Pathy's Principles and Practice of Geriatric Medicine - Группа авторов

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changes and challenges that occur with ageing.

      2 Abnormal cognitive ageing is common enough to be encountered by most physicians treating older adults. Pharmacologic and several non‐pharmacologic interventions are available and effective for slowing decline, compensating for weakness, and/or maximizing functional independence.

      3 Psychopathology is common in older adulthood, most often in the form of depression and anxiety. Early identification is key to preventing comorbid medical conditions and overall quality of life and functional status.

      4 The US Preventive Services Task Force released detailed recommendations for depression screening for adults, which can be implemented during routine office visits. The final recommendation statement and guidelines can be accessed at https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/depression‐in‐adults‐screening.

      5 Successful treatment for medical diseases must allow for the impact of psychological issues. Impaired cognition can interfere with a person’s understanding of their health and prognosis. The treatment plan design should consider a person’s ability to understand and follow through with recommendations.

      6 The International Association of Gerontology and Geriatrics (IAGG) recommends all people age 70 and older have their cognition evaluated by their healthcare provider. Cognitive screening tools such as the Saint Louis University Mental Status Exam (SLUMS) and Rapid Geriatric Assessment (RGA) are open source tools that can assist with in‐office screening and can be accessed at https://www.slu.edu/medicine/internal‐medicine/geriatric‐medicine/aging‐successfully/assessment‐tools/index.php.

      7 There is a need for psychologists to assist in addressing the mental and behavioural health needs of the older adult population. A review of psychology’s role in addressing these needs presented by the American Psychological Association can be found at https://www.apa.org/pi/aging/resources/psychologist‐role‐geriatric.pdf.

      Key points

       Psychological growth continues in older adulthood, with greater emphasis on reflecting on past accomplishments to find a sense of meaning.

       Abnormal behavioural and mental health conditions are commonly encountered in the ageing population, with depression and anxiety being most common.

       Behavioural and mental health conditions adversely impact comorbid medical conditions, medication adherence, and quality of life and may accelerate morbidity and mortality.

       Psychological interventions have proven successful in older adults, and older adults tend to prefer psychotherapy intervention versus medication for mental health problems.

       Mild cognitive change and dementia are increasingly encountered with advancing age. The presence of cognitive impairments needs to be considered when developing a treatment plan to optimize patient health and safety.

       Pharmacological and non‐pharmacological interventions for age‐related cognitive declines are available and may reduce the rate of decline and/or functional status.

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