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Subtle imitation behaviour in convenience samples of normal, demented, and currently depressed elderly subjects
- Authors:
- von GUNTEN Armin, DUC Rene
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(6), June 2007, pp.568-573.
- Publisher:
- Wiley
The clinical significance of imitation behaviour (IB) is unclear. The aim of this study was to investigate the prevalence of subtle naïve and obstinate IB in convenience samples of normal elderly, demented, and depressed subjects. Subtle IB was assessed using a protocol constructed ad hoc in 146 patients, consecutively referred to a memory clinic having received an ICD-10 diagnosis of either dementia or depression, and in 241 healthy subjects. The prevalence of IB in the three groups was determined and the association with possible demographic, cognitive, and non-cognitive variables analysed. Subtle naïve IB was frequent in the elderly with dementia, intermediate in the depressed, and rare in the normal elderly except that the latter frequently stretched out their arms. Obstinate IB never occurred in the normal elderly. IB was predicted by none of the variables used. The groups included were convenience samples with the depressed being a small group precluding further distinction of depressive subtypes. Although naïve IB is a frequent clinical feature in the demented, it also accompanies depressive disorders in the elderly. It can be observed as context-specific IB in the normal elderly. Obstinate IB does not occur in the normal elderly.
Course of cognitive impairment following attempted suicide in older adults
- Authors:
- GUJRAL Swathi, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(6), 2016, pp.592-600.
- Publisher:
- Wiley
Objective: Cognitive impairment has been associated with late-life suicidal behaviour. Without longitudinal data it is unclear whether these are transient features of a depressive state or stable impairments. We examined longitudinally the course of cognitive impairment in older adults with depression and a history of suicide attempt. Methods: The authors investigated the persistence of cognitive impairment over time in 198 depressed older adults (age >60); 91 suicide attempters, 39 depressed individuals with suicidal ideation (ideators), and 68 non-suicidal depressed adults assessed over a 2-year period at four time points. The authors used linear mixed effects modelling to examine group differences in trajectories of cognitive decline over 2 years, using the Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (DRS), and Executive Interview (EXIT). Results: Over the 2-year period, suicide attempters performed significantly worse than both suicide ideators and non-suicidal depressed older adults on the MMSE (mean difference: from ideators: −0.88, p = 0.02; from non-suicidal depressed: −1.52, p < 0.01), while on the EXIT and DRS, suicide attempters performed significantly worse than non-suicidal depressed older adults (mean difference: in EXIT: −1.75, p = 0.01; in DRS: 3.04, p < 0.01; in MMSE: 1.15, p < 0.01). Cognitive impairment in suicide attempters partly resolved, as indicated by a group × time interaction on the DRS (p = 0.039), but not the EXIT (p = 0.58) or the MMSE (p = 0.08). Conclusions: Cognitive impairment in late-life suicidal behavior appears to involve both a stable and a state-related component. (Edited publisher abstract)
Health-related social control among older men with depressive symptomatology
- Authors:
- MAVANDADI Shahrzad, et al
- Journal article citation:
- Aging and Mental Health, 19(11), 2015, pp.997-1004.
- Publisher:
- Taylor and Francis
Objectives: Social control attempts, or attempts by social network members to influence a person's behaviour, significantly predict men's health behaviours and psychological well-being. Despite the fact that depression is associated with compromised interpersonal functioning and poor health behaviours, the association between social control processes and depression has not been studied. Thus, this pilot study explored differential vulnerability to spouses’ social control attempts among older, male primary care patients with varying levels of depression symptom severity and the degree to which these attempts predicted patients’ behavioural and affective responses. Method: Participants included 88 older men referred by their primary care providers for a behavioural health assessment at a Veterans Affairs Medical Center. Data on sociodemographics, depressive symptomatology, health behaviours, spouses’ positive and negative social control attempts, and patients’ behavioural and affective responses to attempts were collected by telephone. Results: The sample was primarily Caucasian (mean age = 65.3 (SD = 8.1) years). Patients’ higher depressive symptoms were significantly associated with positive and negative affective responses to their spouses’ social control attempts. The frequency of control attempts and patients’ behavioural responses, however, were unrelated to patients’ depressive symptoms. Multiple regression models revealed that while spouses’ control attempts were unrelated to patients’ positive behavioural responses, more frequent negative attempts predicted greater negative behavioural responses (e.g., ignoring spouses’ attempts). Moreover, negative control attempts predicted greater negative affective responses (e.g., resentment, sadness). Conclusion: The findings highlight the value of identifying effective social control strategies that maximise positive behavioural change, emotional responses, and health outcomes among older men with depressive symptoms. (Publisher abstract)
Specific psychological and behavioral symptoms of depression in patients with dementia
- Authors:
- PRADO-JEAN Annie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.1065-1072.
