The latest techniques for helping elderly patients https://www.thecarlatreport.com/rss en-us By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/6326 Wed, 01 Jul 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6326-cme-post-test-medical-contributors-to-psychiatric-disorders-cgpr-july-august-september-2026 The evidence base for treatment-resistant depression was largely built on younger adults. This meta-analysis asks what works in patients 55 and older. One intervention stands out, especially when suicidality is in the picture. The evidence base for treatment-resistant depression was largely built on younger adults. This meta-analysis asks what works in patients 55 and older. One intervention stands out, especially when suicidality is in the picture.

]]> http://www.thecarlatreport.com/articles/6329 Wed, 01 Jul 2026 00:00:02 -0400 https://www.thecarlatreport.com/articles/6329-when-antidepressants-stop-working-in-older-adults After reading these articles, you should be able to… After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/6335 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6335-learning-objectives-medical-contributors-to-psychiatric-disorders-cgpr-july-august-september-2026 Older adults are increasingly turning to supplements and substances marketed for memory and cognition, and they’re asking their psychiatrists about them. Here’s what the evidence supports, and how to have that conversation without dismissing or overpromising. Older adults are increasingly turning to supplements and substances marketed for memory and cognition, and they’re asking their psychiatrists about them. Here’s what the evidence supports, and how to have that conversation without dismissing or overpromising.

]]> http://www.thecarlatreport.com/articles/6334 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6334-nootropics-and-cognitive-health-in-older-adults Prion disease is uncommon but not rare, and psychiatrists are often the first clinicians to see it. Dr. Alice Uflacker explains how to recognize rapidly progressive cognitive and behavioral decline, when to refer, and how modern tools like MRI and RT-QuIC have transformed diagnosis. Palliative planning and family counseling are also addressed. Prion disease is uncommon but not rare, and psychiatrists are often the first clinicians to see it. Dr. Alice Uflacker explains how to recognize rapidly progressive cognitive and behavioral decline, when to refer, and how modern tools like MRI and RT-QuIC have transformed diagnosis. Palliative planning and family counseling are also addressed.

]]> http://www.thecarlatreport.com/articles/6333 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6333-recognizing-and-managing-prion-disease CGPR_QA1Alice Uflacker_photo_sm.png Nutrition is already part of psychiatric pathophysiology, although it just rarely makes it into the visit. Dr. Rani Polak, a physician-chef and lifestyle medicine specialist, explains how psychiatrists can ask about diet, what nutritional deficiencies to screen for, and how cooking itself can restore structure, agency, and connection in older adults. Nutrition is already part of psychiatric pathophysiology, although it just rarely makes it into the visit. Dr. Rani Polak, a physician-chef and lifestyle medicine specialist, explains how psychiatrists can ask about diet, what nutritional deficiencies to screen for, and how cooking itself can restore structure, agency, and connection in older adults.

]]> http://www.thecarlatreport.com/articles/6332 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6332-food-as-medicine-in-older-adults CGPR_QA2 Rani Polak_photo_sm.png Choosing the right treatment is only half the job. This article focuses on how to build care plans older adults can follow using teach-back, simplified written instructions, caregiver engagement, and trusted digital resources. Practical strategies address underuse of effective treatments, misuse from unclear plans, and overuse driven by complexity rather than clinical need. Choosing the right treatment is only half the job. This article focuses on how to build care plans older adults can follow using teach-back, simplified written instructions, caregiver engagement, and trusted digital resources. Practical strategies address underuse of effective treatments, misuse from unclear plans, and overuse driven by complexity rather than clinical need.

]]> http://www.thecarlatreport.com/articles/6331 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6331-effectively-translating-knowledge-into-practice CGPR_JulyAugSept2026_Image.jpg How much exercise does it take to protect against depression and anxiety in older adults? A large accelerometer-based study puts a number on it, and finds the biggest gains happen at the very bottom of the activity spectrum. How much exercise does it take to protect against depression and anxiety in older adults? A large accelerometer-based study puts a number on it, and finds the biggest gains happen at the very bottom of the activity spectrum.

