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Inclusion/exclusion criteria in late life depression antidepressant efficacy trials
- Authors:
- ZIMMERMAN Mark, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1009-1016.
- Publisher:
- Wiley
Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs. Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression. Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline. Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression (Edited publisher abstract)
Diversity in older age: older lesbian, gay and bi-sexual people and older transgender people
- Author:
- CENTRE FOR POLICY ON AGEING
- Publisher:
- Centre for Policy on Ageing
- Publication year:
- 2017
- Pagination:
- 24
- Place of publication:
- London
This review summarises findings from selected literature and statistics on older lesbian, gay, bi-sexual and transgender people. It is one of a series of rapid reviews commissioned by Age UK into the diversity that exists in the older population and the inequalities faced by specific groups of older people. Areas covered include: demographics, relationships and communities, financial wellbeing, physical and mental health, housing and neighbourhoods, care and support and end of life care. (Edited publisher abstract)
Can mindfulness-based interventions influence cognitive functioning in older adults? A review and considerations for future research
- Authors:
- BERK Lotte, BOXTEL Martin van, OS Jim van
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1113-1120.
- Publisher:
- Taylor and Francis
Objectives: An increased need exists to examine factors that protect against age-related cognitive decline. There is preliminary evidence that meditation can improve cognitive function. However, most studies are cross-sectional and examine a wide variety of meditation techniques. This review focuses on the standard eight-week mindfulness-based interventions (MBIs) such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). Method: The authors searched the PsychINFO, CINAHL, Web of Science, COCHRANE, and PubMed databases to identify original studies investigating the effects of MBI on cognition in older adults. Results: Six reports were included in the review of which three were randomised controlled trials. Studies reported preliminary positive effects on memory, executive function and processing speed. However, most reports had a high risk of bias and sample sizes were small. The only study with low risk of bias, large sample size and active control group reported no significant findings. Conclusion: The authors conclude that eight-week MBI for older adults are feasible, but results on cognitive improvement are inconclusive due a limited number of studies, small sample sizes, and a high risk of bias. Rather than a narrow focus on cognitive training per se, future research may productively shift to investigate MBI as a tool to alleviate suffering in older adults, and to prevent cognitive problems in later life already in younger target populations. (Edited publisher abstract)
The 1960s baby boomers: future needs and preferences
- Authors:
- YOUNG Aideen, TINKER Anthea
- Journal article citation:
- Working with Older People, 21(4), 2017, pp.215-223.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to consider the likely needs and priorities of the 1960s baby boomers in later life (defined as those born in this country between 1960 and 1969 inclusive), based on their characteristics outlined in the accompanying paper. Design/methodology/approach: A non-systematic search of academic and grey literature plus key policy and statistical data from sources including the Office for National Statistics to identify studies and data relevant to people born in the 1960s in the UK. Findings: The 1960s baby boomers are characterised by high levels of education and technological proficiency and a youthful self-image. They have longer working lives and display greater levels of consumption than previous cohorts. These attributes will likely make this a highly demanding group of older people. Maintaining their health and function is important to this group so there is a scope for products that enable active and healthy ageing. Relatively high levels of childlessness may give rise to innovative housing solutions. At the same time, products that help the baby boomers stay independent at home will help alleviate pressure on social care. Originality/value: There has been little examination of the needs of the 1960s baby boomers in the UK. Given that they stand on the brink of later life, it is timely to consider their likely needs as older people. In view of the size of this cohort, this group’s requirements in later life provide a significant opportunity for businesses to fill the current gaps in the market. Moreover, in the context of increasing neoliberalism, innovations that reduce the dependence of this large cohort on the state and facilitate self-reliance will benefit individuals and society. (Publisher abstract)
Who are the baby boomers of the 1960s?
- Authors:
- YOUNG Aideen, TINKER Anthea
- Journal article citation:
- Working with Older People, 21(4), 2017, pp.197-205.
- Publisher:
- Emerald
Purpose: The 8.3 million babies who were born during the 1960s in the UK are 48-57 years old. With growing concern about population ageing, and the oldest of this large cohort on the brink of later life, it is timely to provide an overview of selected characteristics of this cohort in order to help predict likely needs and choices for services and products in later life. The paper aims to discuss these issues. Design/methodology/approach: A synthesis (non-systematic) of the academic and grey literature plus data from various sources including the Office for National Statistics was used to construct a picture of the 1960s baby boomer. Findings: Characteristics with the potential to signify lifestyle changes among this, compared with previous, cohorts of older people include: a higher probability of living alone in old age due to high rates of childlessness and divorce; a possibly larger proportion of their lives spent with one or more chronic conditions, although the prevalence of disability affecting activities of daily living is lower than for previous cohorts; high levels of home ownership; increased rates of employment at older ages; but reduced wealth compared with previous cohorts. Originality/value: The term baby boomer is generally used to denote people born in the undifferentiated surge of births that occurred in the USA between 1946 and 1964. In the UK, post Second World War spike in births was followed by a separate, broad surge in births across the 1960s but there has been very little analysis specifically of the 1960s cohort in this country. This paper addresses that gap, by bringing together the available evidence and data on this specific cohort in the UK. (Publisher abstract)
Ageing with a unique impairment: a systematically conducted review of older deafblind people's experiences
- Author:
- SIMCOCK Peter
- Journal article citation:
- Ageing and Society, 37(8), 2017, pp.1703-1742.
