Poster Session Roundup

In 2002, nearly two-thirds (65.8 percent) of older offenders in U.S. jails had at least one mental disorder, according to an analysis by Brianne Stanback, M.F.Y.C.S., of the College of Behavioral and Community Sciences at the University of South Florida's School of Aging Studies. The data were extracted from the nationwide Survey of Inmates in Local Jails, conducted by the U.S. Department of Justice, and included 330 survey respondents aged 50 or older, about three-quarters of whom were men.

Substance use disorders were the most common category and were reported by 50.9 percent of the inmate respondents, followed by depression (27.3 percent). Anxiety disorders, excluding posttraumatic stress disorder (PTSD), were present in 11.5 percent, PTSD alone was present in 10.3 percent, and bipolar disorder was present in 10.3 percent of the older inmates.

Mental disorders were more common among inmates aged 50-59 than in older inmates and among unmarried inmates than married ones. A history of physical and sexual abuse was also significantly associated with having mental disorders in this population.

Although men over age 70 had the highest rate of suicide in North America and South America overall, there is substantial regional variation in the relationship between age and suicide, according to Robert Kohn, M.D., of the Warren Alpert Medical School at Brown University and Jorge Rodriguez, M.D., Ph.D., of the Pan American Health Organization/World Health Organization (WHO). They analyzed WHO mortality data by country in the period from 1990 to 2004. People in the age range of 25-44 accounted for the highest proportion (38.3 percent) of all suicides in the Americas, while people aged 61 and older made up 15.7 percent of suicides.

Data showed that there were clear gender differences, however. In many regions of the Americas and overall, the over-70 group did have the highest suicide rate (average 28.5 per 100,000) compared with other age groups in men, but this was not the case for women. Overall, the suicide rate among women in the Americas was the highest (5.4 per 100,000) in the 45-59 age group.

After analyzing trends within the 15-year study period, the authors found that suicide rates decreased significantly in the Americas among those aged 24-44 and aged 60 and over, but increased in those aged 10-19 and 45-59. In North America, suicide rates decreased in nearly all age groups from 1990 to 2004.

The study was funded by the Pan American Health Organization/WHO.

Among 127 older patients who had been diagnosed with mild cognitive impairment or Alzheimer's disease at a memory clinic of the Alzheimer's Disease Research Center at the University of Pittsburgh, only 39 percent initiated advanced care planning such as advanced medical directives within five years of follow-up at the clinic. Younger patients—those under age 65—were statistically more likely to initiate advanced care planning, but the rate still remained below half (43 percent).

The study authors, led by Linda Garand, Ph.D., recommended that health care professionals should educate patients with mild cognitive impairment and early Alzheimer's about setting up plans for future medical, financial, and other major decisions. This research was supported by grants from the National Institutes of Health and the Alzheimer's Association.

In a study of 299 older adults who were receiving congregate meals in the community, 38 percent reported not adhering to their prescribed medications, according to a study conducted by Mark Weinberger, Ph.D., of Weill Cornell Medical College and colleagues. These individuals' attitudes toward and beliefs about medicines and anticipated stigma about taking medications were measured with several questionnaires. They were also assessed with the Structured Clinical Interview for DSM-IV Disorders (SCID). The effect of these factors on respondents' adherence to medication was analyzed.

Using a multivariate linear regression analysis, the researchers found that concerns about medications and perceived social costs, or anticipated stigma, were significantly associated with nonadherence. About 19 percent of the study participants met the criteria for major or minor depression as determined by the SCID, but the presence of depression was not significantly associated with nonadherence to medications. The study was funded by grants from the National Institute of Mental Health (NIMH).

Performance on a portion of the Hopkins Verbal Learning Test-Revised (HVLT-R) significantly predicted older depressed patients' response to an antidepressant drug. In this study, Sara Morimoto, Psy.D., and colleagues at the Cornell Institute of Geriatric Psychiatry at Weill Cornell Medical College enrolled 65 patients aged 60 or older who met the criteria for unipolar major depression after a two-week washout period. Patients were given placebo during this period. These patients were then treated with escitalopram 10 mg daily for 12 weeks, at which time about half (n=31) achieved remission.

The authors found that patients who eventually reached remission on the antidepressant showed significantly better baseline performance on the tasks involved in initiating a semantic strategy, used to aid later recall, on the HVLT-R. The authors suggested that this cognitive test for executive-function impairment may be a useful indicator of response to antidepressant treatment in geriatric patients.

The study was supported by grants from NIMH, the Sanchez and TRU Foundation, and Forest Pharmaceuticals.

Elderly individuals who spent more time on reading and hobbies every week had a lower incidence of dementia in the prospective Monongahela Valley Independent Elders Survey, a longitudinal study conducted by researchers at the University of Pittsburgh between 1987 and 2002. In this analysis, Tiffany Hughes, Ph.D., M.P.H., and colleagues found a significant correlation between spending a high amount of time on reading and hobbies (at least six hours a week) at baseline and subsequent development of dementia during the study period.

The survey included 942 individuals who were followed for an average of six years. Their mean age at baseline was about 76, and 111 developed dementia during the follow-up period. The authors pointed out that the causality between dementia and time on reading and hobby cannot be determined by the observational data. The survey was supported by National Institute on Aging grants.