Background: Management of mentally ill elderly is a challenging task. Due to the lack of awareness, training opportunities in the course curriculum, and nil to negligible knowledge/ understanding/ exposures, allied mental health professionals are hardly available in geriatric mental health (GMH). Awareness generating orientation/ skill development workshops/ seminars/ webinars/ conferences may develop the interest in the young generations, which further may help in generating human resources in the subject. The present article aims to provide a snapshot of the Life Skill Training (LST) workshop developed for psychology students and discusses its effectiveness. Materials and Methods: The authors had an opportunity to organize and facilitate orientation workshop named as “life skill training in GMH“ for the students of psychology in Varanasi. A total of 86 students had participated in two independent workshops. All participants' self-rated appraisal was obtained on a five-point scale (ranging from very poor to very good) for all ten core life skills as laid out by the World Health Organization. The workshop was conducted by applying the tools such as imagination, reflection, communication, presentation, problem-solving, critical thinking, and sharing. The pre-post assessment was done, and qualitative feedback was received from the participants. Results: The results reveal that participants observed betterment in self on each life skill as the obtained value of mean scores after the workshop was found to be slightly more on each of the core life skills. Conclusion: The orientation workshop sensitizes the students regarding the issues related to the field, which may allow them to pursue the subject further.
{"title":"Life skill training workshop in geriatric mental health for postgraduate students: An appraisal","authors":"N. Pandey, R. Tripathi, S. Tiwari","doi":"10.4103/jgmh.jgmh_48_20","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_48_20","url":null,"abstract":"Background: Management of mentally ill elderly is a challenging task. Due to the lack of awareness, training opportunities in the course curriculum, and nil to negligible knowledge/ understanding/ exposures, allied mental health professionals are hardly available in geriatric mental health (GMH). Awareness generating orientation/ skill development workshops/ seminars/ webinars/ conferences may develop the interest in the young generations, which further may help in generating human resources in the subject. The present article aims to provide a snapshot of the Life Skill Training (LST) workshop developed for psychology students and discusses its effectiveness. Materials and Methods: The authors had an opportunity to organize and facilitate orientation workshop named as “life skill training in GMH“ for the students of psychology in Varanasi. A total of 86 students had participated in two independent workshops. All participants' self-rated appraisal was obtained on a five-point scale (ranging from very poor to very good) for all ten core life skills as laid out by the World Health Organization. The workshop was conducted by applying the tools such as imagination, reflection, communication, presentation, problem-solving, critical thinking, and sharing. The pre-post assessment was done, and qualitative feedback was received from the participants. Results: The results reveal that participants observed betterment in self on each life skill as the obtained value of mean scores after the workshop was found to be slightly more on each of the core life skills. Conclusion: The orientation workshop sensitizes the students regarding the issues related to the field, which may allow them to pursue the subject further.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"126 - 129"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48483971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Loneliness is an abstract construct defined in multiple ways. It is a feeling of disconnectedness, emotional isolation, and subjective feeling of lacking social relationships. Research shows loneliness to be common in older people, which, in turn, is a potent risk factor for various physical and psychosocial health conditions. Chronic loneliness is a predisposing factor for suicide, worsens cognitive outcomes, and impairs quality of living. Conventionally, aging is associated with “loss of vitality” and the “desperate need to retain older abilities.” In contrast to these concepts, eastern views center around acceptance, “letting go” and aging with a greater sense of purpose. Traversing loneliness with self-esteem is viewed over a consistent resistance against loneliness. Self-acceptance, wisdom, and understanding the processes of emotional aging can foster hope and resilience which help navigate the inevitable loneliness that may arise in old age due to a multitude of factors. Spirituality has various intersections with mental well-being, however, it is often considered to be an esoteric concept. In this paper, we provide an Indian understanding of accepting and dealing with loneliness through the daily implementation of spiritual practices in life as well as mental health interventions. The four ashramas of Hinduism are discussed with special relevance to Vanaprastha Ashrama (forest-dweller), which signifies renunciation and acceptance associated with aging. The actionable areas with respect to spirituality and its philosophical underpinnings in mitigating loneliness in older people are also highlighted.
