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AAGP president's column: Raise your hand and be heard!
By Susan K. Schultz, MD
Please remember that our Member-in-Training (MIT) group is eagerly awaiting your responses to our member survey to help create materials to reach out to potential new members in training. Your feedback will be valuable in so many ways as we continue to strengthen the AAGP to meet the challenges of the future. While the survey should only take a couple minutes, it gives our members a chance to describe how long they've been in practice, their payors, practice settings, etc., as well as free text options at the end to provide individual comments. This feedback is priceless not only to the MIT group but to our leadership as we think carefully about how to best position the AAGP to have a voice in accountable care, interdisciplinary practice, training requirements, the list goes on!

Please take a moment to click on this survey link, https://www.surveymonkey.com/s/67W678S, and tell us about what you do and what aspects of the field of geriatric psychiatry mean the most to you. Please respond by July 11.

In closing, please raise your hand if the voice of Casey Kasem from his "American Top 40" show is burned into your long-term verbal memory. With his recent death, you may have noticed the media discussion of Lewy Body Disease and how it affected his later days. There have been comments about an early "misdiagnosis" of Parkinson's disease, which is not surprising to AAGP members as we have a unique understanding of the trajectory of these illnesses. As conditions such as LBD enter the media stream, it underscores the importance of our voice being heard in the public dialogue when prominent personalities encounter the very illnesses that we think about most every day. The case of dear Mr. Kasem calls to our attention the key issues of family involvement in care, end-of-life planning, and careful medical decision-making for complex neurodegenerative diseases. AAGP members understand that Lewy Body disease requires exquisite attention to judicious management of medications and comorbidities, with family feedback being priceless every step of the way. In my view, this draws our attention once again to our core mission of beneficence in care and "being there" for our patients every step of the way.

Please help our mission by filling out the survey and guide the AAGP leadership forward. Finally, as Mr. Kasem would say at the end of his shows: "Keep your feet on the ground and keep reaching for the stars."
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ACGME Psychiatry Subspecialty Milestone Work Groups
During the Accreditation Council for Graduate Medical Education (ACGME) Psychiatry Subspecialty Milestone Work Group meetings June 6-7, AAGP members Josepha Cheong, Maria Llorente, Sandra Swantek, Susan Maixner, and Ike Ahmed (chair) worked to define the milestones for the medical knowledge and patient care core competencies that are unique to geriatric psychiatry. They also revised the subspecialty milestones for the other four core competencies, which Ahmed and other subspecialty milestones committee chairs had worked on to make them specific for geriatric psychiatry. They have now refined their draft of the milestones via continued teleconference discussion and the draft will go forward to the ACGME Milestone Advisory Committee for review, which has representation from all of the psychiatry subspecialties, and on which AAGP Secretary/Treasurer Melinda Lantz serves as the geriatric psychiatry advisor. Following Advisory Committee review, the milestones will go out to the Geriatric Psychiatry Training Directors for feedback. This feedback will be evaluated and used to create the final milestone definitions, which should be posted on the ACGME website in the fall of this year. Stay tuned!


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AAGP call for nominations for board director and officer positions: Applications due July 31
The AAGP Nominations Committee is seeking qualified candidates to run for director and officer positions in the 2014 election. All candidates must have a minimum of three years in the organization to be eligible to run. Officer positions are open to Psychiatrist Members and Retired Members. One non-psychiatrist board director position is also open.

Five positions on the AAGP Board of Directors will be open at the conclusion of AAGP's 2015 Annual Meeting in New Orleans:
  • President-Elect
  • Secretary/Treasurer-Elect
  • 2 At-Large Board positions (psychiatrist member)
  • 1 At-Large Board position (non-psychiatrist member)
Those interested in being considered for either a director or officer position are encouraged to submit a completed application to the Nominations Committee.