]]> http://www.thecarlatreport.com/articles/6330 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6330-physical-activity-and-mental-health-how-much-is-enough What if the key to protecting the aging brain isn’t how long patients exercise, but how hard? A comprehensive review suggests cardiorespiratory fitness — not step counts — is the variable that matters most for dementia prevention. What if the key to protecting the aging brain isn’t how long patients exercise, but how hard? A comprehensive review suggests cardiorespiratory fitness — not step counts — is the variable that matters most for dementia prevention.

]]> http://www.thecarlatreport.com/articles/6328 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6328-vigorous-exercise-cuts-dementia-risk Tau-PET is the gold standard for detecting preclinical Alzheimer’s pathology, but it costs thousands and isn’t widely available. What if a $200 blood test could do the same job? Tau-PET is the gold standard for detecting preclinical Alzheimer’s pathology, but it costs thousands and isn’t widely available. What if a $200 blood test could do the same job?

]]> http://www.thecarlatreport.com/articles/6327 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6327-a-simple-blood-test-matches-a-5-000-scan-for-alzheimers Drug-drug interactions are critical to monitor in older adults due to the high prevalence of polypharmacy in this population. Drug-drug interactions are critical to monitor in older adults due to the high prevalence of polypharmacy in this population. 

]]> http://www.thecarlatreport.com/blogs/1/post/6318 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6318-free-sample-section-important-drug-drug-interactions-in-older-adults GFB1e.png Could a shingles vaccine lower dementia risk? A natural experiment in Wales—where vaccine eligibility turned on a single birthdate—found a 20% relative reduction in new dementia diagnoses over seven years. It's not proof of causation, but it's the strongest quasi-experimental evidence yet, and one more reason to make the recommendation. Could a shingles vaccine lower dementia risk? A natural experiment in Wales—where vaccine eligibility turned on a single birthdate—found a 20% relative reduction in new dementia diagnoses over seven years. It's not proof of causation, but it's the strongest quasi-experimental evidence yet, and one more reason to make the recommendation.

]]> http://www.thecarlatreport.com/articles/6266 Sat, 02 May 2026 14:11:51 -0400 https://www.thecarlatreport.com/articles/6266-herpes-zoster-vaccination-and-dementia-risk After reading these articles, you should be able to… After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/6272 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6272-learning-objectives-adhd-in-older-adults-cgpr-april-may-june-2026 By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/6263 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6263-cme-post-test-adhd-in-older-adults-cgpr-april-may-june-2026 Learn how to identify good benzodiazepine deprescribing candidates, frame the deprescribing conversation effectively, and design a gradual taper—with adjunctive options for tough withdrawals. Learn how to identify good benzodiazepine deprescribing candidates, frame the deprescribing conversation effectively, and design a gradual taper—with adjunctive options for tough withdrawals.

]]> http://www.thecarlatreport.com/articles/6271 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6271-how-to-deprescribe-benzodiazepines-in-older-adults CGPR_AprilMayJune_2026_Issue_Image.jpg Most older adults with ADHD were never diagnosed, and most clinicians never think to look. Dr. Goodman explains how to confirm childhood onset, untangle ADHD from cognitive decline and mood disorders, and make the case for why identifying this disorder in late life can be genuinely life-changing. Most older adults with ADHD were never diagnosed, and most clinicians never think to look. Dr. Goodman explains how to confirm childhood onset, untangle ADHD from cognitive decline and mood disorders, and make the case for why identifying this disorder in late life can be genuinely life-changing.

