Search results for ‘Subject term:"older people"’ Sort:
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Reducing injury through self-protection by elderly victims of violence: the interaction effects of gender of victim and the victim/offender relationship
- Authors:
- BACHMAN Ronet, LACHS Mark, MELOY Michelle
- Journal article citation:
- Journal of Elder Abuse and Neglect, 16(4), 2004, pp.1-24.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purposes of this paper are twofold: (1) to provide an epidemiological assessment of the differential vulnerability that elders compared to younger victims have to injury as the result of a violent victimization perpetrated by both known and unknown offenders, and (2) to examine the factors most related to injurious outcomes for elderly victims of violence including self-protective behavior. Using robbery and physical assault data from the National Crime Victimization Survey for 1992 through 2000, this paper found that victims 65 years of age and older were much more likely to require medical care for their injuries compared to younger victims. When multivariate models were examined to predict injury, it was found the effects of verbal and/or other passive forms of self-protective behavior decreased the probability of injury for the elderly against both known and unknown offenders. When elders were attacked by strangers, the effects of physical resistance strategies also served to decrease the probability of injury. However, when the offender was known, such as a family member or a friend, the use of physical forms of resistance increased the probability of injury for elderly victims, particularly female victims. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Vulnerability to winter mortality in elderly people in Britain: population based study
- Authors:
- WILKINSON Paul, et al
- Journal article citation:
- British Medical Journal, 18.9.04, 2004, pp.647-51.
- Publisher:
- British Medical Association
Examines the determinants of vulnerability to winter mortality in British people 75 and over using a population based cohort study (119,389 person years of follow up) in 106 general practices from the Medical Research Council trial of assessment and management of older people in Britain. Mortality (10,123 deaths) was determined by follow up through the Office for National Statistics. Month to month variation accounted for 17% of annual all cause mortality, but only 7.8% after adjustment for temperature. Overall winter:non-winter rate ratio was 1.31. There was little evidence of geographical, age, personal, socioeconomic, or clinical variance except that after adjustment for all major covariates the winter:non-winter ratio in women compared with men was 1.11 (1.00 to 1.23), and those with self-reported history of respiratory illness had a winter:non-winter ratio of 1.20 (1.08 to 1.34) times that of people without such a history. There was no evidence that socioeconomic deprivation or self-reported financial worries were predictive of winter death. Except for female sex and pre-existing respiratory illness there was little evidence for vulnerability to winter death associated with factors thought to lead to vulnerability. The lack of socioeconomic gradient suggests that policies aimed at relief of fuel poverty may need to be supplemented by additional measures to tackle the burden of excess winter deaths in elderly people.
Readmissions - an evaluation of reasons for unplanned readmissions of older people: a United Kingdom and international studies literature review
- Author:
- DOBRZANSKA Linda
- Journal article citation:
- Quality in Ageing, 5(4), December 2004, pp.20-28.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
A literature review study used to research the causes for unplanned readmissions of older patients. The evidence was produced using a wide geographic of sources from electronic databases dated 1990-2003. In total, 92 articles were identified. From these, 83 papers were selected which met the inclusion criteria and corresponded to the aims of the review. The author found that many international studies were inconsistent in their approach to defining terms. Yet despite this, in the United Kingdom researchers generally agreed that the reason for the majority of readmissions was a result of a relapse or complication of an initial illness. Furthermore, Amercian studies reveal that the readmission of older patients is caused by a specific disease and the antecedent care process.
The feasibility and effectiveness of brief interventions to prevent depression in older subjects: a systematic review
- Authors:
- COLE Martin G., DENDUKURI Nandini
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(11), November 2004, pp.1019-1025.
- Publisher:
- Wiley
MEDLINE, PsycINFO and HealthStar were searched for potentially relevant articles published from January 1966 to June 2003, January 1974 to June 2003 and January 1975 to June 2003, respectively. The bibliographies of relevant articles were searched for additional references. Ten studies met the following five inclusion criteria: original research, subjects mean age 50 years or more, controlled trial of a brief ( < 12 weeks) intervention to prevent depression, determination of depression status 12 months or more after enrolment, use of an acceptable definition of depression. The validity of studies was assessed according to six criteria. To examine feasibility we tabulated study enrolment, completion and compliance rates. To examine effectiveness we tabulated differences in depression symptom outcome scores between intervention and control groups or, when possible, absolute (ARR) and relative (RRR) risk reductions for depression. Only two of the ten trials met all of the validity criteria. Study enrolment rates were 21 to 100% (median 72.5%); study completion rates were 46% to 100% (median 85%); compliance rates were 29% to 100% (median 87%). Five of the ten trials had positive results: in two trials there were statistically significant differences in depression symptom outcome scores favoring the intervention group; in three trials ARRs were 2.3% to 45% (median 17%); RRRs were 45% to 71% (median 61%). Some types of brief interventions appear to have the potential to prevent depression in older subjects. Despite the methodologic limitations of the trials and this systematic review, these findings may guide efforts to develop and evaluate brief interventions to prevent depression in this population.
