International Journal of Geriatric Psychiatry, 23(10), October 2008, pp.1058-1065.
Publisher:
Wiley
Depression is more prevalent in subjects with dementia than in those without it. Due to both psychological and biological risk factors it is suggested that a bimodal distribution of depressive symptoms exists with higher prevalence rates being found among patients suffering both with mild and with severe dementia. To confirm or reject the hypothesis of a bimodal distribution of depressive subscale did not differ across CDR groups, whereas the scores on the four other subscales increased with increasing CDR scores. The results did not find a bimodal distribution of depressive symptoms. The explanation for the occurrence of the typical core symptoms of depression, the mood symptoms, is probably complex. The non-mood symptoms are probably strongly influenced by biological factors.
Depression is more prevalent in subjects with dementia than in those without it. Due to both psychological and biological risk factors it is suggested that a bimodal distribution of depressive symptoms exists with higher prevalence rates being found among patients suffering both with mild and with severe dementia. To confirm or reject the hypothesis of a bimodal distribution of depressive symptoms. A sample of 1,159 randomly selected nursing home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale (CDR) and Lawton's Scale of the activities of daily living. Additionally, information was collected from the patients' records. A factor analysis of the Cornell Scale was performed. The use of antidepressants and demographic characteristics, except for gender distribution, did not differ across CDR groups. Patients with dementia had more symptoms such as anxiety, irritability, agitation, retardation, loss of interest, lack of joy and delusion than those without dementia. No symptom was more frequent among non-demented subjects. The factor analysis resulted in a five factors solution: mood, cyclic, physical, retardation and behavioural factor. The score on the mood subscale did not differ across CDR groups, whereas the scores on the four other subscales increased with increasing CDR scores. The results did not find a bimodal distribution of depressive symptoms. The explanation for the occurrence of the typical core symptoms of depression, the mood symptoms, is probably complex. The non-mood symptoms are probably strongly influenced by biological factors.
International Journal of Geriatric Psychiatry, 23(8), August 2008, pp.877-879.
Publisher:
Wiley
The aim of this pilot study was to examine cognition, Behavioural and Psychological Symptoms of Dementia (BPSD) and depression after withdrawal of antipsychotic or antidepressant medication in patients with dementia and BPSD. A 24-week open antidepressant and antipsychotic withdrawal study with 23 patients in Norway. Although the findings are not statistically significant and the number
The aim of this pilot study was to examine cognition, Behavioural and Psychological Symptoms of Dementia (BPSD) and depression after withdrawal of antipsychotic or antidepressant medication in patients with dementia and BPSD. A 24-week open antidepressant and antipsychotic withdrawal study with 23 patients in Norway. Although the findings are not statistically significant and the number of patients is small, the results did show a trend towards decreased depressive and BPSD symptoms after the withdrawal of antidepressants.
International Journal of Geriatric Psychiatry, 20(11), November 2005, pp.1067-1074.
Publisher:
Wiley
The aim was to determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study in the Netherlands. Sensitivity and specificity, positive and negative predictive values, and the area under the receiver operating curve (ROC) were assessed. Cronbach alphas were also calculated. Both major depression (MDD) and minor depression (MinD) according to the DSM-IV criteria, measured with the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), were used as gold standard. The cut-off point 11 on the GDS-30 gave a sensitivity of 96.3% for MDD and 85.1% for MinD, with a specificity varying between 18.9% and 74.1%. Sufficient internal consistency was found for the GDS-30, the GDS-15, the GDS-12 and the GDS-10, with Cronbach's alphas varying between 0.88 and 0.72. The GDS-30 was found to be a valid and reliable case-finding tool for both major and minor depression in nursing home patients with no cognitive impairment and in patients with mild to moderate cognitively impairment
The aim was to determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study in the Netherlands. Sensitivity and specificity, positive and negative predictive values, and the area under the receiver operating curve (ROC) were assessed. Cronbach alphas were also calculated. Both major depression (MDD) and minor depression (MinD) according to the DSM-IV criteria, measured with the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), were used as gold standard. The cut-off point 11 on the GDS-30 gave a sensitivity of 96.3% for MDD and 85.1% for MinD, with a specificity of 69.1%. The sensitivity of most of the shortened versions was sufficient, varying between 88.9% and 100% for MDD, and between 63.8% and 97.9% for MinD. With regard to the shortened versions, best sensitivity (96.3% and 78.7%) and specificity (69.5%) were found for the GDS-10 developed by D'Ath et al. (1994). The specificity rates for most of the shortened versions were found to be less satisfactory, varying between 18.9% and 74.1%. Sufficient internal consistency was found for the GDS-30, the GDS-15, the GDS-12 and the GDS-10, with Cronbach's alphas varying between 0.88 and 0.72. The GDS-30 was found to be a valid and reliable case-finding tool for both major and minor depression in nursing home patients with no cognitive impairment and in patients with mild to moderate cognitively impairment (MMSE 15). The GDS-10 (D'Ath et al., 1994) appeared to be the best least time-consuming alternative for the nursing home setting.