]]> http://www.thecarlatreport.com/articles/6270 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6270-uncovering-adhd-in-late-life CGPR_QA1 David Goodman_new photo_forposting_sm.png Not all gradual memory loss is Alzheimer's disease. Nearly 40% of adults over 80 have LATE, a distinct TDP-43 pathology that mimics AD, progresses more slowly, and won't respond to anti-amyloid therapies. Here's how to recognize it and what to tell families. Not all gradual memory loss is Alzheimer's disease. Nearly 40% of adults over 80 have LATE, a distinct TDP-43 pathology that mimics AD, progresses more slowly, and won't respond to anti-amyloid therapies. Here's how to recognize it and what to tell families.

]]> http://www.thecarlatreport.com/articles/6269 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6269-late-the-other-common-dementia Stimulants aren't off-limits in older adults, but the calculus is different. Dr. Anbarasan explains how to assess cardiovascular risk before prescribing, when nonstimulants make more sense, and how polypharmacy complicates nearly every medication decision in this population. Stimulants aren't off-limits in older adults, but the calculus is different. Dr. Anbarasan explains how to assess cardiovascular risk before prescribing, when nonstimulants make more sense, and how polypharmacy complicates nearly every medication decision in this population.

]]> http://www.thecarlatreport.com/articles/6268 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6268-tailoring-adhd-medication-for-older-patients Standard depression screeners don't ask about irritability, but in older adults it's often the more visible symptom. More than half of depressed patients in this study endorsed it, and severity climbed when family noticed it too. One extra question, asked of the right person, may catch what the PHQ-9 misses. Standard depression screeners don't ask about irritability, but in older adults it's often the more visible symptom. More than half of depressed patients in this study endorsed it, and severity climbed when family noticed it too. One extra question, asked of the right person, may catch what the PHQ-9 misses.

]]> http://www.thecarlatreport.com/articles/6267 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6267-irritability-a-missing-clue-in-late-life-depression Mediterranean diet adherence was linked to lower odds of depressive symptoms in older women (but not in men). Fish intake appeared to drive much of the effect, with fresh fish twice weekly showing the strongest signal. For patients already asking what they can do, this Italian cohort offers a specific, low-risk place to start. Mediterranean diet adherence was linked to lower odds of depressive symptoms in older women (but not in men). Fish intake appeared to drive much of the effect, with fresh fish twice weekly showing the strongest signal. For patients already asking what they can do, this Italian cohort offers a specific, low-risk place to start.

]]> http://www.thecarlatreport.com/articles/6265 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6265-mediterranean-diet-and-depression-in-older-women-fish-may-be-driving-the-effect Telling patients to "eat healthy" may not be specific enough. This large prospective cohort found that each 10% increase in ultra-processed food intake raised cognitive impairment risk by 16% and stroke risk by 8%—independent of Mediterranean, DASH, and MIND diet scores. How food is processed may matter as much as what's on the plate. Telling patients to "eat healthy" may not be specific enough. This large prospective cohort found that each 10% increase in ultra-processed food intake raised cognitive impairment risk by 16% and stroke risk by 8%—independent of Mediterranean, DASH, and MIND diet scores. How food is processed may matter as much as what's on the plate.

]]> http://www.thecarlatreport.com/articles/6264 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6264-ultra-processed-food-linked-to-cognitive-decline-and-stroke-independent-of-diet-quality Can brain stimulation help preserve function in Alzheimer’s disease? A year-long randomized trial suggests that PC- rTMS modestly slows cognitive and functional decline, offering a potential nonpharmacologic adjunct as clinicians seek alternatives to long-term medication burden. Can brain stimulation help preserve function in Alzheimer’s disease? A year-long randomized trial suggests that PC- rTMS modestly slows cognitive and functional decline, offering a potential nonpharmacologic adjunct as clinicians seek alternatives to long-term medication burden.

]]> http://www.thecarlatreport.com/articles/5873 Mon, 23 Feb 2026 20:09:54 -0500 https://www.thecarlatreport.com/articles/5873-stimulating-the-precuneus-may-slow-alzheimers-decline Donepezil is the cholinesterase inhibitor with the longest track record and with which we have the most experience. It is generally considered the first-line agent for dementia. Though not a cure, it delays dementia progression by six to 12 months. Donepezil is the cholinesterase inhibitor with the longest track record and with which we have the most experience. It is generally considered the first-line agent for dementia. Though not a cure, it delays dementia progression by six to 12 months.

