There are shared objectives between psychiatry and palliative care; however, currently, co-involvement on treatment teams is quite limited. Future research is needed to identify ways to facilitate the interface of palliative care and psychiatry.

The ICF-CY provided a systematic approach for describing and categorizing functional problems in children with CAS. The identified factors should guide the multidisciplinary team in conducting comprehensive evaluations, rehabilitation, and long-term follow-up of children with CAS.

Objective To disentangle the complex associations of depression and anxiety with mild cognitive impairment (MCI) at the population level. We examined subgroups of anxiety symptoms and depression symptom profiles in relation to MCI, which we defined using both cognitive and functional approaches. Design Epidemiologic, cross-sectional study. Settings and Participants Age-stratified random population-based sample of 1982 individuals aged 65 and over. Measurements Three definitions of MCI: 1) a purely cognitive classification into Amnestic and Non-Amnestic MCI; 2) a combined cognitive-functional definition by International Working Group (IWG) criteria; 3) a purely functional definition by the Clinical Dementia Rating (CDR)=0.5. Three Depression profiles were identified by factor analysis of the modified Center for Epidemiological Studies - Depression Scale: core mood, self-esteem/interpersonal, and apathy/neurovegetative profiles. Three Anxiety groups: chronic mild worry, chronic severe anxiety, and recent-onset anxiety, were based on screening questions. Results Recent-onset anxiety was associated with MCI by Non-Amnestic and IWG criteria, chronic severe anxiety was associated with MCI by all definitions, while chronic mild worry was associated with none. Of the depression profiles, the core mood profile was associated with CDR-defined MCI, the apathy/neurovegetative profile was associated with MCI by Amnestic, IWG, and CDR definitions, while the self-esteem/interpersonal profile was associated with none. Conclusions In this population-based sample, subgroups with different anxiety and depression profiles had different relationships with cognitive and functional definitions of MCI. Anxiety, depression, and MCI are all multidimensional entities, interacting in complex ways that may shed light on underlying neural mechanisms.

Objectives: Older adults commonly take benzodiazepines (BZDs) that may have long-term adverse cognitive effects. We investigated whether BZD use was related to developing mild cognitive impairment (MCI) or dementia in cognitively normal older adults in the community. Setting/Participants: A population-based cohort (n = 1959) of adults aged 65 and over, recruited from communities of low socioeconomic status. Measurements: BZD use, Clinical Dementia Rating (CDR), anxiety symptoms, depression symptoms, sleep difficulties, and APOE genotype. Design: We examined time from study entry to MCI (CDR = 0.5) and time from study entry to dementia (CDR ≥ 1) in participants who were cognitively normal at baseline (CDR = 0). We used survival analysis (Cox model), adjusted for age, sex, education, sleep, anxiety, and depression. For all the models, we included an interaction term between BZD use and APOE*4. Results: Taking BZDs was significantly associated with higher risk of developing MCI, but not of developing dementia. The effect was not affected by APOE genotype. Conclusions: In a population-based sample of cognitively normal older adults, BZD use is associated with developing MCI, but not dementia. BZD use may be a potentially modifiable risk factor for MCI.

Objective: We investigated whether anticholinergic drug use was related to developing mild cognitive impairment (MCI) or dementia in older adults at the population level. Methods: We used an Anticholinergic Rating (ACR) scale, Clinical Dementia Rating, APOE genotype, and number of prescription medications. We examined time to incident MCI and incident dementia in a population-based cohort (n=1959). We assessed whether developing MCI or dementia was associated with (1) any anticholinergic drug use, (2) total ACR score, or (3) number of anticholinergic drugs taken. Results: Taking any anticholinergic drug was significantly associated with higher risk of developing MCI; however, higher ACR score or higher number of anticholinergic drugs, compared with lower, were not associated with greater risk of developing MCI. We found no significant relationship between anticholinergic use and developing dementia. The relationship between anticholinergic use and cognitive outcome was not affected by APOE genotype. Conclusions: Among cognitively normal older adults in a population-based sample, anticholinergic drug use is independently associated with subsequently developing MCI, but not dementia. Thus, anticholinergic drug use may influence risk of MCI that is nonprogressive to dementia and potentially be a modifiable risk factor for MCI.