Journal articles: 'Geriatric psychiatry Australia'

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Williams, Sid. "Geriatric Psychiatry in Australia." International Journal of Geriatric Psychiatry 2, no. 1 (January 1987): 67–69. http://dx.doi.org/10.1002/gps.930020109.

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AMES, D. "Geriatric Psychiatry in Australia." International Journal of Geriatric Psychiatry 12, no. 2 (February 1997): 143–44. http://dx.doi.org/10.1002/(sici)1099-1166(199702)12:2<143::aid-gps604>3.0.co;2-s.

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Draper, Brian. "Geriatric psychiatry in Australia." International Journal of Geriatric Psychiatry 13, no. 2 (February 1998): 127. http://dx.doi.org/10.1002/(sici)1099-1166(199802)13:2<127::aid-gps692>3.0.co;2-b.

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Sachdev, Perminder S. "Geriatric Psychiatry Research in Australia." American Journal of Geriatric Psychiatry 15, no. 6 (June 2007): 451–54. http://dx.doi.org/10.1097/jgp.0b013e31805d7ec7.

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SHAH, AJIT. "DOWN UNDER AND OVER THE TOP: GERIATRIC PSYCHIATRY IN MELBOURNE AND LONDON. A British Psychogeriatrician's Experience in Australia." International Journal of Geriatric Psychiatry 12, no. 2 (February 1997): 263–66. http://dx.doi.org/10.1002/(sici)1099-1166(199702)12:2<263::aid-gps587>3.0.co;2-9.

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Lin, Xiaoping, Christina Bryant, Jennifer Boldero, and Briony Dow. "Psychological well-being of older Chinese immigrants living in Australia: a comparison with older Caucasians." International Psychogeriatrics 28, no. 10 (July 8, 2016): 1671–79. http://dx.doi.org/10.1017/s1041610216001010.

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ABSTRACTBackground:Few current studies explore psychological well-being among older Chinese immigrants in Australia. The study addressed this gap and provided preliminary data on psychological well-being among this group. Four indicators, namely depression, anxiety, loneliness, and quality of life, were used to present a comprehensive picture of psychological well-being.Methods:Participants were two groups of community-dwelling older people, specifically 59 Chinese immigrants and 60 Australian-born people (median age=77 and 73, respectively). Data were collected through standardized interviews. The Geriatric Depression Scale, the Hospital Anxiety and Depression Scale, the de Jong Gierveld Loneliness Scale and the WHO Quality of Life questionnaire were used to measure depression, anxiety, loneliness, and quality of life, respectively.Results:Chinese participants’ median quality of life score was higher than the scale mid-point, indicating relatively high levels of quality of life. However, 10% exhibited symptoms of depression, 6% had symptoms of anxiety, and 49% felt lonely. Compared to Australian participants, Chinese participants reported poorer quality of life and higher levels of loneliness. Importantly, the difference in quality of life remained when the impact of socio-demographic factors was controlled for.Conclusions:This study was the first to use multiple indicators to explore psychological well-being among older Chinese immigrants in Australia. Its results suggest that their psychological well-being might be worse than that of Australian-born people when using loneliness and quality of life as indicators. In particular, loneliness is a common psychological problem among this group, and there is a need for public awareness of this problem.

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Mitchell, Terry, Michael Woodward, and Yuichi Hirose. "A survey of attitudes of clinicians towards the diagnosis and treatment of mild cognitive impairment in Australia and New Zealand." International Psychogeriatrics 20, no. 1 (February 2008): 77–85. http://dx.doi.org/10.1017/s1041610207005583.

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ABSTRACTObjectives: The aim of the study was to assess the attitudes of clinicians to the diagnostic construct of mild cognitive impairment (MCI), their approach to relaying the diagnosis to patients and families, and recommended treatment and follow-up.Method: An anonymous questionnaire was sent out to 503 members of the Australian Society for Geriatric Medicine (ASGM) and New Zealand Geriatrics Society (NZGS), of whom 163 replied.Results: Most responders (83%) had diagnosed MCI. About 70% rated the importance of separating MCI from dementia, or MCI from normal cognition, as 4 or 5 on a scale from 1 (not very important) to 5 (very important). Most responders reported that they would inform their patients and families of a diagnosis of MCI, and used that term. A minority used the term “early Alzheimer's disease,” but 44% of NZGS members used other terms to relay the diagnosis compared to 13% of ASGM members. Follow-up was most often recommended at 6–12 months. Non-pharmacological treatment (such as mental stimulation strategies) was recommended most often, followed by no treatment.Conclusions: The diagnostic entity of MCI appears to have a general acceptance among those who responded to the survey, and the term has gained use in clinical practice. Most clinicians are recommending follow-up, recognizing the high risk for progression. Treatment recommendations do not favor pharmaceuticals, reflecting the current evidence for lack of effect.

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Llewellyn-Jones, Robert H., Karen A. Baikie, Sally Castell, Carol L. Andrews, Anne Baikie, C. Dimity Pond, Simon M. Willcock, John Snowdon, and Chris C. Tennant. "How to Help Depressed Older People Living in Residential Care: A Multifaceted Shared-Care Intervention for Late-Life Depression." International Psychogeriatrics 13, no. 4 (December 2001): 477–92. http://dx.doi.org/10.1017/s104161020100789x.

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Objective: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. Setting: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). Participants:) The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents who were eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. Intervention Description: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) trainning for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. Conclusions: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed to residents are substantial.

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Storey, Joella E., Jeffrey T. J. Rowland, David Basic, and David A. Conforti. "Accuracy of the Clock Drawing Test for Detecting Dementia in a Multicultural Sample of Elderly Australian Patients." International Psychogeriatrics 14, no. 3 (September 2002): 259–71. http://dx.doi.org/10.1017/s1041610202008463.

