Filter results

Register/log in to your SCIE account to use the search filters below

Search results for ‘Subject term:"older people"’ Sort:  

Results 1 - 10 of 402

Book Full text available online for free

How to identify dementia: a guide for care assistants working in social care

Author:
SKILLS FOR CARE
Publisher:
Skills for Care
Publication year:
2015
Pagination:
2
Place of publication:
Leeds

A brief introduction to the signs and symptoms of dementia, highlighting the reasons why it is important that people with dementia receive a diagnosis and explaining what to do if suspecting that someone may have dementia. (Edited publisher abstract)

Journal article

Phenomenology of depression in older compared with younger adults: meta-analysis

Authors:
HEGEMAN J. M., et al
Journal article citation:
British Journal of Psychiatry, 200(4), April 2012, pp.275-281.
Publisher:
Royal College of Psychiatrists

Late-life depression may present differently to early-life depression. Conceptual and methodological limitations and the inherent subjectivity of narrative reviews have made it difficult to draw firm conclusions. This study was designed to investigate the effect of age on the phenomenology of major depression. A systematic search was conducted in PubMed, Embase and PsycINFO for studies examining the relation between age and phenomenology of major depression according to RDC, DSM and ICD criteria. Inclusion criteria required age groups to be compared at the single-item level using the 17-, 21- or 24-item versions of the Hamilton Rating Scale. A meta-analysis was undertaken for each item of the 17-item scale. Eleven papers met the inclusion criteria. When compared with younger depressed adults, older adults demonstrated more agitation, hypochondriasis and general as well as gastrointestinal somatic symptoms, but less guilt and loss of sexual interest. The authors conclude that the experience of late-life depression differs only in part from that of early-life depression. Older people may have a more somatic presentation, whereas feelings of guilt and loss of sexual function may be more prevalent in younger people.

Journal article

Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence

Authors:
CONNOLLY Amanda, et al
Journal article citation:
Aging and Mental Health, 15(8), November 2011, pp.978-984.
Publisher:
Taylor and Francis

Diagnosis of dementia is an important step for access to care, but many patients remain undiagnosed. This study explored the difference between observed and estimated prevalence of dementia in general practices in England. Six Primary Care Trusts (PCTs) provided data on all 351 general practices in their area in terms of number of doctors, patient list size, number of patients over 65, socio-economic status of practices and number of patients on dementia registers. The prevalence of dementia amongst patients over 65 years was 3.0%, 54.5% lower than the prevalence observed in studies in the UK. For an average size general practice, with 5269 patients, approximately 27 patients with dementia may remain undiagnosed. The observed prevalence of dementia was significantly lower among practices run by one GP compared to multiple GPs, and in more affluent areas. Just under a half of the expected numbers of patients with dementia were recognised in GP dementia registers. The under-diagnosis of dementia varies with practice characteristics, socio-economic deprivation and between PCTs.

Journal article

Personality changes in Alzheimer's disease: a systematic review

Authors:
WAHLIN Tarja-Brita Robins, BYRNE Gerald J.
Journal article citation:
International Journal of Geriatric Psychiatry, 26(10), October 2011, pp.1019-1029.
Publisher:
Wiley-Blackwell

People with Alzheimer's disease (AD) commonly exhibit changes in personality that sometimes precedes other early clinical manifestations such as cognitive impairment and mood changes. Early identification of personality change might therefore assist with diagnosis of AD. The objective of this paper is to provide a systematic review of the literature to examine the nature and extent of change in personality in people with AD. Systematic searches of 5 databases to November 2009 were undertaken to identify studies of informant-rated personality traits in AD patients. Nine studies that mapped changes in traits from the 5-factor model of personality (neuroticism, extraversion, openness, agreeableness and conscientiousness) were selected for analysis. The change in each of these 5 traits was calculated as the mean difference in score before and after the diagnosis of AD. The findings showed a mean increase in neuroticism of 10–20 T scores, a decrease of the same magnitude in extraversion, consistently reduced openness and agreeableness, and a marked decrease in conscientiousness of about 20–30 T scores. These changes were systematic and consistent. The article concludes that conscientiousness and neuroticism are the personality traits that exhibit the most change in dementia, and that these traits might therefore be useful early markers of dementia.

