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COVID 19 and dementia: experience from six European countries
- Authors:
- BURNS Alistair, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, early cite 18 January 2021,
- Publisher:
- Wiley
The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance (IDEAL) is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) the need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis. (Edited publisher abstract)
Effects of transient and chronic loneliness on major depression in older adults: a longitudinal study
- Authors:
- MARTIN-MARIA Natalia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(1), 2021, pp.76-85.
- Publisher:
- Wiley
Objectives: The number of older adults is rapidly rising globally. Loneliness is a common problem that can deteriorate health. The aims of this work were to identify different types of loneliness (transient and chronic) and to assess their association with depression over time. Methods: A nationally representative sample from the Spanish population comprising 1190 individuals aged 50+ years was interviewed on three evaluations over a 7‐year period. The UCLA Loneliness Scale was used to measure loneliness. While chronic loneliness was defined as the presence of loneliness across all three waves, transient loneliness expressed the presence of loneliness in one wave only. A 12‐month major depressive episode was assessed at each interview. After confirming the cross‐sectional relationship, a multilevel mixed‐effects model was used to examine the association between loneliness and depression. Results: Almost a quarter of individuals felt lonely and one out of 10 presented depression at baseline. Of the sample, 22.78% showed transient loneliness, while 6.72% presented the chronic type. People experiencing chronic loneliness were at a higher risk of presenting major depression (OR = 6.11; 95% CI = 2.62, 14.22) than those presenting transient loneliness (OR = 2.22; 95% CI = 1.19, 4.14). This association varied over time and was stronger at the first follow‐up than at the second one. Conclusions: Focusing on loneliness prevention could reduce the risk of depression. Chronic loneliness is a public health problem that should be addressed through the full participation of the political, social, and medical sectors. (Edited publisher abstract)
Improving healthcare access for older adults with intellectual disability: what are the needs?
- Authors:
- NAVAS Patricia, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 32(6), 2019, pp.1453-1464.
- Publisher:
- Wiley
This qualitative study was carried out in Spain with the aim of identifying the changes that the health system should make to improve healthcare access for older adults with intellectual disability. Three hundred and sixty‐nine family members and professionals expressed their opinion on how healthcare access could be improved. Participants responded to two open‐ended questions included in a general survey about the health status of older individuals with intellectual disability. Most informants were women and professionals who had known the person with intellectual disability for more than 12 months. A system of categories, which showed good inter‐rater agreement, was developed to analyse participants’ written responses. Both family members and professionals emphasized the need to improve disability training for healthcare practitioners and highlighted the urgent need for flexibility in the structure of a healthcare system that currently overlooks the specific needs of this vulnerable population. (Publisher abstract)
Resilience and coping as predictors of general well-being in the elderly: a structural equation modeling approach
- Authors:
- TOMÁSA José Manuel, et al
- Journal article citation:
- Aging and Mental Health, 16(3), April 2012, pp.317-326.
- Publisher:
- Taylor and Francis
Well-being is a complex construct concerning optimal experience and functioning. One of the constructs that can determine well-being is coping. This study aimed to explore the relationships between problem-focused coping, emotion-focused coping and resilience with well-being in the elderly. Hypotheses about these relationships are tested within a structural modelling framework. The aims of this article are: to test for the validity of the 3 constructs involved in the structural model; to test for the effects of both coping strategies and resilient coping on well-being in a sample of elderly, by means of a structural model with latent variables; and to empirically study whether a brief scale of resilient coping could predict well-being over and above that predicted by the coping resources. The study participants comprised 225 non-institutionalised elderly people living in the city of Valencia, Spain. The participants completed a survey with included measures of well-being, resilient coping, and coping strategies. Analyses indicate that the best predictive model is that with a single predictor of well-being: resilient coping. Resilient coping is able to predict a significant and large part of the variance in well-being, without the need for including coping strategies.
Being physically active in old age: relationships with being active earlier in life, social status and agents of socialisation
- Authors:
- MARTINEZ Jesus, et al
- Journal article citation:
- Ageing and Society, 30(7), October 2010, pp.1097-1113.
- Publisher:
- Cambridge University Press
This study investigates the social processes that influence older people's participation in physical activity. A questionnaire with items on personal, social and environmental characteristics was completed by a random sample of older adults in the Madrid Autonomous Region. Significant relationships were found between the type of physical activity participation and being physically active at earlier life stages. Other relationships were found including socio-economic status, the encouragement of others or social support in being active, and the knowledge and availability of local facilities. Some cases were observed of re-socialisation into physical activity among those who had been inactive earlier in life, and both appropriate environmental and supportive social conditions appeared instrumental. The authors concluded that the study could inform the design of future social programmes to promote active lifestyles in later life. However, given the complexity of the socialisation processes, it would be advisable for future studies to examine other than the four factors featured in this paper, such as the role of cultural differences.
Knowledge about aging and worry in older adults: testing the mediating role of intolerance of uncertainty
- Authors:
- NUEVO Roberto, et al
- Journal article citation:
- Aging and Mental Health, 13(1), January 2009, pp.135-141.
