The primary care companion for CNS disorders最新文献

Objective: To analyze contemporary trends of dementia and dementia-related mortality in the United States between 1999 and 2020 categorized by demographic and regional attributes.

Methods: A retrospective cohort analysis was conducted using mortality data from individuals aged 35 years to ≥85 years, where dementia/Alzheimer disease was recorded as a contributing or underlying cause of death. Data were extracted from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 1999-2020. Mortality rates adjusted for age due to dementia (annual age-adjusted mortality rate [AAMR]) per 10,000 individuals in the United States were categorized by gender, racial and ethnic groups, and geographic regions.

Results: Results revealed 6,601,680 deaths related to dementia between 1999 and 2020. Among these, 85.5% were non-Hispanic (NH) white, 8% NH black, 4.34% Hispanic or Latino, 1.6% NH Asian or Pacific Islander, and 0.3% NH American Indian or Alaska Native adults. The overall AAMR was 17.49, with women experiencing a higher AAMR of 18.19 compared to men (16.05). Ethnic disparities were evident, with NH black adults having the highest AAMR (18.23), followed by NH white (18.09) and Hispanic adults (12.7). Over the study period, the overall AAMR increased from 10.86 in 1999 to 21.42 in 2020, with a notable 18.4% rise in the AAMR from 1999 to 2001. From 2001 to 2020, the average percent change of the AAMR was 1.0%. This upward trend in mortality was observed for both men and women and across all ethnicities.

Conclusions: The study spanning 1999-2020 revealed concerning trends in dementia-related mortality in the United States. There is a critical need for targeted health care policy initiatives aimed at mitigating the increasing dementia burden.

Prim Care Companion CNS Disord 2024;26(4):24m03724.

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Abstract.

Importance: Adolescence and young adulthood can be a period of immense change. Navigating this critical period of development can be particularly challenging, even for healthy individuals, given the immense cognitive, emotional, neurobiological, physical, and social changes taking place during this time. The additional burden of the core symptoms of attention-deficit/ hyperactivity disorder (ADHD) and associated functional impairments can further complicate this transitional period through to full adulthood.

Objectives and Data Source: In this review, we focus on the distinctive behavioral and neurobiological characteristics of adolescents and young adults (AYAs) with ADHD. We discuss the variety of contemporary challenges faced by these patients as they transition to full adult maturity. A comprehensive literature search of PubMed was performed on February 23, 2022. We searched for English language peer-reviewed articles published in the previous 10 years using primary search terms including "attention deficit hyperactivity disorder," "adolescent," and "young adult." Importantly, we provide various innovative and practical strategies and solutions to overcome the challenges faced by AYAs with ADHD, with the aim of improving the management of this unique patient population.

Relevance: This review is intended to support physicians less familiar with the management and treatment of AYAs with ADHD.

Prim Care Companion CNS Disord 2024;26(4):24nr03718.

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The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Prim Care Companion CNS Disord 2024;26(4):23f03702.

Author affiliations are listed at the end of this article.