Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 36
Elder abuse and neglect in an urban Chinese population
- Authors:
- DONG Xin Qi, SIMON Melissa A., GORBIEN Martin
- Journal article citation:
- Journal of Elder Abuse and Neglect, 19(3/4), 2007, pp.79-96.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
A cross-sectional study performed in an urban medical centre in Nanjing is reported, and shows that elder abuse and neglect is common in mainland China. A total of 412 participants completed the survey, of whom 35% (mean age 69, 59% male) screened positive for elder abuse and neglect. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse and abandonment. Thirty-six percent suffered multiple forms of abuse and neglect. Risk factors associated with abuse and neglect were female gender, lower educational level and lower income. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Determinants of remaining in the community after discharge: results from New Jersey's nursing home transition program
- Authors:
- HOWELL Sandra, et al
- Journal article citation:
- Gerontologist, 47(4), August 2007, pp.535-547.
- Publisher:
- Oxford University Press
To inform states with nursing home transition programs, this study aimed to determine what risk factors are associated with participants' long-term readmission to nursing homes within 1 year after discharge. The authors obtained administrative data for all 1,354 nursing home residents who were discharged, and interviewed 628 transitioning through New Jersey's nursing home transition program in 2000. The Andersen behavioral model was used to select predictors of long-term nursing home readmission, and the Cox proportional hazards regressions was used to examine the relative risk of experiencing such readmissions. Overall, 72.6% of the 1,354 individuals remained in the community, with 8.6% readmitted to a nursing home for long stays (>90 days) and 18.8% dying during the study year. Cox proportional hazards regression analysis showed that being male, single, and dissatisfied with one's living situation; living with others; and falling within 8 to 10 weeks after discharge were significant predictors of long-term nursing home readmission during the first year after discharge. Most of the factors predicting long-term readmission were predisposing, not need, factors. This fact points to the limits of formulaic approaches to assessing candidates for discharge and the importance of working with clients to understand and address their particular vulnerabilities. Consumers, state policy makers, nursing home transition staff, discharge planners, and caregivers can use these findings to understand and help clients understand their particular risks and options, and to identify those individuals needing the greatest attention during the transition period as well as risk-specific services such as fall-prevention programs that should be made available to them.
The role of vascular risk factors in late onset bipolar disorder
- Authors:
- SUBRAMANIAM Hari, DENNIS Michael S., BYRNE E. Jane
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.733-737.
- Publisher:
- Wiley
The association between late life depression and cerebro-vascular risk and cerebro-vascular disease is well established. This study aimed to investigate whether similar links exist with late onset bipolar disorder. Patients with early onset (less than 60 years of age) bipolar disorder were compared with those of late onset (aged 60 and above) in relation to cognitive function, physical health and vascular risk factors. Participants were receiving specialist care from the Leicestershire Mental Health NHS Partnership Trust. Thirty patients with early onset were compared with 20 patients with a late onset bipolar disorder. Diagnosis of bipolar disorder was according to ICD-10 criteria and without an associated clinical diagnosis of dementia. Assessment of cognition included tests of frontal-executive function, and cerebro-vascular risk was quantified with the Framingham stroke risk score. The late onset group had a higher stroke risk score than the early onset group, this difference persisting despite taking age and gender differences into account. However, late onset patients' cognitive function (including frontal lobe tests) and physical health status was no different to the early onset group. There is higher cerebrovascular risk in elderly patients with late onset bipolar disorder, compared to patients with an early onset. This suggests that cerebrovascular risk may be an important factor for the expression of bipolar disorders in later life, and has significant management implications for older bipolar patients.
Trends in suicide rates of the elderly in Austria, 1970-2004: an analysis of changes in terms of age groups, suicide methods and gender
- Authors:
- KAPUSTA Netsor D., ETZERSDORFER Elmar, SONNECK Germot
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(5), May 2007, pp.438-444.
- Publisher:
- Wiley
Suicides of the elderly (persons aged 65 and older) make up a large proportion of total suicides. Since suicide rates of the elderly are highest in western populations, addressing them as a risk group in prevention plans has been recommended. In order to assess possible approaches to prevention strategies, this study examines high-risk groups of the elderly. The authors examined official statistics on suicides that occurred in Austria between 1970-2004 (18,101 Suicides of the elderly). The authors analyzed time trends and differences in suicide methods as well as in age groups and both genders of the elderly. Three major high-risk groups were identified: elderly male suicides by firearms; elderly female suicides by poisoning, which occur more often with increasing age; and suicides of both genders by jumping from heights. Besides conducting treatment of psychiatric disorders of the elderly, restricting the means to commit suicide may help to prevent it among the elderly. Such specific prevention strategies should be implemented in national suicide prevention plans for the high-risk groups identified in this study.
Prevalence of depression symptoms and related risk factors for depressive symptoms among Elderly persons living in a rural Japanese community: a cross-sectional study
- Authors:
- KANEKO Yoshihiro, et al
- Journal article citation:
- Community Mental Health Journal, 43(6), December 2007, pp.583-590.
- Publisher:
- Springer
To clarify the prevalence of depression in a rural community in Japan and to evaluate the social and familial risk factors for depression, with the goal of suicide prevention, a questionnaire survey was conducted on a total of 2,763 elderly persons. The determined prevalence of depressive symptoms (Zung’s self-rated depression scale score of 50 points or more) was 10.4%. Logistic regression analysis showed associations between depressive symptoms and age, absence of a friendly companion, irritation with one’s family, frequent loneliness, the opinion that stress has a large impact on one’s life, suicide ideation, and poor subjective physical and mental health.