For Board of Directors
Term of Service: 3 years (2015-2018)
  • 2 Member (psychiatrist) positions open in 2015
  • 1 Member (non-psychiatrist) position open in 2015


  • For Officer Positions
    President-Elect
    Term of Service: A total of 3 years: successive one-year terms as President-Elect, President, and Immediate Past President

    Secretary/Treasurer-Elect
    Term of Service: A total of 2 years: successive one-year terms as Secretary/Treasurer-Elect and Secretary/Treasurer

    To apply for a director or officer position: email the required documents to main@aagponline.org no later than July 31, 2014. For more information about board and officer responsibilities, desired criteria, and application forms go to www.AAGPonline.org/election.



    AAGP call for candidates for MIT member of Board of Directors: Applications due July 15
    The AAGP Member-in-Training (MIT) Nominations Committee is seeking qualified candidates to run for the MIT Board Member position for 2014/2015. All current Members-in-Training of AAGP are eligible to run. (A member-in-training is defined as a physician who is enrolled in an accredited residency in psychiatry or is enrolled in a fellowship in geriatric psychiatry that is affiliated with an accredited residency program). Members interested in being considered for this position are encouraged to submit a completed application to the MIT Nominations Committee. Learn more: www.AAGPonline.org/MITcall.


    Nominations for APA Geriatric Psychiatry Awards are due Aug. 15
    The American Psychiatric Association's Hartford-Jeste Award for Future Leaders in Geriatric Psychiatry recognizes an early career geriatric psychiatrist who has made noteworthy contributions to the field of geriatric psychiatry through excellence in research, teaching, clinical practice, and community service, and has demonstrated the potential to develop into a future leader in the field. The honoree must be a psychiatrist who holds a position no higher than assistant professor and is no more than seven years removed from completion of a geriatric psychiatry fellowship. Submission Requirements: Nominations for this award must come from APA Members. All applications should include a detailed nomination letter highlighting the nominee's contributions to geriatric psychiatry, and two additional letters of support highlighting more specific facets of the nominee's career and contributions. At least one letter should be from a geriatric psychiatrist familiar with the nominee's work, and two of the letters should come from people outside of the nominee's institution. Applications should also include a copy of the nominee's CV that includes a list of publications as well as grant support. This award is made possible with funds from the John A. Hartford Foundation, a private philanthropy working to improve the health of older Americans.

    APA's Jack Weinberg Memorial Award for Geriatric Psychiatry was established in 1983 in memory of Jack Weinberg, MD, to honor a psychiatrist who, over the course of his/her career, has demonstrated special leadership or who has done outstanding work in clinical practice, training, or research into geriatric psychiatry. Candidates for the award must be psychiatrists who are nominated by an APA member. Submission Requirements: A nomination letter summarizing the accomplishments of the nominee, two letters of endorsement from APA members, a current CV and bibliography.

    Deadline for both awards: Aug. 15, 2014. Send nominations to Sejal Patel at SPatel@psych.org, American Psychiatric Association 1000, Wilson Blvd. #1825, Arlington, VA 22209; 703-907-8579; 703-907-7852 (fax).



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    Scientists recruit healthy seniors for Alzheimer's drug trial
    HealthDay
    Scientists have started recruiting seniors from the United States, Canada and Australia to participate in a $140 million study that will test the protective powers of an experimental drug for Alzheimer's disease.

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    Secret behind why Alzheimer's patients cannot make new memories discovered
    The Telegraph
    A drug to prevent the devastating memory loss associated with Alzheimer's disease is a step closer after scientists discovered the secret behind why people with dementia cannot form new memories. It was previously thought that Alzheimer's was primarily caused by the build up of sticky amyloid plaques in the brain which stop neurons from firing.