- Publisher:
- Taylor and Francis
This Spanish study aims to explore the relationship between knowledge about aging and severity of worry in older adults, and to test the potential mediational role of intolerance of uncertainty. The sample was composed of 120 community-dwelling older adults, with a mean of age of 71.0 years. Mediational analyses and structural equation modelling were used to analyze and compare different models. Greater knowledge about aging was negatively related to both intolerance of uncertainty and worry, and its effect on worry was partially mediated by intolerance of uncertainty. The mediational model obtained an excellent fit to the data and clearly had a better fit than alternative models. These results suggest that a good knowledge of the aging process could help decrease aversive uncertainty and thus reduce the level of worry among older adults. Thus, educational programs to increase knowledge about aging could serve as one preventive strategy for anxiety in old age.
Validation of the Spanish version of the EURO-D scale: an instrument for detecting depression in older people
- Authors:
- LARRAGA Laura, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(12), December 2006, pp.1199-1205.
- Publisher:
- Wiley
The objective was to standardize the EURO-D scale as a method for detecting depression in Spanish older people. In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test-retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated. A high internal consistency was obtained in both phases of the study ( = 0.75; = 0.79, respectively). Test-retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89-0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale. The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results.
Elder abuse in Spain
- Authors:
- OCHOTORENA Joaquin de Paul, ZUGASTI Jose Luis Larrion
- Journal article citation:
- Social Work in Europe, 2(3), 1995, pp.12-13.
- Publisher:
- Russell House
For political reasons Spain has been isolated from the rest of Europe for a number of years. This has resulted in slow progress of both welfare and the means to support social protection. It was not until the middle of the 1980s that Spain began to address subjects in relation to family violence. The article outlines how interest in, resources for, and research related to, elder abuse evolved in Spain.
The mediating role of sense of coherence on mental health outcomes in carers of older dependent relatives: a longitudinal study
- Authors:
- LOPEZ-MARTINEZ Catalina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(5), 2021, pp.722-730.
- Publisher:
- Wiley
Background: Sense of coherence (SOC) is an important protective factor for carer well‐being but research to date remains cross‐sectional, focusing primarily on the direct effects of SOC on carers' mental health. The study's aim was to investigate the mediating role of SOC in the longitudinal relationship between caregiver strain and carers' psychological health, and its stability over time. Methods: Prospective longitudinal study conducted in Jaén (Spain) with a probabilistic sample of 132 carers of older people, with data collected at baseline and at 1‐year follow‐up. We measured SOC, caregiver strain, anxiety and depressive symptoms, and several care‐recipient characteristics and intensity of care provided. We used multiple linear regression modelling and the Sobel test to analyse mediation effects. Results: SOC was significantly negatively longitudinally associated with both anxiety (β = −0.38, p = 0.001) and depressive symptoms (β = −0.28, p = 0.023), after controlling for several confounders. SOC mediated both the relationship between caregiver strain and anxiety, and caregiver strain and depressive symptoms (Sobel test: p < 0.001 for anxiety and p < 0.001 for depressive symptoms). Differences between baseline and 1‐year follow‐up SOC scores were not statistically significant (p = 0.617). Conclusions: SOC appears to buffer the impact of caregiver strain on symptoms of depression and anxiety in informal carers of older people. Our data showed that SOC is an important psychological resource for carers that remained relatively stable under non‐experimental conditions over a period of 1 year in this sample. The findings suggest that interventions aimed at strengthening SOC may protect carer psychological well‐being. (Edited publisher abstract)
Expectations and user experience of a multimodal medicine management system for older users
- Authors:
- HARJUMAA Marja, et al
- Journal article citation:
- Journal of Assistive Technologies, 8(2), 2014, pp.51-63.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to analyse the adoption of a multimodal medication management system (MMS) targeted on older people and home care professionals. The paper aims to describe the expectations of the system and the user experience findings from an empirical qualitative field trial. The field trial results are used to discuss how MMSs should be designed in order to improve adherence to medications. Design/methodology/approach: The paper suggests that building a multimodal medicine management system targeted on both older users and home care professionals brings many benefits over electronic medicine dispenser systems or general reminder systems. The research process uses an iterative prototyping approach including phases of requirements analysis and concept design, prototype building and evaluation in a field trial. Findings: The study demonstrates how a system that merely satisfied users during the prototype building phase does not necessarily succeed as well as expected in the field trials. It would be important to consider reasons for medication non-adherence and non-technology factors influencing willingness to adopt new assistive devices in order to promote diffusion of new MMSs at home. The paper also discusses how the different persuasive functionalities of the system addressed patient-centred factors influencing non-adherence and how they could be addressed. Research limitations/implications: This study has some limitations. The actual adherence to medications was not measured. However, in the future, it will be important to study how the MMSs influence medication adherence. Also, the user experiences of the home care professionals were not studied in the field trials. Home care professionals who were involved in the user studies and trials merely estimated the value for their patients and not for themselves. Originality/value: This paper analyses design issues relevant when designing systems to help older people manage their medications. (Publisher abstract)