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Journal article

The prevalence of anxiety in older adults: methodological issues and a review of the literature

Authors:
BRYANT Christina, JACKSON Henry, AMES David
Journal article citation:
Journal of Affective Disorders, 109(3), 2008, pp.233-250.
Publisher:
Elsevier

A systematic review of literature on anxiety in people over 60, published between 1980 and 2007, finds prevalence rates for anxiety disorders of 1.2% to 15% in community settings, and 1% to 28% in clinical settings. The prevalence of anxiety symptoms is much higher, ranging from 15% to 52.3% in community samples, and 15% to 56% in clinical samples. These discrepancies are partly attributable to conceptual and methodological inconsistencies in the literature. The review finds that Generalised Anxiety Disorder is the most common anxiety disorder among older people, but issues relating to co-morbidity and the nature of anxiety in old age remain unresolved. This hampers the design of interventions and highlights the need for further research with a primary focus on anxiety.

Journal article

The use of fortified foods to treat malnutrition among older adults: a systematic review

Authors:
DOUGLAS Joy W., LAWRENCE Jeannine C., KNOWLDEN Adam P.
Journal article citation:
Quality in Ageing and Older Adults, 18(2), 2017, pp.104-119.
Publisher:
Emerald

Purpose: Food fortification with common kitchen ingredients has been suggested to improve nutritional intake. The purpose of this paper was to systematically review the efficacy of food fortification on calorie and protein intake among older adults. Design/methodology/approach: A systematic search was conducted using Boolean search logic and seven research databases to identify interventions using fortified foods to increase calorie and protein intake among older adults. Ten studies published in English since 1996 were eligible for inclusion. Study quality was evaluated using an adapted Modified Jadad Questionnaire. Findings: Food fortification was associated with increased calorie intake in eight studies, increased protein intake in five studies, and increased body weight in three studies. However, studies were limited by lack of rigor in methodology and small sample sizes. Originality/value: Food fortification may improve calorie and protein intake, but results are limited by study weaknesses. Additionally, it is unclear whether improved intake results in improved clinical outcomes. (Publisher abstract)

Journal article

Association between depression and resilience in older adults: a systematic review and meta-analysis

Authors:
AVILA Maria Priscila Wermelinger, LUCCHETTI Alessandra Lamas Granero, LUCCHETTI Giancarlo
Journal article citation:
International Journal of Geriatric Psychiatry, 32(3), 2017, pp.237-246.
Publisher:
Wiley-Blackwell

Objective: The objective of this study is to determine whether resilience is associated with depressive symptoms in geriatric populations. Method: A systematic review and meta-analysis were performed (up to March 2015) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations on three databases (PubMed/Medline, Scopus, and Web of Science) with no language restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies. Results: A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression and resilience, and were conducted in three countries: the USA, China, and Belgium. A moderate inverse correlation was found on the meta-analysis (r = −0.35, 95% confidence interval: −0.41 to −0.28). Conclusion: Few studies were found on this subject in the older population. An association between greater resilience and less depressive symptomatology was identified, albeit based on cross-sectional studies. These results highlight the need for further studies in the area and the importance of fostering the use of interventions to promote resilience in older adults as a means of preventing and managing depressive symptoms in this population. (Publisher abstract)

Journal article

A systematic review and meta-analysis of music therapy for the older adults with depression

Authors:
ZHOA K., et al
Journal article citation:
International Journal of Geriatric Psychiatry, 31(11), 2016, pp.1188-1198.
Publisher:
Wiley-Blackwell

Objectives: To determine the efficacy of music therapy in the management of depression in the elderly. Method: A systematic review and meta-analysis of randomised controlled trials. Change in depressive symptoms was measured with various scales. Standardised mean differences were calculated for each therapy–control contrast. Results: A comprehensive search yielded 2,692 citations; 19 articles met inclusion criteria. Meta-analysis suggests that music therapy plus standard treatment has statistical significance in reducing depressive symptoms among older adults. Conclusions: This systematic review and meta-analysis suggests that music therapy has an effect on reducing depressive symptoms to some extent. However, high-quality trials evaluating the effects of music therapy on depression are required. (Edited publisher abstract)

Journal article

Assistive technologies in reducing caregiver burden among informal caregivers of older adults: a systematic review

Author:
MARASINGHE Keshini Madara
Journal article citation:
Disability and Rehabilitation: Assistive Technology, 11(5), 2016, pp.353-360.
Publisher:
Informa Healthcare
Place of publication:
London

Aim: The world population is rapidly ageing. As population age, the incidence of functional limitations increases, demanding higher levels of care from caregivers. Assistive technologies improve individuals’ functioning, independence, well-being and quality of life. By increasing independence of older adults, assistive technologies decrease workloads required from informal caregivers. This review investigates, evaluates, and synthesises existing findings to examine whether and how assistive technologies reduce caregiver burden. Methods: Databases searched included MEDLINE, EMBASE, Scopus, and Cochrane Library. Three groups of keywords were combined: those relating to assistive technology, caregiver burden, and older adults. Results: Two theories emerged from the analysis of study results. Caregivers reported that assistive technologies decrease caregiver burden. However, caregivers had concerns that assistive technologies could add to caregiver burden, highlighting the limitations of assistive technology. Conclusions: As suggested by a majority of the studies in this review, assistive technologies contribute to reducing caregiver burden among caregivers of older adults. Assistive technologies assisted caregivers by reducing time, levels of assistance and energy put towards caregiving, anxiety and fear, task difficulty, safety risk particularly for activities requiring physical assistance and increasing the independence of the users. Further research is required to better understand limitations of assistive technologies. (Publisher abstract)

