Anxiety is a common comorbid feature of late-life depression (LLD) and is associated with poorer global cognitive functioning independent of depression severity. However, little is known about whether comorbid anxiety is associated with a domain-specific pattern of cognitive dysfunction. We therefore examined group differences (LLD with and without comorbid anxiety) in cognitive functioning performance across multiple domains.

Older adults with major depressive disorder (N = 228, ages 65–91) were evaluated for anxiety and depression severity, and cognitive functioning (learning, memory, language, processing speed, executive functioning, working memory, and visuospatial functioning). Ordinary least squares regression adjusting for age, sex, education, and concurrent depression severity examined anxiety group differences in performance on tests of cognitive functioning.

Significant group differences emerged for confrontation naming and visuospatial functioning, as well as for verbal fluency, working memory, and inhibition with lower performance for LLD with comorbid anxiety compared to LLD only, controlling for depression severity.

Performance patterns identified among older adults with LLD and comorbid anxiety resemble neuropsychological profiles typically seen in neurodegenerative diseases of aging. These findings have potential implications for etiological considerations in the interpretation of neuropsychological profiles.

To identify if patients discharged from an older adult psychiatric ward were followed up in line with national recommended guidelines. Current National Institute for Clinical Excellence (NICE) guidelines recommend follow up and final discharge letters (FDLs) being available within 7 days of discharge.

A record search was conducted to identify all patients discharged from one ward during a one year period.

Each patient's notes were reviewed to identify what follow up they had in place and how long it took for this to be implemented. We also examined the time taken for a final discharge letter (FDL) to be made available to their General Practitioner (GP).

We identified 99 patients who were discharged from the ward within the specified period.

The mean time taken for patients to be followed up after discharge was 9.72 days. In 63.16% of cases this follow up was provided by Community Psychiatric Nurses (CPNs), with 51.58% being reviewed in medical clinic. A further 9.47% had their initial follow up with an occupational therapist, 4.21% with a psychologist, 4.21% with the addictions team, 4.21% with care home liaison, 2.11% with social work, 2.11% with continuing care and 1.05% with rehab.

FDLs were sent to GPs, on average, 13.6 days after patients were discharged.

Within our data set a few outlier values markedly increased the mean for both outcomes. Using median figures, average follow up time fell to 6 days, meeting national guidelines, and FDL time fell to 8 days, exceeding recommendations by just 1 day.

Within our department, measures have since been put in place to ensure secretaries are reminding medical staff of the recommended time frames for final discharge letters and it should be noted that an immediate discharge letter (IDL) is routinely sent to GPs containing key clinical information prior to patients being discharged.

The results show that our current practice does fall somewhat short of matching national guidelines and further work should be done to investigate how we can improve standards.

We aimed to review various health outcomes for patients admitted to an older adult psychiatry ward specialising in functional illness, over a one year period.

In 2020 the Mental Welfare Commission for Scotland highlighted a concern about the lack of evidence and data surrounding admission to older people’s functional mental health wards. We aimed to review this for North Lanarkshire and provide a comprehensive overview of our in-patient population that will aid in service review and improve care.

We reviewed the electronic notes of all patients (total: 99) admitted to the ward over a one year period. Extracted data included demographics, medications, mental health act status, discharge destination and readmissions.

We found the average age was 73 years old and the median length of stay was 33 days (mean 63). Patients were admitted with a wide range of diagnosis including (most common to least): mood disorders, psychotic disorders, dementia, substance misuse and ARBD, delirium and personality disorders. 30% of patients required detention under the mental health act during their admission, but this fell to only 7% on discharge. 51% of patients were discharged on an antipsychotic. The majority of patients were discharged home; within a year 34% were readmitted to psychiatry and 40% required a medical admission.

We found that our demographic information was broadly consistent with the mental welfare commission's findings. However there is a significant variation in length of stay shown by the difference in the mean and median, due to a small number of significantly longer admissions. Notably there were numerous admissions with a dementia as a primary diagnosis, on a functional ward. In this age group it was significant that a high proportion of patients were prescribed antipsychotics. Further work is required to better understand these findings.

Late-life depression (LLD) is common and frequently co-occurs with neurodegenerative diseases of aging. Little is known about how heterogeneity within LLD relates to factors typically associated with neurodegeneration. Varying levels of anxiety are one source of heterogeneity in LLD. We examined associations between anxiety symptom severity and factors associated with neurodegeneration, including regional brain volumes, amyloid beta (Aβ) deposition, white matter disease, cognitive dysfunction, and functional ability in LLD.

Older adults with major depression (N = 121, Ages 65–91) were evaluated for anxiety severity and the following: brain volume (orbitofrontal cortex [OFC], insula), cortical Aβ standardized uptake value ratio (SUVR), white matter hyperintensity (WMH) volume, global cognition, and functional ability. Separate linear regression analyses adjusting for age, sex, and concurrent depression severity were conducted to examine associations between anxiety and each of these factors. A global regression analysis was then conducted to examine the relative associations of these variables with anxiety severity.

Greater anxiety severity was associated with lower OFC volume (β = −68.25, t = −2.18, p = .031) and greater cognitive dysfunction (β = 0.23, t = 2.46, p = .016). Anxiety severity was not associated with insula volume, Aβ SUVR, WMH, or functional ability. When examining the relative associations of cognitive functioning and OFC volume with anxiety in a global model, cognitive dysfunction (β = 0.24, t = 2.62, p = .010), but not OFC volume, remained significantly associated with anxiety.

Among multiple factors typically associated with neurodegeneration, cognitive dysfunction stands out as a key factor associated with anxiety severity in LLD which has implications for cognitive and psychiatric interventions.

To assess the training and the future workforce needs of paediatric cardiac critical care faculty.

REDCap surveys were sent May−August 2019 to medical directors and faculty at the 120 US centres participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database. Faculty and directors were asked about personal training pathway and planned employment changes. Directors were additionally asked for current faculty numbers, expected job openings, presence of training programmes, and numbers of trainees. Predictive modelling of the workforce was performed using respondents’ data. Patient volume was projected from US Census data and compared to projected provider availability.

Sixty-six per cent (79/120) of directors and 62% (294/477) of contacted faculty responded. Most respondents had training that incorporated critical care medicine with the majority completing training beyond categorical fellowship. Younger respondents and those in dedicated cardiac ICUs were more significantly likely to have advanced training or dual fellowships in cardiology and critical care medicine. An estimated 49–63 faculty enter the workforce annually from various training pathways. Based on modelling, these faculty will likely fill current and projected open positions over the next 5 years.

Paediatric cardiac critical care training has evolved, such that the majority of faculty now have dual fellowship or advanced training. The projected number of incoming faculty will likely fill open positions within the next 5 years. Institutions with existing or anticipated training programmes should be cognisant of these data and prepare graduates for an increasingly competitive market.