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The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis
- Authors:
- MUIR Susan W., GOPAUL Karen, ODASSO Manuel M. Montero
- Journal article citation:
- Age and Ageing, 41(3), 2012, pp.299-308.
- Publisher:
- Oxford University Press
The results of this systematic review and meta-analysis of 26 prospective studies provide strong evidence that cognitive impairment, assessed using global measures of cognition, are associated with serious fall-related injury although there is no agreement on threshold values. Impairment in executive functioning is also associated with increased risk of falls even when global cognitive status is within normal limits and should be included in falls risk evaluations in older people.
Intimate partner violence against older women in Germany: prevalence and associated factors
- Authors:
- STÖCKL Heidi, WATTS Charlotte, PENHALE Bridget
- Journal article citation:
- Journal of Interpersonal Violence, 27(13), September 2012, pp.2545-2564.
- Publisher:
- Sage
Intimate partner violence (IPV) has significant adverse physical and psychological health outcomes, especially among older women. To develop appropriate and effective IPV interventions targeting older women, more needs to be known about its prevalence and the factors associated with increased risk. The aim of this study was to explore the prevalence and factors associated with physical and sexual violence against older women. Data were drawn from a national survey ‘Health, Well-Being and Personal Safety of Women in Germany’ conducted in 2003. This survey consisted of 10,264 female respondents between the age of 16 and 86 years; this analysis looks separately at women aged 50 to 65 and 66 to 86 years at the time of the survey. The findings showed that the prevalence of violence in women’s current relationships was 12% and 5%, respectively. In both age groups, women who had experienced violence during childhood and nonpartner physical or sexual violence after the age of 16 had higher odds of experiencing current partner violence. Current partner violence was associated only with women and their partner’s level of education and women’s vocational training among women aged 66 to 86 years. Relationships where one or both partners drank heavily in recent months were associated with higher odds of violence among women aged 50 to 65.
Depression as a predictor of falls amongst institutionalized elders
- Authors:
- WANG Yun-Chang, et al
- Journal article citation:
- Aging and Mental Health, 16(6), August 2012, pp.763-770.
- Publisher:
- Taylor and Francis
This study investigated the effects of medical condition and depression status on fall incidents amongst institutionalised older people. A cross-sectional study was carried out in New Taipei City, Taiwan to investigate the fall history of institutionalised older people involving 286 subjects. Experiences of falls over the previous year were recorded, with at least two falls during the prior one-year period, or one injurious fall defined as ‘fallers’. Depression was found to have enhanced effects with various medical conditions on fall risk. As compared with the non-depressive reference group, a five-fold fall risk was discernible amongst depressed older people with multiple medications, whilst a six-fold risk was found amongst those using ancillary devices, along with a 11-fold amongst those with neural system diseases. In conclusion, depressed older people with neural system diseases, using ancillary devices or multiple medications, should be specifically listed as very high risk of falling amongst institutionalised older people.
Types of substance misuse and risk factors
- Author:
- RASSOOL G. Hussein
- Journal article citation:
- Nursing Times, 24.7.12, 2012, pp.12-14.
- Publisher:
- Nursing Times
Substance misuse in older adults is common but remains under recognised. Patterns of misuse in this group, the risk factors for alcohol misuse (which include psychological, medial and practical problems), and the effects of this misuse are discussed. The article also covers addiction to nicotine and other substances.
Prevalence and risk factors of depressive symptoms in latest life-results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)
- Authors:
- LUPPA Melanie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(3), March 2012, pp.286-295.
- Publisher:
- Wiley
As depressive symptoms are common in oldest age and associated with broad categories of risk factors, latest-life depression represents an important public health issue. The aim of this study was to determine the age-specific and gender-specific prevalence rates and risk factors of depressive symptoms of the oldest old people. The data was derived from the Leipzig Longitudinal Study of the Aged (LEILA 75+), a population-based study on the epidemiology of dementia and mild cognitive impairment (MCI). A sample of 1006 individuals aged 75 years and older were interviewed on socio-demographic, clinical and psychometric variables. Of the overall sample, 38.2% were classified as depressed. Analysis revealed that the following variables were significantly associated with depressive symptoms: divorced or widowed marital status; low educational level; poor self-rated health status; functional impairment; multi-domain MCI, stressful life events; and poor social networks.
