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The psychometric properties of the Multi-Dimensional Observation Scale for Elderly Subjects (MOSES) in middle aged and older populations of people with mental retardation
- Authors:
- STURMEY P., TSIOURI J. A.,S, PATTI P.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(2), February 2003, pp.131-134.
- Publisher:
- Wiley
This article seeks to assess the internal consistency, inter-scale correlations and factor structure of the MOSES with older adults with mental retardation. A series of outpatients with learning difficulties were assessed with the MOSES. 163 middle aged and older adults with learning difficulties living in community settings participated. MOSES appears to be a psychometrically adequate instrument to screen older adults
Camberwell Assessment of Need for the Elderly (CANE): development, validity and reliability
- Authors:
- REYNOLDS Tom, et al
- Journal article citation:
- British Journal of Psychiatry, 176, May 2000, pp.444-452.
- Publisher:
- Cambridge University Press
There exists no instrument specifically designed to measure comprehensively the needs of older people with mental disorders. This article describes the development of such an instrument which would take account of patients', staff and carers' views on needs. The Camberwell Assessment of Need for the Elderly (CANE) comprises 24 items (plus two items for carer needs), and records staff, carer and patient views. Concludes that the psychometric properties of the CANE seem to be highly acceptable. It was easily used by a wide range of professionals without formal training.
Psychiatric symptoms associated with dementia in older people with learning disability
- Authors:
- MOSS Steve, PATEL Pradip
- Journal article citation:
- British Journal of Psychiatry, 167, November 1995, pp.663-667.
- Publisher:
- Cambridge University Press
Describes a study of non-cognitive features of dementia in a population of 105 people over 50 years of age, with learning disability. Results support the previously reported observation for the general population that cognitive and non-cognitive features are only weakly related. The study suggests that psychiatric symptom information may be useful in screening for dementia in people with learning disabilities.
A systematic review of cognitive decline in the general elderly population
- Authors:
- PARK Helen L., O'CONNELL Janice O., THOMSON Richard G.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1121-1134.
- Publisher:
- Wiley
The aim was to establish the rate of age-related cognitive decline in the general elderly population. Systematic review of studies of cognitive decline in the general elderly population. Medline, Embase and PsycINFO databases were searched using an adapted version of McMaster's aetiology, causation and harm strategies and the Cochrane Dementia and Cognitive Impairment Group strategy. Grey literature was explored and experts contacted. A second observer was involved at all stages and quality appraisal of included studies was performed. Included studies were representative, community-based, cohort studies of people aged over 60, incorporating individuals with dementia. Identification of 5990 abstracts and retrieval of 163 full texts led to inclusion of 19 papers. Heterogeneity made narrative review the appropriate method of data synthesis. Some degree of cognitive impairment with increasing age was found in all studies, although the extent varied. The prevalence of cognitive impairment and the rate of decline increased with age. Studies were of variable quality. Cognitive decline is almost universal in the general elderly population and increases with age. Improved communication between researchers and between clinicians to identify a core minimum data set of neuropsychological tests that could be used in different populations would support consistent study design and meta-analysis, helping to quantify the true rate of cognitive decline in the elderly and assisting diagnosis in clinical practice.
A longitudinal study of neuropsychological change in individuals with Parkinson's disease
- Authors:
- AZUMA Tamiko, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1115-1120.
- Publisher:
- Wiley
Neuropsychological changes in individuals with Parkinson's disease (PD) were studied longitudinally. Sixty-nine idiopathic PD patients, with Mini-Mental State Examination (MMSE) scores falling within normal range, and 37 elderly control participants were given neuropsychological tests twice approximately two years apart. The PD group performed poorer than the control group on Semantic Fluency, Letter Fluency, Modified Wisconsin Card Sorting Task, and Block Design at test time 1. Two years later, the PD group showed significant decline in Semantic and Letter Fluency. A subset of 12 PD patients declined in mental status by second testing (>4 MMSE points). Cox proportional-hazards models were used to see if any baseline measures were associated with relative risk of decline in mental status. In the final model, Repetition performance and Age were significantly associated with cognitive decline. Consistent with previous studies, executive function tasks were those most susceptible to disease progression.
A new approach to the qualitative evaluation of functional disability in dementia
- Authors:
- KURZ X., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(11), November 2003, pp.1050-1055.
