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Screening for dementia in an Irish community sample using MMSE: a comparison of norm-adjusted versus fixed cut-points
- Authors:
- CULLEN Breda, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.371-376.
- Publisher:
- Wiley
The MMSE is a widely-used instrument in screening for dementia in the community. The traditional cut-point of <24/30 may be unsuitable for use in some settings, due to biases in age and education. This study aimed to investigate whether cut-points derived from age- and education-specific norms would improve the performance of the MMSE as a screening tool for dementia and cognitive impairment in an Irish community setting, potentially reducing the number of onward referrals. A secondary aim was to obtain score norms in an Irish sample. One thousand one hundred and fifteen people aged over 65 (mean age 74.8±6.8 years; 68% female) were assessed in their own homes, using MMSE (world) and the AGECAT computerised diagnostic system for mental illness in the elderly. The performance of the MMSE in identifying case- and sub-case-level dementia was investigated using cut-points of <24 and <23, as well as adjusted cut-points based on published norms and norms derived from the Irish sample. Published norms did not prove useful in improving screening accuracy. Cut-points based on 10th percentile Irish norms and the <23 cut-point performed comparably well, both yielding 93% specificity, with overall accuracy of 90% and 91% respectively (as sensitivity was higher for the <23 cut-point). Locally-derived norms yielded better screening accuracy than did published norms or the traditional <24 cut-point. The importance of selecting an appropriate percentile cut-off when using norms is discussed. The best results were obtained with a simple <23 cut-point, and this may be optimal when screening for dementia in an Irish community setting.
What is important to people with dementia living at home? A set of core outcome items for use in the evaluation of non-pharmacological community-based health and social care interventions
- Authors:
- REILLY Siobhan T., et al
- Journal article citation:
- Age and Ageing, 49(4), 2020, pp.664-671.
- Publisher:
- Oxford University Press
Objectives: inconsistency in outcome measurement in dementia care trials impedes the comparisons of effectiveness between trials. The key aim of this study is to establish an agreed standardised core outcome set (COS) for use when evaluating non-pharmacological health and social care interventions for people with dementia living at home. Method: we used a mixed-methods research design, including substantive qualitative research with five key stakeholders groups. We consulted with people living with dementia for many aspects of this research. We applied a modified two-round 54 item Delphi approach to attain consensus on core outcomes. The COS was finalised in a face-to-face consensus meeting in 2018. Results: of the 288 who completed round 1 (21 people living with dementia, 58 care partners, 137 relevant health and social care professionals, 60 researchers, 12 policy makers), 246 completed round 2 (85% response rate). Twenty participants attended the consensus meeting. We reached consensus for the inclusion of 13 outcome items. Conclusion: we identified 13 outcome items which are considered core; many relate to social health. Providing there are adequate measures, measuring these core outcome items will enhance comparisons for effectiveness making trial evidence more useful. The items will provide commissioners and service planners with information on what types of interventions are most likely to be valued highly by people living with dementia. (Edited publisher abstract)
Religiosity and mental health in southern, community-dwelling older adults
- Authors:
- PARKER M., et al
- Journal article citation:
- Aging and Mental Health, 7(5), September 2003, pp.390-397.
- Publisher:
- Taylor and Francis
This study considers potential interaction effects of three measures of religiosity, organized (OR), non-organized (NOR), and intrinsic religiosity (IR), on depression and general mental health, controlling for socio-demographic characteristics and mobility. In-home interviews were conducted among a stratified random sample of Medicare beneficiaries from five central Alabama counties (the University of Alabama at Birmingham Study of Aging). Those who were high on all three dimensions of religiosity reported having fewer symptoms of depression and better mental health than did those who were low on all three dimensions of religiosity. Subjects who scored high on OR reported lower levels of depression (F (1, 981) 1/4 3.97, p<0.05). Neither IR nor NOR had salutary effects on the measure of depression nor on the general measure of mental health. The interpretation of the relationships of religiosity with the Geriatric Depression Scale (GDS) and the general mental health (Mental Component Score of the SF-12; MCS) measures was complicated by the presence of three way interactions (F (1, 981) 1/4 9.02, p<0.01 and F (1, 981) 1/4 5.46, p<0.05, for GDS and MCS respectively). The presence of interaction effects between the different dimensions of religiosity and mental health affirms the importance of remaining sensitive to the multidimensional nature of religiousness and its relationships with measures of mental health.
