C05 – Academy Update Course with the Canadian Academy of Geriatric Psychiatry: The Art of Virtual Cognitive Assessments
Friday, Oct. 20
14:30 – 16:30 (2 hrs)
Meeting Room: Junior Ballroom AB (3rd floor – North Tower)
Shabbir Amanullah*, MD, FRCPC; Amer Burhan, MB ChB, MSc, FRCPC; Angela Golas, MD, FRCPC; Simon JC Davies, DM, MBBS, MRCPsych;
Supported by the Canadian Academy of Geriatric Psychiatry
CanMEDS Roles:
- Medical Expert
At the end of this session, participants will be able to: 1) Describe key tools and strategies for conducting and interpreting a virtual geriatric cognitive assessment; 2) Appreciate the link between mood, executive dysfunction, and gait abnormalities in late-life depression; and 3) Explain the evidence base for drug treatment, with particular reference to older adults, across anxiety disorders and associated conditions.
Dr. Golas will review the art of the virtual consultation for elderly patients and their families, including tools and strategies for optimizing an evidence-based virtual geriatric cognitive assessment. She will also explore practical approaches to interpreting cognitive testing results to aid in generating a differential diagnosis.
Dr. Burhan will present on the emerging triad of mood, cognitive dysfunction, and gait changes in seniors. Using dual task cost on gait, Dr. Burhan and collaborators have shown that seniors with depression have a signal of impairment intermediate between mild cognitive impairment and healthy control subjects. This was followed by a systematic review demonstrating the presence of a tirade of mood, cognitive, and gait impairment in the general population, offering the opportunity to explore potential modifications of this triad to reduce the risk of cognitive decline and gait disturbances in late-life depression.
Dr. Davies will present an overview of the evidence for drug treatment efficacy across anxiety disorders and associated conditions (e.g., obsessive–compulsive disorder, post-traumatic stress disorder) with particular reference to prescribing in older adults. This will include evidence relating to the most used drug classes (selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors) and to a discussion of other medication strategies, including further antidepressants (e.g., mirtazapine, vortioxetine, levomilnacipran), pregabalin, buspirone, the role of benzodiazepines and antipsychotics (monotherapy and augmentation) as well as the potential for use of ketamine in anxiety disorders.
References:
- Geddes MR, O’Connell ME, Fisk JD, et al. Remote cognitive and behavioral assessment: report of the Alzheimer Society of Canada task force on dementia care best practices for COVID-19. Alzheimers Dement (Amst) 2020;12(1):e12111.
- Patience J, Lai KSP, Russell E, et al. Relationship between mood, thinking, and walking: a systematic review examining depressive symptoms, executive function, and gait. Am J Geriatr Psychiatry 2019;27(12):1375–1383.
