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Alcohol abuse treatment for older adults: a review of recent empirical research
- Authors:
- CUMMINGS Sherry M., BRIDE Brian, RAWLINS-SHAW Ann M.
- Journal article citation:
- Journal of Evidence-Based Social Work, 3(1), 2006, pp.79-99.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purpose of this article is to enhance social work practitioners and researchers' understanding of the nature of elder alcohol abuse, the needs of elders with alcohol abuse disorders, and the availability of effective treatment strategies by reviewing the epidemiological and outcomes research literatures related to alcohol abuse and the elderly. The few empirical studies that examine outcomes associated with the treatment of elderly substance abusers reveal positive outcomes, especially when “age-specific,” cognitive-behavioural, and less confrontational treatment approaches are employed. The authors highlight the need for further research concerning the nature of alcohol abuse among the elderly and the impact of specific alcohol treatment strategies on older adults. Such research should consider the needs and experiences of specific sub-populations of elders such as women, minorities, and those with late onset disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Augmentation strategies in geriatric depression
- Author:
- FLINT Alastair J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(2), February 1995, pp.137-146.
- Publisher:
- Wiley
Approximately 30-40 per cent of elderly patients with major depression have inadequate response to an initial therapeutic trial of antidepressant medication. In these cases augmentation of the anti depressant has been recommended as one way of improving the rate of response. A review of the Canadian literature on augmentation strategies in treatment-resistant geriatric depression shows that it is difficult to draw conclusions about the efficacy of these strategies in late life, especially since treatment failures seldom get reported. Other factors such as side-effects may also limit the usefulness of some augmentation regimens in old age. Argues for the need to have controlled studies to better determine the clinical utility of augmentation strategies in physically well depressed elderly, as well as those with depression complicating medical illness, dementia and other neurological disorders.
Alcohol and elderly people: an overview of the literature for social work
- Authors:
- SIMPSON Murray, WILLIAMS Bryan, KENDRICK Andrew
- Journal article citation:
- Ageing and Society, 14(4), December 1994, pp.575-587.
- Publisher:
- Cambridge University Press
Attempts to highlight the pressing need for social work to take more account of the existence of alcohol problems being experienced by many elderly people. Surveying the available sketchy data, it would appear that perhaps as many as 15% of elderly social work clients may have alcohol related problems. Continues by considering whether a discernible pattern of elderly drinking is identifiable. The main implications for social work practice are drawn out.
Dual diagnosis among older adults co-occurring substance abuse and psychiatric illness
- Authors:
- BARTELS Stephen J., et al
- Journal article citation:
- Journal of Dual Diagnosis, 2(3), 2006, pp.9-30.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The goal of this article is to provide a comprehensive critical review of studies reporting the prevalence, characteristics, outcomes, and service utilization associated with comorbid substance abuse and mental illness in older age. The study searched the Medline and PsycINFO databases using combinations of the keywords 'Dual diagnosis,' 'Elderly,' and 'Older.' English-language reports presenting quantitative data on the prevalence and/or any descriptive information about older adults with dual diagnosis were included. The prevalence of older adults with comorbid substance abuse and mental disorders varies by population, and ranges from 7% to 38% of those with psychiatric illness and from 21% to 66% of those with substance abuse. Depression and alcohol use are the most commonly cited co-occurring disorders in older adults. Dual diagnosis in older adults is associated with increased suicidality and greater inpatient and outpatient service utilization. Data on treatment are limited. However, recommendations have been adapted from evidence-based treatment of younger adults with dual diagnosis, older adults with substance abuse, and older adults with mental health problems. The authors concluded that dual diagnosis among older adults is a growing public health problem. Well-designed prevention, early intervention, and treatment studies are needed that specifically address co-occurring disorders in older adult populations.
Presentations and management of Post Traumatic Stress Disorder and the elderly: a need for investigation
- Author:
- BUSUTTIL Walter
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.429-439.
- Publisher:
- Wiley
With an aging population increasing presentations of cases of Post Traumatic Stress Disorder (PTSD) can be expected to old age services. While progress has been made in recent years in relation to the understanding and development of aetiological theories, classification, assessment and management strategies and protocols in the adult population, similar advances have lagged behind for the elderly. The aim was to review the adult literature regarding PTSD and discuss how this might apply to an elderly population. An attempt is made to highlight a better awareness of the field of psychological trauma in the elderly in the hope of stimulating debate and research. A review of the adult literature is conducted relating to classification, aetiology, demographic features, vulnerability, assessment, clinical management including psychotherapy and medications and how these may apply to the elderly. Little has been published in this field that directly relates to the elderly. The adult literature allows insight into understanding how PTSD may present in the elderly, and how they may be managed. Further specific research is needed in the elderly in order to facilitate a better understanding of PTSD that present in this unique population. This will lead to better clinical assessment, management and treatment provision.
