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Insight, quality of life, and functional capacity in middle-aged and older adults with schizophrenia
- Authors:
- ROSEMAN Ashley S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(7), July 2008, pp.760-765.
- Publisher:
- Wiley
The quality of life (QOL) for individuals with schizophrenia is determined by a number of factors, not limited to symptomatology. The current study examined lack of insight as one such factor that may influence subjective QOL or functional capacity. It was hypothesized that insight would significantly interact with symptom severity to influence subjective QOL. Insight was not expected to influence the relation between symptom severity and functional capacity. Participants were middle-aged and older outpatients who met diagnostic criteria for schizophrenia or schizoaffective disorder, and subsyndromal depression. Insight, psychopathology, and subjective QOL were assessed via semi-structured interviews and functional capacity was assessed via performance-based measures. Insight interacts with negative symptom severity to predict subjective QOL. Severity of negative symptoms and insight contribute directly to functional capacity. Individuals with intact insight may be better able to manage their symptoms, resulting in improved QOL. Treatment implications for improving the QOL of middle age and older adults with schizophrenia are discussed.
Comparing depression diagnostic symptoms across younger and older adults
- Authors:
- BALSIS Steve, CULLY Jeffrey A.
- Journal article citation:
- Aging and Mental Health, 12(6), November 2008, pp.800-806.
- Publisher:
- Taylor and Francis
Depression in later life has potential grave implications and contributes to heavy emotional, medical, and economic burdens. Therefore, it is not surprising that identifying depression and its symptoms in later life has remained a sustained concern for professionals who treat older patients. Despite this concern, the current diagnostic gold standard may not identify depression symptoms equally well in older and younger adults. The objective of this analysis is to determine whether older and younger adults with equivalent levels of latent depression are equally likely to endorse particular DSM diagnostic symptoms. DSM depression data were analysed using Item Response Theory (IRT)-based differential item functioning analyses. The data came from 1808 older adults (age 65-98 years) and 3,734 younger adults (age 18-34 years) who participated in the National Epidemiological Survey on Alcoholism and Related Conditions in the United States. The analyses confirmed the hypothesis. The DSM items identify depression differently in younger and older adults. Specifically, results showed that older adults were more likely to endorse somatic items and less likely to endorse cognitive and suicide items than their younger counterparts with equivalent levels of depression. Conclusion: These findings provide evidence that the DSM depression items work differently across age groups when controlling for latent depression. It is important to consider, however, that these findings are limited by the sampling methodology and the particular protocol implemented.
Scottish households below average income, 2006/07
- Author:
- SCOTLAND. Scottish Government
- Publisher:
- Scotland. Scottish Government National Statistics
- Publication year:
- 2008
- Pagination:
- 12p.
- Place of publication:
- Edinburgh
This publication presents annual estimates of the proportion and number of children, working age adults and pensioners living in low income households in Scotland. It presents progress towards UK and Scotland Government targets to reduce poverty. All figures are derived from the Department for Work and Pensions’ Family Resources Survey, Households Below Average Income datasets.
Older people's views of a good death in heart failure: implications for palliative care provision
- Authors:
- GOTT M., et al
- Journal article citation:
- Social Science and Medicine, 67(7), October 2008, pp.1113-1121.
- Publisher:
- Elsevier
Palliative care in the UK has been developed to meet the needs of predominantly middle aged and younger old people with cancer. Few data are available regarding the extent to which services respond to the specific needs of an older group of people with other illnesses. This paper draws on in-depth interviews conducted with 40 people (median age 77) with advanced heart failure and poor prognosis to explore the extent to which older people's views and concerns about dying are consistent with the prevalent model of the ‘good death’ underpinning palliative care delivery. That prevalent model is identified as the “revivalist” good death. Our findings indicate that older people's views of a ‘good death’ often conflict with the values upon which palliative care is predicated. For example, in line with previous research, many participants did not want an open awareness of death preceded by acknowledgement of the potential imminence of dying. Similarly, concepts of autonomy and individuality appeared alien to most. Indeed, whilst there was evidence that palliative care could help improve the end of life experiences of older people, for example in initiating discussions around death and dying, the translation of other aspects of specialist palliative care philosophy appear more problematic. Ultimately, the study identified that improving the end of life experiences of older people must involve addressing the problematised nature of ageing and old age within contemporary society, whilst recognising the cohort and cultural effects that influence attitudes to death and dying.
Nurse-led liaison psychiatry service for older adults: service evaluation
- Authors:
- ANDERSON Daniel, CATTELL Howard, BENTLEY Elaine
- Journal article citation:
- Psychiatric Bulletin, 33(8), August 2008, pp.298-302.
- Publisher:
- Royal College of Psychiatrists
Of the 298 individuals referred to psychiatric services from other hospital wards, 120 were aged 85–94 years old (40%), 193 were male (65%) and 152 were referred from geriatrics (51%). A majority of 204 have not had previous contact with psychiatric services (69%). The most common diagnosis was dementia (33%, n=88), with 27% individuals (n=65) being referred onwards to secondary care. This nurse-led service, using a novel approach of a support worker providing further community support, functions well compared with traditional consultation models. It helps identify many individuals with dementia and engages them into community psychiatric services.
