Search results for ‘Subject term:"older people"’ Sort:
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The feasibility and effectiveness of brief interventions to prevent depression in older subjects: a systematic review
- Authors:
- COLE Martin G., DENDUKURI Nandini
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(11), November 2004, pp.1019-1025.
- Publisher:
- Wiley
MEDLINE, PsycINFO and HealthStar were searched for potentially relevant articles published from January 1966 to June 2003, January 1974 to June 2003 and January 1975 to June 2003, respectively. The bibliographies of relevant articles were searched for additional references. Ten studies met the following five inclusion criteria: original research, subjects mean age 50 years or more, controlled trial of a brief ( < 12 weeks) intervention to prevent depression, determination of depression status 12 months or more after enrolment, use of an acceptable definition of depression. The validity of studies was assessed according to six criteria. To examine feasibility we tabulated study enrolment, completion and compliance rates. To examine effectiveness we tabulated differences in depression symptom outcome scores between intervention and control groups or, when possible, absolute (ARR) and relative (RRR) risk reductions for depression. Only two of the ten trials met all of the validity criteria. Study enrolment rates were 21 to 100% (median 72.5%); study completion rates were 46% to 100% (median 85%); compliance rates were 29% to 100% (median 87%). Five of the ten trials had positive results: in two trials there were statistically significant differences in depression symptom outcome scores favoring the intervention group; in three trials ARRs were 2.3% to 45% (median 17%); RRRs were 45% to 71% (median 61%). Some types of brief interventions appear to have the potential to prevent depression in older subjects. Despite the methodologic limitations of the trials and this systematic review, these findings may guide efforts to develop and evaluate brief interventions to prevent depression in this population.
The role of exercise in falls prevention for older patients
- Author:
- HAINSWORTH Terry
- Journal article citation:
- Nursing Times, 4.05.04, 2004, pp.28-29.
- Publisher:
- Nursing Times
Falls prevention is a key area of health promotion that is familiar to all nurses who work with older people. Looks at guidance from the National Institute for Clinical Evidence (NICE) which evaluates the evidence supporting t'ai chi and many other forms of exercise as a falls prevention intervention.
Resilience and adaptation to stress in later life: empirical perspectives and conceptual implications
- Authors:
- ONG Anthony D., BERGEMAN C.S.
- Journal article citation:
- Ageing International, 29(3), 2004, pp.219-246.
- Publisher:
- Springer
- Place of publication:
- New York
As it has become more widely recognized that increasing numbers of people are living to progressively older ages, it is important to understand the nature of individual traits that promote resilience and well-being in later life, to describe how these traits develop, to identify the factors that threaten and undermine their maintenance, and to elucidate the mechanisms that support and promote their growth. To have a knowledge base upon which to build intervention programs to improve and maintain well-being in later life, it is necessary to build understanding of what the multiple pathways are that lead to resilience, how these pathways may change, and what can be done to stop or forestall maladjustment and decline. In this article, the authors highlight theoretical areas of research on resilience and well-being that have received relatively little attention in previous work with older adults. They also identify unresolved methodological challenges associated with the measurement and analysis of within-person phenomena and elaborate on the implications of these challenges for process research in aging populations. Finally, future intervention directions to advance knowledge of resilience and positive health in later adulthood are discussed.
Factors associated with illegal drug use among older methadone clients
- Author:
- ROSEN Daniel
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.543-547.
- Publisher:
- Oxford University Press
The overall aims of this study are to describe the life stressors of, exposure to illegal drug use of, and illegal drug use by older methadone clients. The current study focuses on a subsample of the larger administrative data of a methadone clinic that is limited to African American and White clients over the age of 50 (N = 143). A logistic regression model tested the relationship between life stressors, exposure to illegal drug use, and a respondent's ability to remain abstinent from illegal drug use in the previous month. Older methadone clients exposed to illegal drug use in their social networks and neighborhoods were significantly more likely to use illegal drugs in the last month. Although demographic trends in the methadone population indicate that this cohort is aging and that their numbers are growing, little research exists on their well-being and service needs.
Neuroticism and longitudinal change in caregiver depression: impact of a spouse-caregiver intervention programme
- Authors:
- JANG Yuri, et al
- Journal article citation:
- Gerontologist, 44(3), June 2004, pp.311-317.
