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Depression in frail elders: impact on family caregivers
- Authors:
- SEWITCH Maida J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(7), July 2004, pp.655-665.
- Publisher:
- Wiley
A cross-sectional study of 193 family caregivers of seniors treated in the emergency department (ED) was conducted. Measures included patient depression (Geriatric Depression Scale - 15), and caregivers' hours of care, mental health and physical functioning (SF-36), and quality of life (EQ-5D). Mean caregiver age was 60.0 ± 16.1 years and 70.5% were female. More caregivers of depressed seniors provided more care in the previous month (37.3% vs 22.4%, p = 0.03), had poor mental health (63.5% vs 47.0%, p = 0.03), and poor perceived quality of life (63.5% vs 50.4%, p = 0.04) compared to caregivers of non-depressed seniors. Multiple logistic regression analyses indicated that patient depression was associated with poor caregiver quality of life (OR = 3.15, 95% CI 1.48, 6.73), and poor mental health in spousal and adult child caregivers (OR = 2.72, 95% CI = 0.88, 8.39, and OR = 3.29, 95% CI = 1.10, 9.86, respectively). Psychosocial support may be needed for caregivers of depressed seniors.
Inequalities in quality of life among people aged 75 years and over in Great Britain
- Author:
- ESRC GROWING OLDER PROGRAMME
- Publisher:
- University of Sheffield. Department of Sociological Studies
- Publication year:
- 2002
- Pagination:
- 4p.
- Place of publication:
- Sheffield
A survey of over 8,000 people aged 75 and over in 23 general practices in Great Britain was undertaken as part of a trial of the assessment and management of the health of older people in the community. Analyses were undertaken of their quality of life in relation to their socio-economic position.
Correlates of everyday competence in Chinese older adults
- Author:
- CHOU K. L.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.308-315.
- Publisher:
- Taylor and Francis
Whether older adults can maintain levels of adaptation that allow continuation of independent living is necessarily contingent upon the maintenance of levels of everyday competence. This study identifies factors correlated to everyday competence measured by a Chinese version of the Direct Assessment of Functional Abilities among Hong Kong Chinese elderly people. The respondents were 393 people aged 60 years or older from a cross-sectional study of a representative community sample of the elderly population in Hong Kong and they were interviewed in a face-to-face format. In multiple regression analyses, we found that self-rated health, sight, and global cognitive ability were positively associated with everyday competence whereas the presence of arthritis had a negative impact on the everyday competence. All these findings are consistent with previous Western studies.
The impact of family members on the self-reported health of older men and women in a rural area of Bangladesh
- Authors:
- RAHMAN Omar, MENKEN Jane, KUHN Randall
- Journal article citation:
- Ageing and Society, 24(6), November 2004, pp.903-920.
- Publisher:
- Cambridge University Press
The purpose of this study is to examine whether the co-residence of spouses and children affects self-reported general health among older men and women in a rural area of Bangladesh. Binary logistic regression has been used to explore the impact of spouses and children on self-reported health, with particular attention to the gender of children and interactions with chronic disease. The data are from the Matlab Health and Socio-Economic Survey. A sample of 765 women and 979 men aged 60 or more years with at least one surviving child was available. The principal result is that for an older woman, optimum self-reported health is most likely when a spouse and at least one son and one daughter are present. Any deviation from this family pattern (either no spouse or children of only one sex) leads to a significantly increased risk of poor self-reported health. On the other hand, among older men there were no differences in self-reported health among the various spouse-child combinations. The relationship between a balanced gender distribution of children and optimum self-reported health among older women may explain the levelling out of fertility at roughly three children per women despite intensive family planning promotion in the area. Further reductions in fertility (an important policy concern) may depend on improving the substitutability of sons and daughters in the support of their elderly mothers.
Reliability and validity of the SF-36 among older Mexican Americans
- Authors:
- PECK M. Kristen, et al
- Journal article citation:
- Gerontologist, 44(3), June 2004, pp.418-425.
- Publisher:
- Oxford University Press
The Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) has been validated in many diverse samples. This measure of health-related quality of life, however, has not yet been examined among older Mexican Americans, a rapidly growing subset of the older population. The authors address the validity of the SF-36 in a sample of older Mexican Americans (N = 621) selected from the Hispanic Established Populations for Epidemiologic Study of the Elderly. Using confirmatory factor analysis through structural equation modeling, we evaluate the construct validity of this scale. The results indicate evidence for a model with eight first-order factors consistent with previous research on the SF-36 and two second-order factors representing mental and physical health.This, in addition to other evidence given here, leads us to the conclusion that the SF-36 is a valid measure of health-related quality of life in this sample of older Mexican Americans.
The effects of pre-retirement factors and retirement route on circumstances In retirement: findings from the Whitehall II study
- Authors:
- HYDE Martin, et al
- Journal article citation:
- Ageing and Society, 24(2), March 2004, pp.279-296.
