Ipsit V Vahia

University of California, San Diego | UCSD · Department of Psychiatry

Background:Deinstitutionalization of nursing care in European counties relies profoundly on the mobilization of the caregivers and municipal homecare services. Yet, caring for home-dwelling people with dementia (PwD) can be stressful and resource demanding. The LIVE@Home.Path trial tailored, implemented, and evaluated the multicomponent LIVE interv...

Introduction:Virtual Reality (VR)-based meditation has shown to help reduce, stress, anxiety, sadness, and anger in younger adults. However, this has not been extensively studied in older adults. Furthermore, there are no standard guidelines on how VR mindfulness interventions should be implemented to ensure successful outcomes in different culture...

Symposium Overview Overall Abstract:The past decade has seen an explosion in the growth of technologies in mental health. Particularly, the scaled adoption of virtual care catalyzed by the COVID-19 pandemic has opened up new frontiers in how digital tools can be incorporated into psychiatry. No area of mental health care is as ripe for digital inno...

Background There is ample evidence in animal models that lithium increases Brain‐Derived Neurotrophic Factor (BDNF) with supporting evidence in human studies. Little is known, however, about the effects of lithium on BDNF in Alzheimer's Dementia (AD). In one study of patients with Mild Cognitive Impairment, serum BDNF increased after treatment with...

Background Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to...

Background: during pain assessment in persons unable to self-report, such as people living with dementia, vocalisations are commonly used as pain indicators. However, there is a lack of evidence from clinical practice regarding their diagnostic value and relationship with pain. We aimed to explore vocalisations and pain in people with dementia und...

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Background: A pressing challenge during the COVID-19 pandemic and beyond is to provide accessible and scalable mental health support to isolated older adults in the community. The Telehealth Intervention Program for Older Adults (TIP-OA) is a large-scale, volunteer-based, friendly telephone support program designed to address this unmet need. Meth...

What Do I Do Now? Geriatric Psychiatry answers a basic question: What are the key differences in the diagnosis and treatment of psychiatric disorders in older individuals compared to young and middle-aged adults? On the one hand, across the lifespan there are many of the same psychiatric disorders that have the same basic symptomatic manifestations...

Predominantly service‐oriented memory clinics were set up in the UK in the early 1980s, offering multidisciplinary, outpatient‐based assessment and diagnosis for mainly older people with memory and other cognitive problems in an acceptable and accessible environment. Memory clinics in the US and Western Europe were also very actively involved in re...

Introduction Virtual Reality (VR)-based meditation has shown to help increase relaxation and decrease anxiety, sadness, and anger in younger adults. However, this has not been extensively studied in older adults (Navarro-Haro et al, 2017). Furthermore, there are no standard guidelines on how VR mindfulness interventions should be implemented to ens...

Introduction The COVID-19 pandemic has necessitated that many research encounters be conducted virtually. Non clinician staff (e.g. research assistants (RAs), study coordinators, or research trainees) with varying levels of clinical training and experience are typically the primary point of contact for research participants. Consequently, they are...

Over the year 2020, two seminal events have brought the issue of healthcare inequities among communities of color, particularly African-Americans, into the forefront. The first of these is the COVID-19 pandemic which has laid bare disparities in health outcomes among communities of color. The second is the social justice movement triggered by polic...

Introduction Prior to COVID-19, psychiatric disorders affected over 10–15% of older adults (>1,000,000 Canadians aged 60+) with estimated costs of $15 billion/year. The pandemic has increased social isolation and limited resources for this vulnerable population, potentially increasing the risk of stress, anxiety, and depression, thus creating an ur...

Objectives: To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD). Design: Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path). Setting: Households in Norway immediate before and 6-9 weeks into the COVID-19 restrictions. Participants: 104 dyad...

Currently, there is a limited understanding of long-term outcomes of COVID-19, and a need for in-home measurements of patients through the whole course of their disease. We study a novel approach for monitoring the long-term trajectories of respiratory and behavioral symptoms of COVID-19 patients at home. We use a sensor that analyzes the radio sig...

Keywords Virtual Reality, Psychotherapy, Engagement, Technology

Older adults face the highest risk of COVID-19 morbidity and mortality. We investigated a one-year change in emotions and factors associated with emotional distress immediately after the onset of the pandemic, with emphasis on older age. Methods: The online Norwegian Citizen Panel includes participants drawn randomly from the Norwegian Population...

Background A case series suggested efficacy for lithium to treat agitation in dementia, but no placebo-controlled trials have been conducted. Objectives To evaluate low-dose lithium treatment of agitation in Alzheimer's disease (AD). Method In a four-site trial, patients with AD and agitation/aggression score ≥ 4 on the Neuropsychiatric Inventory...