{"title":"Loneliness in older people: Spiritual practices as an alternative pathway to action, a treatise from India","authors":"D. Banerjee","doi":"10.4103/jgmh.jgmh_37_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_37_21","url":null,"abstract":"Loneliness is an abstract construct defined in multiple ways. It is a feeling of disconnectedness, emotional isolation, and subjective feeling of lacking social relationships. Research shows loneliness to be common in older people, which, in turn, is a potent risk factor for various physical and psychosocial health conditions. Chronic loneliness is a predisposing factor for suicide, worsens cognitive outcomes, and impairs quality of living. Conventionally, aging is associated with “loss of vitality” and the “desperate need to retain older abilities.” In contrast to these concepts, eastern views center around acceptance, “letting go” and aging with a greater sense of purpose. Traversing loneliness with self-esteem is viewed over a consistent resistance against loneliness. Self-acceptance, wisdom, and understanding the processes of emotional aging can foster hope and resilience which help navigate the inevitable loneliness that may arise in old age due to a multitude of factors. Spirituality has various intersections with mental well-being, however, it is often considered to be an esoteric concept. In this paper, we provide an Indian understanding of accepting and dealing with loneliness through the daily implementation of spiritual practices in life as well as mental health interventions. The four ashramas of Hinduism are discussed with special relevance to Vanaprastha Ashrama (forest-dweller), which signifies renunciation and acceptance associated with aging. The actionable areas with respect to spirituality and its philosophical underpinnings in mitigating loneliness in older people are also highlighted.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"63 - 69"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45840296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Shivarudraiah, Thirumoorthy Ammapattian, Sojan Antony, S. Thangaraju
Background: Older adults are likely to experience psychological and social problems due to decline in physical strength, increased health issues, inadequate financial resources, and family dynamics. In this context, they need psychosocial care services to handle such challenges. Particularly, inmates of old-age homes are more vulnerable to experience such challenges as they are away from the family care. In this background, knowing their views on psychosocial care needs while living in old-age homes is significant to improve old-age home-based care. The aim of this study is to explore the psychosocial care needs expressed by the inmates of old-age homes. Materials and Methods: Inmates of old-age homes were selected using purposive sampling. A total of twenty residents out of four old-age homes of Bengaluru Metropolitan City were interviewed using a semi-structured interview guide. The qualitative content analysis has been carried out to identify core psychosocial care needs out of the text data. Results: Three themes, namely “health-care needs,” “concerns regarding the behavior of the staff,” and “mental health needs,” are emerged. Conclusion: The current study findings provide insiders' views and highlight the importance of psychosocial care services to address their needs at every old-age home.
{"title":"Views of the elderly living in old-age homes on psychosocial care needs","authors":"M. Shivarudraiah, Thirumoorthy Ammapattian, Sojan Antony, S. Thangaraju","doi":"10.4103/jgmh.jgmh_1_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_1_21","url":null,"abstract":"Background: Older adults are likely to experience psychological and social problems due to decline in physical strength, increased health issues, inadequate financial resources, and family dynamics. In this context, they need psychosocial care services to handle such challenges. Particularly, inmates of old-age homes are more vulnerable to experience such challenges as they are away from the family care. In this background, knowing their views on psychosocial care needs while living in old-age homes is significant to improve old-age home-based care. The aim of this study is to explore the psychosocial care needs expressed by the inmates of old-age homes. Materials and Methods: Inmates of old-age homes were selected using purposive sampling. A total of twenty residents out of four old-age homes of Bengaluru Metropolitan City were interviewed using a semi-structured interview guide. The qualitative content analysis has been carried out to identify core psychosocial care needs out of the text data. Results: Three themes, namely “health-care needs,” “concerns regarding the behavior of the staff,” and “mental health needs,” are emerged. Conclusion: The current study findings provide insiders' views and highlight the importance of psychosocial care services to address their needs at every old-age home.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"113 - 117"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43720855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shiva Shanker Reddy Mukku, Ravi Sheshu Nadella, S. Kornapalli
Clinicians often face many challenges in the pharmacological treatment of late-life psychiatric illness especially while choosing an antipsychotic drug. The choice of antipsychotic is mostly guided by the extension of evidence from the adult population and tolerability. In India, based on evidence commonly prescribed antipsychotic drugs for older adults are quetiapine (QTP) followed by olanzapine (OLZN) and risperidone. Cariprazine is a newer antipsychotic that was recently launched in India. It is a novel mechanism of action at D3 receptors is known to have antidepressant and procognitive action in addition to the antipsychotic effects which is desirable in geriatric population. It can be a potential option as an add-on drug in late-life depression in addition to the existing aripiprazole and OLZN. The treatment of late-life mania and very late-onset schizophrenia is limited by the paucity of studies, with randomized control studies done only on QTP and amisulpride, respectively. Cariprazine can be considered in late-life psychotic disorders with the evidence available from its efficacy studies in adult patients. Merits of cariprazine are favorable metabolic profile, cardiac safety, and procognitive action. Demerits include extrapyramidal symptoms and fluctuations in blood pressure. Slower titration and monitoring for akathisia are recommended. There is a need for controlled studies in older adults with cariprazine to get better informed about its efficacy and safety.
