In This Issue

Heisel et al. (pg. 734) investigated whether Narcissistic Per-sonality (NP) increases vulnerability to suicidal ideation andbehavior among 608 geriatric depression day-hospital pa-tients. Twenty of the 538 eligible patients had NarcissisticPersonality Disorder (N�13) or Traits (N�7). Patients withNP were rated significantly higher on a measure of suicidality,controlling for age, gender, depression, and cognitive func-tioning. Findings suggest that NP may be a clinical marker ofelevated suicide risk. Assessment and treatment implicationsare discussed.

Some of the DSM-IV personality disorder (PD) criteria maycontain age bias. Balsis et al. (pg. 742) used item responsetheory analyses to examine the influence of this item-level agebias at the diagnostic level. When older adults were comparedto younger adults at equivalent levels of PD pathology, theywere more likely to receive diagnoses of obsessive-compulsiveand schizoid PDs, less likely to receive diagnoses of avoidantand dependent PDs, and equally likely to receive diagnoses ofhistrionic and paranoid PDs.

Frequent mental distress (FMD; 14 or more mentally un-healthy days during the previous 30 days), health behaviors,body weight, and use of preventive services among 52,600adults �65 years were examined by McGuire et al. (pg. 754)using the 2003 Behavioral Risk Factor Surveillance System.People with FMD were less likely than those without FMD tobe nonsmokers, to consume at least five fruits or vegetablesdaily, and to participate in moderate-to-vigorous physical ac-tivity during the average week.

In order to examine midlife risk factors for vascular dementiaand Alzheimer disease, a total of 157 demented cases and 628matched controls selected from 40,636 men and women en-rolled from 1982 to 1992 in Taiwan were studied by Chiang etal. (pg. 762). There were J-shaped relationships between bodymass index and both subtypes of dementia, indicating under-and overweight in midlife may increase the risk of dementia.The cerebrovascular accident was associated with an increasedrisk of vascular dementia.

Zivin and Christakis (pg. 772) evaluated whether partners ofill spouses have a higher likelihood of developing mentalhealth or substance abuse disorders (MHSA) than partnerswho have healthy spouses. They used Cox models to deter-mine the effect of spouse illness and mortality on partner

MHSA diagnosis. Spouse hospitalizations and spouse deathindependently increase the risk for partner MHSA and depres-sion diagnoses. These findings can identify which individualsare at greatest risk for emotional distress during caregivingand widowhood.

The study by Mittelman et al. (pg. 780) evaluated the effects ofcounseling and support on the self-reported physical health ofspouse caregivers of people with Alzheimer’s disease. The 406participants were randomly assigned to receive the interven-tion or usual care. The intervention included individual andfamily counseling, support group participation, and addi-tional counseling by phone as needed Caregivers who re-ceived the intervention reported significantly better health,beginning 4 months after enrolling in the study and for twoyears thereafter.

The study by Blay et al. (pg. 790) investigates the prevalenceof depression morbidity in the elderly population in Braziland its association with sociodemographic characteristics, self-rated health, and other clinical variables. A community-basedsample of subjects aged 60 years and over (n � 7040) wasinterviewed in person using a structured questionnaire. Theauthors found that the frequency of depression morbidity washigh (22%) and was significantly associated with younger age,lower income, and poorer social, health, and functional status.

Berry et al. (pg. 800) investigated whether orofacial tardivedyskinesia (OTD) was associated with frontal lobe dysfunc-tion and whether the latter was associated with impairedcoping abilities in 52 older people with psychosis. Patientswith and without OTD did not differ in frontal lobe function-ing when general cognitive impairment was controlled. Im-paired coping abilities were associated with general psycho-pathology and not frontal lobe dysfunction, which suggests apotential role for psychological interventions in older peoplewith psychosis.

The study by Sachs-Ericsson et al. (page 815) examined therelationship between body mass index (BMI) and depressivesymptoms in a biracial sample of community dwelling olderadults. BMI was found to predict depressive symptoms over athree year period. The relationship was greater for AfricanAmericans than Caucasians and, in particular, African Amer-icans with less education. There were no gender differences.Obesity appears to have the most adverse impact on thosemost likely to be overweight, lower SES African Americans.