]]> http://www.thecarlatreport.com/articles/5025 Thu, 01 Jan 2026 13:11:35 -0500 https://www.thecarlatreport.com/articles/5025-donepezil-aricept-adlarity-fact-sheet-g Galantamine has no appreciable benefit over donepezil; however, its availability in a liquid formulation is helpful for patients who have difficulty swallowing pills. Galantamine has no appreciable benefit over donepezil; however, its availability in a liquid formulation is helpful for patients who have difficulty swallowing pills.

]]> http://www.thecarlatreport.com/articles/5026 Thu, 01 Jan 2026 13:10:07 -0500 https://www.thecarlatreport.com/articles/5026-galantamine-razadyne-razadyne-er-fact-sheet-g Antipsychotics can reduce severe agitation or psychosis in dementia but at significant cost. Learn when to use them. Antipsychotics can reduce severe agitation or psychosis in dementia but at significant cost. Learn when to use them.

]]> http://www.thecarlatreport.com/articles/5877 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5877-prescribing-antipsychotics-for-neuropsychiatric-symptoms-in-dementia CGPR_Deprescribing_JanFebMar2026.jpg Stopping psychiatric medications can be harder than starting them. Dr. Mark Horowitz explains why withdrawal happens, how hyperbolic tapers work, and how to deprescribe safely while maintaining stability and trust. Stopping psychiatric medications can be harder than starting them. Dr. Mark Horowitz explains why withdrawal happens, how hyperbolic tapers work, and how to deprescribe safely while maintaining stability and trust.

]]> http://www.thecarlatreport.com/articles/5876 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5876-clinical-pearls-for-hyperbolic-tapering-of-psychiatric-medications-in-older-adults CGPR_JanFebMar 2026 QA1_Mark Horowitz_photo_sm.png Not all late-life low mood requires medication. This article explores how apathy differs from depression and how behavioral activation, microgoals, and lifestyle interventions can restore motivation, improve cognition, and reduce unnecessary antidepressant exposure in older adults. Not all late-life low mood requires medication. This article explores how apathy differs from depression and how behavioral activation, microgoals, and lifestyle interventions can restore motivation, improve cognition, and reduce unnecessary antidepressant exposure in older adults.

]]> http://www.thecarlatreport.com/articles/5875 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5875-behavioral-strategies-for-apathy-and-late-life-depression Lithium remains a powerful mood stabilizer in late life, but aging kidneys change the equation. Dr. Michael Gitlin reviews kidney-conscious dosing, monitoring by eGFR, and shared decision-making strategies to balance lithium’s benefits against renal risk in older adults. Lithium remains a powerful mood stabilizer in late life, but aging kidneys change the equation. Dr. Michael Gitlin reviews kidney-conscious dosing, monitoring by eGFR, and shared decision-making strategies to balance lithium’s benefits against renal risk in older adults.

]]> http://www.thecarlatreport.com/articles/5874 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5874-using-lithium-in-older-adults-with-chronic-kidney-disease Jaime A.B. Wilson, PhD, ABN, ABPP, MSCP. Dr. Wilson has no financial relationships with companies related to this material. Jaime A.B. Wilson, PhD, ABN, ABPP, MSCP. Dr. Wilson has no financial relationships with companies related to this material. 

]]> http://www.thecarlatreport.com/articles/5872 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5872-olive-oil-linked-to-lower-dementia-mortality There is no cure for major neurocognitive disorder (MND), but several medications mitigate the progression of cognitive and functional decline. There is no cure for major neurocognitive disorder (MND), but several medications mitigate the progression of cognitive and functional decline.

]]> http://www.thecarlatreport.com/articles/5202 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5202-major-neurocognitive-disorder-medication-treatment