 1Action—getting involved in activities2Inaction—do nothing, react with positivity, feel surprised by discrimination3Involvement—information provision, research involvement4Advice—regarding event or potential for event5Advocacy—to reduce stereotyping, providing education Awareness of Legislation Victoria's anti-discrimination laws are contained in the Equal Opportunity Act 1995, Disability Discrimination Act 1992, and Human Rights and Equal Opportunity Commission Act 1986. Regarding GD, 17% of participants knew where to make a complaint; 27% knew of laws preventing employers from unfairly using genetic information; 15% knew of laws preventing health insurance companies from accessing or requiring genetic information about an insured person; and 10% knew of laws preventing these companies from using genetic information to deny insurance. We aim to increase these percentages. We are funded to hold focus groups to discuss results and clarify issues with several cohorts (gene-negative participants, gene-positive participants, family members, case workers, health professionals, and researchers), and also for a public launch of the above-mentioned resources.
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