What to Expect at the Geriatric Psychiatry Pre-Conference Program at Psych Congress 2022, With Marc Agronin, MD

In this exclusive preview video, Psych Congress Network Geriatric Psychiatry Section Editor Marc Agronin, MD, shares what he is most looking forward to during the Geriatric Psychiatry Pre-Conference Program at Psych Congress 2022. The pre-conference program will provide a comprehensive overview of major topics in geriatric psychiatry, including key differences in treating patients of differing age groups, medication management, neurocognitive disorders, diagnosis, and more!

Dr Agronin will be leading a number of sessions on geriatric psychiatry during the pre-conference program occurring on Friday, September 16, including “Geriatric Psychiatry Updates” Parts 1 and 2.

The 35th Annual Psych Congress meeting is being held in-person at the Ernest N. Morial Convention Center in New Orleans, Louisiana, from September 17th to 20th, 2022. For more information about the agenda and to register to attend, visit the event website here.

Read the Transcript:

Marc Agronin, MD:

Hi, my name is Dr Marc Agronin. I'm a geriatric psychiatrist in Miami, Florida. I've been at Miami Jewish Health for the past 23 years, where I run the behavioral health program and a memory disorder center called Mind Institute at Miami Jewish Health. I want to tell you something I'm really excited about, and that is the geriatric psychiatry pre-conference at the 2022 US Psych Congress. It's going to be a fantastic program and a wonderful overview of the major topics in geriatric psychiatry. So I thought I'd give you a little bit of an overview of what's going to be presented, and I'm going to focus a little bit on my session in the afternoon and I'll leave you with a few gems just to get you interested to come to the session this year.

So the program's going to begin in the morning with two of my colleagues. They will be focusing on mood disorders in late life, psychosis in late life, and overall medication management. And the theme of the day is thinking about how are different psychiatric disorders the same and how are they different as we age? And so from one perspective, the basic diagnostic criteria, the overview of these disorders that will be presented by my colleagues will be essentially the same that as a clinician you're familiar with. But then what they're going to hone in on is the key differences. What does it make a difference if you're treating someone in their eighties and nineties versus someone in their thirties and forties with bipolar disorder? What's different in terms of the manifestations clinically? What's different in terms of how you approach them with management?

To add on to that, one of my colleagues will focus specifically on medication management, and really the same theme of how does the older body deal with medications in ways that are different that we really need to focus on. I think what you'll see is that the basic approaches that we use with younger patients are going to be the same, same medication, same approaches, but there are key differences in terms of selection of treatments and medications that can make all the difference.

In the afternoon, I'm going to then be speaking about neurocognitive disorders, really from A to Z. And I thought I'd leave you with just a few thoughts about this to get you interested and hopefully excited about this program.

As you know, Alzheimer's disease is the main neurocognitive disorder, the most common one in late life, is at epidemic proportions. I don't think there's any clinician who doesn't deal with this either with the patients they work with or with their family. So it's really important to have a knowledge base about this. So I'm going to open up the program by talking about what are neurocognitive disorders? That's this new term we use instead of dementia. And really focusing on the variety of them. We tend to think about Alzheimer's disease, obviously because it's the most common, but there are many other types of neurocognitive orders--Lewy body disease, vascular dementia, frontotemporal dementia--and I want to put all those in perspective because it's so critically important when someone is working with someone with cognitive impairment to understand the breadth of the different potential diagnoses.

With that overview, I'm going to focus then on diagnosis. How do we do a comprehensive workup on an older individual to make certain that we get the correct diagnosis, because that will make all the difference in terms of the management. And if it is Alzheimer's disease, how do we really understand it? And this is one I guess clinical gem that I want to leave you with, because I always emphasize this when I'm speaking about this, and that is we have to keep in mind that just because someone appears to have cognitive impairment, it doesn't mean, and we shouldn't assume, that they have a neurocognitive disorder. There are other factors that can cause neurocognitive changes in late life. Secondly, if we diagnose someone with a neurocognitive disorder, we shouldn't assume that it's always going to be Alzheimer's disease. Too often in the community, individuals get this diagnosis that's stuck with them, and yet it's not accurate. And so I'm going to spend time talking about how do we distinguish between different forms of neurocognitive disorders and how the workup itself is going to give us clues.

Finally, if we diagnose someone with Alzheimer's disease, don't assume that they have a predictable course because I can tell you, working many years as a geriatric psychiatrist, that you show me a hundred different individuals with Alzheimer's disease, I will show you 100 different courses. And so it's important that we put some of these assumptions aside. I'm certain that one overall theme you're going to see coming through the talks in the morning, my talks in the afternoon, is that even though we're looking at disease processes, we need to keep in mind that there's still so much going on with the person we're working with, so many strengths that they have. And those strengths often will give us a key to how we can best work with them.

On that note, what I will be talking about at the end of the program is behavioral disturbances, such as agitation, psychosis, anxiety, panic attacks, and how they manifest within the setting of Alzheimer's disease and other neurocognitive disorders and how we can approach them. I'll spend time talking about both non-pharmacological behavioral approaches and pharmacologic approaches. And this is where these strengths of aging will be so key because obviously when working with someone and trying to help them with, whether it's agitation or some other behavioral disturbance in late life, we have to get to know them as a person and understand how are they different because of aging, what we can work with, how we can bolster them. That makes the difference. It's not just about finding the right medication for them. We have to have a really holistic approach.

Hopefully this is getting you really excited about this geriatric psychiatry pre-conference. It's going to be an entire day program. I'll be chairing the program, working with my colleagues to really give you the depth and the comprehensive understanding that you need to really work with aging individuals across the entire array of different common psychiatric diagnoses, but also to really understand who is the aging person behind it, how you can really understand them best and work with them.

So that's the program. I really hope to see you in New Orleans at the conference this year, and we'll get a chance to talk a lot more about that. Thank you. Hope to see you soon.

Marc Agronin, MD, is a geriatric psychiatrist in Miami at Miami Jewish Health, and the author of The End of Old Age: Living a Longer, More Purposeful Life.