'Mild cognitive impairment' (MCI) in older adults refers to a significant decline in memory function but not other cognitive functions. Pharmacological and non-pharmacological treatments for MCI are needed. The present randomized clinical trial tests the efficacy of a cognitive and behavioral treatment to improve memory performance and participants' attitudes about their memory. A multi-faceted intervention that included education about memory loss, relaxation training, memory skills training, and cognitive restructuring for memory-related beliefs was compared to a no-treatment control condition. Outcomes included memory performance and appraisals of memory function and control. Results indicate that the treated group had significantly better memory appraisals than controls at the end of treatment and at a six-month follow-up. There were no differences between groups on memory performance at post-test but at follow-up the trained individuals showed a trend toward better word list recall than controls. Findings suggest that individuals with MCI can benefit from multi-component memory enhancement training. Further development of such training programs and tests of their efficacy alone and in combination with medications are needed.

Studies examining the treatment of anxiety disorders in patients with COPD are promising, yet their efficacy needs to be established. The long-term effects of treatment of anxiety disorders on quality of life of COPD patients have yet to be explored.

The purpose of this study was to conduct a pilot clinical trial to test the feasibility and efficacy of an exercise program and anti-depressant treatment compared with usual care in improving the emotional and physical functioning of older adults with minor depression. Participants were 37 older adults with minor depression who were randomized to exercise, sertraline, or usual care; 32 participants completed the 16 week study. Outcomes included measures of both emotional (clinician and selfreport) and physical (observed and self-report) functioning. There were trends for the superiority of the exercise and sertraline conditions over usual care in improving SF-36 mental health scores and clinician-rated depression scores. Individuals in the exercise condition showed greater improvements in physical functioning than individuals in the usual care condition. Both sertraline and exercise show promise as treatments for late-life minor depression. However, exercise has the added benefit of improving physical functioning as well.Minor depression, characterized by depressive symptoms which do not fulfill the severity requirement for major depression, is the most common type of depression experienced by older adults . In a recent Dutch community-based sample, Beekman and colleagues reported a 10% prevalence of minor depression compared with only a 2% prevalence of major depression in that sample. This is consistent with Tannock and Katona's findings (Tannock & Katona, 1995) that the incidence of minor depression increases with age. According to DSM-IV (American Psychiatric Association, 1994), minor depression is characterized by depressed mood or anhedonia and 1 to 3 of the following symptoms over a 2 week period: appetite disturbance, sleep disturbance, psychomotor agitation or retardation, loss of energy, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death.Minor depression is associated with a number of adverse health outcomes. It is a risk factor for major depression (Kessler et al., 1997) and is associated with increased numbers of chronic diseases (Beekman et al., 1997), functional limitations (Beekman et al., 1997), increased severity of medical illness (Barefoot & Schroll, 1996;Koenig, 1997), increased service utilization (Callahan et al., 1994;Cuijpers et al., 2004;Wagner et al., 2000), and increased risk of mortality (Barefoot & Schroll, 1996;Enzell, 1984;Murphy et al., 1987; 1999a). In addition to functional limitations, physical disability is also a consequence of both minor and major depression. The risk for onset of disability in persons with late-life depression is significantly higher than in older adults without depression, and is similar or even greater than the risk for disability associated with other chronic illnesses (Penninx et al., 1999b). Furthermore, number of depressive symptoms is associated with increasing impairment in activities of daily living (Langa et al., 2004). Among those older adults with 1-3 symptoms of depression, 30% reported diffi...

Objectives To assess feasibility and to conduct a preliminary evaluation of outcomes following Peaceful Mind, a CBT-based intervention for anxiety in dementia, relative to usual care (UC). Design Pilot randomized controlled trial including assessments at baseline, 3 and 6 months Setting Houston, TX Participants 32 outpatients diagnosed with mild (47%) or moderate (53%) dementia receiving care through outpatient clinics at the Veterans Affairs medical center, Baylor College of Medicine, Harris County Hospital District and community day centers for dementia, and their collaterals, who spent at least 8 hours a week with them. Intervention Peaceful Mind included up to 12 weekly in-home sessions (mean = 8.7, SD = 2.27) during the initial 3 months and up to eight brief telephone sessions (mean = 5.4, SD = 3.17) during months 3 to 6, involving self-monitoring for anxiety, deep breathing, and optional skills (coping self-statements, behavioral activation and sleep management). Patients learned skills, and collaterals served as coaches. In UC, patients received diagnostic feedback; and providers were informed of inclusion status. Measurements Neuropsychiatric Inventory-Anxiety subscale, Rating Anxiety in Dementia scale, Penn State Worry Questionnaire-Abbreviated, Geriatric Anxiety Inventory, Geriatric Depression Scale, Quality of Life in Alzheimer’s disease, Patient Health Questionnaire, Client Satisfaction Questionnaire Results Feasibility was demonstrated with regard to recruitment, attrition, and treatment characteristics. At 3 months, clinicians rated patients receiving Peaceful Mind as less anxious, and patients rated themselves as having higher quality of life; collaterals reported less distress related to loved ones’ anxiety. Although significant positive effects were not noted in other outcomes or at 6-month follow-up, the pilot nature of the trial prohibits conclusions about efficacy. Conclusions Results support that Peaceful Mind is ready for future comparative clinical trials.

Sleep disturbance is common in older adults experiencing knee pain or knee pain with radiographic evidence of OA and is best understood through the consideration of demographic, physical health, physical functioning, pain, and psychosocial variables. Interventions that take into account the multidetermined nature of sleep disturbance in knee pain or knee OA are most likely to be successful.