- Publisher:
- Oxford University Press
The authors examined the impact of caregiver neuroticism on longitudinal change in depression among spouse-caregivers of individuals with Alzheimer's disease receiving either enhanced psychosocial treatment or usual care. We were interested in whether high levels of caregiver neuroticism would lead to a diminished response to the enhanced treatment and whether neuroticism affected the longitudinal course of caregiver depression regardless of intervention. They analyzed data from the NYU Spouse-Caregiver Intervention Study, which randomly assigned caregivers either to an enhanced treatment group that received a comprehensive intervention with counseling, support, and consultation, or to a usual-care control group. The present study analyzed data from 320 caregivers, 160 in each group, who completed the NEO questionnaire. They used random-effects growth curve modeling to examine changes in depression in the first year after intake, examining possible effects of neuroticism on the course of caregiver depression and on response to intervention. Caregivers high in neuroticism showed a worse longitudinal course of depression compared with those low in neuroticism in both the enhanced treatment and usual-care groups after we adjusted for baseline depression as a covariate. Caregivers showed benefits from the enhanced treatment compared with usual care, regardless of neuroticism score. However, caregivers low in neuroticism responded to treatment with declining levels of depression, whereas caregivers high in neuroticism maintained their baseline level of depression. Caregiver neuroticism is a risk factor for increased caregiver depression over time. High neuroticism does not preclude successful caregiver intervention with a highly individualized intervention, but expectations of outcome should be different than for caregivers low in neuroticism. Future studies should investigate the relationship between neuroticism and response to less individualized interventions and the impact of other personality characteristics on response to treatment.
Occupational therapy in nursing and residential care settings: a description of a randomised controlled trial intervention
- Authors:
- SACKLEY Catherine, ATKINSON Jo Copley, WALKER Marion
- Journal article citation:
- British Journal of Occupational Therapy, 67(3), March 2004, pp.104-110.
- Publisher:
- Sage
This article describes an occupational therapy intervention for stroke that was provided as part of a randomised controlled trial in order to evaluate the effects of the intervention of an occupational therapist in a nursing and residential home setting. The intervention was developed and described to enable it to be reproduced in further evaluations, as recommended by the Medical Research Council's guidelines for clinical trials. Sixty residents received occupational therapy: the mean number of visits was 8.5 and the mean total time per participant was 4.7 hours. During 508 visits, the majority of time was spent on activities of daily living training and mobility practice (40%), followed by assessment and goal setting (31%), communication with residents, staff, relatives and other agencies (15%), adaptive equipment (10%) and the treatment of impairments (4%). It is possible to develop evidence-based targeted occupational therapy interventions to be used in the context of a controlled clinical trial. Further work is required to examine the validity of the recording methods and the reproducibility of the intervention.
Community-based prevention for suicide in elderly by depression screening and follow-up
- Authors:
- OYAMA Hirofumi, et al
- Journal article citation:
- Community Mental Health Journal, 40(3), June 2004, pp.249-263.
- Publisher:
- Springer
The aim of the study was to evaluate the outcome of a community-based prevention program against suicides among the elderly aged 65 and over in the Japanese rural town of Joboji (population 7,010), using a quasi-experimental design with two neighboring control areas. During the 10-year implementation of the program based on strategies including screening for depression, follow up with mental health care or psychiatric treatment and health education on depression, the relative risks estimated by the age-adjusted odds ratios for both males and females were reduced to almost one quarter more than a regional historical trend, with a better response to education for females than for males. A community-based management for later-life depression with mental health care supported by the psychiatric treatment can be effective against suicide among the elderly for both males and females.
Therapeutic groupwork for people cognitive losses: working with people with dementia
- Author:
- BENDER Mike
- Publisher:
- Speechmark
- Publication year:
- 2004
- Pagination:
- 274p.
- Place of publication:
- Bicester
Showing how evidence is lacking to support the model of dementia as a disease, the book explores the possibilities of psychological intervention for remediable or enduring cognitive losses. The book aims to give advice to group leaders, medical and mental health practitioners working in the field, for the planning and implementation of groupwork for people with cognitive losses.
Falls: the assessment and prevention of falls in older people; quick reference guide
- Author:
- NATIONAL HEALTH SERVICE. National Institute for Clinical Excellence
- Publisher:
- National Institute for Clinical Excellence
- Publication year:
- 2004
- Pagination:
- 4p.
Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall. Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits and considered for their ability to benefit from interventions to improve strength and balance. Older people who present for medical attention because of a fall, or report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment. This assessment should be performed by healthcare professionals with appropriate skills and experience, normally in the setting of a specialist falls service. This assessment should be part of an individualised, multifactorial intervention.
Falls: the assessment and prevention of falls in older people; understanding NICE guidance; information for older people, their families and carers, and the public
- Author:
- NATIONAL HEALTH SERVICE. National Institute for Clinical Excellence
- Publisher:
- National Institute for Clinical Excellence
- Publication year:
- 2004
- Pagination:
- 24p.
- Place of publication:
- London
Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall. Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits and considered for their ability to benefit from interventions to improve strength and balance. Older people who present for medical attention because of a fall, or report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment. This assessment should be performed by healthcare professionals with appropriate skills and experience, normally in the setting of a specialist falls service. This assessment should be part of an individualised, multifactorial intervention.