Effects of reminiscence and life review on late-life depression: a meta-analysis
- Authors:
- BOHLMEIJER Ernst, SMIT Filip, CUIJPERS Pim
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1088-1094.
- Publisher:
- Wiley
The aim of this study was to assess the effectiveness of reminiscence and life review on late-life depression across different target groups and treatment modalities. Twenty controlled outcome studies were retrieved from Psychlit, Medline and Dissertation Abstracts. For each study a standardised effect size, d, was calculated and a random-effects meta-analysis was conducted. An overall effect size of 0.84 (95% Confidence Intervals (CI)=0.31-1.37) was found, indicating a statistically and clinically significant effect of reminiscence and life review on depressive symptomatology in elderly people. This effect is comparable to the effects commonly found for pharmacotherapy and psychological treatments. The effect was larger in subjects with elevated depressive symptomatology (d=1.23) as compared to other subjects (d=0.37). Other characteristics of the subjects or interventions were not found to be related to increased or decreased effect sizes. Reminiscence and life review are potentially effective treatments for depressive symptoms in the elderly and may thus offer a valuable alternative to psychotherapy or pharmacotherapy. Especially in non-institutionalised elderly people - who often have untreated depression - it may prove to be an effective, safe and acceptable form of treatment. Randomized trials with sufficient statistical power are necessary to confirm the results of this study.
Understanding the needs of the family carers of people with dementia
- Authors:
- WILLS Walter, SOLIMAN Alison
- Journal article citation:
- Mental Health Review, 6(2), June 2001, pp.25-28.
- Publisher:
- Pier Professional
Draws on existing literature to explore and summarise what is known about carers needs.
The arts in dementia care: touching the human spirit
- Authors:
- KILLICK John, ALLAN Kate
- Journal article citation:
- Journal of Dementia Care, 7(5), September 1999, pp.33-37.
- Publisher:
- Hawker
In this second of two research reviews on use of the arts in dementia care the authors investigate the benefits of the visual and verbal arts, from painting and writing to dance.
Illustrating the importance of including the views and experiences of users and carers in evaluating the effectiveness of drug treatments for dementia
- Authors:
- TRAYNOR Victoria, PRITCHARD Emma, DEWING Jan
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 3(2), June 2004, pp.145-159.
- Publisher:
- Sage
Presents a literature review of existing evidence about the effectiveness of the drugs for dementia and illustrate a lack of evidence on the views and experiences of people with dementia (users) and their carers. Suggests that there is a bias and over reliance on conventionally derived scientific evidence about the effectiveness of the drug treatments which is more relevant and meaningful to professionals than users and carers. Explores the evidence on the views and experiences of users and carers about these drug treatments.
The neglect of somatoform disorders by old age psychiatry: some explanations and suggestions for future research
- Authors:
- WIJERATNE Chanaka, BRODATY Henry, HICKIE Ian
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(9), September 2003, pp.812-819.
- Publisher:
- Wiley
The somatoform disorders have long been ignored by old age psychiatry. The main aim of this paper is to identify and examine possible reasons for this neglect. Significant conceptual, diagnostic and classificatory problems have impeded the consideration of somatoform disorders in older people. There is a perception that somatoform disorders are infrequent and have not been validated as independent clinical disorders. However, we present evidence that the more broadly defined somatoform disorders are common in all age groups in primary care and meet criteria for the determination of clinical validity. General difficulties in the assessment of psychiatric disorders in primary care, the setting in which somatoform disorders are most common, are compounded by a lack of support from old age psychiatry services. Effective psychological therapies may not be readily available to sufferers. There is a need for change in the conceptualisation and nosology of the somatoform disorders. The formulation of age appropriate diagnostic criteria and presentations is a prerequisite for determining the clinical validity of these disorders in older people. This can be followed by study of their frequency, associated risk factors and treatment. A system of education that enhances the management of these disorders within primary care and old age psychiatry services is needed.