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A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity
- Authors:
- LAVRETSKY H., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(1), 2013, pp.57-65.
- Publisher:
- Wiley
This study examined the effects of brief daily yogic meditation, Kirtan Kriya, on mental health, cognitive functioning, and immune cell telomerase activity in family dementia caregivers with mild depressive symptoms. Participants performed Kirtan Kriya or passively relaxed to music for 12 minutes each day for eight weeks. Of 49 recruited subjects, 45 were randomised and 39 completed the intervention: 23 subjects in the meditation group and 16 subjects in the relaxation group. The severity of depressive symptoms, mental and cognitive functioning were assessed at baseline and follow-up. Telomerase activity was measured in peripheral blood mononuclear cells (PMBC). The meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning compared with the relaxation group. In the meditation group, 65.2% showed 50% improvement on the Hamilton Depression Rating scale and 52% of the participants showed 50% improvement on the Mental Health Composite Summary score of the Short Form-36 scale compared with 31.2% and 19%, respectively, in the relaxation group. The meditation group showed 43% improvement in telomerase activity compared with 3.7% in the relaxation group. Brief daily meditation by family dementia caregivers may improve mental and cognitive functioning and lower depressive symptoms. This improvement is accompanied by an increase in telomerase activity suggesting improvement in stress-induced cellular aging.
Cognitive stimulation therapy (CST) for people with dementia: who benefits most?
- Author:
- AGUIRRE E.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(3), 2013, pp.284-290.
- Publisher:
- Wiley
National guidelines in the UK recommend that cognitive stimulation programmes should be available for people with mild to moderate dementia. However it is not clear what factors might impact on the effectiveness of this intervention. A total of 272 people with dementia (mean age 82.6 years, 61% female) took part in a 7-week CST intervention; 14 sessions lasting 45 minutes. The average attendance was 10 sessions. Half the participants were community dwelling the remainder were recruited from care homes in the south of England. Assessments were carried out pre-treatment and post-treatment (n=236) and the results compared with those of a previous comparable randomised control trial. CST improved cognition and quality of life; the benefits were independent of whether or not people were taking acetylcholinesteraseinhibitor (AChEI) medication. Increasing age was associated with cognitive benefits, as was female gender. Care home residents improved more than community residents in terms of quality of life, but the community sample seemed to benefit more in relation to behaviour problems. The authors conclude that CST improves cognition and quality of life for people with dementia, particularly older female participants. They suggested that consideration should be given to discovering aspects of CST may enhance the benefits for younger men with dementia.
Teaching and training in old age psychiatry: a general survey of the World Psychiatric Association member societies
- Authors:
- CAMUS Vincent, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(8), August 2003, pp.694-699.
- Publisher:
- Wiley
One of the main goals of the World Psychiatric Association (WPA) section on old age psychiatry is to promote its discipline and consequently to help member societies to promote and develop locally specific medical education programmes in old age psychiatry. In order to target its support to the needs expressed by the member societies, the section conducted a survey within the WPA during the year 2001. Answers were obtained from 50 WPA member societies (response rate 54%) from 48 countries (response rate 52%). The existence of specific old age psychiatry services was reported in 40 (83%) countries, but the discipline is recognized as a subspecialty in only 13 (27%). Formal teaching in old age psychiatry was reported at the undergraduate level in 44 (92%) countries. Specific learning objectives for postgraduate training were reported in 30 (86%) of the countries where the discipline is not yet recognized as a subspecialty. Specific Continuing Medical Education (CME) programs were however reported in only 50% of the countries. Support for the development of educational material was mostly thought to be useful at the postgraduate level. Depression, dementia, psychopharmacology and psychotherapy were among the most frequently cited areas in which educational material might be usefully provided. Support for the development of postgraduate training is seen as the most pressing need by WPA member societies. Such support could help to increase the level of recognition of the discipline locally and hence provide more effective support to older people with mental disorders.
Mental health and HIV infection: psychological and psychiatric aspects
- Editor:
- CATALAN Jose
- Publisher:
- UCL Press
- Publication year:
- 2000
- Pagination:
- 241p.,bibliogs.
- Place of publication:
- London
Presents an overview of the adverse mental health consequences of HIV infection and of the kind of psychological, phsychopharmacological and community forms of intervention available. Includes chapters on: psychological problems in people with HIV infection; HIV and its impact on the mental health of children; dementia associated with HIV infection; suicidal behaviour and HIV infection; euthanasia, physician assisted suicide and AIDS; psychological interventions; and cognitive behavioural therapy and HIV risk sexual behaviour.
Predictors of comprehensive stimulation program efficacy in patients with cognitive impairment. Clinical practice recommendations
- Authors:
- BINETTI Giuliano, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(1), 2013, pp.26-33.
- Publisher:
- Wiley
This longitudinal study examined which factors best predict response to a comprehensive stimulation programme offered to patients with dementia and mild cognitive impairment (MCI) and their caregivers. A total of 145 Italian patients (55 with MCI and 90 with dementia), participating to a cognitive motor rehabilitation program, and their 131 caregivers, attending informational/psychoeducational interventions were followed for six months. Three alternative cognitive stimulation interventions were used: Reality Orientation Therapy, Global Reactivation Therapy, and Memory Training. Mini mental state examination, Alzheimer’s Disease Assessment Scale-Cognition, and Clinician’s Interview-Based Impression of Change-plus were the primary outcome measures. Sixty-eight (46.9%) of the 145 subjects were classified as clinical responders. At baseline, responders had a significantly less insight into impairment, greater functional capacity as well as fewer delusions, euphoria, and aberrant motor behaviours than the non-responder. After 6 months, along with an improvement in cognition, responders also showed decreased behavioural disturbances and severity of disturbances. During the analysis the caregiver's burden of distress remained stable; however after 6 months the burden of the caregivers of MCI responders was reduced. The authors conclude that a high level of insight, preserved functional abilities as well as the lack of severe delusions, euphoria, and aberrant motor behaviours are significant predictors of responsiveness to stimulation programmes.
Psychological therapies with older people: developing treatments for effective practice
- Editor:
- HEPPLE Jason
- Publisher:
- Brunner-Routledge
- Publication year:
- 2002
- Pagination:
- 190p.,bibliog.
- Place of publication:
- Hove
Describes the therapies most likely to be useful in a mental health service for older people, and considers the implications for service provision. Therapies include: interpersonal therapy; cognitive behavioural therapy; pychodynamic and systemic therapy; and cognitive analytical therapy.