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Objective: To assess the accuracy of clock drawing for detecting dementia in a multicultural, non-English-speaking-background population. Design: A prospective cohort study. Setting: A general geriatric medical outpatient clinic in southwest Sydney, Australia. Participants: Ninety-three consecutive new patients to the clinic who had a non-English-speaking-background country of birth (mean age 78.0 years). Measurements: The clock drawing test was conducted at the beginning of each clinic visit by a blinded investigator. Each patient was then assessed by a geriatrician who collected demographic data, administered the Modified Barthel Index, the Geriatric Depression Scale, and the Folstein Mini-Mental State Examination, and categorized each patient as normal or demented, according to DSM-IV criteria. Interpreters were used for participants who spoke a language other than English or who requested them. Each clock drawing was scored according to the 4-point CERAD scale and the previously published methods of Mendez, Shulman, Sunderland, Watson, and Wolf-Klein. Scoring was evaluated for reliability and predictive accuracy, using receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to assess the potential interaction between level of education and each of the clock scoring methods. Results: Using ROC curve analysis, there was no significant difference between the clock scoring methods (area under the curve varied from 0.60 to 0.72). The most sensitive was the Mendez scoring method (98%), with a specificity of 16%. Specificity above 50% was found only for the Wolf-Klein method, with an intermediate sensitivity of 78%. Conclusions: There were no significant differences in the clock scoring methods used to detect dementia. Performance of the clock drawing test was modest at best with low levels of specificity across all methods. Scored according to these methods, clock drawing was not a useful predictor of dementia in our multicultural population.

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Wand, Anne P. F., and James George. "Observations of a traveling fellow: consultation–liaison psychiatry versus joint units for delirium management." International Psychogeriatrics 25, no. 7 (February 21, 2013): 1204–6. http://dx.doi.org/10.1017/s1041610213000124.

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There are various approaches to providing specialist care for patients with delirium in general hospitals. Those described in the literature include joint geriatric/psychiatric units and consultation–liaison (CL) psychiatry services. The Ferdinande Johanna Kanjilal Travelling Fellowship, from the Royal College of Psychiatrists, UK, provided an opportunity to more fully understand each model. This letter outlines observations of the Australian Fellow (AW) of different service structures in the care of hospitalized older people with delirium in the United Kingdom and Ireland.

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Flicker, Leon, and Dina Logiudice. "What can we learn about dementia from research in Indigenous populations?" International Psychogeriatrics 27, no. 12 (October 29, 2015): 1957–58. http://dx.doi.org/10.1017/s1041610215001684.

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Indigenous peoples represent up to 5% of the world's population (almost 400 million people), representing thousands of individual cultures and language groups. The health status of older Indigenous peoples has been little researched, partly related to lower life expectancy and the consideration that Indigenous peoples do not live long enough to experience the common “geriatric syndromes” such as dementia, frailty, and falls. Statistics from Australia and Canada now report that Indigenous populations are undergoing rapid aging, with many examples of survivorship to old age (Arkleset al., 2010; Jacklinet al., 2012). The systematic review by Warrenet al. (2015) is a timely one, in that it reminds clinicians interested in old age that this “fourth” World population deserves further attention. Researchers that have worked with these groups to produce population estimates are relatively few. In their systematic review, Warrenet al.(2015) demonstrate wide variation in prevalence rates of dementia. They conclude that a major cause of this heterogeneity in prevalence is due to basic methodological differences. In particular, those studies that have utilized already acquired routine data may be biased. The type and direction of this bias can be complex. For example, Cotteret al.(2012) using routinely collected data, concluded that the prevalence of dementia in Aboriginal Australians in the Northern Territory was not higher than non-Aboriginal prevalence. Using similar methodologies some years later the conclusion was that the Aboriginal population had markedly higher rates (Liet al., 2014). In the intervening period, a dementia awareness campaign coupled with the development of a culturally appropriate screening tool probably resulted in greater detection in routine care.

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Kotynia-English, Ria, Helen McGowan, and Osvaldo P. Almeida. "A randomized trial of early psychiatric intervention in residential care: impact on health outcomes." International Psychogeriatrics 17, no. 3 (September 2005): 475–85. http://dx.doi.org/10.1017/s1041610205001572.

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Background: The prevalence of psychological and behavioral disturbances among older adults living in residential care facilities is high, and it has been shown previously that people with such symptoms have poorer health outcomes. This study was designed to assess the efficacy of an early psychiatric intervention on the 12-month health outcomes of older adults admitted to residential care facilities in Perth, Western Australia. We hypothesized that subjects in the intervention group would have better mental and physical health outcomes than controls.Methods: The study was designed as a randomized, single-blinded, controlled trial. All subjects aged 65 years or over admitted to one of the 22/26 participating residential care facilities of the Inner City area of Perth were approached to join the study and were allocated randomly to the intervention or usual care group. Demographic and clinical information (including medications and use of physical restraint) was gathered systematically from all participants at baseline, and at 6 and 12 months. At each assessment, the Geriatric Depression Scale (GDS), the Health of the Nation Outcome Scales for older adults (HoNOS 65+), the Mini-mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI) were administered. Subjects in the intervention group who screened positive at the baseline assessment for psychiatric morbidity were reviewed within a 2-week period by the Inner City Mental Health Service of Older Adults (ICMHSOA). If clinically appropriate, mental health services were introduced without the involvement of the research team.Results: One hundred and six subjects and their next of kin consented to participate in the study (53 in each group). Mental health screening and early referral to a psychogeriatric service did not significantly change the average number of medical contacts, self-rated health, use of psychotropic or PRN medication, use of physical restraint, 12-month mortality, or mental health outcomes, as measured by the GDS-15, HoNOS 65+ and NPI (p>0.05 for all relevant outcomes).Conclusion: Systematic mental health screening of older adults admitted to residential care facilities and early clinical intervention does not change 12-month health outcomes. More effective interventions to improve the health outcomes of older adults with psychological and behavioral disturbances admitted to residential care facilities are needed.

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Wade, Victoria, Jeffrey Soar, and Len Gray. "Uptake of telehealth services funded by Medicare in Australia." Australian Health Review 38, no. 5 (2014): 528. http://dx.doi.org/10.1071/ah14090.