- Publisher:
- Cambridge University Press
Retirement has traditionally been seen as the beginning of old age. It has been depicted as mandatory expulsion from the workforce and seen to mark the transition to a period of ill health and poverty. Such ideas and associations are however being challenged in the developed world by socio-demographic changes in retirement and old age. People in the United Kingdom as elsewhere are living longer and healthier lives, and many older people have access to non-state incomes that afford them a reasonable standard of living in retirement. There is however still concern that inequalities persist into old age. Data from two waves of the British Whitehall II study have been used to assess the relative effects of occupational grade, psychological and general health during working life, and retirement patterns or pathways on activities, attitudes to health and income in retirement. The results show that the majority of the sample reported good health, financial security and overall satisfaction with life, but with observable inequalities. Regression analyses demonstrate that pre-retirement circumstances generally had a greater effect on later life than the retirement route or pathway. Retirement no longer represents a drastic break between working and post-work life but rather, the results suggest, there are continuities between the two periods. It is concluded that the main causes of inequalities in retirement are work-based rather than in retirement itself.
Patterns and impact of comorbidity and multimorbidity among community-resident American Indian elders
- Authors:
- JOHN Robert, KERBY Dave S., HENNESSY Catherine Hagan
- Journal article citation:
- Gerontologist, 43(5), October 2003, pp.649-660.
- Publisher:
- Oxford University Press
The purpose of this study is to suggest a new approach to identifying patterns of comorbidity and multimorbidity. A random sample of 1,039 rural community-resident American Indian elders aged 60 years and older was surveyed. Comorbidity was investigated with four standard approaches, and with cluster analysis. Most respondents (57%) reported 3 or more of 11 chronic conditions. Cluster analysis revealed a four-cluster comorbidity structure: cardiopulmonary, sensory-motor, depression, and arthritis. When the impact of comorbidity on four health-related quality of life outcomes was tested, the use of the clusters offered more explanatory power than the other approaches. This study improves understanding of comorbidity within an understudied and underserved population by characterizing comorbidity in conventional and novel ways. The cluster approach has four advantages over previous approaches. In particular, cluster analysis identifies specific health problems that have to be addressed to alter American Indian elders' health-related quality of life.
Quality of life and social support among people from different ethnic groups
- Authors:
- UNIVERSITY OF LONDON. King's College., ECONOMIC AND SOCIAL RESEARCH COUNCIL
- Publisher:
- Economic and Social Research Council
- Publication year:
- 2003
- Pagination:
- 17p., bibliog.
- Place of publication:
- London
In the same way that the concept of ethnicity has provoked considerable debate, so it has proved difficult to arrive at a generally accepted definition as to the meaning of quality of life. Theoretically, it is recognized that the concept should include both objective and subjective elements and cover multiple aspects of a person's life including physical health, psychosocial wellbeing and functioning, independence, control over life, material circumstances and the external environment. In practice, its measurement has been criticised for focusing too much on health or economic related indicators and too little on how older people themselves perceive and define their quality of life.
Geriatric depression in Nigerian primary care attendees
- Authors:
- SOKOYA Olukunle, BAIYEWU Olusegun
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.506-510.
- Publisher:
- Wiley
202 older people were screened using the Geriatric Depression Scale (GDS). The Geriatric Mental State schedule (GMS) was administered to participants who scored above the cut-off on the GDS in order to assess psychopathology. Diagnosis of depression was based on ICD-10 criteria as well as the GMS-AGECAT programme. The rate of geriatric depression in primary care was found to be 7.4%. Severe depression was only 1.5%. Very low income and subjective report of poor health were significantly associated with depression in the cohort. AGECAT recognition of depression was comparable to that by the ICD-10 (k = 0.7). The study is the first known study of geriatric depression in primary care in Nigeria. The rates are comparable with rates obtained in other countries. Specific correlates of depression in the older Nigerians identified included poor self-assessed health and low income.
Bright light treatment improves sleep in institutionalised elderly: an open trial
- Authors:
- FETVEIT Arne, SKJERVE Arvid, BJORRVATIN Bjorn
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.520-526.
- Publisher:
- Wiley
This study evaluates the effects of bright light therapy among demented nursing home patients with sleep disturbances. 11 nursing home patients with actigraphically measured sleep efficiency below 85% took part in an open, non-randomised study where the subjects served as their own control. After two weeks of baseline measurements and two weeks of pretreatment measurements, patients received bright light exposure 2 h/day within the period 08:00-11:00 for two weeks. Sleep-wake patterns during the 24-h day were evaluated by nursing staff ratings and wrist-worn motor activity devices (actigraphs). Sleep improved substantially with bright light exposure. Waking time within nocturnal sleep was reduced by nearly two h, and sleep efficiency improved from 73% to 86%. Corresponding improvements were found in nursing staff ratings. Effects were consistent across subjects. The findings add further evidence of the effectiveness of morning bright light exposure in the treatment of disturbed sleep among demented nursing home patients