Search results for ‘Subject term:"mental health problems"’ Sort:
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Risk of dementia and death in community-dwelling older men with bipolar disorder
- Authors:
- ALMEIDA Osvaldo P., et al
- Journal article citation:
- British Journal of Psychiatry, 209(2), 2016, pp.121-126.
- Publisher:
- Cambridge University Press
Background: Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking. Aims: To investigate the 13-year risk of dementia and death in older adults with bipolar disorder. Method: Cohort study of 37 768 men aged 65–85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest. Results: Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80–2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28–1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system. Conclusions: Bipolar disorder in later life is associated with increased risk of dementia and premature death. (Publisher abstract)
Association of psychological distress late in life and dementia-related mortality
- Authors:
- ROSNESS Tor Atle, et al
- Journal article citation:
- Aging and Mental Health, 20(6), 2016, pp.603-610.
- Publisher:
- Taylor and Francis
Objective: This study investigates the association between self-reported psychological distress and risk of dementia-related mortality. Method: The study included 31,043 eligible individuals between the ages of 60 and 80 years, at time of examination, from the CONOR (Cohort of Norway) database. They were followed for a period of 17.4 years (mean 11.5 years). The CONOR Mental Health Index, a seven-item self-report scale was used. A cut-off score equal to or above 2.15 on the scale denoted psychological distress. Cox regression was used to assess the association between psychological distress and risk of dementia-related mortality. Results: Total number of registered deaths was 11,762 and 1118 (9.5%) were classified as cases of dementia-related mortality. 2501 individuals (8.1%) had psychological distress, of these, 119 (10.6%) had concomitant dementia-related mortality. Individuals with psychological distress had an increased risk of dementia-related mortality after adjusting for age, gender and education. The association remained significant although attenuated when implemented in a full adjusted model, including general health status, smoking, obesity, hypertension, diabetes and history of cardiovascular disease. Conclusion: Results indicate that psychological distress in elderly individuals is associated with increased risk of dementia-related mortality. Individuals at increased risk of dementia may benefit from treatments or interventions that lessen psychological distress, but this needs to be confirmed in future clinical studies. (Edited publisher abstract)
The mental health needs of people living in extra care housing
- Authors:
- BROOKER Dawn J., ARGYLE Elaine, CLANCY David
- Journal article citation:
- Journal of Care Services Management, 3(3), April 2009, pp.295-309.
- Publisher:
- Taylor and Francis
Extra care housing is promoted as the best way of providing long-term support for older people. What happens to people if they develop dementia or other mental health problems in these settings is less clear. While promising ‘a home for life’, the reality is that many have to move on to more dependent care facilities if they experience significant problems. This paper reports data from 268 residents in ten extra care housing schemes who were judged by staff teams as being at risk from exclusion because of mental health problems. The sample included three large village schemes (greater than 170 residents) that had opened in the last five years as well as three medium schemes (60–80 residents) and four smaller schemes (under 50 residents). The overall incidence of dementia and depression was difficult to ascertain from records and from staff reports. Formal diagnosis varied substantially across schemes and staff estimates of diagnosis were also variable. Formal assessment of those residents that staff identified as being most at risk, however, showed that they had similar profiles on the Mini Mental State Examination, Geriatric Depression Scale, Bristol Activities of Daily Living Schedule and Barthel Inventory, regardless of the size of scheme they lived in. Those in larger village schemes were more likely to share their apartment with a spouse but the majority of people identified as being most vulnerable lived alone. These findings suggest that there is a need to take a proactive approach to people's mental health in extra care housing in order to be serious about maintaining a good quality of life for all within housing schemes.
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.
Dementia and serious sight loss
- Author:
- THOMAS POCKLINGTON TRUST
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2007
- Pagination:
- 19p.
- Place of publication:
- London
Visual impairment is one of the most common conditions in later life: common causes are aged related macular degeneration, diabetic retinopathy and glaucoma. Despite the high prevalence of sight loss in older adults, there have been few studies to examine its effects on quality of life, its psychological effect, or its effect on people’s ability to carry out activities of daily living. People with dementia are less able to express their needs and are therefore more likely to have uncorrected visual deficits. Poor vision in people with dementia leads to accelerated loss of independence and to an increased risk of psychotic symptoms such as visual halluciantions. The combined effects of dementia and serious sight loss can severely restrict independence with a consequent increase in reliance upon family carers and a higher risk of institutionalisation. It has been estimated that at least 2.5 per cent of people aged over 75 have both dementia and serious visual impairment. By finding out more about the needs and experiences of this group of people, the research team will be able to make recommendations for improving access to appropriate support for both individuals and their carers.
Mortality in individuals who have had psychiatric treatment: population-based study in Nova Scotia
- Author:
- KISELY Stephen
- Journal article citation:
- British Journal of Psychiatry, 18(6), December 2005, pp.552-556.
- Publisher:
- Cambridge University Press
Most studies of mortality in psychiatric patients have investigated in-patients rather than those attending out-patient clinics or primary care, where most receive treatment. The aim was to evaluate the mortality risk in mental illness for patients in contact with psychiatric services or primary care (n=221 048) across Nova Scotia (population 936 025). A population-based record-linkage analysis was made of the period 1995-2000, using an inception cohort to calculate mortality rate ratios. The mortality rate was 1.74, with increased ratios for all major causes of death. Male mortality was almost double that of females after controlling for demographic factors, treatment setting and place of residence. Patients of lower income, in specialist psychiatric settings, and with dementia or psychoses were also at greater risk. However, in absolute numbers, 72% of deaths occurred in patients who had only seen their general practitioner. Mortality risk is increased in all psychiatric patients, not just those who have received in-patient treatment.
