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A systematic review and meta-analysis of interventions designed to prevent or stop elder maltreatment
- Authors:
- AYALON Liat, et al
- Journal article citation:
- Age and Ageing, 45(2), 2016, pp.216-227.
- Publisher:
- Oxford University Press
Background: Elder maltreatment is a major risk for older adults’ mental health, quality of life, health, institutionalisation and even mortality. Objectives: To perform a systematic review and meta-analysis of interventions designed to prevent or stop elder abuse. Methods: Studies that were posted between January 2000 and December 2014, written in English, specifically designed to prevent or stop elder maltreatment were included. Results: Overall, 24 studies (and four records reporting on the same participants) were kept for the systematic review and the meta-analysis. Studies were broadly grouped into three main categories: (i) interventions designed to improve the ability of professionals to detect or stop elder maltreatment (n = 2), (ii) interventions that target older adults who experience elder maltreatment (n = 3) and (iii) interventions that target caregivers who maltreat older adults (n = 19). Of the latter category, one study targeted family caregivers, five targeted psychological abuse among paid carers and the remaining studies targeted restraint use. The pooled effect of randomised controlled trials (RCTs)/cluster-RCTs that targeted restraint use was significant, supporting the effectiveness of these interventions in reducing restraint use: standardised mean difference: −0.24, 95% confidence interval = −0.38 to −0.09. Interpretation: the most effective place to intervene at the present time is by directly targeting physical restraint by long-term care paid carers. Specific areas that are still lacking evidence at the present time are interventions that target (i) elder neglect, (ii) public awareness, (iii) older adults who experience maltreatment, (iv) professionals responsible for preventing maltreatment, (v) family caregivers who abuse and (vi) carers who abuse. (Publisher abstract)
What cognitive functions are associated with passive suicidal ideation? Findings from a national sample of community dwelling Israelis
- Authors:
- AYALON Liat, LITWIN Howard
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(5), May 2009, pp.472-478.
- Publisher:
- Wiley
This study aimed to identify the specific cognitive domains associated with passive suicidal ideation (e.g. thoughts of being better off dead). A cross sectional, national based study of 1,712 individuals over the age of 50. Outcome measure, passive suicidal ideation, was evaluated by the question, in the past month, have you felt that you would rather be dead?, taken from the Euro-D. Cognitive domains assessed were time orientation, verbal learning, verbal recall, word fluency, and arithmetic. After adjusting for demographic and clinical information, those reporting passive suicidal ideation were significantly more likely to have impaired performance on the time orientation task. None of the other cognitive domains were associated with passive suicidal ideation. Clinicians working with older adults need to be aware not only of demographic and clinical information, but also of cognitive functioning and more specifically, time orientation, as a potential determinant of passive suicidal ideation. Possibly, cognitive domains that are less affected by education and prior learning (e.g. time orientation) have a unique association with passive suicidal ideation.
Subjective cognitive functioning as a predictor of all cause mortality in an Israeli national sample of community dwelling older adults
- Author:
- AYALON Liat
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(8), August 2008, pp.830-836.
- Publisher:
- Wiley
Cognitive functioning has been identified as a predictor of all cause mortality in several epidemiological studies. As a result, researchers have suggested the use of short cognitive screens as prognostic indicators in older adults. Little is known, however, about subjective complaints of cognitive functioning as predictors of all cause mortality. A 7-year follow-up of a national sample of 4,921 Israelis over the age of 60. Main predictors were subjective complaints of memory problems, confusion, and recognition problems. Outcome was time to death. As expected, in the fully adjusted model, age, gender, subjective health, baseline health, and ADL and IADL impairments were significant predictors of all cause mortality. In addition, complaints about difficulties recognizing familiar people also were associated with a greater risk for mortality. Subjective complaints about recognition problems serve as a risk for all cause mortality above and beyond well-known risk factors. Health care professionals can use this information about subjective cognitive functioning in conjunction with other measures in order to identify older adults at risk for an earlier death.