Book Full text available online for free

The assessment of pain in older people: national guidelines

Authors:
ROYAL COLLEGE OF PHYSICIANS, BRITISH GERIATRICS SOCIETY, BRITISH PAIN SOCIETY
Publisher:
Royal College of Physicians
Publication year:
2007
Pagination:
13p.
Place of publication:
London

Pain is a subjective, personal experience, and its assessment is particularly challenging in the presence of severe cognitive impairment, communication difficulties or language and cultural barriers. As a result it is often under-recognised and under-treated in older people. These guidelines form part of a series intended to inform those aspects of physicians’ clinical practice which may be outside their own specialist area and are designed to help them make rapid, informed decisions. The advice is based on synthesis of the best available evidence and expert consensus gathered from practising clinicians and service users. The guidelines set out the key components of assessing pain in older people, together with a variety of practical scales that may be used with different groups, including those with cognitive or communication impairment. The purpose is to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. The guidance is relevant to all healthcare and social care staff and can be applied in a wide variety of settings, including the older person’s own home, in care homes, and in hospital.

Journal article

General practitioners' experiences and understandings of diagnosing dementia: factors impacting on early diagnosis

Authors:
HANSEN Emily C., et al
Journal article citation:
Social Science and Medicine, 67(11), December 2008, pp.1776-1783.
Publisher:
Elsevier

This article reports findings from three linked qualitative research projects that explored how Australian general practitioners (GPs) spoke about their experiences in diagnosing dementia and their views on early diagnosis and barriers towards early diagnosis. The authors conducted this research with the aim of elucidating the GP perspective and using this to better understand the process of diagnosing dementia and delays in diagnosing dementia. Twenty-four GPs based in Australia participated in the study (eleven females and thirteen males). Six of these GPs worked in rural practices, eight in a large town and the remainder in urban practices in a capital city. The major themes in GPs' accounts of the diagnosis of dementia could be grouped under the headings of ‘recognizing dementia’, ‘holistic viewpoint’, ‘family members and patients’ and ‘medication’. Key findings are that dementia is a complex condition that takes time to diagnose. Diagnosis may involve conflict between GPs, family members/carers and the person with dementia (PWD). GPs did not consider that diagnosing dementia early was particularly important and may in fact be harmful to some patients. They are sceptical about the advantages of dementia medications. GPs assess the need for a formal diagnosis of dementia within the broader context of their older patients' lives. They are more likely to pursue a formal diagnosis in situations where they see it leading to benefits for their patient such as accessing dementia specific services. Increasing the availability of support services for PWD and educating GPs about the benefits of a formal diagnosis of dementia for stakeholders other than PWD, for example family members and carers may increase the likelihood that they will diagnose dementia early.

Book Full text available online for free

Improving the detection of correctable low vision in older people

Author:
THOMAS POCKLINGTON TRUST
Publisher:
Thomas Pocklington Trust
Publication year:
2008
Pagination:
8p.
Place of publication:
London

What is the optimum test battery for visual screening of older people and what sensitivity and specificity does this have for detecting correctable visual impairment? The study is mainly quantitative. A battery of computerised visual screening tests will be compared with a full eye examination, in two blind studies. The first study will be used to refine the test battery and to develop a flip chart rapid vision screener. The sensitivity and specificity of the refined computerised screener and flip chart rapid screener will be evaluated in a second study. The main target conditions are uncorrected refractive error and cataract, since these are readily correctable. The sensitivity and specificity of the screening tools for detecting these problems will be calculated. The value of different screening venues will also be investigated People aged 65 years and older will be approached through a variety of sources (e.g., community centres, GP surgeries, hospital clinics, nursing homes). The only selection criterion is age. Two studies each require 300 participants. The results of the computerised screening will be compared with the results of a full eye examination. The ability of the screening tools to detect other eye conditions will also be evaluated, as a secondary aim, as will the prevalence of correctable low vision in older people, the role of ethnicity and poverty, and barriers to existing services.

