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Changes in the expression of worries, anxiety, and generalized anxiety disorder with increasing age: a population study of 70 to 85‐year‐olds
- Authors:
- NILSSON Johanna E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 34(2), 2019, pp.249-257.
- Publisher:
- Wiley
Objectives: The prevalence of generalized anxiety disorder (GAD) is supposed to decrease with age. Reasons suggested include that emotional control increases and that anxiety and worry are expressed differently in older adults. The aim of this study was to examine how the expression of anxiety and worry changes with age and how this influences diagnoses in current classification systems. Method: Semistructured psychiatric examinations were performed in population‐based samples of 70‐ (n = 562), 75‐ (n = 770), 79/80‐ (n = 603), and 85‐year‐olds (n = 433). Individuals with dementia were excluded. GAD was diagnosed according to DSM‐5 (DSM5 GAD) and ICD‐10 (ICD10 GAD) criteria. Individual symptoms were assessed according to severity and frequency. Functioning was measured with Global Assessment of Functioning (GAF). Results: The prevalence of clinical anxiety, autonomic arousal, muscle tension, and irritability decreased with age, while that of worry and fatigue increased. Concentration difficulties and sleep disturbances remained stable. The prevalence of ICD10 GAD tended to decrease, while that of DSM5 GAD did not change with age. Core symptoms and diagnoses of GAD were related to lower GAF scores. However, in those with autonomic arousal and ICD10 GAD, GAF scores increased with age. Conclusions: The prevalence of ICD10 GAD tended to decrease with increasing age while the prevalence of DSM5 GAD remained stable. This difference was partly due to a decreased frequency of severe anxiety and autonomic arousal symptoms, and that worries increased, suggesting changes in the expression of GAD with increasing age. (Publisher abstract)
Natural history of Alzheimer's Disease and other dementias: review of the literature in the light of the findings from the Kungsholmen Project
- Authors:
- AGUERO-TORRES Hedda, FRATIGLIONI Laura, WINBLAD Bengt
- Journal article citation:
- International Journal of Geriatric Psychiatry, 13(11), November 1998, pp.755-766.
- Publisher:
- Wiley
The elderly population is increasing more than any other sector of the population. Dementia increases disability, morbidity and mortality among older people. For these reasons the possibility of predicting progression and prognosis has enormous importance. This article summarises the main findings from the Kungsholmen Project a longitudinal epidemiological study on dementia that started in Stockholm, Sweden. Aims to help give a better understanding of the natural history of dementing disorders and provide hypotheses for further research.
Mental health first aid for the elderly: a pilot study of a training program adapted for helping elderly people
- Authors:
- SVENSSON Bengt, HANSSON Lars
- Journal article citation:
- Aging and Mental Health, 21(6), 2017, pp.595-601.
- Publisher:
- Taylor and Francis
Objectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal ageing and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training programme for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Method: Single group pre-test–post-test design. Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomised controlled trail is needed to investigate the effectiveness of the programme. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved. (Edited publisher abstract)
Psychiatric diagnoses in relation to severity of intellectual disability and challenging behaviors: a register study among older people
- Authors:
- AXMON A., et al
- Journal article citation:
- Aging and Mental Health, 22(10), 2018, pp.1344-1350.
- Publisher:
- Taylor and Francis
Objective: To investigate the possible association between severity of intellectual disability (ID) and presence of challenging behaviour, respectively, on diagnoses of psychiatric disorders among older people with ID. Methods: People with a diagnosis of ID in inpatient or specialist outpatient care in 2002–2012 were identified (n = 2147; 611 with mild ID, 285 with moderate ID, 255 with severe or profound ID, and 996 with other/unspecified ID). Moreover, using impairment of behaviour as a proxy for challenging behaviour, 627 people with, and 1514 without such behaviour were identified. Results: Severe/profound ID was associated with lower odds of diagnoses of psychotic, affective, and anxiety disorders than was mild/moderate ID. People with moderate ID had higher odds than those with mild ID of having diagnoses of affective disorders. Diagnoses of psychotic, affective, and anxiety disorders, and dementia were more common among people with challenging behaviour than among those without. Conclusions: People with severe/profound ID had lower odds of receiving psychiatric diagnoses than those with mild and moderate ID. Whether this is a result of differences in prevalence of disorders or diagnostic difficulties is unknown. Further, challenging behaviours were associated with diagnoses of psychiatric disorders. However, the nature of this association remains unclear. (Edited publisher abstract)
Follow-up two years after diagnosis of diabetes in patients with psychosocial problems receiving an intervention by a medical social worker
- Authors:
- GAFVELS Catharina, et al
- Journal article citation:
- Social Work in Health Care, 53(6), 2014, pp.584-600.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study study investigates the situation of diabetes patients (n = 82) aged 18–65 years, two years after diagnosis, and to compare patients with social and emotional problems (PSP; n = 27) receiving an intervention with patients without such problems (NPSP; n = 55). The study used a social questionnaire, the Hospital Anxiety and Depression scale (HAD), the Sense of Coherence scale (SOC), and the General Coping Questionnaire (GCQ). Interventions were: psychosocial support; psychotherapeutic interventions; crisis interventions; and social supportive interventions regarding work, economy, and dwelling. The sessions lasted for one hour, and the patients had a mean 10 sessions each during a three-month period. The PSP group had a more difficult situation with more strained economy, lower social support, more anxiety and depression, and lower SOC on both occasions. Being in the PSP group predicted experiencing a strong negative influence of the disease at follow-up. Regarding coping strategies, 'problem focusing' decreased in both PSP and NPSP over time. 'Social trust' and 'intrusion' decreased only in NPSP. Otherwise the coping pattern was unchanged, with PSP showing lower scores on 'self-trust' and 'minimization' and higher scores on 'protest,' 'isolation,' and 'intrusion.' The most influenced areas at follow-up in the PSP group were work, relationship to partner and economy, and in the NPSP leisure-time activities, sexual life and work. The findings underline the need to identify patients with psychosocial problems early. (Edited publisher abstract)
Detection of Alzheimer's disease and dementia in the preclinical phase: population based cohort study
- Authors:
- PALMER Katie, et al
- Journal article citation:
- British Medical Journal, 1.02.03, 2003, pp.245-247.
- Publisher:
- British Medical Association
Reports on a three year population based cohort study from Stockholm, Sweden. Participants included 1435 people aged 75-95 years without dementia. After participants had been screened for memory complaints and global cognitive impairment, specific tests of word recall and verbal fluency had positive predictive values for dementia of 85-100% (95% confidence intervals range from 62% to 100%). However, only 18% of future dementia cases were identified in the preclinical phase by this three step procedure. Memory complaints were the most sensitive indicator of Alzheimer's disease and dementia in the whole population, but only half the future dementia cases reported memory problems three years before diagnosis.
Elderly care recipients in a Swedish municipality living in their own homes: their diseases, functional health status and care provided as reported by formal carers
- Authors:
- OLIVIUS Gunilla, HALBERG Ingalill Rahm, OLSSON Birgitta
- Journal article citation:
- Health and Social Care in the Community, 4(3), May 1996, pp.133-141.
- Publisher:
- Wiley
Investigates from the perspective of formal carers the care given to people aged 65 and over in Sweden, who are cared for in their homes by informal care. Concludes that, diagnoses, the care recipients ability to be alone and functional health status are important variables to include when assessing the demands for home care and when planning supplementary care for home care recipients and their informal caregivers.