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Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study
- Authors:
- CASTRO-COSTA Erico, et al
- Journal article citation:
- British Journal of Psychiatry, 191(11), November 2007, pp.393-401.
- Publisher:
- Cambridge University Press
The EURO–D, a12-item self-report questionnaire for depression, was developed with the aim of facilitating cross-cultural research into late-life depression in Europe. The aim was to describe the national variation in depression symptoms and syndrome prevalence across ten European countries. The EURO–D was administered to cross-sectional nationally representative samples of noninstitutionalised persons aged 50 years (n=22 777). The effects of age, gender, education and cognitive functioning on individual symptoms and EURO–D factor scores were estimated. Country-specific depression prevalence rates and mean factor scores were re-estimated, adjusted for these compositional effects. The prevalence of all symptoms was higher in the Latin ethno-lingual group of countries, especially symptoms related to motivation. Women scored higher on affective suffering; older people and those with impaired verbal fluency scored higher on motivation. The prevalence of individual EURO–D symptoms and of probable depression (cut-off score 4) varied consistently between countries. Standardising for effects of age, gender, education and cognitive function suggested that these compositional factors did not account for the observed variation.
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.
Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma
- Authors:
- VERNOOIJ-DASSEN Myrra J. F. J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.377-386.
- Publisher:
- Wiley
Timely recognition and diagnosis of dementia is the pre-condition for improving dementia care, but diagnosis often occurs late in the disease process. The aim was to compare facilitators and obstacles to the timely recognition of dementia across eight European Union states, in order to implement established policies for earlier diagnosis. Twenty-three participants from different disciplines, purposively sampled for professional expertise in dementia research and innovative practice, attended two focus groups. Stigma in ageing and dementia, accompanied by a sense that there is little to offer until later on in the disease, underpinned the widespread reluctance of GPs to recognise dementia at an early stage and were major obstacles to the timely diagnosis of dementia across all eight countries. Dementia care services varied widely across Europe. Countries with the greatest development of dementia health care services were characterised by national guidelines, GPs fulfilling a gatekeeper function, multi-disciplinary memory clinics and innovative programmes that stimulated practice and new services. Dementia-related stigma was perceived as being less prominent in these countries. Overcome of delays in the timely diagnosis of dementia needs more than specialist services. They should address the processes associated with stigma, age and dementia, especially where these relate to physician practice and diagnostic disclosure. Stigma is perceived as variable across European States, with a promising finding that its impact is relatively small in countries with the widest range of dementia care services.
Cross-national comparison and validation of the Alzheimer's Disease Assessment Scale: results from the European Harmonization Project for Instruments in Dementia (EURO-HARPID)
- Authors:
- VERHEY Frans R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(1), January 2004, pp.41-50.
- Publisher:
- Wiley
The Alzheimer's Disease Assessment Scale (ADAS) is often used in international multicenter trials. Use across countries presupposes correct translation and adaptation of the scale, and maintenance of its psychometric properties. The aim was to compare the various translations of the ADAS used in Western Europe, to design internationally harmonized translations and to validate these. An inventory was made of existing versions of the ADAS-Cog used in eight European countries, and adaptations were made. The concurrent validity of the harmonized versions of the ADAS was tested in 283 patients with probable or possible Alzheimer's disease. The Nurses Observation Scale for Geriatrics (NOSGER), CAMCOG-R and MMSE was used to assess concordance between cognitive and behavioural measures. Differences between the versions mainly involved object naming, items for verbal memory, such as the number of trials allowed, the imagery value of the words selected as targets or distractors, and the number of parallel versions. These differences were eliminated by adapting and harmonizing the various versions of the ADAS-Cog. Thereafter, only small differences between the different countries were found, and patterns of correlation between ADAS-Cog, and the NOSGER, CAMCOG-R and MMSE were consistent. The study underlines the need to use harmonized versions of instruments for rating dementia in multinational studies. The findings indicate that the harmonization of the ADAS-Cog was successful.