Alzheimer’s disease is a progressive disease that impairs cognitive and functional abilities. Currently, there is no cure and it is estimated there will be 81 million cases of Alzheimer’s disease by 2040. Life for the individual with Alzheimer’s disease, and their family, changes drastically when the affected individual experiences significant impairments in cognitive or functional ability (severe dementia), is placed in a skilled nursing home facility (institutionalization), or passes away (death). Until a cure is discovered, it will be important to identify modifiable factors that influence progression to severe dementia, institutionalization, and death. Three hundred thirty-five participants who were living in the community were followed after the onset of Alzheimer’s disease and continued until they left the study or the study period ended. Participants completed neuropsychological assessments at each visit. Visits occurred as close to every 6 months as possible and the mean number of visits was 5.32 (SD = 3.46). Outcomes of interest were severe dementia, institutionalization, and death. Predictor variables were hypertension, stroke, congestive heart failure, number of prescription medications being taken, General Medical Health Rating (GMHR) score, and Charlson Comorbidity Index score. Cox Regression was utilized to identify associations with progression to the specified outcomes. GMHR score, congestive heart failure, and number of prescription medications were associated with progression to severe dementia. The number of prescription medications was also associated with nursing home placement. GMHR score, stroke, and number of prescription medications were associated with death. These findings are important because they contribute to a better understanding of how measures of medical health, certain medical conditions, and potentially their prevention or treatment may help those with Alzheimer’s disease sustain a higher quality of life.

Millions of people in the United States are living with a serious mental illness or substance abuse disorder. These individuals suffer from a high rate of medical co-morbidities. Because of this, patients hospitalized on medical-surgical units for medical reasons often are living with psychiatric/substance abuse co-morbidities, which are not addressed during their medical hospital admission. These patients can be perceived as difficult and even dangerous by nurses who have not received training or education in mental health care. The purpose of this project is to measure medical-surgical nurse’s perceptions of their abilities to recognize psychiatric/substance abuse symptoms and their perception of self-competency to provide appropriate interventions. This project utilized the Behavioral Health Care Competency (BHCC) instrument to measure hospital nurse perceptions of behavioral healthcare competency to determine if additional education and training are needed. The BHCC tool was administered to 19 nurses working on two medical-surgical units in Southern Arizona. Findings support the need for educational intervention, especially in the areas of psychotropic medication recommendation and intervention for patients experiencing hallucinations.

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Abstract Background: The world population is aging and the number of older adults with bipolar disorder is increasing. Digital technologies are viewed as a framework to improve care of older adults with bipolar disorder. This analysis quantifes Internet use by older adults with bipolar disorder as part of a larger survey project about information seeking. Methods: A paper-based survey about information seeking by patients with bipolar disorder was developed and translated into 12 languages. The survey was anonymous and completed between March 2014 and January 2016 by 1222 patients in 17 countries. All patients were diagnosed by a psychiatrist. General estimating equations were used to account for correlated data. Results: Overall, 47% of older adults (age 60 years or older) used the Internet versus 87% of younger adults (less than 60 years). More education and having symptoms that interfered with regular activities increased the odds of using the Internet, while being age 60 years or older decreased the odds. Data from 187 older adults and 1021 younger adults were included in the analysis excluding missing values. Conclusions: Older adults with bipolar disorder use the Internet much less frequently than younger adults. Many older adults do not use the Internet, and technology tools are suitable for some but not all older adults. As more health services are only available online, and more digital tools are developed, there is concern about growing health disparities based on age. Mental health experts should participate in determining the appropriate role for digital tools for older adults with bipolar disorder.