International Journal of Geriatric Psychiatry, 11(5), May 1996, pp.405-410.
Publisher:
Wiley
Epidemiological studies of elderly populations have been, in general, more concerned with depression and dementia than with anxiety disorders. This article discusses the results of a study of 5 nursing homes in Sydney, Australia, to examine depression and anxiety amongst residents. Residents were interviewed using the Mini-Mental-State-Examination (MMSE), the Geriatric Depression Scale (GDS) and an anxiety questionnaire by Lindesay et al. Results confirmed that anxiety symptoms are common among nursing home residents and that there is a strong association between anxiety and depression.
Epidemiological studies of elderly populations have been, in general, more concerned with depression and dementia than with anxiety disorders. This article discusses the results of a study of 5 nursing homes in Sydney, Australia, to examine depression and anxiety amongst residents. Residents were interviewed using the Mini-Mental-State-Examination (MMSE), the Geriatric Depression Scale (GDS) and an anxiety questionnaire by Lindesay et al. Results confirmed that anxiety symptoms are common among nursing home residents and that there is a strong association between anxiety and depression.
... schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale–Residential) by using gamma distribution. Results: Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest,
(Edited publisher abstract)
Objectives: Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. This studyexamined the effect of a whole-ecology PA intervention program on NH residents’ depressive symptoms using generalized linear mixed-models (GLMMs). Method: The study used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning (n = 163, Mage = 83.1, 53–100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale–Residential) by using gamma distribution. Results: Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilisation in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. Conclusion: Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents’ depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered.
(Edited publisher abstract)
Dementia: the International Journal of Social Research and Practice, 16(2), 2017, pp.204-218.
Publisher:
Sage
... dementia received the BE-ACTIV intervention while eight residents received a Walking and Talking intervention. Measures of depression (GDS-12R) and QOL (QOL-AD-NH) were administered prior to and following the interventions. Qualitative feedback indicated residents benefited from BE-ACTIV, evident by improved mood, although no statistically significant treatment effect was found. Moreover,
(Edited publisher abstract)
This pilot study aimed to assess the feasibility and acceptability of a behavioural activities intervention (BE-ACTIV) in Australian nursing homes. BE-ACTIV was developed by researchers at the University of Louisville, USA, to improve mood and quality of life (QOL) in nursing home residents with mild to moderate dementia. An eight-week trial was conducted and 10 residents with mild to moderate dementia received the BE-ACTIV intervention while eight residents received a Walking and Talking intervention. Measures of depression (GDS-12R) and QOL (QOL-AD-NH) were administered prior to and following the interventions. Qualitative feedback indicated residents benefited from BE-ACTIV, evident by improved mood, although no statistically significant treatment effect was found. Moreover, the intervention was found to be feasible and acceptable to Australian nursing home staff and our findings highlight the importance of individualizing activities for people with dementia, of which 1:1 staff attention was a key component.
(Edited publisher abstract)
Subject terms:
depression, nursing homes, quality of life, intervention, leisure activities;
Aging and Mental Health, 17(8), 2013, pp.1023-1029.
Publisher:
Taylor and Francis
... completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale. Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher
(Edited publisher abstract)
Using a sample of 257 older adults who lived in their own homes and 166 older adults who lived in an assisted living facility in Australia, this study examines whether the relationship between housing type and depressive symptoms is mediated by a sense of belonging and whether housing type and sense of belonging interact to influence the depressive symptoms among older adults Participants completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale. Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher levels of depressive symptoms. Residing in an assisted living facility was associated with depressive symptoms at low and average levels of belonging. The results highlight the need for more research on the role of sense of belonging as an influencing factor on depressive symptoms among institutionalised older adults for both theoretical and treatment goals.
(Edited publisher abstract)
Subject terms:
older people, depression, housing, care homes, nursing homes;
International Journal of Geriatric Psychiatry, 26(8), August 2011, pp.853-859.