Dehydration: best practice in the care home
- Author:
- CAMPBELL Naomi
- Journal article citation:
- Nursing and Residential Care, 14(1), January 2012, pp.21-25.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
Dehydration of older people in care homes leads to both patient suffering and increased health care costs. This review article looks at the risk factors of dehydration in older people, provides an overview of current best practice guidelines for hydration and discusses strategies to encourage patients to drink more. Two UK initiatives which helped to increase patient and staff awareness of the importance of drinking more fluids, The East Anglia Water company campaign 'Healthy on Tap' and the project 'Thirst 4 Life' in Buckinghamshire, are also briefly mentioned.
The right to take risks
- Author:
- FAULKNER Alison
- Journal article citation:
- Journal of Adult Protection, 14(6), 2012, pp.287-296.
- Publisher:
- Emerald
This article reports on a consultation which aimed to explore the views of disabled people and service users about risk. It reached nine individuals and one focus group, reaching a total of 17 disabled people and service users. Findings revealed that disabled people and service users have quite different concerns about risk to those of the professionals and the regulatory bodies acting on their behalf. Many people talked of the fear of losing their independence, of asserting their rights and the fear of powerlessness in the face of bureaucracy and uncaring staff. The author concluded that raising awareness among professionals and policy makers about the risks that service users themselves fear and experience should demonstrate just how important it is that the people whose risk is under consideration are involved in the process.
Improving decision-making in the care of older people: exploring the decision ecology: report
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2012
- Pagination:
- 71p.
- Place of publication:
- York
The proportion of the population in retirement is estimated to rise significantly. This major demographic change makes it imperative to review the position of older people both as receivers and as givers of care and support. This report reviews the evidence relating to how to improve decisions made by and for older people about their care and support. It investigates how formal, semi-formal and informal relationships can work together to best effect, and the relationship between risk, trust, and good decision-making. The report: examines the nature of decision-making; explores the 'decision ecology' - the multi-factored contextual backdrop to decisions about risk and trust in an ageing society; discusses factors that influence, improve and impede caring decisions taken by a range of actors; considers the role of narratives in improving decisions for, by and about older people and their care; appraises risk management and trust development strategies; and investigates responsibility in decision-making. It argues that effective decision-making requires constructive partnerships between older people (carers and cared-for), and informal and formal carers that understand their value, potential shortcomings and strengths. However, risk elimination is not possible and the wellbeing of older people requires positive risk-taking.
Improving decision-making in the care and support of older people: summary
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2012
- Pagination:
- 4p.
- Place of publication:
- York
The proportion of the population in retirement is estimated to rise significantly. This major demographic change makes it imperative to review the position of older people both as receivers and as givers of care and support. This report summary outlines the findings of a review of the evidence relating to how to improve decisions made by and for older people about their care and support. It investigates how formal, semi-formal and informal relationships can work together to best effect, and the relationship between risk, trust, and good decision-making. This summary lists the key points identified by the review and also briefly discusses the findings in relation to: how decisions are made; the decision-making ecology; influences on caring decisions; the role of narrative; risk and trust; and responsibility. It argues that effective decision-making requires constructive partnerships between older people (carers and cared-for), and informal and formal carers that understand their value, potential shortcomings and strengths. However, risk elimination is not possible and the wellbeing of older people requires positive risk-taking.
Organizational and individual conditions associated with depressive symptoms among nursing home residents over time
- Authors:
- CASSIE Kimberly M., CASSIE William E.
- Journal article citation:
- Gerontologist, 52(6), December 2012, pp.812-821.
- Publisher:
- Oxford University Press
Recent estimates put the rate of depression in those aged over 70 years in the US at 11% regardless of their living situation but the highest rates have been observed among the institutionalised elderly. This study examined the effect of organisational culture and climate on depressive symptoms among nursing home residents. A total of 23 nursing homes, 1,114 employees, and 5,497 residents (two-thirds women) were included in the pooled cross-sectional design. Depressive symptoms were measured using the Minimum Data Set, Depression Rating Scale. Organisational culture and climate were measured using the Organizational Social Context Scale. Levels of depression were generally low; 12,607 of 17,300 assessments revealed no depressive symptoms. For this reason the authors urge caution in interpreting the results. Hierarchical linear modelling showed that depressive symptoms were associated with two dimensions of organisational culture (proficiency and resistance), three dimensions of climate (stress, engagement, and functionality), geographic location, facility size, staffing ratios, and impairments in activities of daily living and cognition. The findings suggest that values and beliefs that guide behaviour in an organisation and employees’ perceived impact of the work environment on their well-being have a significant impact on resident mental health.