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Objective The aim of this study is to identify the extent to which the Medicare item numbers and incentives, introduced in July 2011, have been effective in stimulating telehealth activity in Australia. Methods A retrospective descriptive study utilising data on the uptake of telehealth item numbers and associated in-person services, from July 2011 to April 2014, were obtained from Medicare Australia. The main outcome measures were number of telehealth services over time, plus uptake proportionate to in-person services, by jurisdiction, by speciality, and by patient gender. Results Specialist consultations delivered by video communication and rebated by Medicare rose to 6000 per month, which is 0.24% of the total number of specialist consultations. The highest proportional uptake was in geriatrics and psychiatry. In 52% per cent of video consultations the patient was supported by an on-site healthcare provider, most commonly a general practitioner. There were substantial jurisdictional differences. A significantly lower percentage of female patients were rebated for item 99, which is primarily used by surgeons. Conclusions Medicare rebates and incentives, which are generous by world standards, have resulted in specialist video consultations being provided to underserved areas, although gaps still remain that need new models of care to be developed. What is known about the topic? Video consultations have been rebated by Medicare since July 2011 as a means of increasing access to specialist care in rural areas, aged care facilities and Aboriginal health services. What does this paper add? The uptake of this telehealth initiative has grown over time, but still remains low. For half the video consultations the patient was supported by an on-site healthcare provider, most commonly a general practitioner. Geriatrics and psychiatry are the specialties with the highest proportional uptake. What are the implications for practitioners? New models of care with a greater focus on consultation-liaison with primary care providers need to be developed to realise the potential of this initiative and to fill continuing gaps in services.

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Draper, Brian, and Lee-Fay Low. "Psychiatric services for the “old” old." International Psychogeriatrics 22, no. 4 (March 15, 2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.

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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.

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Woodward, Michael Clifford, and Erin Woodward. "A national survey of memory clinics in Australia." International Psychogeriatrics 21, no. 4 (August 2009): 696–702. http://dx.doi.org/10.1017/s1041610209009156.

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ABSTRACTBackground:There is limited information describing memory clinics at a national level in Australia. The aim of this study was to gather information about the resourcing, practices and clinical diagnoses of Australian memory clinics.Methods:A postal survey was sent to all Australian memory clinics identified by key specialists working in dementia assessment services.Results:Of 23 surveys sent out, 14 were returned. Most clinics are located in Victoria where they receive Victorian state funding. The average clinic has 1.67 effective full time clinical staff including 0.42 medical staff, 0.24 allied health staff, 0.53 clinical nursing staff and 0.48 psychologists. Clinics are open on average twice a week and each half-day clinic has two new and three review patients, seeing new patients twice initially then once more over 12 months. Patients wait 10 weeks for initial assessment with 59% referred by general practitioners. The Mini-mental State Examination and clock drawing are utilized universally. The most common diagnoses are Alzheimer's disease (37.8%) and mild cognitive impairment (19.8%) but 6.9% of patients have no cognitive impairment.Conclusions:This survey has provided useful benchmarking data on Australian memory clinics which can also be used by other countries for comparative analyses.

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Jackman, Matthew, Fiona McDermott, Jacinta Sadler, Nicole El Hage, and Halim Lee. "Guardianship patient characteristics and outcomes in geriatric social work practice: Australian context." Social Work in Health Care 60, no. 8-9 (October 21, 2021): 614–30. http://dx.doi.org/10.1080/00981389.2021.1990189.

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Greve, Melissa, and Daniel O'Connor. "A survey of Australian and New Zealand old age psychiatrists' preferred medications to treat behavioral and psychological symptoms of dementia (BPSD)." International Psychogeriatrics 17, no. 2 (June 2005): 195–205. http://dx.doi.org/10.1017/s1041610205001481.

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Background: People with behavioral and psychological symptoms of dementia (BPSD) are often prescribed psychotropic medications. There is little evidence that one class of medication is more effective and safer than another and so expert opinion plays an important role in shaping local practice. In an earlier U.S. survey of psychiatrists and neurologists, limited consensus emerged regarding the pharmacological management of BPSD. We repeated this study to check consensus levels in Australia and New Zealand, following the introduction of newer atypical neuroleptics, antidepressants and cholinesterase inhibitors, and to identify areas where drug trials will be of greatest benefit.Methods: A brief structured survey, similar to one used in the U.S.A., was posted to a random sample of members of the Australian and New Zealand Faculty of Psychiatry of Old Age.Results: We received 106 replies (71% response). Respondents, who had 14 years' experience on average, rated atypical neuroleptics as their treatment of choice for dementia complicated by psychosis, verbal aggression, physical aggression, sundowning and persistent yelling. Opinions varied widely regarding the management of other symptoms and the role of second-line treatments.Conclusion: Atypical neuroleptics were preferred by most respondents for treatment of most BPSD. These views, while based on considerable clinical experience, have only limited backing from published reports, and head-to-head studies of available treatments are required to ensure that clinical practice has scientific support.

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Stratford, Joe A., Dina Logiudice, Leon Flicker, Roslyn Cook, Wendy Waltrowicz, and David Ames. "A Memory Clinic at a Geriatric Hospital: A Report on 577 Patients Assessed with the CAMDEX Over 9 Years." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 319–26. http://dx.doi.org/10.1046/j.1440-1614.2003.01174.x.

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Objective: To report 9 years’ experience of an Australian memory clinic using the Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia. Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = −0.57 to 0.93). Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders.

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Werner, Perla, and Sarang Kim. "A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia." Journal of Alzheimer's Disease 83, no. 1 (August 31, 2021): 103–10. http://dx.doi.org/10.3233/jad-210277.

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Background: Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects. Objective: The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia. Methods: A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia. Results: Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample. Conclusion: Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.

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Draper, Brian, and Dave Anderson. "The baby boomers are nearly here – but do we have sufficient workforce in old age psychiatry?" International Psychogeriatrics 22, no. 6 (June 3, 2010): 947–49. http://dx.doi.org/10.1017/s1041610210000566.

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In 2011, the baby boomer generation officially commences its residency in the 65 years and over age group (U.S. Census Bureau, 2006). The much anticipated rapid growth in the population aged 65 years and over between 2011 and 2030 will challenge health care systems worldwide. Mental health services for older people will need to prepare for a near doubling of possible demand based upon estimates of the increase in prevalence of mental disorders in late life in this period in the developed world, with the increase likely to be greater in low and middle income countries (Bartels, 2003; Alzheimer's Disease International, 2009). The pressures that this will place upon the old age psychiatry workforce has contributed to the impetus for the Faculties of Psychiatry of Old Age of the Royal College of Psychiatrists and the Royal Australian and New Zealand College of Psychiatrists to prepare a ‘Joint Statement on Specialist Old Age Psychiatry Workforce and Training’ (see Appendix).