{"title":"Cariprazine for late-life psychiatric illness: A review on therapeutic potential and challenges","authors":"Shiva Shanker Reddy Mukku, Ravi Sheshu Nadella, S. Kornapalli","doi":"10.4103/jgmh.jgmh_43_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_43_21","url":null,"abstract":"Clinicians often face many challenges in the pharmacological treatment of late-life psychiatric illness especially while choosing an antipsychotic drug. The choice of antipsychotic is mostly guided by the extension of evidence from the adult population and tolerability. In India, based on evidence commonly prescribed antipsychotic drugs for older adults are quetiapine (QTP) followed by olanzapine (OLZN) and risperidone. Cariprazine is a newer antipsychotic that was recently launched in India. It is a novel mechanism of action at D3 receptors is known to have antidepressant and procognitive action in addition to the antipsychotic effects which is desirable in geriatric population. It can be a potential option as an add-on drug in late-life depression in addition to the existing aripiprazole and OLZN. The treatment of late-life mania and very late-onset schizophrenia is limited by the paucity of studies, with randomized control studies done only on QTP and amisulpride, respectively. Cariprazine can be considered in late-life psychotic disorders with the evidence available from its efficacy studies in adult patients. Merits of cariprazine are favorable metabolic profile, cardiac safety, and procognitive action. Demerits include extrapyramidal symptoms and fluctuations in blood pressure. Slower titration and monitoring for akathisia are recommended. There is a need for controlled studies in older adults with cariprazine to get better informed about its efficacy and safety.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"77 - 82"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43597819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The person is not the disease – Revisiting Alzheimer's dementia after 120 years","authors":"M. D’cruz, D. Banerjee","doi":"10.4103/jgmh.jgmh_39_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_39_21","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"136 - 137"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45830937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Substance use disorders in the elderly population can be assessed through scales and questionnaires. These scales are used for not only screening for substance use disorders but also for assessment for improvement with time and/or intervention. Validity parameters of these scales help us know how do they perform during application in the clinical or community setting. The objective of the review was to (1) review available validated screening tools for substance use disorders, (2) summarize elderly-focused studies, and (3) provide recommendations for use in clinical care. We aimed to review the validated scales of substance use disorders in the geriatric population. We looked at PubMed and Web of Science databases for identifying English language peer-reviewed publications that reported at least one validity parameter for scale in geriatric patients with substance use disorders. We identified 22 studies, with majority of them focusing on alcohol use disorder. Alcohol Use Disorder Identification Test and Cut Down, Annoyed, Guilty, and Eye-Opener Questionnaire (CAGE) were the most common scales used in the population. While most of the studies reported acceptable area under receiver operator curve, sensitivity, and specificity, some of the studies reported lower sensitivity/specificity at optimal cutoff. Validity parameters of various scales have been assessed in the geriatric population. Using suitable cutoffs, they can be useful in the screening of elderly individuals with substance-related problems, so that due evaluation and care can be provided. More instruments need to be assessed for validity to diagnose tobacco use disorders, benzodiazepine use disorders, and other substance use disorders.