- Publisher:
- Wiley
Ninety percent of patients experience at least one behavioural and psychological symptom in dementia (BPSD) during the course of the disease. One-third of people with dementia have depressive symptoms. This study characterised the psychological and behavioural manifestations of depression in patients with dementia. Patients with dementia from several nursing homes in the Limousin region of France participated. Depression was as diagnosed by the Cornell Scale for Depression in Dementia, and BPSD were assessed using the Neuropsychiatric Inventory (NPI). Of 319 patients with dementia, 43% were depressed and 76% had BPSD. All BPSD were significantly more prevalent among depressed patients, but no significant differences were observed according to sex and age. The NPI showed that the most common additional symptoms in depressed patients were agitation, anxiety and irritability. Depression in dementia patients was significantly associated with dis-inhibition, irritability, agitation, and anxiety. The authors concluded that, before addressing them as isolated symptoms, it is important to consider comorbidity with depression in order to optimise the therapeutic approach.
Physical activity programs for persons with dementia (review)
- Authors:
- FORBES D., et al
- Publisher:
- John Wiley and Sons
- Publication year:
- 2008
- Pagination:
- 30p., bibliog.
- Place of publication:
- Chichester
There is some evidence that physical activity delays the onset of dementia in healthy older adults and slows down cognitive decline to prevent the onset of cognitive disability. This systematic review aimed to investigate a) whether physical activity programs maintain or improve cognition, function, behaviour, depression, and mortality compared to usual care in older persons with dementia?; b) whether secondly physical activity programs have an indirect positive impact on family caregivers' health, quality of life, and mortality compared to family caregivers of older persons with dementia who received usual care alone; and c) whether physical activity programs reduce the use of health care services compared to usual care in older persons with dementia and their family caregiver. In this review, 'physical activity' refers to 'usual care plus physical activity'. Few trials examined these important outcomes. In addition, family caregiver outcomes and use of health care services were not reported in any of the included studies. Four trials met the inclusion criteria. However, only two trials were included in the analyses because the required data from the other two trials were not made available. It was concluded that there is insufficient evidence to be able to say whether or not physical activity programs are beneficial for people with dementia. Further well-designed research is required.
Sleep disturbances in the elderly residing in assisted living: findings from the Maryland Assisted Living Study
- Authors:
- RAO Vani, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(10), October 2005, pp.956-966.
- Publisher:
- Wiley
This study aims to estimate the prevalence, types, and associations of sleep disturbance in a stratified random sample of AL residents, and to explore the effect of sleep disturbance on cognitive and physical functioning, as assessed by the Mini- Mental State Exam (MMSE) and the Psychogeriatric Dependency Rating Scale (PGDRS). Participants were 198 randomly selected assisted living residents in 22 Maryland facilities. Participants were rated on an 11-item sleep questionnaire regarding insomnia and daytime sleepiness. Sleep disturbance was present in 69% of residents, insomnia (IN) in 42% and excessive daytime sleepiness (DS) in 34.6%. IN and DS scores were not significantly correlated. Use of hypnotics, sedating antidepressants, and depression were associated with insomnia. Depression and poor general medical health were associated with daytime sleepiness. On a cognitive task (Mini Mental State Examination) participants with insomnia only out-performed participants with no sleep disturbance and daytime sleepiness; on a measure of physical function (PsychoGeriatric Dependency Rating Scale- physical domain), participants with insomnia fared better than those with daytime sleepiness only and those with both insomnia and daytime sleepiness. Participants with DS only performed worse on both measures compared to those with no sleep disturbance, those with insomnia only, and those with both insomnia and daytime sleepiness. The prevalence of sleep disturbance in AL is similar to that reported in nursing homes. Daytime sleepiness is associated with poorer cognitive and day-to-day functioning, while insomnia is associated with better outcomes. Effective management of DS may lead to improved functioning in the AL residents.
