Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 23
Understanding vascular dementia
- Author:
- ALZHEIMER'S SOCIETY
- Publisher:
- Alzheimer's Society
- Publication year:
- 2005
- Pagination:
- 18p.
- Place of publication:
- London
This booklet has been written to help anyone affected by vascular dementia – people with dementia, carers, family members and professionals – to understand the condition. It is a type of dementia caused by problems with the supply of blood to, or within the brain. The stages are similar to those of Alzheimer's disease, but the decline of functions happens in steps, rather than gradually. Symptoms vary, depending on which parts of the brain have been damaged and how severe the damage is. Researchers believe that people who have had a stroke have an increased risk of developing vascular dementia. In the early stages, the individual may not experience memory problems and the personality will be unaffected. Subcategories of vascular dementia include (1) mild vascular cognitive impairment, (2) multi-infarct dementia, (3) vascular dementia due to a strategic single infarct, (5) vascular dementia due to hemorrhagic lesions, (6) Binswanger’s disease and (7) mixed dementia (combination of AD and vascular dementia.
The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach
- Authors:
- DE COSTER Liesbeth, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.358-362.
- Publisher:
- Wiley
Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post-stroke depression difficult. The aim was to assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post-stroke depression. Two hundred and six patients with first-ever stroke, participating in a longitudinal study, were administered the Structured Clinical Interview for DSM-IV and the Hamilton Depression Rating Scale (HAM-D). In a discriminant analysis the relative contribution of the individual HAM-D items to the diagnosis of major depressive disorder was evaluated. The cumulative incidence of post-stroke major depressive disorder was 32%. The discriminant model based on HAM-D item scores was highly significant (p<0.001) and classified 88.3% of patients correctly as depressed or nondepressed. As expected, depressed mood discriminated best between depressed and non-depressed stroke patients. Reduced interests had a relatively low sensitivity and may in part reflect apathy, which often is considered a separate construct. With the exception of suicidal thoughts, most psychological symptoms, such as hypochondriasis, lack of insight and feelings of guilt, were not very sensitive. Some somatic symptoms, such as reduced appetite, psychomotor retardation, and fatigue had high discriminative properties. Psychological, neurocognitive and somatic symptoms of depression differ among themselves in terms of diagnostic sensitivity, and should be considered individually. Some somatic symptoms are highly sensitive for depression and should not be neglected by following an exclusive or attributional approach to the diagnosis of PSD.
Mortality from dementia in a community-dwelling Brazilian population
- Authors:
- NITRINI Ricardo, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(3), March 2005, pp.247-253.
- Publisher:
- Wiley
The influence of dementia on mortality has not yet been reported for a Latin American country. The aim was to evaluate the influence of dementia on mortality of a community-dwelling elderly population in Brazil, and to verify the extent to which the diagnosis of dementia is reported on death certificates. A cohort of 1,656 individuals, aged 65 and over, was screened for dementia at their domiciles, in 1997. The same population was re-evaluated in 2000, and information on deaths was obtained from relatives and from the municipal obituary service. Kaplan-Meier curves were used for the survival analysis, and the mortality risk ratio (MMR) was calculated using Cox proportional hazards models. We obtained data from 1,393 subjects, corresponding to 84.1% of the target population. The number of deaths was 58 (51.3%) among the patients with dementia and 163 (12.7%) among those without dementia in 1997 (p < 0.0001). Dementia and Alzheimer's disease (AD) decreased survival, with hazards ratios of 5.16 [95% Confidence Interval (CI): 3.74-7.12] for dementia and 4.76 (95% CI: 3.16-7.18) for AD. The Cox proportional hazards model identified dementia (MMR = 3.92, 95% CI: 2.80-5.48) as the most significant predictor of death, followed by age, history of stroke, complaints of visual impairment and heart failure and by severe arterial hypertension in the baseline evaluation. Dementia and/or AD were mentioned in only 12.5% of the death certificates of individuals with dementia. Dementia causes a significant decrease in survival, and the diagnosis of dementia is rarely reported on death certificates in Brazil.
Depression in later life
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Publisher:
- Jessica Kingsley
- Publication year:
- 2005
- Pagination:
- 160p.,bibliog.
- Place of publication:
- London
The authors take a multidisciplinary approach and employ both medical and psycho-social models of depression. The medical model is used to identify symptoms, make diagnoses and work towards optimal treatment. Psycho-social perspectives provide insight into the scale and complexity of the condition and point to its social causes. The authors identify different levels of depression through in-depth analysis and consider the condition in relation to, but distinct from, dementia, psychosis and anxiety disorders, helping professionals to make the correct diagnosis. Supporting case studies show that depression, and the physical symptoms often linked to it, are amenable to treatment. The authors provide practical guidance for health and social care practitioners and suggest numerous coping strategies.
Psychosis in the elderly
- Editors:
- HASSETT Anne, AMES David, CHIU Edmond
- Publisher:
- Taylor and Francis
- Publication year:
- 2005
- Pagination:
- 259p.
- Place of publication:
- Abingdon
Across the spectrum of psychopathology in later life, psychotic symptomatology has been the most neglected, and although literature in this area is increasing, this is the first book to address the need for an overarching framework to examine and understand late-life psychotic phenomena. Exploring the practical and ethical issues that arise when managing psychotic elderly patients in the community, as well as the sequelae of stigmatisation and carer stress, this text: brings together the latest research findings on schizophrenia as it presents in later life; covers the frequent comorbidity of psychotic symptoms with cognitive impairment, mood disturbance and physical illness; highlights the diversity of late-life psychotic symptomatology, discussing both aetiological considerations and management strategies.
Physical health and depressive symptoms in older Europeans: results from EURODEP
- Authors:
- BRAAM A. W., et al
- Journal article citation:
- British Journal of Psychiatry, 187(1), July 2005, pp.35-42.
