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Late life depression: a comparison of risk factors and symptoms according to age of onset in community dwelling older adults
- Authors:
- GALLAGHER Damien, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.981-987.
- Publisher:
- Wiley
Late onset depression is often associated with acquired organic pathology, with patients less likely to report a family history of depression. The majority of previous studies have been in hospital populations. This study addressed this question in a sample of community dwelling older adults. Participants included 89 subjects with GMS-AGECAT depression who were identified from a sample of 1,231 community dwelling adults aged 65 and over. Subjects were analysed across a range of aetiological and phenomenological variables according to age of onset of first depressive episode. Findings indicated that subjects with late onset depression were significantly less likely to report a family history of depression, were less likely to report previous hospitalisation for depression and had greater cognitive impairment. Late onset subjects were also less likely to report feelings of guilt or thoughts that life was not worth living in the previous month. While patients with late onset depression differed from early onset patients according to certain aetiological risk factors, there was not a distinctive profile of depressive symptomatology which might be considered clinically useful – findings consistent with previous hospital-based studies.
Does volunteering moderate the relation between functional limitations and mortality?
- Authors:
- OKUN Morris A., et al
- Journal article citation:
- Social Science and Medicine, 71(9), November 2010, pp.1662-1668.
- Publisher:
- Elsevier
It has previously been shown that functional limitations increase the risk of mortality in later life, while organisational volunteering decreases this risk. To date, however, no research has investigated the joint effect of functional limitations and organisational volunteering on mortality. In this study the authors tested the hypothesis that volunteering moderates the relation between functional limitations and risk of mortality. Survey data from a representative sample of 916 non-institutionalised adults 65 years old and older who lived in the United States were used. Data on mortality were extracted six years later from the National Death Index. Findings indicated that functional limitations were indeed associated with an increased risk of dying only among participants who never or almost never volunteered, suggesting that volunteering buffers the association between functional limitations and mortality. The authors suggest that while it may be more difficult for older adults with functional limitations to volunteer, they may receive important benefits from doing so.
Pathways to problem gambling in seniors
- Authors:
- TIRACHAIMONGKOL Luxana Connie, JACKSON Alun Conrad, TOMNAY Jane Elizabeth
- Journal article citation:
- Journal of Gerontological Social Work, 53(6), August 2010, pp.531-546.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study aimed to investigate pathways to later life problem gambling, for individuals aged 55 years and above, in order to improve interventions for vulnerable older adults. This study builds on a generic Pathways Model. Gambling-related risk and protective factors/correlates were extracted from the literature. Common themes were then identified and classified into three main pathway clusters. Cluster one related to individual vulnerability factors. These included distressing situation, urgency or apathy, service barriers, lack of welfare assistance, absence/lack of support, unhelpful coping/problem solving mechanisms and expectations, and lack of structured time plus exposure to gambling facilities. Cluster two comprised social and environmental factors; such as unsupportive environment, impulsive temperament, illusion of control, gambling as a significant part of cultural/ethnic identity, competitive personality, big win, enticing gambling-associated promotions. Cluster three related to factors affecting behavioural regulation such as disinhibition, impaired decision-making, proximity to gambling facilities and multiple addictions. Overall the findings suggested that Pathways One and Two of the model, which correspond to behaviourally conditioned and emotionally vulnerable subsets respectively, are likely to be most relevant to late-life problem gambling. The factors that lead to late-life problem gambling can range from straightforward causes to abstract social influences, and may involve age-related, as well as non-age related circumstances. The authors conclude that protecting older adults from late-life problem gambling is about promoting older adults’ general sense of well-being while reducing factors that may diminish their enjoyment and outlook on life.
Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults
- Authors:
- MARTY Meghan A., SEGAL Daniel L., COOLIDGE Frederick L.
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.1015-1023.
- Publisher:
- Taylor and Francis
Older adults have a disproportionally high rate of completed suicide as compared to the general population. This study sought to examine the relationships between coping strategies with protective factors against suicide and suicidal ideation in this population. The participants were 108 community-dwelling older adults with an age range of 60-95 years who completed a self-report questionnaire packet comprising the Coping Orientations to Problems Experienced scale, Reasons for Living inventory, and Geriatric Suicide Ideation Scale (GSIS). The results showed that problem- and emotion-focused coping were associated positively with reasons for living and negatively with suicide ideation. Dysfunctional coping was associated positively with suicide ideation, but the results did not support the hypothesised negative relationship with reasons for living. Thus, problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicidal ideation among community-dwelling older adults. The article concludes that some coping strategies may serve as protective factors against suicide and that coping strategies should be evaluated as part of a thorough assessment of suicidal risk among older adults. The results also provide some evidence of convergent validity for the recently developed GSIS.
High incidence of clinically relevant depressive symptoms in vulnerable persons of 75 years or older living in the community
- Authors:
- DOZEMAN Els, et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.828-833.