- Publisher:
- Cambridge University Press
Little is known about the experiences of people ageing with impairments; social gerontology has largely focused on those ageing into disability rather than those ageing with disability. This paper synthesises existing knowledge to determine what is known about the experiences of those ageing with deafblindness. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. A total of 24 references were identified for inclusion. No studies examining deafblind people's experience of ageing and old age specifically were found, suggesting that those ageing with deafblindness are an under-studied sub-group within the deafblind population. However, deafblind people describe ageing experiences in studies exploring their lives generally, and in personal accounts of living with the impairment. Practitioner-authored material also explores the topic. Similarities in experience were identified between those ageing with deafblindness and those ageing with other impairments: ongoing change and consequent need for adaptation; a particular relationship between ageing and impairment; a sense that whilst one can learn adaptive strategies having lived with impairment for many years, it does not necessarily get easier; and a particular relationship with care and support services. These experiences illustrate the unique nature of ageing with impairment, and challenge gerontologists to engage in further research and theorising in the field of disability in later life. (Publisher abstract)
Potential of mobile technologies and applications in the detection of mild cognitive impairment among older generation groups
- Authors:
- KLIMOVA Blanka, VALIS Martin, KUCA Kamil
- Journal article citation:
- Social Work in Health Care, 56(7), 2017, pp.588-599.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
At present, demographic changes result in the growing number of older people. This trend inevitably brings about serious social and economic issues, as well as occurrence of ageing diseases. The purpose of this study is to discuss the potential of using mobile technologies and applications in the detection of ageing disorders such as mild cognitive impairment. The methods used for this review study include a literature search in the world’s acknowledged databases. The findings of this study indicate that mobile applications can serve as appropriate diagnostic tools for ageing disorders such as mild cognitive impairment because they seem to provide better, faster, and less costly care for older people. (Publisher abstract)
What do we know about older former carers? Key issues and themes
- Authors:
- LARKIN Mary, MILNE Alisoun
- Journal article citation:
- Health and Social Care in the Community, 25(4), 2017, p.1396–1403.
- Publisher:
- Wiley
Despite a significant growth in the number older former family carers, they remain largely invisible in carer-related research and literature. To begin to address this deficit, a four-stage literature review was conducted to identify existing knowledge about older former carers. Narrative synthesis of the findings yielded five themes – the concept of ‘older former carer’, the legacies of caring, influences on the legacies of caring, conceptualising post-caring and support services for older former carers. Critical analysis of these findings suggests that existing evidence has a number of strengths. It highlights the terminological and conceptual confusion in the field, identifies the profound financial and health-related legacies older former carers’ experience, the factors which shape these legacies and some of the complexities of bereavement older former carers face. The support needs of older former carers are also illuminated. However, the field is characterised by key weaknesses. The evidence base is fragmented and uneven. In part this reflects lack of definitional consensus and in part the fact that there is much more evidence about some sub-groups, such as carers of relatives admitted to a care home, than others. Methodology-related weaknesses include small sample sizes and a focus on a single, often condition-specific, group of older former carers. An overarching criticism relates to the narrow conceptual/theoretical purview. As post-caring tends to be viewed as one of the final temporal ‘stages’ of the carer's ‘care-giving career’, a bifurcatory model of carer/former carer is created, i.e. that a carer actively provides care and a former carer is no longer caring. This constructs being a former carer – namely formerality – as a single fixed state failing to capture its dynamic and shifting nature and constrains the potential of research to generate new knowledge and extend understanding. (Publisher abstract)
The diversity of befriending by, and of, older people
- Authors:
- MORIARTY Jo, MANTHORPE Jill
- Journal article citation:
- Working with Older People, 21(2), 2017, pp.63-71.
- Publisher:
- Emerald
Purpose: There is increasing interest in befriending services that aim to combat loneliness among older people. The purpose of this paper is to use the Equality Act 2010 as a framework for considering why older people might need these services and why some groups are over and under represented among service users. Design/methodology/approach: Databases, websites and other resources were searched systematically for material on befriending. The final review consisted of 80 items, ranging from research articles, reports, and toolkits. Findings: Individual face to face befriending has been the mainstay of the type of befriending support for older people. The increasing diversity of the older population and reductions in funding has led to adaptations of this model for different groups living in different circumstances. Research limitations/implications: The resources and time available to conduct the review were limited. It is possible that some relevant material was not identified. Practical implications: Practitioners working with older people need to know about befriending schemes available in their area and consider the reasons why some groups of older people might be reluctant to use them or require specialist schemes. Originality/value: Existing research on befriending rarely reports the demographic characteristics of those using the service in detail or considers why some groups of older people might have greater needs for befriending services or be reluctant to use them. The Equality Act 2010 provides a structured framework for considering diversity in access to, and use of, services. (Publisher abstract)
Falls prevention: access and acceptability to all?
- Authors:
- MANTHORPE Jill, MORIARTY Jo
- Journal article citation:
- Working with Older People, 21(2), 2017, pp.72-81.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the equalities' dimension of falls prevention services in light of the Equality Act 2010 and its protected characteristics. Research and policy are discussed in light of the Act and public services’ duties to be aware of their responsibilities. Design/methodology/approach: An initial research review was undertaken in 2012 and updated in 2016. Findings: The research on falls prevention services does not always collect data on users of the service and services do not always collect data about their users that would enable them to build a picture of their users in line with the Equality Act 2010. Practical implications: Services and commissioners will need to be able to show that the services funded by the public purse are accessible, acceptable and appropriate to the UK’s increasingly diverse older population. This paper describes some of the existing resources and research papers that contain elements of attention to the protected characteristics of the Equality Act 2010. Originality/value: This is an update on a research review undertaken in 2012. (Edited publisher abstract)