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    IOM report on PTSD treatment
    On June 20, the Institute of Medicine (IOM) released a report, entitled Treatment for Post-Traumatic Stress Disorder In Military and Veterans Populations, stating that government care provided to service members and veterans with post- traumatic stress disorder (PTSD) suffers from inadequate management and tracking, leaving officials unable to determine the effectiveness of treatment programs. The report, which was mandated by Congress and funded by the Department of Defense (DOD), calls on the DOD and the Department of Veterans Affairs (VA) to develop an "integrated, coordinated and comprehensive" strategy for following and assessing their care. It recommends a range of actions, including implementation of a system to document patients' progress—regardless of whether they get treatment or long-term follow-up—clear training standards for all providers and greater engagement of family members in veterans' treatment.

    The IOM report noted that about five percent of patients in the military's health system have PTSD and that the DOD and the VA spent more than $3 billion in 2012 on screening, diagnosing and treating PTSD. It stated that PTSD is a signature injury of the wars in Afghanistan and Iraq and described it as putting a "staggering" burden on the forces that were deployed. The number of veterans of all eras who sought care for PTSD from the VA more than doubled from 2003 to 2012, from approximately 190,000 veterans to more than half a million. PTSD is the third most common major service-connected disability after hearing loss and tinnitus.

    Both the DOD and the VA, despite substantially boosting their mental health staffing in recent years, are falling behind given the demand for PTSD services, the report stated. The report faults the DOD programs as "local, ad hoc, incremental and crisis-driven." The VA’s PTSD care rates somewhat better with that agency "able to ensure more consistency of treatment," yet it has little data to substantiate progress.

    "Given that the DOD and VA are responsible for serving millions of service members, families and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not," said Sandro Galea of Columbia University's Mailman School of Public Health, who chaired the IOM committee responsible for the report. "They could be highly effective, but we won’t know unless outcomes are tracked and evaluated."

    The nearly 300-page report is part of an assessment of PTSD services for current and past military service members that began several years ago. An initial report came out in 2012.



    Senate subcommittee conducts markup of FY 2015 HHS Appropriations Bill
    On June 10, the Subcommittee on Labor, Health and Human Services, Education and Related Agencies of the Senate Appropriations Committee approved a Fiscal Year (FY) 2015 funding package for the Department of Health and Human Services (HHS) that includes a number of provisions targeting Alzheimer’s disease and related dementias. The full Appropriations Committee needs to approve the measure before it goes to the full Senate for a vote. Specifically, the Subcommittee bill calls for:
    • $100 million for the National Institute on Aging (NIA) for Alzheimer's research (this amount is in addition to the $100 million contained in the FY 2014 Omnibus Appropriations bill);
    • $100 million for the National Institutes of Health's (NIH) BRAIN Initiative;
    • $14.3 million to expand home and community based caregiver services;
    • $4.2 million for outreach activities to raise awareness of dementia and reduce stigma;
    • $3.3 million for the Centers for Disease Control’s (CDC) Healthy Brain Initiative;
    • Report language to instruct NIH to submit a professional judgment budget for Alzheimer's disease research and a report that outlines research conducted on Alzheimer's disease related to milestones under the National Plan to Address Alzheimer’s Disease.
    In addition, the Senate Subcommittee's proposal includes an overall two percent increase for NIH and 2.5 percent for CDC, and $10 million for the Elder Justice Initiative. The full Appropriations Committee's vote on the Subcommittee's report has been postponed indefinitely.

    AAGP has joined with other mental health organizations in supporting the provisions adopted by the Senate Subcommittee and will work with those groups to urge all senators to preserve these provisions in the Senate's final appropriations bill and also to urge all House members, particularly the leadership and the members of the House Appropriations Committee, to adopt the Senate's Alzheimer's and dementia figures and report language when developing the House version of the FY 2015 HHS funding measure.



