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The rich picture on older people with cancer
- Author:
- MACMILLAN CANCER SUPPORT
- Publisher:
- Macmillan Cancer Support
- Publication year:
- 2012
- Pagination:
- 68p.
- Place of publication:
- London
The ‘Rich Pictures’ are evidence-based summaries of the numbers, needs and experiences of different groupings within the 2 million people living with cancer in the UK. They contain a range of evidence and insight including how many people are within the group, what their survival rates are, and what their typical needs and experiences are. This document provides information on older people living with cancer. The greatest risk factor for cancer is age, and over 60% of everyone living with cancer is aged 65 years and over. Around 1.3 million (13%) people aged 65 years and over are living with or beyond cancer. The document summarises what is known about the needs and experiences of older people at different stages of the cancer journey (diagnosis, treatment, survivorship, and progressive illness and end of life), and also what is known about their lifestyle and perceptions. It considers 4 types of needs: physical and medical needs; financial needs; practical and information needs; and emotional and psychological needs.
Stagnation in mortality decline among elders in the Netherlands
- Authors:
- JANSSEN Fanny, et al
- Journal article citation:
- Gerontologist, 43(5), October 2003, pp.722-734.
- Publisher:
- Oxford University Press
This study assesses whether the stagnation of old-age (80+) mortality decline observed in The Netherlands in the 1980s continued in the 1990s and determines which factors contributed to this stagnation. Emphasis is on the role of smoking. Poisson regression analysis with linear splines was applied to total and cause-specific mortality data by age, year of death (1950-1999), and sex. An age-period-cohort analysis was carried out to determine whether the trends followed period or cohort patterns. ICD revisions were bridged by use of a concordance table. A sudden reversal in old-age mortality decline occurred around 1980, leading to a stagnation of the decline and even increases in mortality thereafter. Smoking-related cancers, chronic obstructive pulmonary disease, and diseases specifically related to old age contributed to this stagnation. Trends in smoking-related cancers and chronic obstructive pulmonary disease showed a cohort pattern-especially for men. When these smoking-related diseases were excluded, the trends in old-age mortality in The Netherlands showed an increasing stagnation for both sexes. Smoking behaviour can only partly explain the stagnation of mortality. Other factors such as increased frailty and changes in medical and social services for elderly people probably played a more decisive role in the recent stagnation.
Development of the Korean version of Alzheimer's Disease Assessment Scale (ADAS-K)
- Authors:
- YOUN J. C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(9), September 2002, pp.797-803.
- Publisher:
- Wiley
The purpose of this study was the development of the Korean Version of Alzheimer's Disease Assessment Scale (ADAS-K). ADAS-K was administrated to 84 AD patients as well as 105 non-demented control subjects. Three aspects of reliability were tested. To evaluate the validity of ADAS-K, discriminant validity and concurrent validity were tested. To evaluate the sensitivity of ADAS-K to disease severity, all subjects, AD patients and control subjects, were grouped by CDR scale and their mean scores on ADAS-K were compared. The authors demonstrated that ADAS-K is a reliable and valid instrument not only for AD diagnosis but also for evaluation of its severity.
Measuring Alzheimer's disease progression with transition probabilities in the Taiwanese population
- Authors:
- FUH Jong-Ling, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(3), March 2004, pp.266-270.
- Publisher:
- Wiley
The transition probability of Alzheimer's disease (AD) is defined as the likelihood that the disease progresses from one stage to another in a given time period. The purpose was to estimate the separate stage-to-stage and stage-to-death transition probabilities for Taiwanese patients with AD and to evaluate the hazard ratios of age, sex, behavioral symptoms, and medications on disease progression. The authors examined data (severity of dementia, hallucinations or delusions, use of cholinesterase inhibitors [CEIs], survival) in 365 patients with probable AD at baseline and at follow-Gup (mean ± SD 29 ± 17 months, range 3-109 months). Modified survival analysis revealed that transition probabilities of Taiwanese patients were similar to those of Western patients. The probability of dementia remaining at the same stage was higher in patients taking CEIs than in other. Men had a higher probability of dying in the mild stage. Transition probabilities can be used to measure AD progression. CEIs used to treat AD might alter the disease course.
Nursing home suicides: a psychological autopsy study
- Authors:
- SOUMINEN Kirsi, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1095-1101.