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Brodaty, Henry, and Anne Cumming. "Dementia services in Australia." International Journal of Geriatric Psychiatry 25, no. 9 (August 23, 2010): 887–995. http://dx.doi.org/10.1002/gps.2587.

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McMaster, Mitchell, Elaine Fielding, David Lim, Wendy Moyle, and Elizabeth Beattie. "A cross-sectional examination of the prevalence of psychotropic medications for people living with dementia in Australian long-term care facilities: issues of concern." International Psychogeriatrics 30, no. 7 (December 4, 2017): 1019–26. http://dx.doi.org/10.1017/s1041610217002447.

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ABSTRACTBackground:Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored.Methods:There have previously been no studies with nationally representative samples to investigate psychotropic administration in LTCs in Australia. This study determines the prevalence of psychotropic administration in a representative stratified random sample of 446 residents living with dementia from 53 Australian LTCs. Questionnaire and medical chart data in this study is drawn from a larger cross-sectional, mixed methods study on quality of life in Australian LTCs.Results:It was found that 257 (58%) residents were prescribed psychotropic medications including: antipsychotics (n = 160, 36%), benzodiazepines (n = 136, 31%), antidepressants (n = 117, 26%), and anti-dementia medications (n = 9, 2%). BPSD were found to be very common in the sample, with 82% (n = 364) of participants experiencing at least one BPSD. The most prevalent BPSD were depression (n = 286, 70%) and agitation (n = 299, 67%).Conclusions:Although detailed background information was not collected on individual cases, the prevalence found is indicative of systematic industry-wide, over-prescription of psychotropic medications as a first-line treatment for BPSD. This study highlights a clear need for further research and interventions in this area.

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KIRBY, DI. "DOWN UNDER AND OVER THE TOP: GERIATRIC PSYCHIATRY IN MELBOURNE AND LONDON. An Australian Registrar's Experience of a Psychogeriatric Service in London." International Journal of Geriatric Psychiatry 12, no. 2 (February 1997): 261–62. http://dx.doi.org/10.1002/(sici)1099-1166(199702)12:2<261::aid-gps586>3.0.co;2-i.

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SINGH, DHIREN, and DANIEL W. O'CONNOR. "Depot risperidone in elderly patients: the experience of an Australian aged psychiatry service." International Psychogeriatrics 19, no. 4 (July 5, 2007): 789–92. http://dx.doi.org/10.1017/s1041610207005686.

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Antipsychotic medications form the mainstay of both the acute and maintenance treatment of schizophrenia. In recent years, atypical antipsychotics like risperidone, olanzapine and clozapine have come to be preferred because of their lower incidence of extra-pyramidal, anti-cholinergic and cardiac side-effects and a possible greater efficacy in reducing negative and neuro-cognitive symptoms (Ritchie et al., 2006).

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Farugia, Taya L., Carla Cuni-Lopez, and Anthony R. White. "Potential Impacts of Extreme Heat and Bushfires on Dementia." Journal of Alzheimer's Disease 79, no. 3 (February 2, 2021): 969–78. http://dx.doi.org/10.3233/jad-201388.

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Australia often experiences natural disasters and extreme weather conditions such as: flooding, sandstorms, heatwaves, and bushfires (also known as wildfires or forest fires). The proportion of the Australian population aged 65 years and over is increasing, alongside the severity and frequency of extreme weather conditions and natural disasters. Extreme heat can affect the entire population but particularly at the extremes of life, and patients with morbidities. Frequently identified as a vulnerable demographic in natural disasters, there is limited research on older adults and their capacity to deal with extreme heat and bushfires. There is a considerable amount of literature that suggests a significant association between mental disorders such as dementia, and increased vulnerability to extreme heat. The prevalence rate for dementia is estimated at 30%by age 85 years, but there has been limited research on the effects extreme heat and bushfires have on individuals living with dementia. This review explores the differential diagnosis of dementia, the Australian climate, and the potential impact Australia’s extreme heat and bushfires have on individuals from vulnerable communities including low socioeconomic status Indigenous and Non-Indigenous populations living with dementia, in both metropolitan and rural communities. Furthermore, we investigate possible prevention strategies and provide suggestions for future research on the topic of Australian bushfires and heatwaves and their impact on people living with dementia. This paper includes recommendations to ensure rural communities have access to appropriate support services, medical treatment, awareness, and information surrounding dementia.

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SHAH, AJIT, and T. GANESVARAN. "PSYCHOGERIATRIC INPATIENT SUICIDES IN AUSTRALIA." International Journal of Geriatric Psychiatry 12, no. 1 (January 1997): 15–19. http://dx.doi.org/10.1002/(sici)1099-1166(199701)12:1<15::aid-gps415>3.0.co;2-s.

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Shin, Hee-Young, Svetla Gadzhanova, Elizabeth E. Roughead, Michael B. Ward, and Lisa G. Pont. "The use of antipsychotics among people treated with medications for dementia in residential aged care facilities." International Psychogeriatrics 28, no. 6 (January 18, 2016): 977–82. http://dx.doi.org/10.1017/s1041610215002434.

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ABSTRACTBackground:Antipsychotic agents have limited efficacy for Behavioral and Psychological Symptoms of Dementia (BPSD) and there are concerns about their safety. Despite this, they are frequently used for the management of BPSD. This study aimed to assess the use of antipsychotics among people on anti-dementia medicines in Australian residential aged care facilities.Methods:Data were obtained from an individual patient unit dose packaging database covering 40 residential aged care facilities in New South Wales, Australia. Residents supplied an anti-dementia medicine between July 2008 and June 2013 were included. Prevalence of concurrent antipsychotic use was established. Incident antipsychotic users between January 2009 and December 2011 were identified. We examined initial antipsychotic dose, maximum titrated doses, type and duration of antipsychotic use, and compared use with Australian guidelines.Results:There were 291 residents treated with anti-dementia medicines, 129 (44%) of whom received antipsychotics concomitantly with an anti-dementia medicine. Among the 59 incident antipsychotic users, risperidone (73%) was the most commonly used antipsychotic agent. Amongst the risperidone initiators, 43% of patients had initial doses greater than 0.5 mg/day and 6% of patients exceeded 2.0 mg/day for their maximum dose. 53% of concomitant users received daily treatment for greater than six months.Conclusions:Our study using records of individual patient unit dose supply, which represents the intended medication consumption schedule, shows high rates of concurrent use of antipsychotics and anti-dementia medicines and long durations of use. The use of antipsychotics in patients with dementia needs to be carefully monitored to improve patient outcomes.