Mental health status of home care elders in Michigan
- Authors:
- LI Lydia W., CONWELL Yeates
- Journal article citation:
- Gerontologist, 47(4), August 2007, pp.528-534.
- Publisher:
- Oxford University Press
This study describes the mental health status of community-living frail elders in Michigan and identifies subgroups of individuals who are vulnerable to mental health problems. The study analyzed the baseline assessment data collected from older adults who were admitted to two community-based long-term-care programs in Michigan (N = 18,939). The programmes aim to help adults at risk of nursing home placement to remain in the community by providing them with supportive services. Results show that 40.5% of the individuals in the sample have recognized mental disorders, 39.6% use psychotropic medications, 24.5% have probable depression, and 1.4% have self-injury thoughts or attempts. Frail elders who are White, younger, and female - as well as those who experience more pain, disease burden, cognitive impairment, and limitations in instrumental activities of daily living - are more prone to psychological distress. Mental health care is greatly needed by community-living frail elders.
Deliberate self-harm in older adults: a review of the literature from 1995 to 2004
- Authors:
- CHAN Jenifer, DRAPER Brian, BANERJEE Sube
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.720-732.
- Publisher:
- Wiley
In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life. Relevant studies published between 1995 and 2004 are critically reviewed to summarise advances in the understanding of factors associated with deliberate self-harm in later life. The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality. The authors conclude that future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed.
Constructions of frailty in the English language, care practice and the lived experience
- Author:
- GRENIER Amanda
- Journal article citation:
- Ageing and Society, 27(3), May 2007, pp.425-445.
- Publisher:
- Cambridge University Press
The way frailty is conceptualised and interpreted has profound implications for social responses, care practice and the personal experience of care. This paper begins with an exegesis of the concept of frailty, and then examines the dominant notions of frailty, including how ‘frailty’ operates as a ‘dividing-practice’ through the classification of those eligible for care. The definitions and uses of ‘frailty’ in three discursive locations are explored in: (a) the Oxford English Dictionary, (b) the international research literature, and (c) older women's accounts of their lived experience. Three distinctive discourses are found, and applying a Foucauldian analysis, it is shown that the differences reflect overlaps and tensions between biomedical concepts and lived experiences, as well as negative underlying assumptions and ‘subjugated knowledge’. The concept of frailty represents and orders the context, organisational practices, social representations and lived experiences of care for older people. The evidence suggests that if, as the older women's accounts recommended, socially- and emotionally-located expressions of frailty were recognised in addition to the existing conceptions of risk of the body, frailty might no longer be thought of primarily as a negative experience of rupture and decline. To encourage this change, it is suggested that practice focuses on the prevention of frailty and associated feelings of loss, rather than reinforcing the feelings and experiences which render a person ‘frail’.
Marital status and mortality in the elderly: a systematic review and meta-analysis
- Authors:
- MANZOLI Lamberto, et al
- Journal article citation:
- Social Science and Medicine, 64(1), January 2007, pp.77-94.
- Publisher:
- Elsevier
Although a relationship between marital status and mortality has long been recognized, no summary estimates of the strength of the association are available. A meta-analysis of cohort studies was conducted to produce an overall estimate of the excess mortality associated with being unmarried in aged individuals as well as to evaluate whether and to what degree the effect of marriage differs with respect to gender, geographical/cultural context, type of non-married condition and study methodological quality. All included studies were published after the year 1994, used multivariate analyses and were written in English. Pooling 53 independent comparisons, consisting of more than 250,000 elderly subjects, the overall relative risk (RR) for married versus non-married individuals (including widowed, divorced/separated and never married) was 0.88 (95% Confidence Interval: 0.85–0.91). This estimate did not vary by gender, study quality, or between Europe and North America. Compared to married individuals, the widowed had a RR of death of 1.11 (1.08–1.14), divorced/separated 1.16 (1.09–1.23), never married 1.11 (1.07–1.15). Although some evidence of publication bias was found, the overall estimate of the effect of marriage was robust to several statistical approaches and sensitivity analyses. When the overall meta-analysis was repeated with an extremely conservative approach and including eight non-significant comparisons, which were initially excluded because of data unavailable, the marriage protective influence remained significant, although the effect size was reduced (RR=0.94; 0.92–0.95). Despite some methodological and conceptual limitations, these findings might be important to support health care providers in identifying individuals “at risk” and could be integrated into the current programs of mortality risk estimation for the elderly.
The vulnerability for elder abuse among a sample of custodial grandfathers: an exploratory study
- Author:
- BULLOCK Karen
- Journal article citation:
- Journal of Elder Abuse and Neglect, 19(3/4), 2007, pp.133-150.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Most research on grandparents who take on a custodial role in respect of grandchildren focus on grandmothers, and little is known about the potential risks facing grandfathers. This paper is based on a group of 26 Black, White and Latino custodial grandfathers, and focuses on the types and warning signs of abuse, exploitation and neglect by their families, including grandchildren who have often suffered violent and abusive backgrounds themselves. The most commonly expressed warning sign was a feeling of powerlessness and exclusion from family decision making over issues such as setting limits on children’s behaviours and actions. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).