The role of depressive symptoms in recovery from injuries to the extremities in older persons. a prospective study
- Authors:
- KEMPEN Gertrudis I. J. M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(1), January 2003, pp.14-22.
- Publisher:
- Wiley
Previous research suggests that depressive symptoms play a role in recovery after hip fracture. However none of these studies were prospective and included only patients with hip fractures. Depressive symptoms at baseline were not predictive for disability after the injury when covariates were taken into account. However, depressive symptoms 8 weeks after the fall were significantly related to disability at 8 weeks, 5 months and even 12 months after the injury. In addition, disability levels before the injury were highly predictive for recovery later on. Severity of injury was particularly predictive for disability at 8 weeks while age (which may generally represent the amount of physiological reserve) predicted disability at 5 and 12 months after the injury. Cognitive functioning 8 weeks post-injury was, in contrast to previous research, not predictive for recovery when covariates were taken into account.
Negative symptoms in the elderly patient with dementia
- Authors:
- REICHMAN William E., NEGRON Arnaldo
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(S1), December 2001, pp.7-11.
- Publisher:
- Wiley
Negative symptoms are a well-documented and studied feature of schizophrenia. However, behaviourial alterations such as apathy, social withdrawal and emotional disengagement appear to be commonly found in patients suffering from Alzheimer's disease. This paper briefly review the phenomenology of negative symptoms in the elderly, focusing on their presence in dementia and more specifically, Alzheimer's disease. Calls for further research to identify pharmacological treatments that significantly reduce the severity of negative symptoms in older patients suffering from dementia as well as schizophrenia.
Dementia and suicidal behavior
- Authors:
- CIPRIANI Gabriele, et al
- Journal article citation:
- Aggression and Violent Behavior, 18(6), 2013, p.656–659.
- Publisher:
- Elsevier
Behavioural and psychological symptoms of dementia, including depression, might complicate the course of the disorder additionally. Dementia is more frequent in older people and suicide rates are higher in later life than in any other age group. To explore the phenomenology of suicidal behaviour in patients with dementia, the authors searched electronic databases and key journals for original research and review articles on suicide in demented patients using the search terms “suicide, suicidal behaviour, dementia, Alzheimer disease, and old age”. Although cognitive impairment could result in a diminishing ability to think flexibly and to solve problems or to cope with conflict, in the early stage of dementia such impairments are absent or mild, and suicidal behaviour might be expected, especially following diagnosis. In addition, personality changes based on declining cognitive capacity and the neurochemical imbalances described in late-life depression and in dementia may predispose patients to aggressive or impulsive acts, such as suicide attempt. The literature on suicidal behaviour and dementia highlights the need for further research in this area. (Publisher abstract)
Caregiver mental health and potentially harmful caregiving behavior: the central role of caregiver anger
- Author:
- MacNEIL Gordon
- Journal article citation:
- Gerontologist, 50(1), February 2010, pp.76-86.
- Publisher:
- Oxford University Press
Caregivers feeling stress or experiencing mental health problems are more likely to engage in abusive acts towards elderly care recipients. Potentially harmful behaviour was used as a measure of caregivers’ engagement in, or risk of engagement in, behaviour that places dependent care recipients at risk of physical or psychological abuse and may be seen as a precursor to identifiably abusive behaviour. The study examined the ability of anger to mediate and moderate the relations of depression, resentment, and anxiety with potentially harmful behaviour. Four hundred and seventeen carers, selected from the first wave of the second Family Relationships in Late Life study of caregivers of community-dwelling elderly care recipients with whom they coreside, completed face-to-face interviews. Results indicated that anger was found to mediate the relation between anxiety and potentially harmful behaviour, and anger both mediates and moderates the effects of both depression and resentment with potentially harmful behaviour. In conclusion, the identification of anger levels among caregivers who report symptoms of depression is warranted - reducing depression in caregivers who report high levels of anger may result in reductions of potentially harmful behaviour. Screening for resentment is also warranted, as the relationship between resentment and anger is similar to that between depression and anger.