Objectives To show the feasibility of using different unobtrusive activity-sensing technologies to provide objective behavioral markers of patients with dementia (PwD). Design Monitored the behaviors of two PwD living in memory care unit using the Oregon Center for Aging & Technology (ORCATECH) platform, and the behaviors of two PwD living in assi...

Importance Virtual reality (VR) is a promising tool with the potential to enhance care of cognitive and affective disorders in the aging population. VR has been implemented in clinical settings with adolescents and children; however, it has been less studied in the geriatric population. Objective The objective of this study is to determine the exi...

The goals of this scoping literature review are to (1) aggregate the current research involving socially assistive robots in the setting of geriatric psychiatry and (2) examine the outcome measures used in these studies and determine where the gaps and needs are. In light of the global COVID-19 pandemic, the geriatric psychiatric population in part...

Background Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction. Aims Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment o...

Background Behavioral and Psychotic Symptoms in dementia (BPSD) are associated with negative outcomes including increased mortality and morbidity, increased cost of care and caregiver burnout. Newer technologies are leading to a greatly enhanced ability to monitor and predict these symptoms using passive sensing and sophisticated analytics that rel...

Facing the change together: reflections of coping and resilience from American geriatric psychiatrists during COVID-19 - Carmen Black Parker, Malcolm P Forbes, Ipsit V Vahia, Brent P Forester, Dilip V Jeste, Charles F Reynolds

Objective: Aifred is an artificial intelligence (AI)-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician-patient interaction. Methods: Twenty psychiatry and family medicine attend...

Objectives Cognitive impairments are directly related to severity of symptoms and are a primary cause for functional impairment. Intraindividual cognitive variability likely plays a role in both risk and resiliency from symptoms. In fact, such cognitive variability may be an earlier marker of cognitive decline and emergent psychiatric symptoms than...

Reaction time (RT) and RT variability are core components of cognitive performance that can be captured through brief and easy-to-administer tasks of simple RT and choice RT. The current study aims to describe age-related differences in cognitive performance, toward better characterizing normative performance across the lifespan. We examined mean a...

[This corrects the article DOI: 10.3389/fphar.2019.01699.].

Objectives Alzheimer's Disease (AD)-related behavioral symptoms (i.e. agitation and/or pacing) develop in nearly 90% of AD patients. In this N=1 study, we provide proof-of-concept of detecting changes in movement patterns that may reflect underlying behavioral symptoms using a highly novel radio sensor and identifying environmental triggers. Metho...

Background The prevalence of dementia is expected to rapidly increase in the next decades, warranting innovative solutions improving diagnostics, monitoring and resource utilization to facilitate smart housing and living in the nursing home. This systematic review presents a synthesis of research on sensing technology to assess behavioral and psych...

Background Individuals with generalized anxiety disorder (GAD) symptoms show deficits in emotion processing, but results of prior studies have been conflicting, and little is known about developmental trajectories of emotion processing over time. We examined the association between GAD symptoms and sensitivity to recognizing emotional facial expres...

Worldwide, there is an unprecedented and ongoing expansion of both the proportion of older adults in society and innovations in digital technology. This rapidly increasing number of older adults is placing unprecedented demands on health care systems, warranting the development of new solutions. Although advancements in smart devices and wearables...

Introduction A growing body of literature indicates that clinically significant behavior markers can be extracted from mobile and communication data. However, it remains less clear whether and how such data can be incorporated into the care process, and whether they may actually have an impact in psychotherapy. Here, we describe the methodology of...

Face emotion perception is important for social functioning and mental health. In addition to recognizing categories of face emotion, accurate emotion perception relies on the ability to detect subtle differences in emotion intensity. The primary aim of this study was to examine participants' ability to discriminate the intensity of facial emotions...

BACKGROUND Obtaining collateral information from a patient is an essential component of providing effective psychiatric and psychotherapeutic care. Research indicates that patients' social and electronic media contains information relevant to their psychotherapy and clinical care. However, it remains unclear to what degree this content is being act...

Purpose of review: Recent advances in technology have changed the landscape of treatment for adults with mental illness. This review highlights technological innovations that may improve care for older adults with mental illness and neurocognitive disorders through the measurement and assessment of physical motion. These technologies include weara...

UNSTRUCTURED Worldwide, there is an unprecedented and ongoing expansion of both the proportion of older adults in society and innovations in digital technology. This rapidly increasing number of older adults is placing unprecedented demands on health care systems, warranting the development of new solutions. Although advancements in smart devices a...

The rapidly expanding population of elderly, many of whom will experience a form of mental illness, argues for more providers with geriatric psychiatry expertise. Fellowship training in geriatric psychiatry provides a comprehensive experience in the diagnosis and management of psychiatric illness in late life. Few psychiatry trainees are choosing t...

Introduction: Despite tremendous growth in the number of health applications (apps), little is known about how well these apps protect their users' health-related data. This gap in knowledge is of particular concern for apps targeting people with dementia, whose cognitive impairment puts them at increased risk of privacy breaches. In this article,...

