The Key To Keeping Older Adults At Home Could Be Recognizing Cognitive Impairment

Doctors, nurses and others who provide health care to older adults are often so focused on acute medical problems that they may miss symptoms of cognitive impairment. A unique educational summit to be held in April and May in Indianapolis focuses on the problem and will enhance the skills of these health-care providers in recognizing and managing cognitive impairment. The goal is to enable older adults to remain in their homes. According to Malaz Boustani, M.D., associate professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute research scientist, more than half of Americans with cognitive impairment are not recognized as having the conditions when they go to a hospital and more than three-quarters are not recognized as having cognitive impairment by their primary care physicians. The result is that less than 10 percent receive medications appropriate to their level of cognitive impairment and approximately one-quarter receive medications which are inappropriate.

WPA: Sleep Disturbances Linked to Suicidal Behavior in Adults

By Kristina Fiore, Staff Writer, MedPage Today Published: April 03, 2009 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston. Patients who toss and turn at night may be at an increased risk of suicidal behavior, researchers said. A survey of U.S. adults found that those who had trouble falling asleep, awoke in the middle of the night and couldn't get back to bed, or woke up too early were significantly more likely to contemplate, plan, or attempt suicide, said Marcin Wojnar, M.D., of the University of Michigan.

"The presence of sleep problems should alert doctors to assess patients for a heightened risk of suicide even if they don't have a psychiatric condition," Dr. Wojnar said.

The findings were presented at the World Psychiatric Association meeting in Florence, Italy.

In the latest study, researchers found a consistent link between early waking and all three suicidal behaviors. Patients with sleeping problems were twice as likely to have suicidal thoughts in the preceding 12 months as those with no sleep troubles. They were also 2.1 times and 2.7 times more likely to report planning or attempting suicide, respectively.

There was also a relationship between difficulty falling asleep and suicide, with a 1.9-fold increased risk of suicidal ideas and 2.2-fold risk of suicidal planning.

Finally, those who tossed and turned in the middle of the night were twice as likely to have contemplated suicide and three times more likely to have attempted it.

The researchers said their results were adjusted for factors known to influence suicide, including substance abuse, depression, anxiety disorders, and chronic medical conditions such as stroke, heart disease, and cancer.

'Compassion Fatigue' Drains Some Caregivers

By Todd Neale, Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine. Healthcare professionals who care for cancer patients may suffer from compassion fatigue, a condition similar to burnout, researchers found.

Witnessing the pain and suffering of cancer firsthand can affect how nurses, doctors, and others who care for terminally ill patients interact with patients and other people around them, according to Caroline Carney Doebbeling, M.D., of Indiana University School of Medicine and the Regenstrief Institute in Indianapolis, and colleagues.

People who develop compassion fatigue may have depression and anxiety disorders, may distance themselves emotionally from their work, and may be chronically tired, irritable, and bored, Dr. Doebbeling and colleagues reported in a review published in the March issue of the Journal of Health Psychology.