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Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older people
- Authors:
- SAMUELSSON G., et al
- Journal article citation:
- Health and Social Care in the Community, 11(2), March 2003, pp.95-102.
- Publisher:
- Wiley
This study was designed to describe the pattern of long-term formal support received by people with mental disorders and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support, based on a cohort of 192 people born in 1902 and 1903 in a community in Southern Sweden. They were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 and on 8 further occasions until they were 92. Participation ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% with other psychiatric diagnoses and 12% with good mental health. The last group all had physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% with good mental health received no formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other 2. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with mental disorder, including dementia, were significantly more likely to use formal support compared with people with good mental health. Social factors were the main factors predicting formal support.
Incremental patterns in the amount of informal and formal care among non-demented and demented elderly persons results from a 3-year follow-up population-based study
- Authors:
- WIMO A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(1), January 2011, pp.56-64.
- Publisher:
- Wiley
Against the assumption that care for older people includes complex interactions between formal services and informal care, this study aimed describe longitudinal patterns in formal and informal care given to older people with and without dementia. The older people studied (who were participating in a longitudinal population-based study on ageing and dementia called the Kungsholmen-Nordanstig Project) were aged 75 years and over, and living at home in a rural area in northern Sweden. They were clinically examined and interviewed at the baseline of the project and at follow-up approximately 3 years later. The researchers found that overall quantified informal care at follow-up for those still living at home was about 3 times larger than formal care. They also found that the amount of informal care was lower for people with dementia still living at home at follow-up than at baseline, probably due to effects such as institutionalisation and mortality, and that having mild cognitive decline and no home support at baseline had a strong association with receiving care or being dead at follow-up.
Mental health first aid for the elderly: a pilot study of a training program adapted for helping elderly people
- Authors:
- SVENSSON Bengt, HANSSON Lars
- Journal article citation:
- Aging and Mental Health, 21(6), 2017, pp.595-601.
- Publisher:
- Taylor and Francis
Objectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal ageing and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training programme for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Method: Single group pre-test–post-test design. Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomised controlled trail is needed to investigate the effectiveness of the programme. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved. (Edited publisher abstract)
Baseline leisure time activity and cognition more than two decades later
- Authors:
- KAREHOLT Ingemar, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(1), January 2011, pp.65-74.
- Publisher:
- Wiley
Using information from 2 baseline surveys carried out in 1968 and 1981, this study analysed the correlation between different leisure time activities and cognition more than 20 years later. The surveys interviewed random samples of Swedish people aged 46-75 years, and a total of 1,643 follow-up observations were made. The range of activities included political, mental, socio-cultural, social, physical, and organisational activities. There was a significant association between later cognition and earlier political, mental and socio-cultural activities, controlling for a range of factors. Physical activities had a significant association with cognition only among women. The researchers concluded that the findings reinforce the theory that various forms of engagement in mid-life can have a protective effect with respect to cognition in later life, and support the long-term importance of policies to encourage an active life style among middle aged adults.
Work-related physical activity and the risk of dementia and Alzheimer's disease
- Authors:
- ROVIO Suvi, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(9), September 2007, pp.874-882.
- Publisher:
- Wiley
Leisure-time physical activity has been related with a reduced risk of dementia and Alzheimer's disease (AD). The effects of occupational and commuting physical activity (physical activity at work and on the way to work) on cognitive health are still unclear. This study aimed to clarify the association between work-related physical activity and dementia/AD. Participants of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study were derived from random, population-based samples previously studied in a survey carried out in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1449 individuals (73%) aged 65 to 79 years participated in the re-examination in 1998. Neither occupational [Odds Ratio (OR) 1.45; 95% Confidence Intervals (CI) 0.66-3.17] nor commuting physical activity (OR 0.46; 95% CI 0.10-2.17) were associated with the risk of dementia or AD after adjustments for age, sex, education, follow-up time, locomotor symptoms, main occupation during life, income at midlife, leisure-time physical activity, other subtype of work-related physical activity, ApoE genotype, vascular disorders and the smoking status. There were also no interactions between work-related physical activity and the ApoE 4 genotype, leisure-time physical activity or sex. In this study, work-related physical activity was not found to be sufficient to protect against dementia and AD later in life. The lack of effect might be partly due to a residual confounding. Nevertheless, physical activity during leisure-time may be beneficial even for people who are physically active at work or when commuting.