- Publisher:
- Wiley
Older adults comprise a fifth of all suicides. Elders are the fastest growing part of the population, thus the number of persons needing nursing home care will increase dramatically in the near future. Little information has been available about suicides in nursing homes. The present study described all suicides among older adults in nursing homes in Finland during a 12-month period emphasizing the factors that have been found to be associated with suicide in the general elderly population. Drawing on data from a psychological autopsy study of all suicides (n=1397) in Finland during one year, all suicides committed by patients in nursing homes were identified. Retrospective DSM-IV consensus diagnoses were assigned. Twelve elderly (aged 60 years or more) nursing home residents who died by suicide, 0.9% of all suicides, were identified. The primary finding of the present study was that nursing home residents who died by suicide had suffered from highly comorbid somatopsychiatric disorders. One or more diagnoses on Axis I were made for all who died by suicide in nursing home. Depressive syndrome was diagnosed in three-quarters of subjects. Only a third of these were identified to have suffered from depressive symptoms before their death. Early recognition and adequate treatment of both somatic diseases and mental disorders, particularly depression, as well as early recognition of suicide risk among nursing home residents, are needed in order to prevent suicide.
Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria: results of the Leipzig Longitudinal Study of the Aged (LEILA75+)
- Authors:
- TURNER Stuart W., et al
- Journal article citation:
- British Journal of Psychiatry, 182(5), May 2003, pp.444-448.
- Publisher:
- Cambridge University Press
Although mild cognitive impairment is associated with an increased risk of developing dementia, there has been little work on its incidence and prevalence. The aim of this article was to report age-specific prevalence, incidence and predictive validities for four diagnostic concepts of mild cognitive impairment. A community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study. Prevalence rates ranged from 3% to 20%, depending on the concept applied. The annual incidence rates applying different case definitions varied from 8 to 77 per 1000 person-years. Rates of conversion to dementia over 2.6 years ranged from 23% to 47%. Mild cognitive impairment is frequent in older people. Prevalence, incidence and predictive validities are highly dependent on the diagnostic criteria applied.
Mortality of people with intellectual disability in northern Sydney
- Author:
- BAKER Wesley
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 27(4), December 2002, pp.255-264.
- Publisher:
- Taylor and Francis
A population-derived cohort of 693 people with intellectual disability in the Lower North Shore (LNS) area of Sydney, New South Wales, Australia was followed from 1989 to 1999 to determine mortality rates, the demographics of the deceased, and causes of death. The general population of LNS was used for comparison. Age- and sex-adjusted mortality rates were higher than those in the LNS population. The main cause of death was respiratory disease, followed by external causes and cancer. Of those who had died, the greatest proportion were functioning in the severe to profound range of intellectual disability, and half were living in institutional care. Public health resources and services need to be directed to this vulnerable population in order to address the excess mortality.
Mortality of persons with intellectual disability in residential care in Israel 1991-1997
- Author:
- MERRICK Joav
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 27(4), December 2002, pp.265-272.
- Publisher:
- Taylor and Francis
Reports on the number of deaths for the period 1991-1997 in Israeli residential centres. Some 450 deaths were reported, corresponding to a mortality rate of 10.25 deaths per 1000 population per year. The number of deaths compared with those in the general population. Information on the age and sex distribution, level of intellectual disability, ethnic background and cause of death is presented.
Dementia known to mental health services: first findings of a case register for a defined elderly population
- Authors:
- HOLMES Clive, COOPER Brian, LEVY Raymond
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(10), October 1995, pp.875-881.
- Publisher:
- Wiley
The aims and methodology of the population-based Camberwell Dementia Case Register are described. Data collection during the first 18 months of the Register's operation have been used to check the reliability of clinical diagnosis as assessed on the one hand by standardized interview and test procedures and on the other hand from available hospital records; further, to examine the predictive validity of a 'consensus' diagnosis by comparison with the neuropathological findings in deceased patients.
Alternative statistical approaches to identifying dementia in a community-dwelling sample
- Authors:
- KUCHIBHATLA M., FILLENBAUM G. G.
- Journal article citation:
- Aging and Mental Health, 7(5), September 2003, pp.383-389.
- Publisher:
- Taylor and Francis
Little attention has been paid to examining the extent to which alternative statistical models may facilitate identification of persons with dementia. Using a sub-sample of the Duke Established Populations for Epidemiologic Studies of the Elderly, two analytical approaches were compared: logistic regression (which focuses on identifying specific characteristics predictive here of dementia), and recursive partitioning methods using tree-based models (which permit identification of the characteristics of those groups with high dementing disorder). In the stepwise multiple logistic regression model which included as potential predictors, gender, age, history of chronic health conditions, scales of basic and instrumental activities of daily living (IADL), and cognitive status, only IADL and cognitive status were significant predictors, with cognitive status the single most important factor. The classification tree approach, which permits identification of the characteristics of those groups with particularly high dementia rates, identified cognitive status as the most important criterion for dementia (as did logistic regression analysis). Among those without cognitive impairment, older age was a risk factor, confirming findings consistently reported in the literature. Among the cognitively impaired, IADL was an important risk factor. Those with five or more IADL problems were further classified into two risk groups, based on number of ADL problems. While classification tree analysis encourages identification of groups at risk, logistic regression encourages targeting of specific characteristics.