Journal article

The 6 and 12 month outcomes of older medical inpatients who recover from delirium

Authors:
COLE Martin G., et al
Journal article citation:
International Journal of Geriatric Psychiatry, 23(3), March 2008, pp.301-307.
Publisher:
Wiley-Blackwell

The aim was to compare the 6 and 12 month outcomes of patients who recovered from delirium by 8 weeks with those who did not have an index episode. Older medical inpatients were assessed for delirium using the Confusion Assessment Method. All patients with delirium and a sample of patients without delirium were enrolled. Recovery from delirium at 8 weeks was determined using the Delirium Index and an algorithm based on DSM-III-R criteria. The primary composite outcome was cognitive or functional decline, institutional residence or death at 6 and 12 months. The authors fitted two logistic regression models to predict outcome odds ratio (OR) of delirium-recovered vs no delirium groups, adjusting for co-morbidity, severity of physical illness and demographic variables. In secondary analyses, each component of the primary outcome was examined separately. Of 361 patients enrolled, 59 died, 33 withdrew and one was lost to follow-up before 8 weeks. Of 268 patients assessed at 8 weeks, 115 and 95 were in delirium-recovered and no delirium groups, respectively. The 6 month OR for the primary composite outcome was 0.89 (95% CI 0.46, 1.70); the 12 month OR was 1.5 (95% CI 0.77, 2.90). Secondary analyses revealed a clinically important increase in mortality at 6 and 12 months. Among patients who survived, there were no significant differences in cognition, function or institutional status between delirium-recovered and no delirium groups at 6 and 12 months. If replicated, these findings have potentially important implications for clinical practice and research.

Journal article Full text available online for free

Prevalence of dementia in intellectual disability using different diagnostic criteria

Authors:
STRYDOM A., et al
Journal article citation:
British Journal of Psychiatry, 191(8), August 2007, pp.150-157.
Publisher:
Royal College of Psychiatrists

Diagnosis of dementia is complex in adults with intellectual disability owing to their pre-existing deficits and different presentation. The aim was to describe the clinical features and prevalence of dementia and its subtypes, and to compare the concurrent validity of dementia criteria in older adults with intellectual disability. The Becoming Older with Learning Disability (BOLD) memory study is a two-stage epidemiological survey of adults with intellectual disability without Down syndrome aged 60 years and older, with comprehensive assessment of people who screen positive. Dementia was diagnosed according to ICD–10, DSM–IV and DC–LD criteria. The DSM–IV dementia criteria were more inclusive. Diagnosis using ICD–10 excluded people with even moderate dementia. Clinical subtypes of dementia can be recognised in adults with intellectual disability. Alzheimer’s dementia was the most common, with a prevalence of 8.6% (95% CI 5.2–13.0), almost three times greater than expected. Dementia is common in older adults with intellectual disability, but prevalence differs according to the diagnostic criteria used. This has implications for clinical practice.

Journal article Full text available online for free

Be honest with me

Author:
PEARL Joanna
Journal article citation:
Community Care, 26.8.04, 2004, pp.34-35.
Publisher:
Reed Business Information

Reports how people with dementia are not consistently given their diagnosis or the information and support they need afterwards. Looks at the benefits knowing the diagnosis can have for patients and carers in decision-making, planning and quality of life. Also reports on a good practice model at the Dementia Advice and Support Service (DASS) in Nottingham. The service provides support and information after diagnosis and had involved staff and service users in high-quality dementia service development.

Key to icons

  • Free resource Free resource
  • Journal article Journal article
  • Book Book
  • Digital media Digital media
  • Journal Journal

Give us your feedback

Social Care Online continues to be developed in response to user feedback.

Contact us with your comments and for any problems using the website.

Sign up/login for more

Register/login to use standard search filters, access resource links, advanced search and email alerts