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MOFFATT, FIONA. "DOWN UNDER AND OVER THE TOP: GERIATRIC PSYCHIATRY IN MELBOURNE AND LONDON. An Australian Occupational Therapist's Impression of Work in a London Psychogeriatric Service." International Journal of Geriatric Psychiatry 12, no. 2 (February 1997): 259–60. http://dx.doi.org/10.1002/(sici)1099-1166(199702)12:2<259::aid-gps585>3.0.co;2-z.

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BENBOW, SUSAN MARY, and DAVID TENCH. "A survey of psychiatrists in northwest England concerning their use of maintenance electroconvulsive therapy." International Psychogeriatrics 19, no. 5 (March 9, 2007): 985–87. http://dx.doi.org/10.1017/s104161020700498x.

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Dr. Lim's practice audit of maintenance electroconvulsive therapy (M-ECT) in the elderly (Lim, 2006) describes a group of older people treated with M-ECT in Australia but does not describe the views of Australian psychiatrists regarding the use of this form of treatment. We explored the views of psychiatrists in northwest England regarding the use of M-ECT in the 1990s: our study group was a subset of the cohort reported in Benbow et al. (1998), namely those respondents to a first-stage questionnaire who stated that they had used M-ECT (25%) or were prepared to consider its use (67%). A second-stage questionnaire inquired specifically about practice in relation to M-ECT, defined as the regular administration of ECT in order to minimize the likelihood of further episodes of illness, and was sent to 85 individuals of whom 77 responded, giving a response rate of 87.5%. Of these respondents, 49% stated that they had not prescribed maintenance treatment within the past 10 years; 42% estimated that they had prescribed one or two courses; 8% three to four courses and 1% five to six courses. None had prescribed more than six courses, so the experience of any one individual was relatively limited.

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Nagendra, Janani, and John Snowdon. "An Australian study of delusional disorder in late life." International Psychogeriatrics 32, no. 4 (July 29, 2019): 453–62. http://dx.doi.org/10.1017/s1041610219000966.

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ABSTRACTObjectives:There is a paucity of available research to guide clinical practice in delusional disorder (DD), particularly in late life. This study aimed to evaluate antipsychotic use and treatment outcomes in patients with DD aged 65 years and older. Secondarily, we sought to examine associated clinical features and socio-demographic variables.Design and setting:This descriptive study reviewed all consecutive cases of DD referred to an Australian old age psychiatry service over a 12-year period. Fifty-five patients were assessed in the inpatient and/or community setting, with data verified from a review of all individual medical records.Measurements:Data were collected with respect to antipsychotic use, outcomes, and clinical features. Socio-demographic variables of DD cases were compared to a non-matched comparison group (n=278) and an age and gender matched comparison group with a 1:1 ratio (n=55).Results:The predominant type of DD was persecutory (87%). Non-prominent hallucinations were experienced by 18%, and depressive symptoms occurred in 22%. There was a statistically significant association between having DD and social isolation (χ2= 11.04 (DF=1) p<0.001; McNemar’s test p<0.001). Atypical antipsychotic medication was prescribed in 32 cases, with follow-up permitted in 51 of the 55 cases (mean duration 36.6 months). Sustained recovery occurred in 20%, and improvement in an additional 35% of the study sample. Four patients subsequently developed dementia, and two developed mild cognitive impairment.Conclusions:Clinical improvement, including sustained recovery, occurred in more than half of those with late life DD. The majority of those who improved (96%) received atypical antipsychotics.

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Shah, Ajit. "Foundations of Clinical Psychiatry. 2nd ed. Sidney Bloch and Bruce S. Singh. Melbourne, Australia: Melbourne University Press, 2001, 606 pp." International Psychogeriatrics 13, no. 3 (September 2001): 380–81. http://dx.doi.org/10.1017/s1041610201257767.

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Christensen, Helen, and Patricia A. Jacomb. "The lifetime productivity of eminent Australian academics." International Journal of Geriatric Psychiatry 7, no. 9 (September 1992): 681–86. http://dx.doi.org/10.1002/gps.930070910.

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Burvill, Peter Walter. "Suicide in the Multiethnic Elderly Population of Australia, 1979–1990." International Psychogeriatrics 7, no. 2 (June 1995): 319–33. http://dx.doi.org/10.1017/s1041610295002079.

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Australia is a multiethnic society with 25% of its elderly population born outside the country. Rates and methods, gender, and country of birth are given for all suicides aged 65 and over in Australia during the 12-year period of 1979–1990. There was a marked heterogeneity in rates and methods of suicide among the various migrant groups. The data also showed that the suicide rates of migrants were mostly higher than in their country of origin. Migrants born in countries with high suicide rates generally had high rates in Australia, and vice versa. Possible reasons for this finding are discussed. Factors influencing rates and methods of suicide in elderly migrants appeared to have much in common with factors operating in migrants of all age groups.

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Snowdon, John, and Richard Fleming. "Recognising depression in residential facilities: an Australian challenge." International Journal of Geriatric Psychiatry 23, no. 3 (2008): 295–300. http://dx.doi.org/10.1002/gps.1877.

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Sachdev, Perminder, and Henry Brodaty. "Vascular Dementia: An Australian Perspective." Alzheimer Disease & Associated Disorders 13, Supplement 3 (December 1999): S206—S212. http://dx.doi.org/10.1097/00002093-199912003-00029.

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Pachana, Nancy A., Elizabeth Beattie, Gerard J. Byrne, and Henry Brodaty. "COVID-19 and psychogeriatrics: the view from Australia." International Psychogeriatrics 32, no. 10 (May 12, 2020): 1135–41. http://dx.doi.org/10.1017/s1041610220000885.

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Hollingworth, Samantha A., and Gerard J. Byrne. "Prescribing trends in cognition enhancing drugs in Australia." International Psychogeriatrics 23, no. 2 (July 30, 2010): 238–45. http://dx.doi.org/10.1017/s1041610210001146.