A study of suicides of older people in Sydney
- Authors:
- SNOWDON John, BAUME Pierre
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(3), March 2002, pp.261-269.
- Publisher:
- Wiley
Reports based on studies of coroner's files show that suicides in old age are commonly related to depression, but that in a majority of cases disability or ill-health is also a major factor. The aim of this study was to try to understand more clearly the precipitant causes of suicide in an older population using an Australian metropolitan coroner's office provided data concerning suicides in 1994-1998 of persons aged over 65 years. Of 210 elderly people who killed themselves, 160 (76%) were clearly depressed, including a majority of the 24% deemed to have understandable reasons for suicide. Physical ill-health or disability was the major factor leading to suicide in 34% and appeared to contribute to suicidal ideation in another 24% of those who died; they had usually not been seen by psychiatrists. Because depression is often treatable, even when associated with depressing circumstances, there is potential for further reduction of old age suicide rates by recognising and appropriately responding to symptoms of depression and distress.
What are subjective cognitive difficulties and do they matter?
- Authors:
- OPDEBEECK Carol, et al
- Journal article citation:
- Age and Ageing, 48(1), 2019, pp.122-127.
- Publisher:
- Oxford University Press
Background: Subjective cognitive difficulties (SCD) have been associated with a higher risk of developing dementia. However, there is large variation in the way SCD are assessed and in their associations with cognitive functioning. Objective: To compare the agreement of different SCD measures in identifying people with SCD and to investigate whether SCD are more strongly associated with cognitive functioning, mood, subjective age or background variables. Methods: This cross-sectional study included 206 community-dwelling people aged ≥65. SCD were assessed with individual domain specific questions and a multiple-item scaled measure. Performance on tests of memory, attention, and executive function, and ratings of mood, subjective age and demographic information were recorded. Results: There was some classification overlap between the five measures of SCD, however of the 64 people identified as having SCD, only one person appeared in all five measures of SCD and 34 people were classified by one measure only. There were limited associations between SCD and objective cognition, with more consistent associations with mood and subjective age. Conclusions: Tthe conflicting evidence regarding whether SCD are related to objective cognition and future risk of dementia may be due to different measures of SCD being employed. Careful consideration and standardisation is recommended regarding the cognitive domains and the reference groups for comparison, the response structure and the classification criteria. Longitudinal studies of SCD that include these considerations are needed to clarify the conceptual utility of SCD. (Publisher abstract)
The effect of midlife risk factors on dementia in older age
- Author:
- PERSONAL SOCIAL SERVICES RESEARCH UNIT
- Publisher:
- Public Health England
- Publication year:
- 2017
- Pagination:
- 45
- Place of publication:
- London
This evidence review examines the association between different midlife (ages 40 to 64) risk factors and onset of dementia later in life. The review covers all types of dementia and in all age groups. The review is part of a wider study to help commissioners to make decisions about the prioritisation of primary prevention measures for dementia. The risk factors considered comprise: smoking, excessive drinking, high blood pressure, lack of physical activity and obesity, diabetes, depression and other common mental health conditions, social isolation and loneliness, and lifelong learning and cognitive stimulation. The review shows that there is evidence that the risk of dementia is increased by: physical inactivity, current smoking, diabetes, hypertension in mid-life, and obesity in mid-life and depression. It also shows that mental activity can reduce the risk of dementia. The review identifies areas for future research. (Edited publisher abstract)
The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm
- Authors:
- MITCHELL Rebecca, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(8), 2017, pp.892-900.
- Publisher:
- Wiley
Objective: Characteristics of older people with and without dementia who are hospitalised following self-harm remains largely unexplored. This research compares the characteristics of older people with and without dementia who self-harm, compares associations of mental health-related diagnoses with those hospitalised for a self-harm and a non-self-harm injury and examines mortality by injury intent. Method: A population-based study of individuals aged 50+ years with and without dementia admitted to hospital for a self-harm injury (and those with other injuries) using linked hospital admission and mortality records during 2003–2012 in New South Wales (NSW), Australia. Health outcomes, including hospital length of stay (LOS), 28-day readmission and 30-day and 12-month mortality were examined by dementia status. Results: There were 427 hospitalisations of individuals with dementia and 11,684 hospitalisations of individuals without dementia following self-harm. The hospitalisation rate for self-harm for individuals with dementia aged 60+ years was double the rate for individuals without dementia (72.2 and 37.5 per 100,000). For both older people with and without dementia, those who self-harmed were more likely to have co-existent mental health and alcohol use disorders than individuals who had a non-self-harm injury. Individuals with dementia had higher 12-month mortality rates, 28-day readmission and longer LOS than individuals without dementia. Conclusion: Dementia is associated with an increased risk of hospitalisation for self-harm in older people and worse outcomes. The high rate of coexistent mental health conditions suggests that interventions which reduce behavioural and psychological symptoms of dementia might reduce self-harm in people with dementia (Publisher abstract)