Search results for ‘Subject term:"older people"’ Sort:
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The prevalence of anxiety in older adults: methodological issues and a review of the literature
- Authors:
- BRYANT Christina, JACKSON Henry, AMES David
- Journal article citation:
- Journal of Affective Disorders, 109(3), 2008, pp.233-250.
- Publisher:
- Elsevier
A systematic review of literature on anxiety in people over 60, published between 1980 and 2007, finds prevalence rates for anxiety disorders of 1.2% to 15% in community settings, and 1% to 28% in clinical settings. The prevalence of anxiety symptoms is much higher, ranging from 15% to 52.3% in community samples, and 15% to 56% in clinical samples. These discrepancies are partly attributable to conceptual and methodological inconsistencies in the literature. The review finds that Generalised Anxiety Disorder is the most common anxiety disorder among older people, but issues relating to co-morbidity and the nature of anxiety in old age remain unresolved. This hampers the design of interventions and highlights the need for further research with a primary focus on anxiety.
Alcohol, dementia and cognitive decline in the elderly: a systematic review
- Authors:
- PETERS Ruth, et al
- Journal article citation:
- Age and Ageing, 37(5), September 2008, pp.505-512.
- Publisher:
- Oxford University Press
Evidence from the review and meta-analysis of results from 23 longitudinal studies of people aged 65 and older suggests that small amounts of alcohol may be protective against unspecified incident dementia (risk ratio 0.63) and Alzheimer’s disease (RR 0.57) but not vascular dementia (RR 0.82) or cognitive decline (RR 0.89). However, studies varied, with differing lengths of follow-up, measurement of alcohol intake, inclusion of true abstainers and assessment of potential confounders. The results should therefore be interpreted with caution and, given the ethical objections to randomised placebo-controlled trials in this area, it may never be possible to know for certainty the relationship between alcohol intake and dementia.
Assessing the effectiveness of interventions to promote advance directives among older adults: a systematic review and multi-level analysis
- Authors:
- BRAVO Gina, DUBOIS Marie-France, WAGNEUR Bernard
- Journal article citation:
- Social Science and Medicine, 67(7), October 2008, pp.1122-1132.
- Publisher:
- Elsevier
Many studies have investigated the effectiveness of interventions in promoting advance directives (ADs) but there is uncertainty as to what works best, and in whom. We conducted a systematic review of the evidence in this regard, using both classical meta-analysis approaches and multi-level analyses. Eleven databases were searched for relevant reports published through March 2007. All prospective studies were eligible, whether involving a single group or several and, in the latter case, regardless of the allocation mechanism. Outcomes included formal and informal ADs assessed by chart review or self-report. Heterogeneous sets of outcomes were pooled under a random-effects model. The search yielded 55 studies, half of which targeted outpatients. Most groups of subjects were educated in a single session led by one healthcare professional. Outcomes were measured within six months of the intervention in 73% of cases. The largest set of single-arm studies yielded an overall AD completion rate of 45.6%. Across randomized trials, the largest pooled odds ratio was 4.0, decreasing to 2.6 when all comparative studies were included. Multi-variable analyses identified the provision of oral information over multiple sessions as the most successful intervention. This was true regardless of the target population. These findings support the effectiveness of educational interventions in increasing the formulation of ADs and provide practical advice on how best to achieve this goal.
Brief interventions to prevent depression in older subjects: a systematic review of feasibility and effectiveness
- Author:
- COLE Martin G.
- Journal article citation:
- American Journal of Geriatric Psychiatry, 16(6), June 2008, pp.435-443.
- Publisher:
- Lippincott Williams and Wilkins
This systematic review proposed to explore the feasibility and effectiveness of brief interventions to prevent depression in older subjects. Computer databases were searched for potentially relevant articles published up until August, 2007. The bibliographies of relevant articles were searched for additional references and all the retrieved articles were screened to meet the following five inclusion criteria: original research, subjects mean age 40 years or more, controlled trial of a brief (<12 weeks) intervention to prevent depression, determination of depression status 6 months or more after enrolment, and use of an acceptable definition of depression. To examine feasibility, study enrolment, completion, and compliance rates were tabulated. To examine effectiveness, differences in depression symptom outcome scores or, when possible, absolute risk reductions (ARR) and relative risk reductions (RRR) for depression were tabulated. Fourteen trials were located. All were trials of brief psychosocial interventions. Many had one or more methodological limitations. Eight trials had positive results. In three trials there were significant differences in depression symptom outcome scores favouring the intervention group. Guidelines to improve the quality of future trials are proposed.
The prevalence of elder abuse and neglect: a systematic review
- Authors:
- COOPER Claudia, SELWOOD Amber, LIVINGSTON Gill
- Journal article citation:
- Age and Ageing, 37(2), 2008, pp.151-160.
