Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 68
Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects
- Authors:
- SCHREINER Andrea S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.498-505.
- Publisher:
- Wiley
Proper screening of depression among older adults depends on accurate cut-off scores. Recent articles have recommended the Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD) for this screening. However, there has been no investigation of the sensitivity and specificity of either scale using Japanese subjects. The purpose of the present study was to identify appropriate GDS and CSDD cut-offs for Japanese older adults. The GDS and the CSDD were interview-administered to nondepressed Japanese older adults (n = 74) and to Japanese older adults with a SCID-IV diagnosis of major or minor depression (n = 37). Depressed subjects were also administered the Hamilton Depression Rating Scale (HDRS). Data were also collected on demographic variables, mental status, health status, and medication use. ROC curve analysis identified a cut-off score of 6 for the GDS which had a sensitivity of 0.973, a specificity of 0.959, a False Positive Rate (FPR) of 0.894, and a False Negative Rate (FNR) of 0. A cutoff score of 5 for the CSDD yielded a sensitivity of 1, a specificity of 0.919, a FPR of 0.942, and a FNR of 0. Comparisons indicate current HDRS cut-offs may overlook subthreshold depression. The GDS cut-off score identified among Japanese subjects was the same as that reported for Western subjects. Due to the substantial prevalence of psychiatric disorders found in false-negative subjects, the above cut-off scores were chosen to optimize the potential for true positives. These scores are recommended for alerting physicians and other caregivers as to when more intensive depression evaluation is needed.
Delusions of Japanese patients with Alzheimer's disease
- Authors:
- IKEDA Manabu, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.527-532.
- Publisher:
- Wiley
Delusions constitute one of the most prominent psychiatric complications in Alzheimer's disease (AD). However, there is little consensus of the prevalence and associated factors for delusions in AD. 112 consecutive patients with AD were recruited over a one year period and administered the Neuropsychiatric Inventory (NPI). Delusions were present in 53 patients (47.3%). Delusions of theft were the most common type of delusion (75.5% of patients with delusions), followed by misidentification delusions and delusions of suspicion. More hallucination, agitation, and female gender were found in the delusions group. The authors found a high frequency of delusions, particularly of delusions of theft and suggested that gender was associated with the expression of delusions in Japanese patients with AD.
Treatment of patients with Alzheimer's disease: a national survey following release of the NICE guidance
- Authors:
- CONNOLLY Claire M., BULLOCK Roger
- Journal article citation:
- Psychiatric Bulletin, 27(1), January 2003, pp.11-13.
- Publisher:
- Royal College of Psychiatrists
The National Institute for Clinical Excellence (NICE) has issued guidance regarding the treatment of Alzheimer's disease. A postal survey of old age psychiatrists, geriatricians and neurologists was conducted to establish working practice pre-NICE and investigate expectations about the effect of this guidance. The overall response rate was 26.3%. Old age psychiatrists prescribe the majority of drugs for the treatment of Alzheimer's disease. There was variation in the annual expenditure on such treatment. The main reason for non-prescription was a lack of funding. Over 80% of doctors thought that patients with mild disease should now be targeted for treatment. In order to implement the guidance it will be necessary to address the issue of funding and have clear role allocation between local services.
The psychometric properties of the Multi-Dimensional Observation Scale for Elderly Subjects (MOSES) in middle aged and older populations of people with mental retardation
- Authors:
- STURMEY P., TSIOURI J. A.,S, PATTI P.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(2), February 2003, pp.131-134.
- Publisher:
- Wiley
This article seeks to assess the internal consistency, inter-scale correlations and factor structure of the MOSES with older adults with mental retardation. A series of outpatients with learning difficulties were assessed with the MOSES. 163 middle aged and older adults with learning difficulties living in community settings participated. MOSES appears to be a psychometrically adequate instrument to screen older adults
Nursing home suicides: a psychological autopsy study
- Authors:
- SOUMINEN Kirsi, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1095-1101.
- Publisher:
- Wiley
Older adults comprise a fifth of all suicides. Elders are the fastest growing part of the population, thus the number of persons needing nursing home care will increase dramatically in the near future. Little information has been available about suicides in nursing homes. The present study described all suicides among older adults in nursing homes in Finland during a 12-month period emphasizing the factors that have been found to be associated with suicide in the general elderly population. Drawing on data from a psychological autopsy study of all suicides (n=1397) in Finland during one year, all suicides committed by patients in nursing homes were identified. Retrospective DSM-IV consensus diagnoses were assigned. Twelve elderly (aged 60 years or more) nursing home residents who died by suicide, 0.9% of all suicides, were identified. The primary finding of the present study was that nursing home residents who died by suicide had suffered from highly comorbid somatopsychiatric disorders. One or more diagnoses on Axis I were made for all who died by suicide in nursing home. Depressive syndrome was diagnosed in three-quarters of subjects. Only a third of these were identified to have suffered from depressive symptoms before their death. Early recognition and adequate treatment of both somatic diseases and mental disorders, particularly depression, as well as early recognition of suicide risk among nursing home residents, are needed in order to prevent suicide.