老年人群中的物质使用障碍可以通过量表和问卷进行评估。这些量表不仅用于物质使用障碍的筛查，还用于评估随着时间和/或干预的改善。这些量表的有效性参数有助于我们了解它们在临床或社区应用过程中的表现。该综述的目的是（1）综述可用的经验证的物质使用障碍筛查工具，（2）总结以老年人为重点的研究，以及（3）提供临床护理使用建议。我们旨在审查老年人群中物质使用障碍的有效量表。我们查看了PubMed和Web of Science数据库，以确定英文同行评审出版物，这些出版物报告了至少一个物质使用障碍老年患者量表的有效性参数。我们确定了22项研究，其中大多数集中在酒精使用障碍上。酒精使用障碍识别测试和削减、烦恼、内疚和大开眼界问卷（CAGE）是人群中最常见的量表。虽然大多数研究报告了受试者-操作者曲线下的可接受面积、灵敏度和特异性，但一些研究报告了最佳截止点下的较低灵敏度/特异性。已经在老年人群中评估了各种量表的有效性参数。使用合适的截止值，它们可以用于筛查有物质相关问题的老年人，从而提供适当的评估和护理。需要评估更多仪器的有效性，以诊断烟草使用障碍、苯二氮卓类药物使用障碍和其他物质使用障碍。
{"title":"Validated scales for substance use disorders in the geriatric population: A scoping review","authors":"S. Sarkar, Esha Sood, R. Bhad, A. Mishra","doi":"10.4103/jgmh.jgmh_38_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_38_21","url":null,"abstract":"Substance use disorders in the elderly population can be assessed through scales and questionnaires. These scales are used for not only screening for substance use disorders but also for assessment for improvement with time and/or intervention. Validity parameters of these scales help us know how do they perform during application in the clinical or community setting. The objective of the review was to (1) review available validated screening tools for substance use disorders, (2) summarize elderly-focused studies, and (3) provide recommendations for use in clinical care. We aimed to review the validated scales of substance use disorders in the geriatric population. We looked at PubMed and Web of Science databases for identifying English language peer-reviewed publications that reported at least one validity parameter for scale in geriatric patients with substance use disorders. We identified 22 studies, with majority of them focusing on alcohol use disorder. Alcohol Use Disorder Identification Test and Cut Down, Annoyed, Guilty, and Eye-Opener Questionnaire (CAGE) were the most common scales used in the population. While most of the studies reported acceptable area under receiver operator curve, sensitivity, and specificity, some of the studies reported lower sensitivity/specificity at optimal cutoff. Validity parameters of various scales have been assessed in the geriatric population. Using suitable cutoffs, they can be useful in the screening of elderly individuals with substance-related problems, so that due evaluation and care can be provided. More instruments need to be assessed for validity to diagnose tobacco use disorders, benzodiazepine use disorders, and other substance use disorders.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"70 - 76"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44583096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geriatric patients are commonly exposed to multimorbidity, polypharmacy, and potentially inappropriate medication use, with prevalence increasing over time. We seek to illustrate this risk to older adults through a case report of an older woman presenting with irritability to psychiatric emergency services in the context of potentially inappropriate medication use. On evaluation, the irritability was found to be associated with hip pain due to osteoarthritis and gastric irritation due to the use of analgesics, antacids, and other micronutrient supplements. She was diagnosed with analgesic-induced syndrome of inappropriate antidiuretic hormone production with dilutional hyponatremia and hypochloremia, iatrogenic upper gastrointestinal mucosal ulceration with melena and anemia due to blood loss, analgesic-induced coagulation disorder, acute kidney injury, impending hepatic injury, and hyponatremia-induced second-degree atrioventricular block. She recovered with treatment rationalization, pain management, and supportive care. We wish to highlight that an innocuous presentation such as increased irritability in the absence of a mental illness in an older adult may often overlie multimorbidity and potentially inappropriate medication use. We would also like to use this case report to illustrate the barriers to comprehension and compliance that may occur in geriatric patients, with the need for frequent pharmacological assessments including prescription checks and pill counts.
