Carla Miller, PhD, RD, Associate Professor, Department of Human Nutrition, Ohio State University, Columbus, OH, USA.

The translation of effective treatments for obesity and diabetes management into clinical care has been slow. However, self-management education and counselling regarding diet and physical activity can improve weight, blood glucose, and lipid levels, and blood pressure control among older adults with type 2 diabetes. A collaborative approach to counselling is more effective than simply lecturing in promoting and sustaining behaviour change. The five A’s to behavioural counselling—assess, advise, agree, assist, and arrange—provide a model for care. A key component of the five A’s for counselling is the development of an action plan that specifies goals and implementation intentions for behaviour change.
Key words: type 2 diabetes mellitus, older adults, behavioural research, patient education, behavioural therapy.

Amit Morris, BSc, School of Medicine, Queen’s University, Kingston, ON; Department of Psychiatry, Sleep and Alertness Clinic, Toronto Western Hospital, University of Toronto, Toronto, ON.

Henry J. Moller, MD, FRCP(C), DABSM, Department of Psychiatry, Sleep and Alertness Clinic, Toronto Western Hospital, University of Toronto, Toronto, ON.

Colin M. Shapiro, MBBCh, PhD, FRCP(C), Department of Psychiatry, Sleep and Alertness Clinic, Toronto Western Hospital, University of Toronto, Toronto, ON.

Chronic insomnia is common among older adults and has significant negative consequences for health and well being. A comprehensive approach to treatment begins with identification and management of any underlying conditions. Treatment of insomnia includes both non-pharmacologic and pharmacologic options. Non-pharmacologic approaches form the foundation of treatment; hypnotic medications can also be effective but may be associated with adverse drug effects. Zopiclone and zaleplon appear to be associated with fewer side effects than benzodiazepines.

Key words: insomnia, older adults, drug therapy, behavioural therapy, hypnotics.