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ABSTRACTBackground: This study sought to examine the trends in the prescribing of subsidized and unsubsidized cognition enhancing drugs (CEDs) in Australia over five years from 2002 to 2007. Subsidized cholinesterase inhibitor medication could be prescribed to people with mild to moderate Alzheimer's disease (AD) once a specialist physician had confirmed this diagnosis. Memantine was available for use in moderately severe AD but not subsidized.Methods: We analyzed the Medicare Australia and Drug Utilisation Sub-Committee databases for CED prescription data, 2002–2007, by gender, age and prescriber class. Aggregated prescription data for each medication were converted to defined daily doses (DDD) per 1000 persons per day using national census data.Results: There were 1,583,667 CED prescriptions dispensed during the study period. CED use increased 58% from 0.91 to 1.56 DDD/1000 persons/day between 2002 and 2007. Peak use was in those aged 85–89 years. Age-adjusted utilization was slightly higher in females than males. Donepezil was the most widely used CED (66%), followed by galantamine (27%) then memantine (4%). General practitioners prescribed the majority of CEDs. Geriatricians exhibited a greater preference for galantamine than other prescribers. CED dispensing peaked towards the end of each calendar year, reflecting stockpiling by patients under the influence of a federal safety net subsidy.Conclusions: Despite subsidized access to CEDs in Australia, only a minority of people with AD was prescribed these drugs during the period of the study. It is likely that the combination of complex prescribing rules and negative perceptions about efficacy or cost-effectiveness might have contributed to these findings.

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Poulsen, Emma E., David Sibbritt, Deirdre McLaughlin, Jon Adams, and Nancy A. Pachana. "Predictors of Complementary and Alternative Medicine (CAM) use in two cohorts of Australian women." International Psychogeriatrics 25, no. 1 (August 23, 2012): 168–70. http://dx.doi.org/10.1017/s1041610212001378.

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Complementary and Alternative Medicine (CAM) use has been researched widely; however, studies with older adults and Australian populations are limited. The profile of Australian women CAM users has been mapped using the 1996 data from the ALSWH (Adamset al., 2003). Mid-age adults were frequent CAM users (28%) followed by young adults (19%) and older adults (15%). No consistent characteristics of CAM users across age groups were identified. Generally, CAM users lived in non-urban settings, and reported poorer physical and mental health. Predictors of CAM use for Australian women have not yet been explored.

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Zhang, Ying, Veronica Chow, Agnes I. Vitry, Philip Ryan, Elizabeth E. Roughead, Gillian E. Caughey, Emmae N. Ramsay, Andrew L. Gilbert, Adrian Esterman, and Mary A. Luszcz. "Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing." International Psychogeriatrics 22, no. 3 (January 28, 2010): 437–44. http://dx.doi.org/10.1017/s1041610209991554.

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ABSTRACTBackground:Depression is one of the leading contributors to the burden of non-fatal diseases in Australia. Although there is an overall increasing trend in antidepressant use, the relationship between use of antidepressants and depressive symptomatology is not clear, particularly in the older population.Methods:Data for this study were obtained from the Australian Longitudinal Study of Ageing (ALSA), a cohort of 2087 people aged over 65 years at baseline. Four waves of home interviews were conducted between 1992 and 2004 to collect information on sociodemographic and health status. Depressive symptoms were measured by the Center for Epidemiologic Studies – Depression Scale. Use of antidepressants was based on self-report, with the interviewer able to check packaging details if available. Longitudinal analysis was performed using logistic generalized estimating equations to detect if there was any trend in the use of antidepressants, adjusting for potential confounding factors.Results:The prevalence of depressive symptoms was 15.2% in 1992 and 15.8% in 2004 (p> 0.05). The prevalence of antidepressant users increased from 6.5% to 10.9% (p< 0.01) over this period. Among people with depressive symptoms, less than 20% were taking antidepressants at any wave. Among people without depressive symptoms, the prevalence of antidepressant use was 5.2% in 1992 and 12.0% in 2004 (p< 0.01). Being female (OR = 1.67, 95%CI: 1.25–2.24), having poor self-perceived health status (OR = 1.17, 95%CI: 1.04–1.32), having physical impairment (OR = 1.48, 95%CI: 1.14–1.91) and having depressive symptoms (OR = 1.62, 95%CI: 1.24–2.13) significantly increased the use of antidepressants, while living in community (OR = 0.51, 95%CI: 0.37–0.71) reduced the risk of antidepressant use.Conclusions:Use of antidepressants increased, while depressive symptoms remained stable, in the ALSA over a 12-year period. Use of antidepressants was low for people with depressive symptoms.

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Wattis, John P. "Psychogeriatric assessment scales. Anthony Jorm and Andrew Mackinnon. ANUTECH Pty Ltd, Canberra, Australia." International Journal of Geriatric Psychiatry 10, no. 11 (November 1995): 997. http://dx.doi.org/10.1002/gps.930101119.

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Loi, Samantha M., Anita M. Goh, Dhamidhu Eratne, Ramon Mocellin, Sarah Farrand, Andrew Evans, Charles Malpas, Wendy Kelso, Mark Walterfang, and Dennis Velakoulis. "404 - Factors associated with diagnostic delay in younger-onset dementia iagnostic delay in younger-onset dementia." International Psychogeriatrics 33, S1 (October 2021): 31. http://dx.doi.org/10.1017/s1041610221001630.

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Background:Younger-onset dementia (YOD) is a dementia of which symptom onset occurs at 65 years or less. There are approximately 27000 people in Australia with a YOD and the causes can range from Alzheimer’s dementia (AD), frontotemporal dementia (FTD), metabolic and genetic disorders. It is crucial to obtain a definitive diagnosis as soon as possible in order for appropriate treatment to take place and future planning. Previous research has reported 4-5 years to get a diagnosis (Draper et al. 2016) and factors associated with delay include younger age (van Vliet et al. 2013) and psychiatric comorbidity (Draper et al. 2016). We report on our experience of diagnostic delay.Methods:This was a retrospective file review of 10 years of inpatients from Neuropsychiatry, Royal Melbourne Hospital, Australia. Neuropsychiatry is a tertiar service which provides assessment of people with cognitive, psychiatric, neurological and behavioural symptoms. Factors such as age of onset, number of services/specialists seen were extracted and analysed using multivariate regression.Results:Of the 306 individual patients who had a YOD, these were grouped into the major dementia groups (such as AD, FTD, Huntington’s disease, vascular dementia, alcohol-related dementia). The most commonly occurring dementia was AD (24.2%), followed by FTD (23%). There was an average of 3.7 years (SD=2.6), range 0.5-15 years, of delay to diagnosis. Cognitive impairment, as measured using the Neuropsychiatry Unit Cognitive Assessment (NUCOG) was moderate, with a mean score of 68.9 (SD=17.9). Within the groups of dementia, patients with Niemann-Pick type C (NPC) had the longest delay to diagnosis F(11,272)=3.677, p<0.0001, with 6.3 years delay. Age of symptom onset and number of specialists/services seen were the significant predictors of delay to diagnosis F(7, 212)=3.975, p<0.001, R211.6.Discussion and conclusions:This was an eclectic group of people with YOD. The results of regression suggests that there are other factors which contribute to the delay, which are not just demographic related. Rarer disorders, such as NPC which present at an early age, and present with symptoms that are not cognitive in nature, can contribute to diagnostic delay.