Support for family carers for an elderly person at home: a systematic literature review
- Authors:
- STOLTZ Peter, UDDEN Giggi, WILLMAN Ania
- Journal article citation:
- Scandinavian Journal of Caring Sciences, 18(2), June 2004, pp.111-119.
- Publisher:
- Blackwell Publishing
Sweden, like other countries, has an ageing population, and support for the carers of older people in their own homes is an important policy issue. Support may take a variety of forms, both formal and informal, and this review aims to identify and synthesise high quality evidence on family carers’ perspectives of their situations and needs. Twenty-six papers (primarily American and of carers of people with Alzheimer’s disease) are included in the review, showing that carers fear social isolation and want to network with their peers, either for social or learning purposes. They also want respite care. However, the evidence is not clear on whether they actually benefit from these forms of support, or how service provision should be attempted.
Service provision for elderly depressed persons and political and professional awareness for this subject: a comparison of six European countries
- Author:
- BRAMSFELD Anke
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(5), May 2003, pp.392-401.
- Publisher:
- Wiley
Under-treatment of depression in late-life is a subject of rising public health concern throughout Europe. This study investigates and compares the availability of services for depressed elderly persons in Denmark, France, Germany, Sweden, Switzerland and the UK. Additionally, it explores factors that might contribute to an adequate services supply for depressed elderly people. Review of the literature and guide supported expert interviews. Analysis of the practice of care provision for depressed elderly persons and of indicators for political and professional awareness, such as university chairs, certification processes and political programmes in gerontopsychiatry. Only Switzerland and the UK offer countrywide community-oriented services for depressed elderly persons. Clinical experience in treating depression in late-life is not regularly acquired in the vocational training of the concerned professionals. Indicators suggest that the medical society and health politics in Switzerland and the UK regard psychiatric disease in the elderly more importantly than it is the case in the other investigated countries. Service provision for depressed elderly persons seems to be more elaborated and better available in countries where gerontopsychiatry is institutionalised to a greater extend in the medical society and health politics.
Loneliness research and interventions: a review of the literature
- Author:
- ANDERSSON L.
- Journal article citation:
- Aging and Mental Health, 2(4), November 1998, pp.264-274.
- Publisher:
- Taylor and Francis
This article describes and reviews concepts and studies in the area of social relations and health, with special emphasis on loneliness. Related concepts such as social networks and social support are also considered. The fundamental distinction between the objective manifestation of being alone and the subjective manifestation of experiencing loneliness is emphasised. The second part of the article consists of a description of various network interventions followed by an overview and discussion of loneliness interventions.
Psychiatric diagnoses in relation to severity of intellectual disability and challenging behaviors: a register study among older people
- Authors:
- AXMON A., et al
- Journal article citation:
- Aging and Mental Health, 22(10), 2018, pp.1344-1350.
- Publisher:
- Taylor and Francis
Objective: To investigate the possible association between severity of intellectual disability (ID) and presence of challenging behaviour, respectively, on diagnoses of psychiatric disorders among older people with ID. Methods: People with a diagnosis of ID in inpatient or specialist outpatient care in 2002–2012 were identified (n = 2147; 611 with mild ID, 285 with moderate ID, 255 with severe or profound ID, and 996 with other/unspecified ID). Moreover, using impairment of behaviour as a proxy for challenging behaviour, 627 people with, and 1514 without such behaviour were identified. Results: Severe/profound ID was associated with lower odds of diagnoses of psychotic, affective, and anxiety disorders than was mild/moderate ID. People with moderate ID had higher odds than those with mild ID of having diagnoses of affective disorders. Diagnoses of psychotic, affective, and anxiety disorders, and dementia were more common among people with challenging behaviour than among those without. Conclusions: People with severe/profound ID had lower odds of receiving psychiatric diagnoses than those with mild and moderate ID. Whether this is a result of differences in prevalence of disorders or diagnostic difficulties is unknown. Further, challenging behaviours were associated with diagnoses of psychiatric disorders. However, the nature of this association remains unclear. (Edited publisher abstract)
Older criminals: a descriptive study of psychiatrically examined offenders in Sweden
- Authors:
- FAZEL Seena, GRANN Martin
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(10), October 2002, pp.907-913.
- Publisher:
- Wiley
This article retrospectively examines psychiatric diagnoses of older offenders referred by court for psychiatric assessment in Sweden, and compared them with younger offenders. Results found there appears to be important differences in psychiatric morbidity between older offenders and younger ones who come into contact with forensic psychiatric services. This research may assist in the planning of forensic and therapeutic services for the increasing number of older adults passing through the criminal justice system.