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Byline: Susan McPherson Since the sudden onset of lockdowns and remote work a year ago, reliance on digital platforms has grown exponentially. For example, Zoom Video Communications' revenue in 2020 [...]

Byline: Susan McPherson It was quite a year in the world of corporate activism. In 2020, businesses and their leaders stood up like never before. CEOs and their boards halted [...]

Objective: This report provides a description of the prevalence and clinical features of the major depressive syndrome of Alzheimer's disease using data derived from structured diagnostic assessments of 243 patients with probable Alzheimer's disease and 151 nondemented elderly comparison subjects. Method: Subjects were characterized by a consortium of four Alzheimer's disease research centers and the Geriatric Psychiatry Branch of the National Institute of Mental Health. All sites administered the Clinical Assessment of Depression in Dementia, a structured, anchored diagnostic interview that was developed to reliably diagnose and characterize major depressive episodes in this population. Results: Despite the use of a common, reliable methodology for the assessment and diagnosis of major depressive episodes, the prevalence of major depression in Alzheimer's disease ranged widely from 22.5% to 54.4% across the recruitment sites. The prevalence of major depressive episodes among Alzheimer's disease patients in the aggregate sample exceeded that for elderly comparison subjects and reached nearly 50% among the most severely demented patients. Alzheimer's disease patients with a current major depressive episode had earlier mean ages at onset, a higher mean Hamilton Depression Rating Scale score, and were more likely to be experiencing psychotic symptoms than those who had not developed a major depressive episode. Although the major depressive episodes of Alzheimer's disease patients and nondemented elderly comparison subjects included similar numbers of depressive symptoms, patients with Alzheimer's disease were more likely to report a diminished ability to concentrate or indecisiveness and less likely to experience sleep disturbances and feelings of worthlessness or excessive guilt during their major depressive episodes. None of the clinical features of major depression differed significantly in frequency among depressed Alzheimer's disease patients with mild, moderate, or severe dementia. Concurrent psychotic symptoms progressively increased with dementia severity. Conclusions: The high rate of major depressive episodes that occur after the onset of cognitive impairment among patients with Alzheimer's disease (the majority of whom had no premorbid history of major depression), common emergence in the early stages of dementia when symptoms of cognitive impairment are least likely to contribute to the syndromal diagnosis of major depression, and differences in the clinical presentations of the major depressive episodes of Alzheimer's disease patients and nondemented elderly comparison subjects, all support the validity of the major depressive syndrome of Alzheimer's disease. Our findings suggest that the major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults.

An excerpt from the article "The lost art of connecting: The gather, ask, do method for building meaningful business relationships" by Susan McPherson.

The article reflects the views of author on social activism in the business world, and how business leaders have to build corporate gains with the help of 2021 trends that will dominate the corporate social responsibility movement. Topics include boards halted campaign contributions to politicians who spread lies about a stolen presidential election; and , companies were challenged to evaluate their policies, practices, philanthropy, investments.

Categorising mental disorders for purposes of diagnosis, research and practice has historically been justified on philosophical terms as a pragmatic activity; categories which have been subject to wide-ranging philosophical critique have been defended on the grounds that they serve as heuristic devices providing loose representations of shared experiences, not labels for real structures. In acknowledgement of this, there has been increasing recognition that subclassifying multiple discrete forms of persistent depression moves too far away from the notion of a heuristic and that attempts to create more precise categories become less clinically useful. Hence the most recent Diagnostic and Statistical Manual of Mental Disorders (V.5) and International Classification of Diseases (V.11) both group persistent forms of depression together. However, the UK National Institute for Health and Care Excellence has delineated certain subclassifications of persistent depression in its new guideline, which grossly distorts the phenomenology of depression. This approach commits a fundamental philosophical error in conflating absence of knowledge with knowledge of absence. In this sense, the new guideline appears to be engaging in an activity akin to the digital game Minecraft, in which the craft of building structures from units of construction is largely divorced from the laws of physics. The risk of ignoring these philosophical errors and making false claims about scientific plausibility is that the guideline recommendations inevitably represent a highly distorted phenomenology of depression and will be of very little value to patients or practitioners looking for guidance on best possible treatment options.

Dementia is a common condition of the elderly; yet it often is unrecognized by primary care providers. This article presents a compelling argument for screening for dementia in a primary care setting. It also provides a protocol for effective screen-ing, instructions on how to use it, and steps to follow if the screening indicates the patient may have dementia. [ABSTRACT FROM AUTHOR]

Apathy is a common behavioral disturbance in patients with Alzheimer's disease (AD). Recent studies have linked the presence of apathy to alterations in frontal lobe functions, but few studies have explored the relationship using standard neuropsychological measures in patients with AD. We administered a comprehensive battery of neuropsychological tests and a behavior rating scale to 80 patients with AD. We explored the relationship of apathy to executive dysfunction. AD patients with apathy performed significantly worse on tests of executive function (WAIS–R Digit Symbol, Trail-Making, Stroop Color Interference Test) than AD patients without apathy. The presence of dysphoria did not modify these results and no significant relationships were found between tests of executive functions and dysphoria. Performance on executive measures as a group were effective in correctly classifying patients as apathetic or nonapathetic with 75% accuracy. Neuropsychological measures not dependent on executive functions were unrelated to apathy. Apathy is associated with executive dysfunction and not with other neuropsychological deficits. Apathy is distinct from dysphoria. (JINS, 2002, 8, 373–381.)

