Clinical Geriatrics

Introduction
Mild cognitive impairment (MCI) is an emerging term for an intermediate stage between cognitive changes of normal aging and dementia in elderly people. While normal aging is a gradual decline in cognition, MCI refers to cognitive impairment beyond that expected for age and education, but does not meet criteria for dementia.¹ As the population ages and longevity increases, physicians will increasingly see patients experiencing memory loss, so learning an approach to states such as MCI is now warranted. Primary care physicians should be aware that dementia

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral condition characterized by symptoms of impulsitivity, distractibility, and impaired concentration stamina. ADHD is present throughout the lifecycle and is associated with significant functional and emotional impairment.1,2 When studied in all other age groups, ADHD demonstrates a consistency of epidemiology and prognosis that would predict similar findings in older adults.3 However, while very little is known regarding prevalence rates, morbidity, and prognosis of ADHD in adults over age

Case Presentation
Mr. P* is a 71-year-old widowed male resident of an assisted living facility who was recently diagnosed with Parkinson’s disease (PD), depression, and generalized anxiety. Mr. P had no prior history of mental illness. He acknowledged some regular alcohol use as a young man, consisting of drinking three to four alcoholic beverages per day over many years, but denied any alcohol-related blackouts, seizures, or treatment. Recent symptoms of anxiety and depression were attributed to a prolonged grief reaction from the loss of his wife ju

This is the first part of a two-part series that examines central serotonin syndrome in the elderly. Part I reviews the history and prevalence of the disorder, causative agents, presentation and diagnostic criteria, and ways to distinguish the condition from other similar states, such as neuroleptic malignant syndrome. Part II will focus on the pathophysiology, opiate and psychiatric drug interactions, and treatment approaches for central serotonin syndrome in the elderly.

INTRODUCTION
The term serotonin syndrome was first used in a case report in 1982, but study of th

Behavioral and psychological symptoms of dementia (BPSD) is a term used to describe a heterogeneous group of noncognitive symptoms and behaviors that occurs in people with dementia.1 The term BPSD was defined by the International Psychogeriatric Association at the Update Consensus Conference, entitled “Behavioral and Psychological Symptoms of Dementia (BPSD): A Clinical and Research Update,” held in May 1999, as “Symptoms of disturbed perception, thought content, mood or behavior that frequently occur in patients with dementia.”2 The various behavioral symptoms described include physic