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Use of an Italian version of the telephone interview for cognitive status in Alzheimer's disease
- Authors:
- DAL FORNO, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(2), February 2006, pp.126-133.
- Publisher:
- Wiley
Enquires into the Validation of an Italian version of the Telephone Interview for Cognitive Status (I-TICS). Telephone administration of the I-TICS within 6 weeks of face-to-face testing with the Mini Mental State Examination (MMSE), in Probable Alzheimer's disease (AD) patients and healthy controls. Two hundred and seven consecutive outpatients with cognitive impairment were recruited from Dementia Clinic of University Campus BioMedico. Of these, 45 probable AD patients with complete data were analyzed. Other dementias, Mild Cognitive Impairment (MCI), and patients with incomplete data were excluded. The control sample consisted of 64 age- and sex-matched healthy subjects. For diagnosis, an extensive clinical evaluation, laboratory testing, brain imaging, EEG, neuropsychological battery and a depression scale were used. For I-TICS validation, telephone I-TICS and face-to-face MMSE were administered. The I-TICS correlated highly and linearly with the MMSE (Pearson's r = 0.904). Conversion equations are provided. Sensitivity and specificity were similar between tests (area under curve = 0.894 for the I-TICS; 0.966 for the MMSE). I-TICS sensitivity was 84% and specificity 86% at a cut-off score of 28. No significant difference in accuracy with the MMSE was present. Total agreement between I-TICS and MMSE was substantial at 86% (Cohen's K = 0.717). Repeated testing in a subset of patients showed a disease progression related decrease of 4.2 points/year (t = 2.664; p = 0.018) in I-TICS scores. The I-TICS is a valid instrument in clinical and research screening and monitoring of AD. Potential applications in other dementias and MCI are worth further studies.
Socio-economic status differences in older people's use of informal and formal help: a comparison of four European countries
- Authors:
- van GROENOU Marjolein Broese, et al
- Journal article citation:
- Ageing and Society, 26(5), September 2006, pp.745-766.
- Publisher:
- Cambridge University Press
This study investigates the variations by older people's socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.
Suicidal behaviour in nursing homes: a survey in a region of north-east Italy
- Authors:
- SCOCCO Paolo, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(4), April 2006, pp.307-311.
- Publisher:
- Wiley
The complete list of Nursing Homes was provided by the Regional Department of Health for the Veneto region, in the North-East of Italy. Structured interviews were completed with nursing home managers, inquiring about nursing home, staff and management characteristics, mental health care available and the number of completed and attempted suicides (AS) in 2001 made by residents older than 65 years, occurring either inside or outside nursing homes. All facilities which reported suicidal events were asked additional information. In the study period, five completed suicides and eight AS were reported. All but one suicides and one AS had a history of mental disorders. Seven subjects had been living in a nursing home for less than one year. There were no significant differences in the frequency of suicidal events between the facilities which employed or did not employ mental health workers. The suicide rate found in this facility sample is much higher than the rate reported by the Italian National Statistic Institute for the over-65-year-old population of the Veneto Region in 2001, and is similar to the rate reported in a previous study conducted in another country. It is concluded that in Veneto nursing homes behavioural control of residents, lack of access to a variety of means used for suicidal purposes and medical supervision does not seem to have protected the nursing home population from suicidal risks.
Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom
- Authors:
- COMAS-HERRERA Adelina, et al
- Journal article citation:
- Ageing and Society, 26(2), March 2006, pp.285-302.
- Publisher:
- Cambridge University Press
This paper reports findings from a European Commission funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom, and presents projections of future long-term care expenditure in the four countries under a number of assumptions about the future. Macro-simulation (or cell-based) models were used to make comparable projections based on a set of common assumptions. A central base-case served as a point of comparison by which to explore the sensitivity of the models to alternative scenarios for the key determinants. The sensitivity of the models to variant assumptions about the future numbers of older people, the prevalence of functional dependency and informal care, patterns of long-term provision, and macroeconomic conditions are examined. It was found that, under the base-case, the proportion of gross domestic product spent on long-term care is projected to more than double between 2000 and 2050 in each country. The projected future demand for long-term care services for older people is sensitive to assumptions about the future number of older people, the prevalence of dependency and the availability of informal care, and projected expenditure is sensitive to assumptions about rises in the real unit-costs of services and the structure of the models. It is important, for planning purposes, to recognise the considerable uncertainty about future levels of long-term care expenditure.
Anemia and cognitive performance in hospitalized older patients: results from the GIFA study
- Authors:
- ZAMBONI Valentina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(6), June 2006, pp.529-534.
- Publisher:
- Wiley
Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons. Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia. Mean age of the sample (n = 13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p < 0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment. Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions. Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units.
A comparative case study of care systems for frail elderly people: Germany, Spain, France, Italy, United Kingdom and Sweden
- Authors:
- LE BIHAN Blanche, MARTIN Claude
- Journal article citation:
- Social Policy and Administration, 40(1), February 2006, pp.26-46.
- Publisher:
- Wiley
Comparative studies of European social policies towards frail elderly people typically focus on the systems and their implementation. The study presented in this article, conducted in 2001 in six European countries (Germany, Spain, Italy, France, the United Kingdom and Sweden) aims at comparing the rights of the individuals within the different care systems. The methodology used is a case study approach, which draws on a series of situations of dependent elderly people. The analysis focuses on the public authorities' responses – the care packages, which determine the type of care required and the financial contribution of the user – in each of the six countries, in relation to the concrete situations of frail elderly people. As local variations are important, in all the countries studied, local authorities have been chosen in each of the countries. This approach provides interesting concrete elements on the services and financial help which can be given to frail elderly people, and provides an understand of the national care systems organized in the different countries and the main difficulties encountered by public authorities in facing this problem of frail elderly people.