- Publisher:
- Taylor and Francis
Incidence rates of depressive symptoms and their predictors were examined in a vulnerable elderly population. In a community-based cohort, 651 vulnerable elderly people aged 75 and over were identified by means of the COOP-WONCA charts (Dartmouth Coop Functional Health Assessment Charts/World Organisation of Family Doctors). To study the incidence of clinically relevant symptoms of depression and their predictors, 266 people with no symptoms were selected and measured again for clinical relevant symptoms of depression at 6 and 18 months. Logistic regression analyses were applied to determine risk indicators. The results showed that after 18 months 48% of the elderly people had developed clinically relevant symptoms of depression. No specific risk factors were identified within this population. The article concludes that the incidence of depressive symptoms identified in the study were considerably higher than those previously found in elderly populations living in the community. A vulnerable health status is associated with a high risk of depressive symptoms.
Older adults' experiences and perceptions of dual tasking
- Authors:
- MUHAIDAT Jennifer, et al
- Journal article citation:
- British Journal of Occupational Therapy, 73(9), September 2010, pp.405-412.
- Publisher:
- Sage
Currently, there is no agreement on which dual task (DT) test best assesses mobility or balance deficits in older adults. This study investigated older adults' perceptions of risk in relation to dual tasking to identify DTs relevant to their everyday life. Gender-specific focus groups were conducted. Fifteen older people aged 70 above participated. The topics posed to the groups included structured and open questions designed to explore experiences of combining two activities and the consequences of that for balance. The findings were analysed to identify DT examples, task difficulty levels and balance-threatening tasks. Results indicated that the majority of participants were able to identify DT examples and some identified a concurrent impact on balance. There were gender differences in the examples: women focused more on household tasks and men on outdoor activities. Tasks that were considered difficult for the participants included stair negotiation and avoiding moving obstacles, accompanied by secondary tasks. The authors concluded that views of older people should be taken into consideration in developing tests that are more appropriate to everyday living.
Determinants of disparities between perceived and psychological risk of falling among elderly people: cohort study
- Authors:
- DELBAERE Kim, et al
- Journal article citation:
- British Medical Journal, 28.8.10, 2010, p.436.
- Publisher:
- British Medical Association
This study investigated older people’s fear of falling by exploring the prevalence and determinants of perceived fall risk (measured by the falls efficacy scale international) and physiological fall risk (measured by the physiological profile assessment) and to understand the role of disparities in perceived and physiological risk in the cause of falls. It was found that many elderly people underestimated or overestimated their risk of falling. These disparities were primarily associated with psychological measures and strongly influenced the probability of falling. It is concluded that measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in elderly people.
Professional judgements of risk and capacity in situations of self-neglect among older people
- Author:
- MCDERMOTT Shannon
- Journal article citation:
- Ageing and Society, 30(6), August 2010, pp.1055-1072.
- Publisher:
- Cambridge University Press
Over the past 50 years, self-neglect among older people has been conceptualised in both social policy and the academy as a social problem which is defined in relation to medical illness and requires professional intervention. Few authors, however, have analysed the concept of self-neglect in relation to critical sociological theory. This is problematic because professional judgements, which provide the impetus for intervention, are inherently influenced by the social and cultural context. The purpose of this article is to use critical theory as a framework for interpreting and understanding judgements that are made in situations of self-neglect. This framework is used to analyse findings from a qualitative study which explored judgements about self-neglect among older people made by 24 professionals in Sydney, Australia. A two-part methodology was chosen. The first part involved 125 hours of observations at meetings and home assessments conducted by professionals associated with the Community Options Programme. The second part involved in-depth interviews with 18 professionals who worked with self-neglecting older people in the community. The findings show that professional judgements of self-neglect focus on risk and capacity, and that these perceptions influence when and how interventions occur. The assumptions upon which professional judgements are based are then further analysed in relation to critical theory.
Minimising the use of restraint in care homes for older people: exploring restraint
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2010
- Place of publication:
- London
This video explores the issue of restraint and how good practice can strike a balance between care and support with managing safety and risk. Four scenarios are enacted which explore episodes familiar to many care home staff: a resident trying to leave a care home, preventing someone from getting up from a chair, waking at night and getting ready for a meal. Two experts on restraint, Ann McFarlane and Tracy Paine, discuss why it is vital to find out as much as possible about the person so as to understand why they are behaving in a particular way and to gather clues as to how to their preferences and needs can be met. They make the case for good design in care homes, for letting residents live as much as possible in their own time frames and for residents' committees. [This film has been reviewed and is no longer available to view.]
Best of intentions: report from our investigation into the care and treatment of Mrs I
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2010
- Pagination:
- 8p.
- Place of publication:
- Edinburgh
Mrs I was detained in hospital under a compulsory treatment order (CTO) in May 2006, where, soon afterwards, she died from natural causes. Despite regular contact with services, Mrs I's physical and mental health had deteriorated considerably before services moved to intervene. She had been known to have been neglecting herself for the previous year and was described as suffering from malnutrition and appearing severely neglected. This investigation was carried out in order to examine the care and treatment of Mrs I and why it had taken so long for professionals to intervene. Recommendations about the operation of health and social services are made.