Alzheimer Disease: Fox LS

Olin JT, Dagerman KS, Fox LS, Bowers B, Schneider LS. · Division of Service and Intervention Research, National Institute of Mental Health, Bethesda, Maryland 20892-9635, USA. · Alzheimer Dis Assoc Disord. · Pubmed #12351920 No free full text.

Abstract: The Alzheimer's Association and National Institutes of Health have emphasized the need for participation of racial/ethnic populations in Alzheimer disease (AD) clinical research. Many articles have described strategies to enhance participation including establishing enduring ties to the community and tailoring the site to be more culturally welcoming or user-friendly to the community. Yet, most of these reports are not data driven. To get a better indication of the knowledge base, this review summarizes research across a broad range of domains (e.g., cancer, kidney disease, AD) that used systematic approaches to identify methods and factors that reduce barriers to recruitment, participation, and retention of a more racially and ethnically diverse population. Overall, 121 reports were found with 8 of these in AD. As a relatively new area of investigation, the literature was primarily descriptive; outcome data were seldom provided. While these studies help to identify areas of potential importance in racial/ethnic participation, hypothesis-driven research remains necessary to tease apart the key techniques that engender racial/ethnic participation in AD studies. This article suggests several recommendations, including the need for prospective research of specific recruitment methods. Fundamentally, researchers should consider that these strategies apply to all potential research participants, and not simply to traditionally underserved racial/ethnic populations.

Olin JT, Fox LS, Pawluczyk S, Taggart NA, Schneider LS. · Geriatric Psychopharmacology Program, Adult and Geriatric Treatment and Preventive Interventions Research Branch, National Institute of Mental Health, 6001 Executive Blvd., Rm 7160 MSC 9635, Bethesda, MD 20892-9635, USA. · Am J Geriatr Psychiatry. · Pubmed #11739066 No free full text.

Abstract: The authors performed a 6-week, randomized, double-blind, placebo-controlled, parallel-group trial of carbamazepine (400 mg/day) with 21 agitated subjects (16 completers) who had been treated unsuccessfully with antipsychotics. There was greater improvement for the carbamazepine group on the Clinical Global Impression of Change (P=0.055) and the Brief Psychiatric Rating Scale (BPRS) Hostility item (P=0.009), with a trend toward worsening on the BPRS Hallucination item (P=0.067). Overall, carbamazepine showed modest clinical benefit in these subjects, who had not responded to antipsychotics, and particular benefit for hostility. The effect on global ratings was similar to those found in an earlier report in nursing home residents.

Knight BG, Silverstein M, McCallum TJ, Fox LS. · Andrus Gerontology Center, University of Southern California, Los Angeles, 90089-0191, USA. · J Gerontol B Psychol Sci Soc Sci. · Pubmed #11833976 No free full text.

Abstract: A sociocultural stress and coping model to explain emotional distress among caregivers of family members who have dementia across ethnic and cultural groups is presented and explored in a sample of 41 African American and 128 non-African American caregivers. In this sample, African American caregivers reported lower levels of burden but equal levels of depression and anxiety. In the structural equation model, previous reports that African Americans' lower appraisal of caregiving as burdensome resulted in lower levels of emotional distress were confirmed. However, in this model, this pathway was counterbalanced by a tendency of African American caregivers to use emotion-focused coping and, therefore, increase emotional distress. African American caregivers were also younger and in poorer health, factors which tend to increase both burden and emotional distress outcomes. As suggested by the sociocultural stress and coping model, the influences of ethnic group variables on stress and coping processes are complex and multidirectional.