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Ageing and well-being in an international context
- Author:
- CLIFTON Jonathan
- Publisher:
- Institute for Public Policy Research
- Publication year:
- 2009
- Pagination:
- 36p., bibliog.
- Place of publication:
- London
The author asks what lessons the UK can learn from several case studies from overseas about how the well-being of older people can be incorporated into a wider range of policy areas than those, traditionally, of pensions, health and social care. For example, in the UK an ageing population brings more focus onto mental health, loneliness and isolation issues, whereas life satisfaction is highest in Japan among those over 65. In addition, case studies from Ireland, the United States, Norway, Finland, New Zealand and China are presented with much variation in findings. Examples of how the well-being of older people can be addressed in the four key areas of relationships, work, learning and the built environment are discussed and put forward by the author as good practice for the future of an ageing population in the UK.
Early response as predictor of final remission in elderly depressed patients
- Authors:
- KOK Rob M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(11), November 2009, pp.1299-1303.
- Publisher:
- Wiley
Several studies have attempted to predict the final response or remission based on improvement during the early course of treatment of major depression, but there is variation in the cut offs used to define early response and in the best week to predict final results. This study aimed to compare different cut-offs at different time points early in the treatment of elderly depressed patients, using a 12 week randomised controlled trial in 81 elderly inpatients with major depression comparing venlafaxine with nortriptyline. The results showed that in elderly in patients, prediction of final remission is possible as early as week 3. In conclusion the researchers suggested that, combining the results from this study and other studies addressing this issue, treatment should be changed in the elderly if after 3-4 weeks less than 30% improvement in depression score has been achieved.
A creative reminiscence program for older adults with severe mental disorders: results of a pilot evaluation
- Author:
- WILLMESE Bernadette M.
- Journal article citation:
- Aging and Mental Health, 13(5), September 2009, pp.736-743.
- Publisher:
- Taylor and Francis
Older adults with severe mental disorders can experience major dissatisfaction with conditions of life that are connected with ageing. To assist them in developing a coherent, meaningful life-story and to improve their life satisfaction, a pilot evaluation of a creative reminiscence program called Searching for meaning in life was conducted. One week before and one week after the intervention 36 participants from three psychiatric hospitals and one sheltered housing program in the Netherlands were interviewed. Life satisfaction was measured with the Manchester Short Assessment of Quality of Life (MANSA) and the Philadelphia Geriatric Center Moral Scale (PGCMS). At follow-up questions were also asked about the intervention. About 78% of the participants completed the course. Most of them were satisfied with the course (74%). The overall sample showed significantly more life satisfaction after the intervention. Participants with a psychotic disorder also improved significantly in life satisfaction but at the same time their depressive symptoms increased significantly. Participants with a moderate to high level of depressive symptoms at baseline had relatively favourable outcomes. Their life satisfaction had improved significantly and they especially had a better attitude toward their ageing. disorders.
Depression and excess mortality: evidence for a dose response relation in community living elderly
- Authors:
- SCHOEVERS R.A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(2), February 2009, pp.169-176.
- Publisher:
- Wiley
Depression is associated with an increased mortality risk. This study aimed to investigate the association between depression severity and duration with mortality in community-living elderly. A two-wave prospective cohort study with 10-year follow-up of vital status was used in a randomly selected cohort of 3,746 non-demented older community-living persons in the city of Amsterdam. Main outcome measures were excess mortality of both the baseline cohort, and of non-demented subjects participating in both assessments (n = 1989). Both moderate and severe depression predicted 10-year mortality after multivariate adjustment. Chronic depression was associated with a 41% higher mortality risk in 6-year follow-up compared to subjects without depression. Severity and chronicity of depression are associated with a higher mortality risk. In combination with other findings this is suggestive of a causal relationship and may have implications for both preventive and treatment strategies of late-life depression.
The efficiency of using everyday technological devices by older adults: the role of cognitive functions
- Authors:
- SLEGERS Karin, VAN BOXTELL Martin P. J., JOLLES Jelle
- Journal article citation:
- Ageing and Society, 29(2), February 2009, pp.309-325.
- Publisher:
- Cambridge University Press
To test the role of cognitive abilities in performing technological tasks, the authors designed the Technological Transfer Test (TTT). This new and ecologically valid test comprises eight technological tasks that are common in modern life (operating a CD player, a telephone, an ATM, a train-ticket vending machine, a microwave-oven, an alarm clock, a smart card charging device and a telephone voice menu). The TTT and a comprehensive battery of cognitive tests were administered to 236 healthy adults aged 64–75 years living in the Netherlands on two separate occasions. The results demonstrated that the performance time for five of the eight tasks was predicted by cognitive abilities. The exact cognitive functions affecting technological performance varied by the technological task. Among several measures and components of cognition, the speed of information processing and cognitive flexibility had the greatest predictive power. The results imply that age-related cognitive decline has a profound effect on the interaction between older adults and technological appliances.
Housing our Ageing Population: Panel for Innovation
- Authors:
- HOMES AND COMMUNITIES AGENCY, GREAT BRITAIN. Department of Health, GREAT BRITAIN. Department for Communities and Local Government
- Publisher:
- Homes and Communities Agency
- Publication year:
- 2009
- Pagination:
- 59p.
