Psychotic Disorders in the Elderly

Fischer, Corinne E.; Namasivayam, Andrew; Crawford-Holland, Lucas; Hakobyan, Narek; Schweizer, Tom A.; Muñoz, David G.; Pollock, Bruce G.

doi:10.1016/j.psc.2022.07.001

Cited by 2 publications

(2 citation statements)

References 56 publications

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“…A more specific association between cerebral vasculopathy and psychotic disorders has been formalized by Steffans and Krishnan, who proposed diagnostic criteria based on known stroke or transient acute vascular event, radiological findings of hyperintensity, cortical or subcortical infarcts, age of onset after 50 years, and reduction in cognitive, executive, and information-processing speed [77]. The efficacy, in these patients, of typical and atypical antipsychotics, antidepressants, and mood stabilizers [78], also tested by us, raises the interesting question, to be explored in future studies, of the mechanism by which vascular dysfunction affects neurotransmissions' dopaminergic, serotonergic, and membrane activity. Our work adds some data in the context of uncertainty and interest where there is a lack of large longitudinal observational studies, which is certainly difficult due to the complexity of the patients.…”

Section: Vascular Schizophrenia-like Psychosis As Specific Phenotypementioning

confidence: 99%

Vascular Schizophrenia-like Psychosis in Older Adults

Lauriola,

D’Onofrio,

Ciccone

et al. 2023

JCM

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Background: The aims of this study were to analyze prevalence and severity of vascular risk factors in older patients referred to our clinic due to onset of Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP) and to create a specific phenotype based on pathophysiological insight rather than age of onset. Methods: In a longitudinal study, 103 (M = 39, F = 64; mean age of 80.32 ± 7.65 years) patients were evaluated with cognitive, neuropsychiatric, and functional assessment scales. Blood concentration of hemoglobin (Hb), mean corpuscular volume (MCV), platelets, total protein test (TPT), creatinine, azotemia, glycemia, total cholesterol (TC), triglycerides (TG), uric acid (UA), sodium (Na), potassium (K), chlorine (Cl), calcium (Ca), folate, vitamin B12 (Vit-B12), and homocysteine were measured. Presence/absence of tobacco use, alcohol consumption, psychoactive substance use, hypertension, hyperlipidemia, diabetes mellitus, and history of vascular disease were collected. Results: Females were more apathetic than males (NPI-Apathy: p = 0.040). Males had a significantly higher level of Hb (p = 0.019) and UA (p = 0.001), and a lower level of platelets (p = 0.004) and Ca (p = 0.003), and used more tobacco (p = 0.046) and alcohol (p = 0.024) than females. Comparing patients < 80 and ≥80 years, we found differences in frequency of vascular risk factors among men (p = 0.027). In total, 102 patients were treated for psychosis (59.16% of them were using atypical antipsychotics). Conclusions: The results of this study could be useful for a progressive demonstration of the causal relationship between cardiac and cerebral vascular events and VLOSLP.

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Section: Vascular Schizophrenia-like Psychosis As Specific Phenotypementioning

confidence: 99%

Vascular Schizophrenia-like Psychosis in Older Adults

Lauriola,

D’Onofrio,

Ciccone

et al. 2023

JCM

View full text Add to dashboard Cite

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“…Similarly, Amoo [ 2 ] also confirmed a significant increase in psychiatric disorders among older adults. Although the prevalence of psychiatric disorders has not been studied systematically [ 3 ], Fischer [ 4 ] reported that the life-time prevalence of late-life psychotic disorders ranged from 0.3 to 1%. Older individuals with psychotic disorders may undergo acceleration of brain aging, indicating a cumulative biological effect of illness burden [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Screening indicators to evaluate the clinical significance of drug-drug interactions in polypharmacy among older adults with psychiatric disorders: a delphi study

Liu,

Li,

Yang

et al. 2024

BMC Psychiatry

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Background Polypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of drug-drug interactions (DDIs) in polypharmacy. We aimed to identify indicators suitable for evaluating the clinical significance of DDIs in polypharmacy in older adults with psychiatric disorders. Methods The online tools were used to distribute and collect the questionnaires. The Delphi method was applied to analyze experts’ opinions. The degree of authority and coordination of experts were analyzed using the coefficient of variation, coefficient of coordination, expert’s judgment factor, familiarity with the study content factor, and Kendall coordination coefficient. Statistical analysis was conducted using the IBM SPSS® Statistics Package version 26.0. Results After three rounds of expert consultation, five primary and eleven secondary indicators were identified. The primary “pharmacodynamic indicator” included “severity of adverse drug reactions”, “duration of adverse drug reaction”, “symptom relief”, “time to onset of symptomatic relief”, “number of days in hospital”, and “duration of medication”. The secondary “pharmacokinetic indicator” contained “dosage administered” and “dosing intervals”. The primary “patient tolerance indicator” contained one secondary indicator of “patient tolerability”. The primary indicator “patient adherence” contained one secondary indicator of “patient adherence to medication”. The primary indicator “cost of drug combination” contained one secondary indicator of “readmission”. These indicators were used to determine the clinical significance of DDIs during polypharmacy. Conclusions The clinical significance of drug combinations should be taken into account when polypharmacy is used in the elderly. The five primary indicators and eleven secondary indicators might be preferred to evaluate their risks and benefits. Medication management in this population requires a multidisciplinary team, in which nurses play a key role. Future research should focus on how to establish efficient multidisciplinary team workflows and use functional factors to assess DDIs in polypharmacy for psychiatric disorders.

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Psychotic Disorders in the Elderly

Cited by 2 publications

References 56 publications

Vascular Schizophrenia-like Psychosis in Older Adults

Vascular Schizophrenia-like Psychosis in Older Adults

Screening indicators to evaluate the clinical significance of drug-drug interactions in polypharmacy among older adults with psychiatric disorders: a delphi study

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