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Talbot, Louise A., Margaret Thomas, Adrian Bauman, Karine E. Manera, and Ben J. Smith. "Impacts of the National Your Brain Matters Dementia Risk Reduction Campaign in Australia Over 2 Years." Journal of Alzheimer's Disease 82, no. 3 (August 3, 2021): 1219–28. http://dx.doi.org/10.3233/jad-210317.

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Background: The number of people living with dementia is rising globally due to population aging. Mass media campaigns which aim to reduce the risk of people developing dementia have been conducted across many countries, but few have reported evaluation findings. Objective: The present study investigated the impact of the Your Brain Matters dementia risk reduction campaign in Australia. Methods: The campaign was evaluated by observational cross-sectional surveys of 1000 Australian adults aged 18–75 years before and 24 months after delivery. The national campaign utilized multiple media channels to promote messages about the importance of brain health and reducing the risk of dementia. Dementia risk reduction knowledge, confidence, intentions and actions were measured at baseline and follow-up, and analyzed 2019–2020. Results: Earned television and radio were the most common exposure channels. The proportion of people who understood that it is beneficial to take action to reduce dementia risk before middle age increased (54.1% to 59.4%, OR 1.20 95% CI: 1.01–1.44). There was also an increase (28.5% to 32.8%, OR 1.30, 95% CI: 1.07–1.59) in the proportion who reported taking action to improve brain health. There was no improvement in knowledge about vascular risk factors, or confidence to reduce personal dementia risk. Conclusion: The findings showed some receptivity and positive responses to messages about the benefits of taking action to reduce the risk of dementia. The campaign demonstrated the potential for generating news coverage about this issue, which should highlight the preventive benefits of vascular health behaviors.

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Gao, Lan, Dieu Nguyen, and Marj Moodie. "Economic Burden of Dementia Caused by Cardiovascular Disease in Australia." Journal of Alzheimer's Disease 86, no. 2 (March 22, 2022): 601–12. http://dx.doi.org/10.3233/jad-215368.

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Background: The established link between cardiovascular disease (CVD) and dementia may provide new insights into dementia prevention. Objective: It aims to quantify the burden of dementia attributable to people with CVD. Methods: A Markov microsimulation model was developed to simulate the lifetime cost and quality-adjusted life-years (QALYs) related to people with and without CVD in Australia. A de-novo systematic review was undertaken to identify all evidence around the association between CVD [i.e., stroke, myocardial infarction (MI), atrial fibrillation (AF), and heart failure (HF)] and the risk of developing dementia. Incremental costs and QALY losses were estimated for people by type of CVD compared to the general Australian population without CVD. Results: Of the comprehensive literature search, 19 observational studies were included in the qualitative synthesis. Patients who had CVD incurred both higher healthcare costs over their lifetime (ranging from $73,131 for patients with AF to $127,396 for patients with HF) and fewer QALYs gains (from –1.099 for patients with MI to –5.163 for patients with stroke), compared to people who did not have CVD. The total incremental economic burden of dementia from patients aged 65 years and over with CVD was $6.45 billion (stroke), $11.89 billion (AF), $17.57 billion (MI), or $7.95 billion (HF) over their remaining life expectancy. Conclusion: The results highlighted the importance of CVD prevention to reduce the CVD burden and decrease the prevalence of dementia. Interventions that target patients with dementia risk factors like CVD may prove to be effective and cost-effective strategies.

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McSwiggan, Sally, Susanne Meares, and Melanie Porter. "Decision-making capacity evaluation in adult guardianship: a systematic review." International Psychogeriatrics 28, no. 3 (September 28, 2015): 373–84. http://dx.doi.org/10.1017/s1041610215001490.

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ABSTRACTBackground:Evidence of impaired decision-making capacity is a legal requirement for adult guardianship. To understand the quality of the evidence health professionals commonly provide in reports submitted to guardianship courts, a systematic review was undertaken to appraise the design and methodological quality of the published literature on health professionals’ written reports of decision-making capacity and to describe the content of these reports.Methods:Electronic searches from 1980 to 2015 identified 1183 articles of which 11 met the inclusion criteria where each evaluated quantitatively the content of health professionals’ written reports submitted to adult guardianship proceedings. Methodological quality of the selected studies was rated using a critical appraisal tool.Results:Nine studies sourced files from courts in the U.S. and one from Sweden; another reported on guardianship decisions from Australia. Four studies were rated as moderately strong or strong. Strengths included the use of comparison groups and a reliable and valid instrument to code reports. The review showed a person's medical condition was often cited as evidence of impaired decision-making capacity. Cognitive, psychiatric and functional abilities were less often described, and a person's values and preferences were rarely recorded.Conclusions:It is recommended health professionals describe the process by which a person makes a particular decision (their ability to understand, appreciate, reason and communicate) in addition to providing medical information, including cognitive, psychiatric and functional abilities. This approach provides support for a professional's opinion and evidence for a court. International studies of health professionals’ approach to decision-making capacity evaluation are needed.

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Koo, Yu Wen, Kairi Kõlves, and Diego De Leo. "Suicide in older adults: a comparison with middle-aged adults using the Queensland Suicide Register." International Psychogeriatrics 29, no. 3 (November 17, 2016): 419–30. http://dx.doi.org/10.1017/s1041610216001848.