- Publisher:
- Wiley
Dementia patients suffer from the progressive deterioration of cognitive and functional abilities. Instrumental disabilities usually appear in the earlier stages of the disease while basic disabilities appear in the more advanced stages. In order to differentiate between mild, moderate and severe patients both instrumental and basic functional disabilities should be taken into account simultaneously. The objective of this study was to find a new method for classifying dementia patients based on their disabilities by using a basic and an instrumental Activities of Daily Living (ADL) scale. Functional disability was assessed in a Belgian cohort of dementia patients using the Katz and Lawton Instrumental Activities of Daily Living (IADL) scales. A k-means derived clustering method allocated patients to disability clusters according to their Katz and Lawton scores. In order to validate the classification, we compared socio-demographic, clinical and costs parameters between the groups. The clustering method allocated patients between three clusters: dependent, non-dependent with instrumental functional disability (ND-IFD) and non-dependent. Dependence, as defined by these clusters, significantly correlates with age, residential setting, MMSE, patient's quality of life and costs. This new classification of patients suffering from dementia will provide better understanding of functional disabilities and will complement the evaluation of disease severity based on cognitive function.
Associations between behaviour disorders and health status among older adults with intellectual disability
- Authors:
- DAVIDSON P. W., et al
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.424-430.
- Publisher:
- Taylor and Francis
Few studies have examined the relationship of behaviour and health status among aging persons with intellectual and developmental disabilities (I/DD). Behavioural disorders, which often are coincident with functional decline in older persons with I/DD, may be more related to medical morbidity than previously reported. This cross-sectional study examined the association between health status and behaviour disorders with increasing age in a cohort of 60,752 adults with I/DD clustered into four adult-age groupings (21-44, 45-59, 60-74, and >74). Age grouping data suggested an association between morbidity and increased likelihood of behaviour symptoms in all but the oldest age grouping. The magnitude of the association and trend varied by specific disease across age groupings compared to that found in healthy cohorts. About 25% of the adults with I/DD had psychiatric diagnoses and the frequency of such diagnoses did not decrease with age grouping. These results suggest that adverse health status may increase the likelihood of persistent behavioural disturbances in older persons with I/DD. Moreover, behavioural disorders may be sentinels for occult medical morbidity, which in turn may be responsive to intervention.
Prevalence of cognitive impairment amongst Singapore's elderly Chinese: a community-based study using the ECAQ and the IQCODE
- Authors:
- LIM Hsien Jer, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(2), February 2003, pp.142-148.
- Publisher:
- Wiley
This study examined the prevalence of cognitive impairment in the elderly Chinese living in the Queenstown district of Singapore using two locally-validated cognitive screening instruments: the Elderly Cognitive Assessment Questionnaire (ECAQ), and the Informant Questionnaire on the Cognitive Decline of the Elderly (IQCODE). It was found that We have found the prevalence of cognitive impairment amongst Singapore's elderly to be higher than previously reported. These findings imply that current resources may be inadequate for the effective care and management of the cognitively-impaired elderly people.
Relationship between fluid intelligence and ability to benefit from cognitive-behavioural therapy in older adults: a preliminary investigation
- Authors:
- DOUBLEDAY Elizabeth K., KING Paul, PAPAGEORGIOU Costas
- Journal article citation:
- British Journal of Clinical Psychology, 41(4), November 2002, pp.423-428.
- Publisher:
- Wiley
The aim of this study was to conduct a preliminary evaluation of the hypothesis that fluid intelligence, or the ability to solve novel problems, in older adults is associated with the ability to benefit from cognitive-behavioural therapy (CBT), but unrelated to the ability to benefit from non-directive supportive counselling (SC). The results for the SC group showed a significant and positive association between fluid intelligence scores and anxiety change scores, such that older adults with higher levels of fluid intelligence demonstrated the most benefit from this intervention. In contrast, there was no significant association between level of fluid intelligence and ability to benefit from therapy in the CBT group. CBT for anxiety disorders is suitable for older adults, irrespective of their fluid intelligence, while the nature of SC may render it more sensitive to level of fluid intelligence.
The geriatric mental state examination in the 21st century
- Authors:
- COPELAND J. R. M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(8), August 2002, pp.729-732.
- Publisher:
- Wiley
The Geriatric Mental State Examination is now established as one of the most commonly used mental health assessments for older people. Its strengths lie in extensive validity studies, high inter-rater reliability, accessibility to trained raters, irrespective of professional background and its continual evolution and adaptation. Its computerisation, association with supplementary instruments and support by a diagnostic algorithm provides a comprehensive diagnostic system and syndrome profile for each subject. The instrument has been validated against most major diagnostic systems and has been used as outcome measures in intervention studies. It has been translated into numerous languages and validated as a diagnostic instrument in various cultures. Such studies have exposed weaknesses, including the over diagnoses of organic states in populations with poorly developed education. On-going studies continue to address these issues, providing a culture sensitive instrument enabling unique trans-cultural research in a relatively under-researched field.