- Publisher:
- Cambridge University Press
Associations between physical health and depression are consistent across cultures among adults up to 65 years of age. In later life, the impact of physical health on depression is much more substantial and may depend on sociocultural factors. The aim was to examine cross-national differences in the association between physical health and depressive symptoms in elderly people across western Europe. Fourteen community-based studies on depression in later life in nine western European countries contributed to a total study sample of 22 570 respondents aged 65 years and older. Measures were harmonised for depressive symptoms (EURO-D scale), functional limitations and chronic physical conditions. In the majority of the participating samples, the association of depressive symptoms with functional disability was stronger than with chronic physical conditions. Associations were slightly more pronounced in the UK and Ireland. The association between physical health and depressive symptoms in later life is consistent across western Europe.
Older people with chronic schizophrenia
- Authors:
- KARIM S., OVERSHOTT R., BURNS A.
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.315-324.
- Publisher:
- Taylor and Francis
Older people with chronic schizophrenia are a numerically small but important group with complex clinical and service needs. Along with a reduction in positive schizophrenic symptoms with increasing age, a majority suffer from negative symptoms, cognitive deficits, depression, side effects due to long-term use of antipsychotics and co-morbid medical problems. They may have social disabilities making them vulnerable to poverty, isolation and poor quality of life. Evidence suggests that judicious use of antipsychotics combined with psychotherapy and psychosocial interventions are effective. There are shortcomings in the standard of both hospital and community care, and the cost implications of providing adequate services are high.
The CIDI as an instrument for diagnosing depression in older Turkish and Moroccan labour migrants: an exploratory study into equivalence
- Authors:
- SMITS Carolien H. M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.436-445.
- Publisher:
- Wiley
The number of elderly migrants from Turkey and Morocco in Western Europe will increase sharply in the coming decades. Many of these migrants seem to have mental health problems. As mental health care programs are based on DSM criteria, there is a need for diagnostic instruments with good psychometric properties. This exploratory study examines the presence of construct bias, method bias and item bias in the Composite International Diagnostic Interview (CIDI) Basis Life time version 2.1 in elderly Turkish and Moroccan men and women. From a community based health survey four groups of migrants aged 55-74 were selected for semi-structured interviews including the CIDI depression section. Data included interview transcriptions and observations of 11 respondents in each group (Turkish men, Turkish women, Moroccan men, and Moroccan women). The data were analysed using qualitative techniques. Construct bias, method bias and item bias of the CIDI was found in all groups. The poor match between the CIDI on the one hand and the taboo on mental health problems and the poor level of education of the respondents can partly explain this bias. The use of the CIDI in elderly migrants of Moroccan and Turkish descent is problematic, due to the presence of construct, method and item bias.
The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms
- Authors:
- CHENG Sheung-Tak, CHAN Alfred C. M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.465-470.
- Publisher:
- Wiley
No study has examined the diagnostic validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in the Chinese elderly. This study aims to determine appropriate cutoffs for the 20- (CESD-20) as well as a ten-item (CESD-10) version of the instrument. Data were also provided, based on simulated scoring, for the diagnostic performance of the scales when using dichotomous instead of 4-point rating scales. Three hundred and ninety eight persons aged 60 +referred for psychiatric asssessment by a physician were administered the CES-D as well as given an independent psychiatric assessment. A spectrum of depression diagnosis as the criterion was used to assess the diagnostic validity of the CES-D. The ten and the 20-item version of the CES-D, regardless of scoring method, produced essentially identical performance indices. The optimal thresholds were 12 and 22 for CESD-10 and CESD-20 respectively, and based on these thresholds, sensitivity, specificity, positive predictive value and negative predictive value were 0.76, 0.55, 0.57 and 0.74 for CESD-10, and 0.75, 0.51, 0.55 and 0.72 for CESD-20. With both ends of the rating scale collapsed to create dichotomous items, the optimal thresholds became 4 for CESD-10 and 7 for CESD-20, and the correponding performance indices were 0.67, 0.58, 0.56 and 0.69 for CESD-10, and 0.70, 0.58, 0.57 and 0.70 for CESD-20. The ten-item version can be used in lieu of the 20-item version, and a dichotomous response format would probably work as well as the original four-point format, in order to simplify administration for elderly persons
Depressive symptom quality and neuropsychological performance in dementia
- Authors:
- JANZING Joost G. E., NAARDING Paul, ELING Paul A. T. M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.479-484.
- Publisher:
- Wiley
It is unknown to what extent depression and cognitive dysfunction are related in subjects with dementia. A limitation of earlier studies is that only general measures of depression have been studied. In a sample of 60 subjects with dementia according to DSM-III-R criteria depressive symptoms were divided into factors of mood and motivation disturbance according to a principal components analysis. Correlations were computed between the factor scores and the performance on a number of specific neuropsychological tests. As the symptom content of motivation disturbance suggests subcorticofrontal dysfunction it was hypothesized that this factor is related to impaired executive functions. 77% of the depressive symptoms contributed to the dimension of motivation disturbance and most of these symptoms occurred outside the context of a major depressive episode. Our hypothesis was supported by a significant negative correlation between motivation symptoms and semantic verbal fluency. This relationship seems to have specificity, as both the dimensions of mood symptoms and of general depressive symptoms did not correlate significantly with specific neuropsychological test scores. The division of depressive symptoms in factors of mood and motivation disturbance contributes to insight into the relationship between depression and cognitive dysfunction in dementia. An advantage of the motivation disturbance factor compared to the regular apathy scales is that it consists of depressive symptoms. Therefore, it becomes evident that apathy or impaired motivation may occur in patients with dementia both in and outside the context of a depressive syndrome.