Recent studies have identified cognitive deficits in semantic memory and verbal language abilities among women with Alzheimer's disease (AD). Few studies to date have explored gender differences in episodic memory function in AD. The present study compared the performance of men and women diagnosed with AD on a battery of neuropsychological measures. Results indicated the presence of gender-related cognitive deficits on tasks of confrontation naming, expressive world knowledge, and both episodic and semantic memory for women with AD, relative to findings in men.

This study examined the relationship between subjective memory complaints and performance on tests of memory by relatives of patients with probable Alzheimer's disease (AD) and by older adults without a family history of dementia. Relatives of AD patients did not differ significantly from controls either in level of complaint or in performance on neuropsychological tests. However, among relatives of patients with early-onset AD, significant correlations were found between performance on memory tests and self-rated changes in everyday memory. These findings raise the possibility that relatives who have entered the age range in which their parents or siblings developed dementia symptoms are monitoring their memory performance more diligently than relatives of patients whose illness began at much later ages or persons who have no close relatives with AD.

Cognitive performance of 32 siblings and children of patients with probable Alzheimer disease was assessed longitudinally over an interval averaging 4 years. Mean scores were within normal limits for age on all measures at both test times. However, relatives of patients with early-onset dementia (≤ 67 years) were more likely to show a decline in performance from the first to second testing than relatives of patients with late-onset dementia. Additional follow-up will be needed to determine the reliability of performance trajectories and to assess whether mild cognitive changes are related to future dementia. However, findings suggest that it may be important to consider family history of dementia in studies of normal cognitive aging.

Vascular dementia (VaD) is the second most common cause of dementia in the elderly. Neuropsychologically, VaD has been characterized traditionally as having a “patchy” pattern of cognitive deficits. Newly developed diagnostic criteria for VaD suggest that this “patchy” pattern is associated with one type of VaD—multiple cortical infarctions, and that several additional subtypes of VaD exist, each featuring a characteristic pattern of neuropsychological deficits. Strategic infarct dementias have unique features that reflect the specific brain region affected. Lacunar state and Binswanger's disease produce subcortical dementia with disproportionate executive dysfunction. The profile of neuropsychological disturbances observed in VaD patients provides important insight into the localization and pathophysiology of the underlying cerebrovascular disease.

The successful management of pain in the elderly requires a careful analysis of psychosocial, behavioral, cognitive, spiritual, and cultural contributions to the pain. This multidimensional level of analysis will lead to a pain regimen that includes the appropriate pharmacologic and nonpharmacologic factors that will in turn lead to increased patient satisfaction and autonomy while enhancing compliance. The specific inclusion of behavioral-cognitive techniques has been shown to be as effective in the elderly as they are in younger populations when presented in a manner consistent with their mental status. Compensating for the changes associated with normal aging by presenting the material in a brief, concrete, and highly organized fashion leads to enhanced patient autonomy and self-esteem without the addition of potentially damaging side effects.

Self-ratings of everyday memory function and performance on memory tests were examined in 61 first-degree relatives of patients with Alzheimer's disease (AD) and 41 matched controls without a family history of dementia. Subjective memory ratings were significantly related to depression scores, despite the low levels of depressive symptoms in this healthy sample. Relatives of patients with early-onset dementia had higher levels of memory complaints compared to control participants, mediated in part by higher levels of depressive symptoms among these relatives. For the sample as a whole, there was little relationship between subjective memory ratings and performance on memory tests, but among early-onset AD relatives, subjective perceptions of memory decline were associated with poorer memory performance.

The nineteenth century British antivaccination movement attracted popular and parliamentary support and ultimately saw the 1853 law which had made smallpox vaccination compulsory nullified by the 1898 ‘conscientious objector’ clause. In keeping with popular public health discourse of the time, the movement had employed rhetoric associated with sanitary science and liberalism. In the early twentieth century new discoveries in bacteriology were fuelling advances in vaccination and the medical establishment was increasingly pushing for public health to move towards more interventionist medical approaches. With the onset of war in 1914, the medical establishment hoped to persuade the government to introduce compulsory typhoid inoculation for soldiers. This article analyses antivaccination literature, mainstream newspapers and medical press along with parliamentary debates to examine how the British antivaccination movement engaged with this new threat of compulsion by expanding the rhetoric of ‘conscience’ and emphasising medical freedom while also asserting scientific critique concerning the effectiveness of vaccines and the new laboratory based diagnostic practices. In spite of ‘conscience’ fitting well with an emerging public health discourse of individual subjectivity, the mainstream press ridiculed the idea of working-class soldiers having a conscience, coalescing around the idea that ‘conscientious objection’ be reserved for spiritual, philosophical and educated men who objected to military service. Moreover, in spite of engaging in reasoned scientific critique, parliament and press consorted in the demarcation of scientific knowledge as exclusive to medical scientists, reflecting a growing allegiance between the state and the medical establishment during the war. Any scientific arguments critical of medical orthodoxy were subjugated, labelled as ‘crank’ or ‘faddist’ as well as unpatriotic. The antivaccination narratives around conscience contributed to or were part of an evolving discourse on consent and ethics in medicine. Potential parallels are drawn with current and likely future debates around vaccination and counterhegemonic scientific approaches.

The author discusses the things that an angel investor offers which include talent, connection to other investors, and advice and moral support for the business.

A list of the women who are key architects for change and empowering women worldwide is presented including Tory Burch in philanthropy Liye Kebede for maternal health and Jacqueline Novogratz for social entrepreneurs.