Medication in advanced dementia: how can we judge what is appropriate?

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Caroline Struthers appraises a recent US cross-sectional study of the use of medications of “questionable benefit” in nursing home residents with advanced dementia. She concludes that all medications are of questionable value if they have side effects which might have a negative impact on quality of life or are likely to cause harm.

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Lost in anxiety: treatment-resistant anxiety in older people

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Andrés Fonseca appraises a new systematic review of interventions for treatment-resistant anxiety in older people, which finds a disconcerting lack of evidence to help him support the many older patients he sees who are affected by anxiety disorders.

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Cognitive and exercise interventions for older adults with and without cognitive impairment

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Jake Crawshaw reports on a recent systematic review of cognitive and exercise interventions for older people with and without cognitive impairment.

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Alternatives to medication for agitation in dementia

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Andrés Fonseca summarises the findings of a recent systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in dementia.

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Psychotherapy for depression in older adults: promising results, but insufficient good quality research

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This recent meta-analysis confirms that psychotherapy has a moderate to high effect on depression in older adults. However, a note of caution is sounded because of publication bias and the low quality of several of the included studies.

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What should we prescribe for neuropsychiatric symptoms in Alzheimer’s disease?

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Psychiatrist Andrés Fonseca considers how his clinical practice should change, after reading a systematic review and meta-analysis of drug treatment for neuropsychiatric symptoms in Alzheimer’s disease

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Program of regular exercise may be beneficial in reducing depression in older adults

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The evidence-base supporting the use of exercise for depression is ever growing. Susie Johnson reports on a recent systematic review that adds to the discussion, but it’s not without its own limitations.

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Are there any effective interventions for preventing falls in older people with mental health problems?

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Falls are estimated to cost the NHS more than £2.3 billion per year (College of Optometrists, 2011) and are associated with significant morbidity and mortality. This fact alone should be giving us the drive to look for ways to prevent falls in healthcare settings. A systematic review recently published in BMC Nursing (Bunn et al, 2014) is [read the full story...]

Is the menopause depressing? Not necessarily

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Some of the lady Elves in the forest have been sharing their concerns about the menopause, and whilst keeping an eye out for hot flushes, night sweats and mood swings; what other changes will the menopause will bring?! Well, Freeman and colleagues have some good news and bad news for us. In November 2013, JAMA [read the full story...]