Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life

Adherence and oral agents with older patients

OBJECTIVE

Oral antineoplastic agents offer multiple advantages in cancer therapies. Thus, understanding issues of adherence to these agents for older adults becomes critical to successful comprehensive care of the older cancer patient.

DATA SOURCES

This analysis of adherence to oral agents among older cancer patients draws on interdisciplinary geriatric and oncologic research reports and clinical reviews.

CONCLUSION

Older adults are at increased risk for poor adherence to oral agents. Barriers to adherence are diverse. Problems emerge from age-related physical changes, comorbid conditions, polypharmacy, and drug interactions. Psychosocial barriers include limited insurance coverage and transportation problems to social isolation and inadequate social support.

IMPLICATION FOR NURSING PRACTICE

Nurses should lead interdisciplinary, individualized plans of care to mitigate barriers and support adherence to cancer therapy.

The vascular depression hypothesis: an update

Since being proposed as a unique subtype of late-life depression (LLD), the vascular depression hypothesis has received considerable research attention. Although this effort has generated considerable empirical support for the validity of the subtype, fundamental questions remain including how the illness is defined, whether cerebrovascular disease and executive dysfunction (ED) define two separate entities or one underlying subtype, and whether ED is responsible for poor response to antidepressant treatment. In this guest editorial, we explore these and other issues (i.e., the role of personality and social support, psychosocial treatments targeting cognitive abilities frequently impaired in LLD) using a number of important papers that are either directly or indirectly related to the vascular depression hypothesis. In so doing we highlight a range of critical problems facing the vascular depression hypothesis and the effort to establish the illness as a unique diagnostic entity in late-life.