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Prevalence of anxiety disorders among elderly people
- Authors:
- KIRMIZIOGLU Yalcin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(9), September 2009, pp.1026-1033.
- Publisher:
- Wiley
The objectives of this study are to determine current and lifetime prevalence of anxiety disorders and also to explore the relationship, if any, between possible risk factors and anxiety disorders, amongst elderly people living in the Sivas province of Turkey. The research sample consisted of 462 persons. A Socio-demographic Data Form was given to the participants and the Anxiety Module of SCID-I was applied. Chi-square and Fischer's exact tests were used to evaluate the data obtained. The current prevalence for all types of anxiety disorder was found to be 17.1% overall and the lifetime prevalence was found to be 18.6%. The current prevalence rates for particular disorders were found to be 0.4% for panic disorder, 3.2% for obsessive-compulsive disorder, 1.9% for post-traumatic stress disorder, 2.8% for social phobia, 11.5% for specific phobia, 6.9% for generalized anxiety disorder (GAD). Lifetime prevalence rates for these disorders (except GAD) were 1.1%, 3.2%, 3.0%, 2.85%, 11.5% respectively. Anxiety disorders are more common among elderly people than was previously thought. The lifetime prevalence of specific phobia amongst the elderly is higher than that of general population; the lifetime prevalence ratios of obsessive-compulsive disorder and social phobia are similar to that of the general population in Sivas. In order to improve the delivery of health services, it is recommended that further studies should be conducted among elderly people, both by applying standardized diagnostic tools, but also taking into account socio-economic factors and using convenient therapy methods developed specifically for this group.
Understanding health anxiety among community dwelling seniors with varying degrees of frailty
- Authors:
- BOURGAULT-FAGNOU Michelle D., HADJISTAVROPOULOS Heather D.
- Journal article citation:
- Aging and Mental Health, 13(2), March 2009, pp.226-237.
- Publisher:
- Taylor and Francis
The levels of health anxiety among younger adults and older people, with either low or high levels of frailty were compared. Predictors of health anxiety in older people were explored. Forty-nine seniors with high levels of frailty were compared with 63 seniors with low levels of frailty and 130 younger adults. Comparisons were made on the Illness Attitudes Scale (IAS) and on a Medically Adjusted Illness Attitudes Scale, an adapted version ensuring scores reflect health anxiety, and not greater illness. Seniors also completed measures of frailty, pain, depression, trait anxiety and coping. Results varied depending on the health anxiety measure. Using the traditional IAS, seniors with high frailty experienced greater levels of health anxiety than seniors with low-frailty and younger adults. Using the medically adjusted version, seniors with high frailty experienced similar levels of heath anxiety compared with younger adults; seniors with low frailty had the lowest levels of health anxiety. Using multiple regression analysis, emotional preoccupation and trait anxiety uniquely predicted health anxiety among seniors. Researchers and clinicians should ensure that health anxiety measures actually assess health anxiety and not physical illness. Using an appropriate health anxiety measure, the results suggest seniors with relatively fewer health problems may experience reduced health anxiety compared with other older adults and younger adults. The results are considered in the context of research on aging and anxiety. Implications for clinical practice and future research are discussed.
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.
Older adults’ perception of mentally ill older adults
- Authors:
- WEBB Alicia K., JACOB-LAWSON Joy M., WADDELL Erin L.
- Journal article citation:
- Aging and Mental Health, 13(6), November 2009, pp.838-846.
- Publisher:
- Taylor and Francis
Many mentally ill older adults are stigmatised, which reduces their quality of life and discourages them from seeking help. The aim of this study was to identify factors associated with this stigma. The attitudes of 101 older adults aged from 51 to 87 years towards three hypothetical older women with depression, anxiety or schizophrenia were investigated by means of a questionnaire. The results suggested that schizophrenic persons are viewed as most dangerous and dependent, and thus are probably at greatest risk of social isolation which can compromise their quality of life. The anxious persons were seen as the most responsible for their illness, and may be at risk of suffering stigma and discrimination. Depression fell in the middle of the two on all measures. Men were more critical of the mentally ill than women, and older adults also had more negative views of the mentally ill. Higher education was associated with lower levels of social distance towards depressed and anxious older adults. It I suggested that these findings can be used to improve education to reduce the stigma associated with mental illness in older adults.
Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: a structural equation modelling approach
- Authors:
- DELBAERE Kim, et al
- Journal article citation:
- Aging and Mental Health, 13(4), July 2009, pp.587-592.
- Publisher:
- Taylor and Francis
How and when concerns about falls emerge is not yet completely known, because these concerns are present in both people with and without a falls history. The aim of this study was to investigate the role of catastrophic beliefs about falls and previous falls in the development of concerns about falls and resulting mobility restrictions (MR). Within a cross-sectional design, 896 older people living independently in the community in the Netherlands completed a battery of questionnaires. Self-report data was gathered on previous falls, catastrophic beliefs about consequences of a fall (Catastrophizing About Falls Scale), concerns about falls (modified Falls Efficacy Scale) and mobility restrictions during daily life (Sickness Impact Profile 68). Using structural equation modelling, it was found that the number of falls in the previous year was not directly related to mobility restrictions in daily life, but via an increase of concerns about falls. Also catastrophic beliefs about the consequences of falls were related to concerns about falls and to mobility restrictions. Goodness-of-fit indices revealed that the presented model had an acceptable fit. Alternative models resulted in lesser-fit indices. Both previous falls and catastrophic beliefs about falls are unique and independent predictors of concerns about falls and, subsequently, of mobility restrictions. A cognitive-behavioural perspective upon mobility restrictions may provide important additional components for treatment and prevention of excessive concerns about falls in older people.
Posttraumatic stress disorder in older people after a fall
- Authors:
- CHUNG Man Cheung, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(9), September 2009, pp.955-964.
- Publisher:
- Wiley
This study determines the prevalence and correlates of Posttraumatic Stress Disorder (PTSD) in older people post-fall. A prospective survey study was used, with baseline data collected by interview in hospital post-fall and by postal self-completion at 12 and 24 weeks post-baseline. A convenience sample of 196 people ( 65 years) were serially recruited, 87.9% of those eligible. Information collected at baseline included falls-related data, activity problems, fear of falling, PTSD symptoms, anxiety and depression, and at follow-up PTSD symptoms, anxiety and depression, the receipt of rehabilitation and further falls. In hospital, of 40 participants whose fall had occurred over 1 month previously 35% had full acute PTSD and 17.5% had partial acute PTSD. At follow-up full or partial chronic PTSD was found in 26.1% of participants at first follow-up, and in 27.4% of participants at second follow-up. Older age, pre-fall activity problems, fear of falling, and anxiety assessed at baseline were associated with follow-up PTSD diagnosis, as were anxiety and depression assessed concurrently. PTSD occurs in a substantial minority of older people post-fall. No pattern emerged of factors predictive of PTSD, although the association between fear of falling and PTSD suggests some patients thought to have fear of falling may be manifesting PTSD, and require identification to enable therapeutic intervention.
Assessment of anxiety in older home care recipients
- Authors:
- DIEFENBACH Gretchen J., et al
- Journal article citation:
- Gerontologist, 49(2), April 2009, pp.141-153.