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ABSTRACTBackground:Globally, suicide rates increase with age, being highest in older adults. This study analyzed differences in suicides in older adults (65 years and over) compared to middle-aged adults (35–64 years) in Queensland, Australia, during the years 2000–2012.Methods:The Queensland Suicide Register was utilized for the analysis. Annual suicide rates were calculated by gender and age group, and odds ratios with 95% confidence intervals were examined.Results:In Queensland, the average annual rate of suicides for older adults was 15.27 per 100,000 persons compared to 18.77 in middle-aged adults in 2000–2012. There were no significant changes in time trends for older adults in 2002–2012. Suicide methods differed between gender and age groups. Older adults who died by suicide were more likely to be male, widowed, living alone or in a nursing home, and out of the work force. The prevalence of untreated psychiatric conditions, diagnosed psychiatric disorders, and consultations with a mental health professional three months prior to death was lower in older adults than middle-aged adults. Somatic illness, bereavement, and attention to suicide in the media were more common among older adults than middle-age adults. Older females were particularly more likely to pay attention to suicide in the media.Conclusion:Our findings show older adults who died by suicide were more likely to experience somatic illnesses, bereavement, and pay attention to suicide in the media compared to middle aged. Preventing suicide in older adults would therefore require holistic and comprehensive approaches.

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Smith, K., L. Flicker, D. Atkinson, A. Dwyer, N. T. Lautenschlager, J. Thomas, O. P. Almeida, and D. LoGiudice. "The KICA Carer: informant information to enhance the Kimberley Indigenous Cognitive Assessment." International Psychogeriatrics 28, no. 1 (August 14, 2015): 101–7. http://dx.doi.org/10.1017/s1041610215001283.

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ABSTRACTBackground:A quality dementia-screening tool is required for older remote Aboriginal Australians who have high rates of dementia and limited access to appropriate medical equipment and clinicians. The Kimberley Indigenous Cognitive Assessment (KICA Cog) is a valid cognitive test for dementia in Aboriginal and Torres Strait Islander peoples. The KICA cognitive informant questionnaire (KICA Carer) had yet to be analyzed to determine validity alone or in combination with the KICA Cog.Methods:The KICA Carer was completed by nominated informants of 349 remote-living Aboriginal Australians in the Kimberley region, Western Australia. Validity was assessed by comparing KICA Carer with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) consensus diagnoses based on a blinded specialist review. KICA Carer and KICA Cog were then compared to determine joint validity.Results:A KICA Carer score of ≥3/16 gave optimum sensitivity (76.2%) and specificity (81.4%), area under curve (AUC) 0.89 (95% CI = 0.85, 0.94) with positive predictive value (PPV) of 35.8%, and negative predictive value (NPV) of 96.2%. A KICA Cog score of ≤33/39 gave a sensitivity of 92.9% and specificity of 89.9%, AUC 0.96 (95% CI = 0.94, 0.98), with PPV of 55.6% and NPV of 98.9%. Cut-off scores of KICA Cog ≤ 33/39 and KICA Carer ≥ 2/16 in series indicate possible dementia, with sensitivity of 90.5% and specificity of 93.5%. In this setting, PPV was 66.5% and NPV was 98.6%.Conclusions:The KICA Carer is an important tool to accurately screen dementia in remote Aboriginal Australians when the KICA Cog is unable to be used for a patient. It is readily accepted by caregivers.Key points:•For the best practice in the cognitive assessment of an Aboriginal Australian aged over 45 years, KICA Cog should be utilized.•In cases where Aboriginal patients are not assessed directly, KICA Carer should be conducted with an informant. A cut-off score of ≥3/16 should be used (these tools can be downloaded fromwww.wacha.org.au/kica.html).

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Nishtala, Prasad S., Andrew J. McLachlan, J. Simon Bell, and Timothy F. Chen. "Determinants of antipsychotic medication use among older people living in aged care homes in Australia." International Journal of Geriatric Psychiatry 25, no. 5 (May 2010): 449–57. http://dx.doi.org/10.1002/gps.2359.

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O'Connor, Daniel, Lucy Horgan, Alice Cheung, Dawn Fisher, Kuruvilla George, and Simon Stafrace. "An audit of physical restraint and seclusion in five psychogeriatric admission wards in Victoria, Australia." International Journal of Geriatric Psychiatry 19, no. 8 (July 28, 2004): 797–99. http://dx.doi.org/10.1002/gps.1154.

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Peisah, Carmelle. "Reflections on changes in defining testamentary capacity." International Psychogeriatrics 17, no. 4 (December 2005): 709–12. http://dx.doi.org/10.1017/s1041610205002875.

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Old age psychiatrists are often called upon to give expert evidence in challenges of testamentary capacity. The nineteenth-century English case, Banks v. Goodfellow (1870) remains the hallmark case for defining the criteria for testamentary capacity in Australia and other Common Law countries. However, a need to go beyond the traditional Banks and Goodfellow criteria for defining testamentary capacity (i.e. (i) understanding of the nature of a will; (ii) knowledge of the nature and extent of one's assets; (iii) being able to recall and understand the claims of potential heirs; (iv) being free of delusions or hallucinations that influence one's testamentary decisions) has been identified recently in the international literature (Shulman et al., 2005). Recent court rulings in Australia which have acknowledged the differences between the nineteenth-century context and today are therefore of international interest, as are recently adapted guidelines for clinicians asked to assess capacity.

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Eayrs, Phaedra. "Snapshot: Alzheimer's Australia pilot of an innovative approach to consumer education and training." International Psychogeriatrics 21, S1 (April 2009): S69—S71. http://dx.doi.org/10.1017/s1041610209008710.

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ABSTRACTBackground: Enabling the families and carers of people with dementia to access information, support and opportunities for education and training is critical to ensuring that both the carer and person with dementia maintain their quality of life. The Dementia Caring Pilot Project trialed an innovative approach to providing this support through offering tailored activities aimed at enhancing and developing a range of skills, both dementia-specific and life oriented.Method: Alzheimer's Australia worked closely with Commonwealth Carer Respite Centres (CCRCs) across Australia to identify potential participants, and then deliver skills enhancement activities that were suited to their individual needs.Results: Nationally, 47 CCRCs participated in the Project and 324 skills enhancement activities were provided to over 1000 participants.Conclusions: The Project was successful in giving the families and carers of people with dementia the opportunity to express the need for the capabilities they wished to enhance, and to have the opportunity of a flexible service response.

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Journal articles on the topic 'Geriatric psychiatry Australia'

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