    RAND releases Dementia Care Blueprint
    A new RAND Corporation study, Improving Dementia Long-Term Care: A Policy Blueprint, released on June 23, found that long-term care is one of the biggest costs for those with dementia and outlines 25 policy options that could improve the situation. Those options include:
    • Increase public awareness of dementia to reduce stigma and promote earlier detection;
    • Improve access to and use of long-term services and supports for people with dementia;
    • Promote high-quality care that is focused on meeting the needs of individuals and family caregivers;
    • Provide better support for family members who provide caregiving to people with dementia;
    • Reduce the financial burden placed upon individuals and families who must pay for long-term services and support for people with dementia.
    Researchers highlighted:
    • That one of the first steps is to increase detection and diagnosis of dementia through better outreach to the public and wider use of cognitive assessment tools by providers;
    • The importance of promoting high quality, long-term care by centering care around individuals and family caregivers;
    • Middle-class Americans, in particular, struggle with the high costs of dementia long-term insurance policies and often do not qualify for Medicaid; and
    • Because fewer family caregivers will be available to care for aging baby boomers because of shrinking family sizes, high-impact policy options should better support those who are paid to provide dementia care.
    For more details about the RAND study, go to www.rand.org/pubs/research_reports/RR597.html.



    American Delirium Society: Call for proposals
    The Conference Planning Committee of the American Delirium Society invites you to submit proposals for presentation at ADS’ 5th Annual Meeting, May 31-June 2, 2015: https://www.americandeliriumsociety.org/conference-events/call-for-proposals
    • July 15, 2014: Deadline for Submission of Proposals for Symposia, Workshops and Roundtables
    • Nov. 24, 2014: Deadline for Submission of Oral Presentation Abstracts
    • March 2, 2015: Deadline for Poster Abstract Submissions



    Free online sessions from the AAGP 2014 Annual Meeting
    Access two sessions from the AAGP 2014 Annual Meeting and earn continuing medical education credits.

    Neurocognitive Disorders, the DSM-5, and Informed Treatment Choices
    • View Symposium Archive: www.neurosciencecme.com/CM888 (Credit Expiration Date: Wednesday, May 6, 2015)
    • CME Credit (Physicians): The American Association for Geriatric Psychiatry (AAGP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
    • The American Association for Geriatric Psychiatry (AAGP) designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
    Late-Life Depression: More Than a Mood Disorder
    • View Symposium Archive: www.neurosciencecme.com/CM889 (Credit Expiration Date: Wednesday, May 6, 2015)
    • CME Credit (Physicians): The American Association for Geriatric Psychiatry (AAGP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
    • The American Association for Geriatric Psychiatry (AAGP) designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.



    IN THE NEWS


    Study links traumatic brain injury to increased dementia risk
    Reuters
    Older military veterans who have suffered a serious head injury are more likely to be diagnosed with dementia than uninjured veterans, according to a new study. The report looked at traumatic brain injury, which includes concussions, skull fractures and bleeding inside the skull.
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    Could a cocoa extract prevent Alzheimer's?
    Medical News Today
    More than 5 million Americans are living with Alzheimer's disease and by 2050, this number is expected to increase to 16 million. With figures like these, the race is on to find ways to prevent Alzheimer's. Now, a new study by researchers from the Icahn School of Medicine at Mount Sinai in New York finds that a cocoa extract could do just that.
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    Study: An intellectual life could protect against dementia
    The Atlantic
    As America ages, the specter of cognitive decline looms. In a 2012 AARP membership survey, 87 percent of respondents said they were extremely or very concerned about "staying mentally sharp." As there's currently no cure for Alzheimer's or dementia, their concern is not unwarranted. There is a prevailing idea, though, that staying mentally active could help keep the disease at bay. A new study out of the Mayo Clinic, published in JAMA Neurology, lends some more credence to this theory.
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    80 percent of people think Alzheimer's is a normal part of aging
    TIME
    Despite estimates that more than one billion people will be affected by Alzheimer's disease by 2050, many around the world still don't understand the disease. In a survey of more than 6,000 people from 12 countries, the Alzheimer's Association says nearly a quarter of responders list Alzheimer's disease as the condition they most fear getting, behind cancer. Yet in some countries, including India, China and Saudi Arabia, more than 80 percent believe that the neurodegenerative condition is a normal part of aging, and not an abnormal state of the brain in which plaques of proteins build up and break down nerve connections.
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