- Place of publication:
- London
Following the Lifetime Homes, Lifetime Neighbourhoods national strategy report, the Housing our Ageing Population: Panel for Innovation was established in 2009 to examine what further reform is needed to ensure that new build specialised housing meets the needs and aspirations of the older people of the future. This report brings together the findings and recommendations of the panel, which focused on improving the quality of life of the ageing population by influencing the availability and choice of high-quality sustainable homes and neighbourhoods, challenging the perceptions of mainstream and specialised housing for older people, raising the aspirations of older people to demand higher quality more sustainable homes, and spreading awareness of the possibilities offered through innovative design of housing and neighbourhoods. It highlights key design recommendations, offers case studies from London, Bristol, York, Denmark, the Netherlands, Germany, Switzerland and Sweden, proposes further work, links to parallel studies that emphasise the role of place making in enhancing quality of life, and forms the basis of advice to government ministers.
Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up
- Authors:
- LICHT E., et al
- Journal article citation:
- British Medical Journal, 21.2.09, 2009, pp.463-466.
- Publisher:
- British Medical Association
This study aimed to investigate the duration of depression, recovery over time, and predictors of prognosis in an older cohort (55 years) in 32 general practices in West Friesland, the Netherlands. Participants were 234 patients aged 55 years or more with a prevalent major depressive disorder. Main outcome measures were depression at baseline and every six months using structured diagnostic interviews (primary care evaluation of mental disorders according to diagnoses in Diagnostic and Statistical Manual of Mental Disorders, fourth edition) and a measure of severity of symptoms (Montgomery Åsberg depression rating scale). The main outcome measures were time to recovery and the likelihood of recovery at different time points. Multivariable analyses were used to identify variables predicting prognosis. The median duration of a major depressive episode was 18.0 months (95% confidence interval 12.8 to 23.1). 35% of depressed patients recovered within one year, 60% within two years, and 68% within three years. A poor outcome was associated with severity of depression at baseline, a family history of depression, and poorer physical functioning. During follow-up functional status remained limited in patients with chronic depression but not in those who had recovered. Depression among patients aged 55 years or more in primary care has a poor prognosis. Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.
Intergenerational relations across 4 years: well-being is affected by quality, not by support exchange
- Authors:
- MERZ Eva-Maria, SCHUENGEL Carlo, SCHULZE Hans-Joachim
- Journal article citation:
- Gerontologist, 49(4), August 2009, pp.536-548.
- Publisher:
- Oxford University Press
Providing support to an aging parent may pose challenges to adult children but also provide an opportunity to "give back" to loved ones. The current study investigated changes in emotional and instrumental support and quality across a period of 4 years. Additionally, associations between intergenerational support and well-being in adult children over time were investigated. Data from the first and second waves of the Netherlands Kinship Panel Study (N = 6,062) were analyzed to investigate the relative importance of relationship quality and support exchange and to test the potential buffering role of relationship quality for effects of the changing balance of support on well-being. It was found that provision of instrumental and emotional support to parents increased during a period of 4 years. At the same time, instrumental support children received from parents decreased, whereas emotional support from parents increased. Intergenerational support exchange between children and parents was not associated with well-being in children, whereas the quality of the intergenerational relationship strongly predicted their well-being. Implications: Decreasing relationship quality seems a greater threat to the well-being of caregiving children than increased support and care tasks. Family counselling and public awareness to address this decline in intergenerational relationship quality may be important for well-being of families.
Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality
- Authors:
- VAN DER WEELE Gerda M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(6), June 2009, pp.595-601.
- Publisher:
- Wiley
This study aimed to examine the prevalence of concurrent depression and anxiety and its relationship with functional status, quality of life and mortality in individuals at age 90. In the Leiden 85-plus Study, a population based cohort study, depression (15-item Geriatric Depression Scale 5 points) and anxiety (Anxiety Screening Questionnaire 1 positive answer) were assessed in all 90-year old subjects with 19 points on the Mini Mental State Examination (MMSE). Functional status included: cognitive function (MMSE) and disability in activities of daily living (Groningen Activity Restriction Scale). Quality of life included: loneliness (Loneliness Scale of De Jong-Gierveld) and life satisfaction (Cantril's ladder). For all subjects mortality data were available up to a maximum age of 95.3 years. Findings were that of the subjects aged 90 years with MMSE 19 points (56 men, 145 women), 50 subjects experienced depression and 25 subjects anxiety; of them 34 (17%) experienced depression only, 9 (4%) anxiety only, and 16 (8%) both depression and anxiety. Presence of depression was associated with an overall decreased functional status and quality of life and with increased mortality. Within the depressed group, subjects with anxiety did not differ from subjects without anxiety, except for higher loneliness scores. The authors conclude that among individuals aged 90 years, depression and anxiety and their co-occurrence are highly prevalent. Anxiety does not add to poor functional status and increased mortality beyond that associated with depression, and is probably part of the phenomenology of depression in old age.
Supportive living environments: a first concept of a dwelling designed for older adults with dementia
- Authors:
- VAN HOOF Joost, KORT Helianthe S.M.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 8(2), May 2009, pp.293-316.
- Publisher:
- Sage
Dementia has severe implications to the quality of daily life, in particular to independent functioning. This sets extra demands to living environments. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining vitality, and lower the burden of family care. For this purpose, a first concept of a design for a dementia dwelling is presented in this paper, which incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. These design features were derived from literature search and focus group sessions. Current design guidelines are frequently based on practical experience only, and therefore, more systematic field research should be carried out to find evidence for the various design modifications. Also, it needs to be studied how the design features of the dementia dwelling can be incorporated into the existing housing stock.