Journal article Full text available online for free

Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions

Authors:
ESIWE Collins, et al
Journal article citation:
Age and Ageing, 44(5), 2015, pp.771-775.
Publisher:
Oxford University Press

Background: Depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: One hundred and eighteen patients aged over 65 years, admitted to acute medical wards at a teaching hospital, were interviewed in a standardised manner using relevant sections of the Present State Examination—Schedules for Clinical Assessment in Neuropsychiatry to identify depression according to ICD-10 criteria. Subsequently, participants completed the two depression screening questions and the 15-item version of the Geriatric Depression Scale (GDS-15). Results: A threshold of one or more positive responses to the two NICE depression screening questions gave a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 49% and negative predictive value (NPV) of 100%. The GDS-15 optimal cut-off was 6/7 with a sensitivity of 80%, specificity of 86%, PPV of 62% and NPV of 94%. A two-stage screening process utilising the NICE two questions followed by the GDS-15 with these cut-offs gave a sensitivity of 80%, specificity of 91%, PPV of 71% and NPV of 94%. Conclusion: The two depression questions perform well as an initial screening process for non-cognitively impaired older people in the acute medical setting. A positive response to either question would indicate that further assessment is required by a clinician competent in diagnosing depression in this population, or the possible use of a more detailed instrument such as the GDS-15 to reduce the number of false-positive cases. (Publisher abstract)

Journal article

Does participation in home-delivered meals programs improve outcomes for older adults? Results of a systematic review

Authors:
CAMPBELL Anthony D., et al
Journal article citation:
Journal of Nutrition in Gerontology and Geriatrics, 34(2), 2015, pp.124-167.
Publisher:
Taylor and Francis

Participation in home-delivered meals programs may contribute to the health and independence of older adults living in the community, especially those who are food insecure or those who are making transitions from acute, subacute, and chronic care settings to the home. A comprehensive and systematic review of all studies related to home-delivered meals was carried out in order to shed light on the state of the science. A complete review of articles appearing in PubMed using the keyword “Meal” was conducted; and titles, abstracts, and full-texts were screened for relevance. Included in this review are 80 articles. Most studies are descriptive and do not report on outcomes. Frequently reported outcomes included nutritional status based on self-reported dietary intake. Additionally, most studies included in this review are cross-sectional, have a small sample size, and/or are limited to a particular setting or participant population. More rigorous research is needed to (1) gain insight into why so few eligible older adults access home-delivered meals programs, (2) support expansion of home-delivered meals to all eligible older adults, (3) better identify what home-delivered meals models alone and in combination with other services works best and for whom, and (4) better target home-delivered meals programs where and when resources are scarce. (Edited publisher abstract)

Journal article

The relationship between depression and frailty syndrome: a systematic review

Authors:
BUIGUES Cristina, et al
Journal article citation:
Aging and Mental Health, 19(9), 2015, pp.762-772.
Publisher:
Taylor and Francis

Objectives: Frailty is a geriatric syndrome characterised by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve. Frailty and depressive symptoms are common issues facing older adults and may be associated. It is not clear if the depression facilitates the appearance of frailty syndrome or vice versa or these two coexist independently in the same individuals. Method: Searches were conducted in several databases (Embase, PubMed, CINAHL, Scopus, and PsycINFO) for papers published between November 2003 to February 2014 about frailty syndrome and depression in people aged 65 and older. The reference lists of from the articles retrieved were also pearled in order to identify any which may have been missed in the initial search. Two independent reviewers extracted descriptive information on the prevalence and co-occurrence of frailty and depression in older individuals and of frailty criteria among depressed patients. Results: Depression and frailty occur in a significant proportion of frail older individuals. Common pathophysiological alterations and biomarkers in the two syndromes have been recently described. Conclusion: Studies on the causal relationship between the two syndromes are clearly necessary in the future. (Edited publisher abstract)

Journal article

Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature

Authors:
DINNEN Stephanie, SIMIOLA Vanessa, COOK Joan M.
Journal article citation:
Aging and Mental Health, 19(2), 2014, pp.144-150.
Publisher:
Taylor and Francis

Objectives: This systematic review examined reports of psychological treatment for trauma-related problems, primarily post-traumatic stress disorder (PTSD), in studies with samples of at least 50% adults aged 55 and older using standardised measures. Methods: The review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar.Results: A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalisability, including non-randomised research designs, lack of comparison conditions and small sample sizes.Conclusion: Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed. (Edited publisher abstract)

Journal article

Elder abuse: a systematic review of risk factors in community-dwelling elders

Authors:
JOHANNESEN Mark, LoGIUDICE Dina
Journal article citation:
Age and Ageing, 42(3), 2013, pp.292-298.
Publisher:
Oxford University Press

Objective: To undertake a systematic literature review of risk factors for abuse in community-dwelling elders, as a first step towards exploring the clinical utility of a risk factor framework. Search strategy and selection criteria: A search was undertaken using the MEDLINE, CINAHL, EMBASE and PsycINFO databases for articles published in English up to March 2011, to identify original studies with statistically significant risk factors for abuse in community-dwelling elders. Studies concerning self-neglect and persons aged under 55 were excluded. Results: Forty-nine studies met the inclusion criteria, with 13 risk factors being reproducible across a range of settings in high-quality studies. These concerned the elder person (cognitive impairment, behavioural problems, psychiatric illness or psychological problems, functional dependency, poor physical health or frailty, low income or wealth, trauma or past abuse and ethnicity), perpetrator (caregiver burden or stress, and psychiatric illness or psychological problems), relationship (family disharmony, poor or conflictual relationships) and environment (low social support and living with others except for financial abuse). Conclusions: Current evidence supports the multifactorial aetiology of elder abuse involving risk factors within the elder person, perpetrator, relationship and environment. (Publisher abstract)

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