So sad to see good care go bad - but is it surprising?
- Authors:
- BENDER Mike, WAINWRIGHT Tony
- Journal article citation:
- Journal of Dementia Care, 12(5), September 2004, pp.27-30.
- Publisher:
- Hawker
Argues that abuse and failures in care settings should be attributed to inherent qualities of healthcare systems, based on the way human societies work, rather than the failures of individuals. Seeing mistreatment as rare and unusual, each case a very exceptional, atypical instance of an evil person abusing trust in an otherwise good system, is convenient and comfortable. Suggests reasons why this is not so and why root cause analysis is more useful. Abuse can occur anywhere and does not require heinous and evil owners, managers or staff. Lists risk factors for abuse of older people in residential care, and suggests how the risk can be minimised.
A model predicting suicidal ideation and hopelessness in depressed older adults: the impact of emotion inhibition and affect intensity
- Authors:
- LYNCH T.R., et al
- Journal article citation:
- Aging and Mental Health, 8(6), November 2004, pp.486-497.
- Publisher:
- Taylor and Francis
This study begins a preliminary examination of constructs theorized to be related to suicidal behavior by testing a model of the influence of both temperament and emotion regulation on suicidal ideation and hopelessness in a sample of depressed older adults. The model was evaluated using structural equation modeling procedures in a sample of depressed, older adults. Findings supported a temporally predictive model in which negative affect intensity and reactivity lead to emotion inhibition, operationalized as ambivalence over emotional expression and thought suppression, which in turn lead to increased presence of suicidal predictors, operationalized as hopelessness and suicidal ideation. These results suggest that suicide prevention efforts in older adults may be improved by targeting emotion inhibition in treatment, especially among affectively intense and reactive older adults.
Home Care Quality Indicators (HCQIs) based on the MDS-HC
- Authors:
- HIRDES John P., et al
- Journal article citation:
- Gerontologist, 44(5), October 2004, pp.665-679.
- Publisher:
- Oxford University Press
Of the 73 original candidate HCQIs, 22 were retained for the final list of recommended indicators. All but three indicators include risk adjusters based on individual-level covariates. An agency-level risk adjustment was developed to correct for selection and ascertainment bias. The HCQIs are new tools providing a first step along the path of quality improvement for home care. These indicators can provide high-quality evidence on performance at the agency level and on a regional basis.
Anxiety and the risk of death in older men and women
- Authors:
- VAN HOUT Hein P., et al
- Journal article citation:
- British Journal of Psychiatry, 185(11), November 2004, pp.399-404.
- Publisher:
- Cambridge University Press
There are inconsistent reports as to whether people with anxiety disorders have a higher mortality risk. The aim was to determine whether anxiety disorders predict mortality in older men and women in the community. Longitudinal data were used from a large, community-based random sample (n=3107) of older men and women (55–85 years) in The Netherlands, with a follow-up period of 7.5 years. Anxiety disorders were assessed according to DSM–III criteria in a two-stage screening design. In men, the adjusted mortality risk was 1.78 (95% CI 1.01–3.13) in cases with diagnosed anxiety disorders at baseline. In women, no significant association was found with mortality. The study revealed a gender difference in the association between anxiety and mortality. For men, but not for women, an increased mortality risk was found for anxiety disorders.
Vascular disease/risk and late-life depression in a Korean community population
- Authors:
- KIM Jae-Min, et al
- Journal article citation:
- British Journal of Psychiatry, 185(8), August 2004, pp.102-107.
- Publisher:
- Cambridge University Press
Associations between vascular risk factors and late-life depression are controversial. The aim was to investigate the association between measures of vascular disease/risk and depression and confounding and effect modification by APOE genotype and cognitive function. In a Korean community population aged 65+ (n=732), diagnosis of depression (Geriatric Mental State Schedule) and information on vascular status, disability, APOE genotype and cognitive function were obtained. Previous stroke and lower high-densitylipoprotein cholesterol level (but neither hypertension nor diabetes) were significantly associated with depression (independently of disability and cognitive function). These associations were stronger in participants with borderline cognitive impairment, although not to a significant extent. Except for previous stroke and an atherogenic lipid profile, associations between depression and other common risk factors for cerebrovascular disease were not evident.
Risk indicators of depression in residential homes
- Authors:
- EISSES A. M. H., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(7), July 2004, pp.634-640.
- Publisher:
- Wiley
In a cross-sectional study risk indicators for depressive symptoms (Geriatric Depression Scale) were examined in bivariate and multivariate analyses, four hundred and seventy-nine elderly subjects from 11 residential homes took part in the study. Functional impairment, loneliness, higher education levels, a family history of depression and neuroticism are associated with depressive symptom. The risk indicators of depression found in residential homes are similar to those in the community.