- Publisher:
- Oxford University Press
Forty-nine studies, of which only seven used measures for which reliability and validity had been assessed, met the inclusion criteria for this review. In general population studies, 6% of older people reported significant abuse in the previous month, and 5.6% of couples reported physical violence in their relationships in the previous year. In studies using valid instruments, nearly 25% reported significant levels of psychological abuse. Five per cent of family carers reported physical abuse towards care recipients with dementia in a year, and a third reported any significant abuse. Sixteen per cent of care home staff admitted significant psychological abuse. However, rates of abuse recorded using objective measures (5%), or reported to home management or adult protective services (1-2%) were low. The study concludes that a quarter of vulnerable adults are at risk of abuse and that only a small proportion of abuse is currently detected.
Effect of community-based intervention using depression screening on elderly suicide risk: a meta-analysis of the evidence from Japan
- Authors:
- OYAMA Hirofumi, et al
- Journal article citation:
- Community Mental Health Journal, 44(5), October 2008, pp.311-320.
- Publisher:
- Springer
A systematic review was undertaken to quantify the effect of community-based depression screening (CDS) with follow-up on the completed suicide risk for residents aged 65 and over. Five quasi-experimental studies in Japanese regions with high suicide rates were included in the meta-analysis. Combined incidence rate ratios (95% confidence intervals) by the Mantel–Haenszel method and by the DerSimonian–Laird method in two homogenous studies implementing the follow-up conducted by psychiatrists were 0.30 (0.13–0.68) and 0.33 (0.14–0.80) in men, and 0.33 (0.19–0.58) and 0.33 (0.19–0.60) in women, respectively; and those in three homogenous studies implementing the follow-up conducted by general practitioners were 0.73 (0.45–1.18) and 0.74 (0.45–1.23) in men, and 0.36 (0.21–0.60) and 0.39 (0.22–0.66) in women, respectively. There are very few studies included, however, to demonstrate an association between CDS and the reduced risk, suggesting gender difference in the effectiveness.
Endurance and strength training outcomes on cognitively impaired and cognitively intact older adults: a meta-analysis
- Authors:
- HEYN P. C., JOHNSON K. E., KRAMER A. F.
- Journal article citation:
- Journal of Nutrition Health and Aging, 12(6), 2008, pp.401-409.
- Publisher:
- Springer
Nursing home residents are often viewed as too frail or cognitively impaired to be able to participate in or benefit from exercise rehabilitation, and those with a Mini Mental State Examination (MMSE) score of under 25 are frequently excluded from such programmes. This systematic review and meta-analysis identifies 41 randomised trials of exercise programmes: 21 conducted with cognitively impaired individuals (defined as MMSE scores of less than 25); and 20 with cognitively intact individuals (MMSE scores over 25). Moderate to large effect sizes were found for both groups, with no statistically significant differences between the two in respect of strength or endurance outcomes. The paper concludes that cognitively impaired people should not be excluded from exercise rehabilitation programmes.
Cardiac conditions
- Authors:
- PECK Michel D., AI Amy L.
- Journal article citation:
- Journal of Gerontological Social Work, 50(S1), 2008, pp.13-44.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Cardiovascular disease (CVD) is the leading cause of death in the USA, and the incidence of age-related CVD will inevitably increase with an aging population. There is increasing evidence of co-morbid mental health conditions in CVD patients, especially depression and anxiety, and this systematic review explores the empirical literature on psychosocial treatments. This identified three meta-analyses and 11 additional randomised controlled trials. The meta-analyses provide positive evidence for the benefits of psychosocial treatments on some primary health outcomes but these are less clear in subsequent trials. Further research is required. The paper concludes with a ‘treatment resource appendix’ directed at US practitioners. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Arthritis pain
- Authors:
- YOON Eunkyung, DOHERTY John B.
- Journal article citation:
- Journal of Gerontological Social Work, 50(S1), 2008, pp.79-103.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Arthritic pain is a common and disabling condition for many older people in the USA, and is often under-treated despite its significant negative impact on quality of life. This systematic review examines the empirical literature on psychosocial interventions, including cognitive-behavioural treatments and psycho-educational interventions. The former has been shown to have a major positive impact on pain control, while the latter has contributed to better understanding and self-treatment. The paper concludes with a ‘treatment resource appendix’ directed at US practitioners. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The effects of fall prevention trials on depressive symptoms and fear of falling among the aged: a systematic review
- Authors:
- SJOSTEN N., VAAPIO S., KIVELA S. L.
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.30-46.
- Publisher:
- Taylor and Francis
Firstly, to explore whether depressive symptoms and fear of falling have been used as outcome measures in fall prevention trials. Secondly, to determine the effects of fall prevention trials on these variables among the aged. A literature search covering various medical databases was conducted to identify randomised controlled trials regarding the effects of fall prevention programmes on depressive symptoms and fear of falling among the aged. The studies were classified according to the intervention method (single/multifactorial) and study results (positive/negative) regarding depressive symptoms or fear of falling. Methodological quality was assessed in relation to blinding at outcome assessment, follow-up and whether intention-to-treat analysis was used. Depressive symptoms were used as an outcome measure in eight and fear of falling in 21 studies. A multifactorial approach seems the most effective method in reducing fear of falling, while some single methods such as Tai Chi also seem beneficial. Little evidence was found relating to the effects of fall prevention trials on depressive symptoms. Fear of falling may be reduced by fall prevention programmes. More studies assessing the effects on depressive symptoms, especially among the depressed aged are needed.