Geriatric Psychiatry

GERIATRIC PSYCHIATRY

History&Milestones

• 1979- Division of Geriatric Psychiatry founded. The first in the state of Missouri.
• 1980- 10 bed inpatient Geriatric Psychiatry Unit opened.
• 1980- First teaching nursing home contract established.Multi-disciplinary nursing home consultation begun.Medical students, residents exposed to nursing home patients.
• 1982-Clinical Trials Unit developed in Geriatric Psychiatry
• 1983- Geriatric Psychiatry Fellowship started with a training grant from the National Institute for Mental Health. (6th program in the nation to receive funding).
• 1985-Alzheimer's Brain Bank inaugurated, the first and still only community brain bank in the state of Missouri. Established with a 3 year grant from the Alzheimer's Association.
• 1990-Geriatric Psychiatry Fellowship expands to 3 trainees per year.
• 1990- First Added Qualifications in Geriatric Psychiatry course developed
• 1992-Preceptorships on Alzheimer's disease ; late life depression, begun
• 1993-Dedicated Geriatric Psychiatry Consultation-Liason service established
• 1995-Geriatric ECT service inaugurated 2000-New 16 bed Geriatric Psychiatry inpatient unit opened

CLINICAL SERVICES

The Geriatric Psychiatry Division(GPD) provides a spectrum of clinical services for older adults with a variety of late-life mental disorders.These include: Memory disorders evaluation. Late life depression clinic.Anxiety disorders evaluation and treatment.Late-life psychoses. Comprehensive assessment to determine placement in a least restrictive environment .Legal consultation for capacity and guardianship determinations. The GPD utilizes a multidisciplinary , bio-psycho-social approach to evaluation and treatment. Consultation to area long term care facilities is available. A 16 bed Geriatric psychiatry unit is available and specializes in the management of delirium, behavioral disturbances in dementia, mood disorders, psychoses, and other serious late-life mental disorders requiring hospitalization. A highly trained team of nurses, aides, social workers, neuropsychologist, and other therapists work closely with medical students, residents, fellows, and attending Geriatric Psychiatrists. Outpatient and inpatient ECT service for the elderly, especially the high-risk elderly, receives referrals from throughout the region. The GPD provides a consultation-liason service to other departments at St Louis University Hospital.

Family therapy, education and consultation are also provided. An excellent Neuropsychology assessment service is an integral component of the GPD.

EDUCATION

The GPD has been a leader in providing mental health and aging education/training to medical students, residents,physicians,nurses,psychologists, social workers, pharmacists, and various therapists throughout the region, nation, and even internationally.Observers and visiting professors from many countries have been hosted by the GPD at St Louis University. Recent symposia have included: "Mood Disorders Across the Life Spectrum" and an annual "Update in Psychogeriatrics" in Puerto Rico.

RESEARCH

The GPD is engaged in a variety of collaborative basic science and clinical research projects.The Department of Neurology&Psychiatry's Clinical Research Unit fosters many Phase 2 and 3 drug studies and other research. The GPD has been a leader in helping to develop promising compounds for the treatment of Alzheimer's disease, depression and related disorders.

A summer research experience for medical and pre-medical students is offered. Recent projects include: "The Use of an Apraxia Screening Tool to Stage Alzheimer's Disease", "Atypical Antipsychotics and the Risk of Diabetes Among Elderly In Nursing Homes", 'The Utility of Alzheimer's Hospice", "The Neuroanatomic and Neurochemical Correlates of Problem Behaviors In Dementia: A Brain Bank Study", "An Attenuated Vaccine to A-Beta in the Treatment of Alzheimer's Disease",and "The Use of the Clock Drawing Test to Predict Rehab Potential Post-Stroke."

Under the leadership of its recently appointed chair, Dr Henry Kaminski, the GPD looks forward to continued growth in the areas of clinical service, education and research . To provide state of the art care for older adults and their families with a variety of late-life mental disorders.To help train future experts in late life mental disorders and to contribute via research to our better-understanding of Alzheimer's disease, depression, delirium, psychoses, and other other disabling geriatric psychiatric syndromes.

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