Publisher:
Wiley
Symptoms of depression are often missed in older nursing home residents because they may be dismissed as an inevitable consequence of ageing. This paper describes the construction of an instrument (NH-SDI) to detect depression in older nursing home residents. Three hundred and twenty eight older people were selected at random from 17 nursing homes in France, and examined by a single investigator. for a cut-off score above 5. The authors concluded that the NH-SDI appeared to be a useful instrument for the detection of depression in nursing homes and could easily be used by staff as part of routine procedures.
Symptoms of depression are often missed in older nursing home residents because they may be dismissed as an inevitable consequence of ageing. This paper describes the construction of an instrument (NH-SDI) to detect depression in older nursing home residents. Three hundred and twenty eight older people were selected at random from 17 nursing homes in France, and examined by a single investigator. The examination included a psychiatric assessment, an evaluation of cognitive function, an evaluation of depressive state using four different instruments, and assessment of any changes in behaviour in those suffering from dementia. A scale of 16 dichotomous items (NH-SDI) was created. The internal consistency was satisfactory, as was its reliability with a sensitivity of 85% and a specificity of 87% for a cut-off score above 5. The authors concluded that the NH-SDI appeared to be a useful instrument for the detection of depression in nursing homes and could easily be used by staff as part of routine procedures.
Aging and Mental Health, 14(7), September 2010, pp.881-887.
Publisher:
Taylor and Francis
Reminiscence therapy is a psychological intervention which is specifically designed to address issues of particular relevance to older adults, such as depression. Integrative reminiscence is a process that promotes acceptance of self and others, conflict resolution and reconciliation, a sense of meaning and self-worth, and the integration of the present and past. Instrumental reminiscence involves remembering past plans and goal-directed activities, recalling how one dealt with past problems, and drawing from past experience to solve the present problems. The aim of this study was to examine the therapeutic effectiveness of these two types of reminiscence interventions for the treatment of depression in institutionalised older adults dwelling in a nursing home. These interventions were reduction in symptoms of depression in contrast with the control group. Although instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant. The study provides support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living in residential care settings.
Reminiscence therapy is a psychological intervention which is specifically designed to address issues of particular relevance to older adults, such as depression. Integrative reminiscence is a process that promotes acceptance of self and others, conflict resolution and reconciliation, a sense of meaning and self-worth, and the integration of the present and past. Instrumental reminiscence involves remembering past plans and goal-directed activities, recalling how one dealt with past problems, and drawing from past experience to solve the present problems. The aim of this study was to examine the therapeutic effectiveness of these two types of reminiscence interventions for the treatment of depression in institutionalised older adults dwelling in a nursing home. These interventions were implemented in a short-term (6 sessions) group format and compared to an active social discussion control group. The participants were 29 residents of Kahrizak Nursing Home in Iran with depressive symptoms varying from mild to severe who were randomly assigned to 1 of the 3 groups. Analysis of changes from pre-test to post-test revealed that integrative reminiscence therapy led to statistically significant reduction in symptoms of depression in contrast with the control group. Although instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant. The study provides support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living in residential care settings.
Subject terms:
nursing homes, older people, reminiscence therapy, depression, group therapy;
This article (a) describes a 10-week, behavioural, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. BE-ACTIV, which stands for Behavioral Activities Intervention, was developed in two pilot study phases: a treatment symptoms. Despite low power, statistical and graphical comparisons suggest superiority of the intervention over treatment as usual. Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses
This article (a) describes a 10-week, behavioural, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. BE-ACTIV, which stands for Behavioral Activities Intervention, was developed in two pilot study phases: a treatment development phase and a feasibility–outcome phase with a small, randomized trial. The intervention was piloted with five depressed residents in a single nursing home in collaboration with the social services and activities staff. In the second phase randomized 20 residents from six nursing homes to receive either the intervention or treatment as usual. The intervention was well received by residents, family, and staff members. Experience with the intervention and input from staff members resulted in modifications to streamline the intervention and improve implementation. Results suggest that BE-ACTIV reduced institutional barriers to participation in pleasant activities, increased resident control over activity participation, increased overall activity participation, and improved depressive symptoms. Despite low power, statistical and graphical comparisons suggest superiority of the intervention over treatment as usual. Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses institutional barriers, involves facility staff in treatment, and is acceptable to residents. As such, BE-ACTIV merits further evaluation to establish efficacy and effectiveness.