{"title":"Potentially inappropriate medication with syndrome of inappropriate antidiuretic hormone secretion and gastrointestinal bleed in an older adult presenting as a psychiatric emergency","authors":"M. D’cruz, Ankit Sharma, D. Damodharan","doi":"10.4103/jgmh.jgmh_23_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_23_21","url":null,"abstract":"Geriatric patients are commonly exposed to multimorbidity, polypharmacy, and potentially inappropriate medication use, with prevalence increasing over time. We seek to illustrate this risk to older adults through a case report of an older woman presenting with irritability to psychiatric emergency services in the context of potentially inappropriate medication use. On evaluation, the irritability was found to be associated with hip pain due to osteoarthritis and gastric irritation due to the use of analgesics, antacids, and other micronutrient supplements. She was diagnosed with analgesic-induced syndrome of inappropriate antidiuretic hormone production with dilutional hyponatremia and hypochloremia, iatrogenic upper gastrointestinal mucosal ulceration with melena and anemia due to blood loss, analgesic-induced coagulation disorder, acute kidney injury, impending hepatic injury, and hyponatremia-induced second-degree atrioventricular block. She recovered with treatment rationalization, pain management, and supportive care. We wish to highlight that an innocuous presentation such as increased irritability in the absence of a mental illness in an older adult may often overlie multimorbidity and potentially inappropriate medication use. We would also like to use this case report to illustrate the barriers to comprehension and compliance that may occur in geriatric patients, with the need for frequent pharmacological assessments including prescription checks and pill counts.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"130 - 132"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48817313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Baweja, Himanshu, Akreti Tandon, Muskan Goyal, R. Mishra, M. Deshpande
Alzheimer's disease (AD) is classified as an age-related neuro-degenerative disorder leading to loss of memory and decline in cognitive abilities, often characterized as dementia. According to the WHO report 2020, out of 50 million people battling with dementia worldwide, 60%–70% cases account for AD. Some researchers have reported two to three times higher incidence of AD among women than men and further confirmed that postmenopausal women are more prone to AD than healthy men of the same age. This hints at the potential neuroprotective role of estrogen hormone, whose level drops to <30 pg/mL postmenopause. Several epidemiological studies also suggest early postmenopausal use of estrogens may contribute to the prevention, attenuation, or even delay in the onset of AD. Collectively, this evidence supports the further development of estrogen-like compounds for the treatment and prevention of AD, with a rising interest in phytoestrogens as potential interventions with lower side effects. This review highlights multiple pathways of estrogen-mediated neuroprotection against neurodegenerative diseases like AD and discusses the role of selective estrogen receptor molecules mainly phytoestrogens, in AD progression so that latter can be considered and used as an alternate therapy for treating Alzheimer patients.
{"title":"Neuroprotective effects of phytoestrogens: A potential alternative to estrogen therapy in Alzheimer's disease patients","authors":"V. Baweja, Himanshu, Akreti Tandon, Muskan Goyal, R. Mishra, M. Deshpande","doi":"10.4103/jgmh.jgmh_33_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_33_21","url":null,"abstract":"Alzheimer's disease (AD) is classified as an age-related neuro-degenerative disorder leading to loss of memory and decline in cognitive abilities, often characterized as dementia. According to the WHO report 2020, out of 50 million people battling with dementia worldwide, 60%–70% cases account for AD. Some researchers have reported two to three times higher incidence of AD among women than men and further confirmed that postmenopausal women are more prone to AD than healthy men of the same age. This hints at the potential neuroprotective role of estrogen hormone, whose level drops to <30 pg/mL postmenopause. Several epidemiological studies also suggest early postmenopausal use of estrogens may contribute to the prevention, attenuation, or even delay in the onset of AD. Collectively, this evidence supports the further development of estrogen-like compounds for the treatment and prevention of AD, with a rising interest in phytoestrogens as potential interventions with lower side effects. This review highlights multiple pathways of estrogen-mediated neuroprotection against neurodegenerative diseases like AD and discusses the role of selective estrogen receptor molecules mainly phytoestrogens, in AD progression so that latter can be considered and used as an alternate therapy for treating Alzheimer patients.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"83 - 92"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46949745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Grover, A. Mehra, Swapnajeet Sahoo, Parvaiz Alam
COVID-19 pandemic has influenced humans in many ways. In terms of mental health outcomes, many studies across the globe have shown a high prevalence of anxiety and depression among persons suffering from the acute COVID infection and during the post-COVID infection phase. Additionally, studies have also shown a high prevalence of cognitive deficits as part of the long COVID. In this report, we present a 63-year-old male who developed marked cognitive impairment after COVID-19 infection.