Depression in older Americans with urinary incontinence (UI): the relationship with activities of daily living (ADL) and avoidance behaviours
- Author:
- BERTERA Elizabeth
- Journal article citation:
- Journal of Gerontological Social Work, 39(4), 2002, pp.39-55.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study uses interview responses from 986 Medicare beneficiaries with urinary incontinence (UI) to investigate the effects of behavioural responses to UI on depression in community-dwelling adults. Behavioural responses included limitations in ADLs, and avoidance of routine activities such as bending, reaching and stooping. Logistic regression models included depression in the past 3 years and “feeling blue” in the past year as proxies for depression. Avoiding 2 or more activities increased the odds of “feeling blue” and depression. ADL limitations were associated with depression, but not “feeling blue.” Implications for depression and independent living in older adults are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Consulting older community care clients about their services: some lessons for researchers and service managers
- Authors:
- PATMORE Charles, QURESHI Hazel, NICHOLAS Elinor
- Journal article citation:
- Research Policy and Planning, 18(1), 2000, pp.4-11.
- Publisher:
- Social Services Research Group
For purposes like Best Value reviews, social services needs methods for consulting frail older people. This article presents the results of research with 88 older users of social services community care, who were interviewed in groups, individually, or through a telephone conference about how they would like to be consulted about their services. They expressed a clear overall preference for individual interviews at home, which proved clearly more suitable than focus groups for people aged over 80. Written questionnaires were consistently criticised. Opinions were varied about individual telephone interviews. Senior service managers were favoured as interviewers.
Translating research into practice
- Author:
- BRADLEY Greta
- Journal article citation:
- Social Work and Social Sciences Review, 7(1), 1997, pp.3-12.
- Publisher:
- Whiting and Birch
This article reports on the outcomes from a small piece of research into assessment for community care services. The article focuses on policy guidance and training initiatives in particular those which emphasise the triangle of relationships between policy, research and practice. Argues that research which appears immediately relevant to national agency debates is likely to be drawn into such discussion and can inform or confirm decisions. Lastly the article explores whether practitioners' reactions to research can influence managers' views about the relevance of certain findings and so encourage an agency response. Through a series of specific examples a picture emerges of the dynamics of research, practice and policy.
Participatory research with older people: a sourcebook
- Author:
- HESLOP Mandy
- Publisher:
- Help Age International
- Publication year:
- 2002
- Pagination:
- 86p.,bibliog.
- Place of publication:
- London
This book has been produced as a resource to help all preparatory stages of participatory research with older people. It offers an overview of the research process and contains practical examples and case studies involving older people. Topics covered: planning and carrying out research; using research; training and research tools.
Client feedback - does it lead to improved services? Part one - background and development of the measurement tool
- Author:
- LEWIN Gill
- Journal article citation:
- Managing Community Care, 6(1), February 1998, pp.28-35.
- Publisher:
- Pavilion
This case study describes how Western Australia's largest home-care organisation approached the task of obtaining feedback on its performance from its clients. The aim was to use this feedback both as a valid and reliable indicator of its performance, in order to be accountable to its funders, and as the basis for strategies to improve further the services provided to clients.
The working of social work
- Editors:
- CHEETHAM Juliet, KAZI Mansoor A.F.
- Publisher:
- Jessica Kingsley
- Publication year:
- 1998
- Pagination:
- 238p.,bibliogs.
- Place of publication:
- London
Presents recent research of relevance to key issues in social work policy and practice and promotes the understanding and use of research methods appropriate for academic, practitioner and agency-based research. Includes chapters on: researching the effectiveness of a small-scale community-based project for sex offenders; the rights and wrongs of social work with children and young people; a pluralistic approach to researching community care assessments; elder abuse within a residential setting; evaluating outcome decisions; experience of single case evaluation in a small agency; evaluation of social work practice in relation to poverty issues; applying the lessons of qualitative research to the content of social work; promoting evaluation research on social work practice; and putting single case evaluation into practice.