- Publisher:
- Oxford University Press
This study determined the psychometric properties of a variety of anxiety measures administered to older adults receiving home care services. Data were collected from 66 adults aged 65 years and older who were receiving home care services. Participants completed self-report and clinician-rated measures of anxiety and diagnostic interviews for generalized anxiety disorder (GAD). Most measures demonstrated acceptable psychometric properties. All of the measures showed excellent interrater reliability to support verbal administration, which is the typical mode of assessment in home care. The ease of use for each measure (e.g., time of administration) was also evaluated. The Geriatric Anxiety Inventory (GAI) demonstrated the strongest and the Beck Anxiety Inventory the weakest psychometric properties. The GAI and the GAD screening questions from The Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ) demonstrated the greatest utility in screening for anxiety disorders (either GAD or anxiety disorder not otherwise specified). Implications: These data support the use of anxiety measures within a geriatric home care setting. The strengths and weaknesses of each measure are discussed to facilitate selection of the optimal measure depending upon assessment goals and available resources.
Breaking the cycle of intergenerational isolation in London neighborhoods
- Author:
- O'SULLIVAN June
- Journal article citation:
- Journal of Intergenerational Relationships, 7(4), 2009, pp.447-449.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia
This short article describes the various intergenerational initiatives tested by the Westminster Children’s Society (WCS). Based in poor and deprived areas of London, the WCS was created in 1903 to support local families by providing community nurseries, training, employment, and family support. The paper highlights how community fragmentation and segregation are serious issues in the areas where WCS is based. Through research with older residents, the WCS found many felt lonely and isolated, and were frightened by groups of young people on the street. In response to these social problems, the author presents several projects created by the WCS focused on intergenerational issues in an effort to bring the old and young together. However, experience has shown that many of the problems are largely born out of each group being ignorant of one another, creating a failure of intergenerational connection.
Do improvements in emotional distress correlate with becoming more mindful? A study of older adults
- Authors:
- SPLEVINS Kate, SMITH Alistair, SIMPSON Jane
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.328-335.
- Publisher:
- Taylor and Francis
The study aimed (1) to investigate changes in older adults' emotional wellbeing (specifically depression, anxiety and stress levels) and mindful ability following a mindfulness-based cognitive therapy (MBCT) course; (2) to explore correlations between mindfulness (measured as an overall ability and as individual components; observe, describe, act with awareness and accept without judgement) and changes in depression, anxiety and stress levels. Twenty-two participants took an eight-week MBCT course. Levels of depression, anxiety and stress were recorded pre- and post-intervention, as was mindfulness ability (measured both as an overall ability and as individual components). Significant improvements in emotional wellbeing and mindfulness were reported post-MBCT, with large to moderate effect sizes. Increased mindfulness was moderately and significantly associated with improved emotional wellbeing. Increases on all four components of mindfulness were positively associated with greater emotional wellbeing, however only act with awareness and accept without judgement were significantly correlated (with reduced depression). Older adults in the sample reported higher scores on observe and act with awareness than other populations.
Psychological distress and its correlates in older care-dependent persons living at home
- Author:
- THYGESEN Elin
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.319-327.
- Publisher:
- Taylor and Francis
This study examined psychological distress in older people receiving home nursing care. The influence of risk factors and personal resources on their perceived psychological distress was also examined. Method: A linear regression analysis was applied in a cross-sectional sample of 214 patients aged 75 years and older. Psychological distress was measured using the General Health Questionnaire (GHQ). The independent variables were sex, education, age, living arrangement, household composition, reported illnesses, Barthel ADL Index, self-rated health, Subjective Health Complaints, Clinical Dementia Rating Scale, Sense of Coherence and Revised Social Provision Scale. Of the 214 participants, 23 (10.7%) reported experiencing psychological distress using a cut-off point of 4 or more on a GHQ case score. Sense of coherence, education and subjective health complaints were the only factors that were significantly related to psychological distress in the multivariate analysis. The general level of psychological distress was low. Low psychological distress was related to an inner strength conceptualized as sense of coherence. Commonly reported risk factors such as sex, household composition and perceived social support, and objective measures of somatic and mental health and bodily dysfunctions were not related to psychological distress. Suggested reasons for this are greater acceptance of bodily and functional shortcomings and of changes related to goal achievement in old age, according to the model of selective optimization with compensation.