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The factor structure of the hospital anxiety and depression scale in older individuals with acquired amputations: a comparison of four models using confirmatory factor analysis
- Authors:
- DESMOND Diedre M., McLACHLAN Malcolm
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.344-349.
- Publisher:
- Wiley
There has been little attention to the underlying dimensional structure of the Hospital Anxiety and Depression Scale (HADS) in analyses involving individuals older than 65 years of age despite its routine application in this age group. The factor structure of the HADS was investigated using a sample of 680 veterans with limb amputations who were aged at least 66 years (mean 79.0, SD 5.02; range 66-92) Four models were specified and estimated using Lisrel 8.54. Model 1 specified a uni-dimensional structure. Model 2 specified a correlated two-factor model. Model 3 specified a correlated two-factor model but with cross factor loadings for item 7. Model 4 specified a three-factor model after Clark and Watson's (1991) tripartite theory of anxiety and depression. The results indicate that factor models for the HADS developed in younger samples are replicable with older adults, thus supporting the suggestion that the HADS structure is invariant for age. However, considering the composition of the current sample, i.e. veterans with limb amputations, further research is necessary to determine whether these findings are generalisable to the wider population of older adults.
High prevalence of anxiety symptoms in hospitalized geriatric patients
- Authors:
- KVAAL Kari, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(7), July 2001, pp.690-693.
- Publisher:
- Wiley
Examines the prevalence of anxiety symptoms in hospitalized geriatric patients using a controlled cross-sectional study of ninety-eight geriatric in-patients and 68 healthy home-dwelling controls of similar age recruited from senior citizen centres in Norway. The geriatric patients scored significantly higher than the controls. Applying Spielberger's recommended cut-off of 39/40 on the STAI sumscore, 41% of the female and 47% of the male geriatric patients might be suspected of suffering from significant anxiety symptoms. Concludes that STAI proved feasible for use in the elderly. The scoring on the STAI is high in geriatric in-patients. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders.
A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes
- Authors:
- VUC Andrea V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.e180-e187.
- Publisher:
- Wiley
This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerised brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. Methods: A randomised controlled pilot trial was performed. Results: At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Conclusion: Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30–100 people per group to accurately determine significance. (Publisher abstract)
The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients
- Authors:
- SMALBRUGGE Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(4), April 2006, pp.325-332.
- Publisher:
- Wiley
The study-population consisted of 350 elderly nursing home patients from 14 nursing homes in the Netherlands. Well being, disability, use of health care services (i.e. assistance in ADL, paramedical care, number of medications) and depression and anxiety and other relevant characteristics (gender, age, education, marital status, urbanization, cognition, morbidity, social support) were measured cross-sectionally. Associations of well being, disability and use of health care services with independent baseline characteristics were assessed with bivariate and with multivariate analyses. Results found that the presence of depression and/or anxiety was associated with significantly less well being, but not with more disability. Presence of depression and/or anxiety was also significantly associated with four of the seven indicators of health care service use measured in this study: less assistance in ADL, more consultation of medical specialists, a higher mean number of medications and more use of antidepressants. It is concluded that presence of depression and/or anxiety has a statistically and clinically significant negative impact on well being, but not on disability. Future studies should focus on interventions for improving the detection, diagnosis and treatment of depression and/or anxiety in the nursing home.
Older patients undergoing dialysis treatment: cognitive functioning, depressive mood and health-related quality of life
- Authors:
- TYRRELL J., et al
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.374-379.
- Publisher:
- Taylor and Francis
An increasing number of older patients receive dialysis treatment to compensate for deficient kidneys due to end-stage renal disease (ESRD). Ethical questions arise about the benefits of dialysis when a patient appears unwilling or unable to comply with this treatment procedure. Such attitudes and behaviour may be due to psychological factors, but these are not routinely assessed. The purpose of this study was to evaluate levels of cognitive impairment, depressive mood and self-reported quality of life in older dialysis patients (>70 years). A total of 51 outpatients receiving dialysis were assessed by psychologists, using a depression scale (MADRS), two cognitive tests (MMSE and BEC 96), and a quality of life questionnaire (NHP). Sixty percent of the patients were depressed, and between 30–47% had cognitive impairment. Almost half of the depressed patients were also cognitively impaired. The scores for self-reported quality of life varied widely within the sample. Cognitive impairment and depressive mood are often overlooked and underestimated in this population. Regular assessments of depressive mood, cognitive ability and quality of life are recommended, given the prevalence of problems in these domains for older dialysis patients. The information obtained should assist staff as they reflect on individual cases where the benefits of continuing treatment are being examined.
The experience of shame in older psychiatric patients: a preliminary enquiry
- Authors:
- CROSSLEY D., ROCKETT K.
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.368-373.
- Publisher:
- Taylor and Francis
Shame is a complex set of attitudes, feelings and behaviours that tend to motivate hiding and, if provoked, can lead to conflict with others. It is also related to the exercise of power within the relationship of care and therefore may be a relevant factor if older adults are forced to accept increased dependency. There are no systematic enquiries into shame processes and older psychiatric patients. The experience of trait and situational shame and psychopathology was explored with 50 older psychiatric patients, using a range of questionnaire measures. As predicted, trait shame correlated significantly with anxiety and depression scores. There was preliminary evidence to suggest that being in need of others may be shame-provoking for some patients and may have a bearing on why some patients fear dependency, conceal symptoms and have conflicted relationships with carers.
The early onset dementias: a study of clinical characteristics and service use
- Authors:
- FERRAN Jose, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(10), October 1996, pp.863-869.
- Publisher:
- Wiley
The clinical characteristics and the level of service use were studied in a cohort of patients referred for the investigation of presenile dementia, having had the onset of symptoms before the age of 65. The most common diagnoses given were Alzheimer's disease, vascular dementia and depressive pseudodementia. The level of psychiatric morbidity was high, depression insomnia, anxiety and aggression being the most common symptoms. As regards rate of service use, 22% of the Liverpool patients were in residential care after 1 year of follow-up, in contrast to 8% initially. The authors conclude that there is a need for specialised multidisciplinary services for this group of patients, both diagnostic and supportive.