{"title":"Marked cognitive decline following COVID-19 infection","authors":"S. Grover, A. Mehra, Swapnajeet Sahoo, Parvaiz Alam","doi":"10.4103/jgmh.jgmh_5_22","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_5_22","url":null,"abstract":"COVID-19 pandemic has influenced humans in many ways. In terms of mental health outcomes, many studies across the globe have shown a high prevalence of anxiety and depression among persons suffering from the acute COVID infection and during the post-COVID infection phase. Additionally, studies have also shown a high prevalence of cognitive deficits as part of the long COVID. In this report, we present a 63-year-old male who developed marked cognitive impairment after COVID-19 infection.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"133 - 135"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45751493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Older people with psychiatric illnesses face unique challenges in terms of clinical, sociocultural, and environmental factors. The Ministry of Health and Family Welfare, Government of India (MoHFw, GOI), has released telemedicine guidelines in April 2020, closely followed by a telepsychiatry operational guidelines as a collaborative effort of the National Institute of Mental Health and Neurosciences, Bengaluru, and the MoHFw, GOI. The current article presents a critical analysis of the provisions in these guidelines relevant to psychogeriatric care. The gray areas in the existing protocols which may hamper their applicability and accessibility in older adults include digital connectivity, continuity of care, patient autonomy and capacity assessment, medical comorbidities, evaluation of dementia, confidentiality, and teleconsultations in the institutionalized elderly. Preexisting challenges are seen to be compounded by the coronavirus disease 2019 pandemic, in addition to the onset of newer psychosocial and clinical adversities. The article also highlights certain recommendations for possible modifications of the guidelines in future. The telepsychiatry guidelines provide a paradigm shift in mental health care. However, the lacunae involved in the care of vulnerable groups such as the geriatric population based on these guidelines need to be reconsidered by all levels of stakeholders supported by evidence-based research.
{"title":"Relevance of the Indian telemedicine guidelines 2020 in psychogeriatric care: A critical appraisal","authors":"S. Mukhopadhyay, D. Banerjee","doi":"10.4103/jgmh.jgmh_24_21","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_24_21","url":null,"abstract":"Older people with psychiatric illnesses face unique challenges in terms of clinical, sociocultural, and environmental factors. The Ministry of Health and Family Welfare, Government of India (MoHFw, GOI), has released telemedicine guidelines in April 2020, closely followed by a telepsychiatry operational guidelines as a collaborative effort of the National Institute of Mental Health and Neurosciences, Bengaluru, and the MoHFw, GOI. The current article presents a critical analysis of the provisions in these guidelines relevant to psychogeriatric care. The gray areas in the existing protocols which may hamper their applicability and accessibility in older adults include digital connectivity, continuity of care, patient autonomy and capacity assessment, medical comorbidities, evaluation of dementia, confidentiality, and teleconsultations in the institutionalized elderly. Preexisting challenges are seen to be compounded by the coronavirus disease 2019 pandemic, in addition to the onset of newer psychosocial and clinical adversities. The article also highlights certain recommendations for possible modifications of the guidelines in future. The telepsychiatry guidelines provide a paradigm shift in mental health care. However, the lacunae involved in the care of vulnerable groups such as the geriatric population based on these guidelines need to be reconsidered by all levels of stakeholders supported by evidence-based research.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"3 - 10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42653542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：