Ageing with HIV: newly diagnosed older adults in Italy
- Authors:
- ORCHI N., et al
- Journal article citation:
- AIDS Care, 20(4), April 2008, pp.419-425.
- Publisher:
- Taylor and Francis
The prevalence of HIV/AIDS among people in midlife and late adulthood has been increasing in Western countries over the last decade. This study analyzed data from a prospective, observational multi-centre study on individuals newly diagnosed with HIV between January 2004 and March 2007 in 10 public counselling and testing sites in Latium, Italy. To analyze the association of individual characteristics with age, the study compared older adults (≥50 years) with their younger counterpart (18-49 years). To adjust for potential confounding effect of the epidemiological, clinical and behavioural characteristics, to identify factors associated with older age at HIV diagnosis, multivariate logistic regression analysis was performed. Overall, 1,073 individuals were identified, 125 of whom (11.6%) were aged 50 years or above. The questionnaire was completed by 41%. Compared with their younger counterparts, a higher proportion of older patients were males, born in Italy, reported heterosexual or unknown HIV risk exposure, were never tested for HIV before and were in a more advanced stage of HIV infection at diagnosis. In addition, older adults had a lower educational level and were more frequently living with their partners or children. With respect to psycho-behavioural characteristics, older patients were more likely to have paid money for sex and have never used recreational drugs. No differences were found regarding condom use, which was poor in both age groups. These findings may have important implications for the management of older adults with HIV, who should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare. Moreover, strategies including information on HIV and prevention of risk behaviours are needed.
Inter-generational relationships at different ages: an attachment perspective
- Authors:
- MERZ Eva-Maria, SCHUENGEL Carlo, SCHULZE Hans-Joachim
- Journal article citation:
- Ageing and Society, 28(5), July 2008, pp.717-736.
- Publisher:
- Cambridge University Press
This study examines the characteristics of parent-child relationships after childhood from a theoretical attachment perspective. It describes how relationships between adult children and their parents vary by age group of the child on three dimensions that were derived from attachment theory: direction, penetration and quality. Data from 4,589 respondents to the Netherlands Kinship Panel Study were analysed to describe relationships between adult-children and their parents. Analyses of covariance were used to specify differences by age group. The results showed that age had notable effects on relationships between adult children and parents, especially their direction and penetration or centrality. The direction was reversed for parents of children in the two oldest age groups. The level of penetration was lower for the older age groups, and quality was higher in the younger age groups, but the effect size was small. The age effects on the dimensions were qualified by the personal circumstances of the adult children. Having one's own children was associated with different patterns of attachment at different ages. Adult children may be an important source of support for their elderly parents and may even become ‘attachment figures’. Given the current increases in longevity, there could be increasing pressure on adult children to support their parents. Attachment theory is a useful framework for studying the characteristics of inter-generational relationships, also after childhood.
Informal care for older people provided by their adult children: projections of supply and demand to 2041 in England
- Author:
- PICKARD Linda
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2008
- Pagination:
- 18p., bibliog.
- Place of publication:
- London
The PSSRU was funded by the Strategy Unit (Cabinet Office) and the Department of Health to produce projections of the supply of informal care for younger adults and older people in England to 2041. For younger and older adults , the supply of informal care was compared to demand in future years. The analyses focus on the supply of intense care provided for 20 or more hours a week and on demand for social care from disabled people. The results show that, on the assumptions used, future informal care supply is projected to be lower than estimated demand in respect of both younger adults and older people.
At last, proposals for a service deep in crisis
- Author:
- CANN Paul
- Journal article citation:
- Community Care, 29.5.08, 2008, p.29.
- Publisher:
- Reed Business Information
The author gives is opinion on why the changes in the adult green paper are so necessary. He discusses the financing of adult social care and the increasing personalisation of services .
Audit of cardiovascular disease risk factors among supported adults with intellectual disability attending an ageing clinic
- Authors:
- WALLACE Robyn A., SCHLUTER Philip
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 33(1), March 2008, pp.48-58.
- Publisher:
- Taylor and Francis
Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Medical charts of all adults aged 40 years or over attending a specialised ageing clinic for adults with ID between January 2002 and June 2005 in Australia were reviewed. Overall, 155 adults' charts were reviewed and 8 (5%) had diagnosed CVD. Risk factor assessments found 18% with hypertension (of 73% checked), 8% with elevated glucose (of 97% checked), 27% with elevated total cholesterol (of 94% checked), 70% overweight or obese (of 55% checked), 11% current or ex-smokers (100% checked), and 96% with inadequate daily exercise (100% checked). Only the prevalence of hypertension and smoking increased significantly with age. Apart from lack of exercise (which was much more prevalent than for the general population) and overweight or obesity, the overall CVD risk factor profile of supported older adults with ID appears generally more favourable compared to the age-matched general population, although the occurrence of all risk factors is still common. Healthy lifestyle programs for this population should focus on implementation of exercise and nutrition strategies.