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.
A systematic review of cognitive decline in the general elderly population
- Authors:
- PARK Helen L., O'CONNELL Janice O., THOMSON Richard G.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1121-1134.
- Publisher:
- Wiley
The aim was to establish the rate of age-related cognitive decline in the general elderly population. Systematic review of studies of cognitive decline in the general elderly population. Medline, Embase and PsycINFO databases were searched using an adapted version of McMaster's aetiology, causation and harm strategies and the Cochrane Dementia and Cognitive Impairment Group strategy. Grey literature was explored and experts contacted. A second observer was involved at all stages and quality appraisal of included studies was performed. Included studies were representative, community-based, cohort studies of people aged over 60, incorporating individuals with dementia. Identification of 5990 abstracts and retrieval of 163 full texts led to inclusion of 19 papers. Heterogeneity made narrative review the appropriate method of data synthesis. Some degree of cognitive impairment with increasing age was found in all studies, although the extent varied. The prevalence of cognitive impairment and the rate of decline increased with age. Studies were of variable quality. Cognitive decline is almost universal in the general elderly population and increases with age. Improved communication between researchers and between clinicians to identify a core minimum data set of neuropsychological tests that could be used in different populations would support consistent study design and meta-analysis, helping to quantify the true rate of cognitive decline in the elderly and assisting diagnosis in clinical practice.
A longitudinal study of neuropsychological change in individuals with Parkinson's disease
- Authors:
- AZUMA Tamiko, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1115-1120.
- Publisher:
- Wiley
Neuropsychological changes in individuals with Parkinson's disease (PD) were studied longitudinally. Sixty-nine idiopathic PD patients, with Mini-Mental State Examination (MMSE) scores falling within normal range, and 37 elderly control participants were given neuropsychological tests twice approximately two years apart. The PD group performed poorer than the control group on Semantic Fluency, Letter Fluency, Modified Wisconsin Card Sorting Task, and Block Design at test time 1. Two years later, the PD group showed significant decline in Semantic and Letter Fluency. A subset of 12 PD patients declined in mental status by second testing (>4 MMSE points). Cox proportional-hazards models were used to see if any baseline measures were associated with relative risk of decline in mental status. In the final model, Repetition performance and Age were significantly associated with cognitive decline. Consistent with previous studies, executive function tasks were those most susceptible to disease progression.
The association of psychosocial factors and depression with hypertension among older adults
- Authors:
- BOSWORTH Hayden B., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1142-1148.
- Publisher:
- Wiley
This article seeks to examine the relationship between depression and hypertension in an elderly population and how psychosocial variables influence this relationship. The study included 293 subjects, who met DSM-IV criteria for unipolar depression, and 151 subjects with no psychiatric disorder. All subjects were over the age of 58. Participants were administered the Duke Depression Evaluation Schedule at baseline and at yearly intervals for 3 years. Cross-sectional analyses of baseline data showed that hypertensive patients were more likely to be depressed and of non-white race. Bivariate analyses provided evidence that hypertension was associated with higher amounts of total stressors and lower social support. No differences in the prevalence of hypertension were found between men and women. In addition, there was no evidence of change in hypertension status over time. Patients, especially minorities, who experience depression, stress, or a lack of social support, are at an increased likelihood of having hypertension and clinicians should consider this risk when treating this population.
Gender in elderly suicide: analysis of coroners inquests of 200 cases of elderly suicide in Cheshire 1989-2001
- Authors:
- SALIB Emad, GREEN Laura
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1082-1087.
- Publisher:
- Wiley
The aim of this study is to review gender differences in elderly suicide in relation to specific social aspects of the suicidal process and health care contact before death. Such information may have practical value in identifying and targeting vulnerable elderly in whom suicide may be potentially preventable. Data were extracted from the records of coroner's inquests into all reported suicide of persons aged 60 and over, in Cheshire over a period of 13 years 1989-2001. The Coroner's office covers the whole county of Cheshire (population 1 000 000). Men were less likely to have been known to psychiatric services (Odds Ratio [OR] 0.4 95% 0.2-0.6) and with less frequently reported history of previous attempted suicide compared to women (OR 0.5 95% Confidence Intervals [CI] 0.2-1). All deceased from ethnic minorities were men, none of whom had been known to psychiatric services. There was no significant difference between women and men in relation to, physical or psychiatric morbidity, GP contact prior to suicide, intimation of intent or living alone. Of suicide victims not known to services a surprisingly high proportion of 38% and 16% were found to have psychiatric morbidity in men and women respectively.