Objective: To investigate the feasibility, safety, and utility of tablet devices as novel nonpharmacologic tools in managing older psychiatric inpatients with agitation and dementia. Methods: Thirty-six patients at a geriatric psychiatry inpatient unit were provided with tablets when agitated and used various apps on the tablet related to commun...

Our objective was to examine the association of mobile phone use and ownership with psychopathology, cognitive functioning, and functional outcome in 196 outpatients aged 40 years and older who were diagnosed with schizophrenia. Participants reported their past and current mobile phone use on a standardized self-report scale and they were administe...

This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood diso...

As the population of older Latinos in the U.S. increases, availability of culturally adapted geriatric psychiatry services is becoming a growing concern. This issue is exacerbated for rural Latino populations. In this study, we assessed whether neurocognitive assessment via telepsychiatry (TP) using a Spanish-language battery would be comparable to...

There is a growing public health interest in the aging human immunodeficiency virus (HIV)-infected (HIV+) population, although there is a dearth of research on successful aging with HIV. This study aimed to understand the risk and protective factors associated with self-rated successful aging (SRSA) with HIV. Cross-sectional, case-controlled. HIV N...

It remains unclear how augmenting anti-psychotic medications with anti-depressants impacts primary positive and negative symptoms of schizophrenia. In this study, we used data collected from a randomized trial comparing citalopram to placebo for management of subsyndromal depression (SSD) in schizophrenia and schizoaffective disorder, to assess the...

This resource contains a comprehensive review of the current research advances in late life mood disorders. This detailed review reflects the new understanding of neurobiology and psychosocial origins of geriatric mood disorders in the first decade of the 21st Century and is provided by the international group of leading experts in the field.

This study is a retrospective chart review comparing rural-dwelling Caucasian and Hispanic outpatients' attribution of depressive symptoms. Based on the data gathered at intake, Hispanics were more likely to attribute depression to curse/spell and supernatural causes, while Caucasians were more likely to attribute symptoms to hereditary factors or...

Objective: There is growing public health interest in understanding and promoting successful aging. While there has been some exciting empirical work on objective measures of physical health, relatively little published research combines physical, cognitive, and psychological assessments in large, randomly selected, community-based samples to asse...

Background: Heterogeneity in clinical outcomes may be caused by factors working at multiple levels, e.g., between groups, between subjects, or within subjects over time. A more nuanced assessment of differences in variation among schizophrenia patients and between patients and healthy comparison subjects can clarify etiology and even facilitate th...

IntroductionHistorical PerspectivesDeterminants of Successful AgingInterventions to Increase Successful AgingConclusion References

Given the rapid rate of population aging, basic science and public health efforts have increasingly focused on the determinants of successful cognitive aging. In this chapter, we review the definition and biological, psychological, and environmental determinants of cognitive health in later life. Successful cognitive aging is a multi-dimensional co...

Resilience is proposed as a significant component of successful aging. Young adult carriers of the Serotonin Transporter Polymorphism (5-HTTLPR) short(s) allele appear to have reduced resilience to stress. We examined whether the presence of the short allele was associated with poorer emotional resilience in older adults. In a cross-sectional study...

Background: There is currently a lack of consensus on the definition of successful aging (SA) and existing implementations have omitted constructs associated with SA. We used empirical methods to develop a dimensional model of SA that incorporates a wider range of associated variables, and we examined the relationship among these components using...

Behavioral activation and avoidance are well studied in depression, yet the relationship of these constructs to symptoms, cognitive ability and functioning in schizophrenia is poorly understood. In a sample of 73 middle-aged and older outpatients with schizophrenia (mean [SD] age, 50.3 [6.3] years), we examined the relationship of the Activation an...

To determine whether measures of successful aging are associated with sexual activity, satisfaction, and function in older postmenopausal women. Cross-sectional study using self-report surveys; analyses included chi-square and t-tests and multiple linear regression analyses. Community-dwelling older postmenopausal women in the greater San Diego reg...

Although there are many challenges in operationally defining and measuring positive psychological constructs, there is accumulating evidence that optimism, resilience, positive attitudes toward aging, and spirituality are related to reduced risk for morbidity and mortality in older age. This article reviews the definition, measurement, associations...

INTRODUCTION: Attitudes toward own aging (ATOA) refers to expectations about the personal experience of aging. As of now, there is limited literature that addresses the impact of ATOA on indicators of psychological, physical, and social health. In this study, we examine associations between ATOA and several measures associated with successful aging...

In this article, the authors explore trends in intended usage of atypical antipsychotics to treat dementia following the United States Food and Drug Administration advisory safety warning issued in April 2005. Analysis suggests that physician-reported intended usage of antipsychotics to treat dementia has declined by nearly 50 percent over the past...