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Jalali A, Ziapour A, Karimi Z, Rezaei M, Emami B, Kalhori RP, Khosravi F, Sameni JS, Kazeminia M. Global prevalence of depression, anxiety, and stress in the elderly population: a systematic review and meta-analysis. BMC Geriatr 2024; 24:809. [PMID: 39367305 PMCID: PMC11451041 DOI: 10.1186/s12877-024-05311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/16/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Several preliminary studies have been conducted in the field of the prevalence of depression, anxiety, and stress in the elderly population. These studies have examined the prevalence in limited geographic areas with small sample sizes. Also, there are many limitations in the meta-analysis studies. The objective of the present study was to synthesize the global prevalence statistics of depression, anxiety, and stress in the elderly population through a systematic review and meta-analysis. METHODS The present systematic review included retrieval of primary studies from the oldest relevant study up to 2023. To find the relevant studies, international databases such as Scopus, Embase, PubMed, and Web of Science (WoS) were systematically searched. Also, a manual search was performed through the Google Scholar search engine and a review of the sources of related articles. The qualitative assessment of the studies was conducted using the Joanna Briggs Institute (JBI) checklist. Due to a high heterogeneity among the study results, a Random Effects model was chosen. RESULTS A total of 42 articles on depression, 47 articles on anxiety and 13 articles on stress were included in the meta-analysis. The overall estimates for prevalence based on a random-effects model were as follows: depression, 19.2% (95% CI: 13.0 - 27.5%); anxiety, 16.5% (95% CI: 11.1 - 22.8%); and stress, 13.9% (95% CI: 5.5 - 30.9%). The highest prevalence of depression and anxiety was recorded in Africa. The prevalence of depression was higher in nursing homes, and stress was more prevalent in individuals with COVID-19 compared to other populations. CONCLUSION The findings revealed a high prevalence of depression, anxiety, and stress in the elderly population. Therefore, it is recommended that healthcare professionals and policymakers pay more attention to the prevention and management of these disorders in the elderly population.
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Affiliation(s)
- Amir Jalali
- Department of Medical Education, Virtue University of Medical Sciences, Tehran, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Zohreh Karimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Rezaei
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bashir Emami
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Pourmirza Kalhori
- Department of Emergency Medicine, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fataneh Khosravi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jelveh Sadat Sameni
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Poudyal S, Sharma K, Subba HK, Subba R. Psycho-social problems among older people residing in community of Chitwan, Nepal-A cross-sectional study. PLoS One 2024; 19:e0310849. [PMID: 39298402 DOI: 10.1371/journal.pone.0310849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 09/04/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Older people are vulnerable to various psycho-social problems such as depression, anxiety, insomnia, dementia, and loneliness that have profound impact on overall health and their quality of life and higher use of health services. Prevention and treatment of psychological problems in this risk group is critical for improving their quality of life. OBJECTIVE This study aimed to find out the psycho-social problems among older people residing in community. METHODS The study was a cross-sectional study design and 388 older people aged 65 years and above residing in different wards of Bharatpur Metropolitan city were selected using probability simple random sampling technique. Data were collected using interview schedule containing geriatric depression scale-15; Geriatric anxiety scale-10, University of California Loss Angels Loneliness Scale (UCLA-20), Anthens Insomnia Scale and Mini-Cog Test. Obtained data were analyzed in SPSS version 20 for windows. Chi-square test was applied to measure the association between psychosocial problems and selected variables. RESULT Findings of the study revealed that the mean age (± SD) of respondents was 72.92 (±7.12) years. Almost all (93.6%) older people had full functioning of activity of daily living and two third (66.5%) had other co-morbid conditions. More than two third (67.0%) of older adults had depression, 60.3% had anxiety, 53.6% had moderate to high level loneliness, 47.2% had insomnia, and 33.3% had dementia. Age, functional dependency, sex, co-morbidity, financial dependence, education and occupation were significantly associated with the psychosocial problems among older people. CONCLUSION AND RECOMMENDATION Psychosocial problems are common among older people residing in community of Chitwan. Hence, there is need to develop and implement health care strategy by local health care planner to prevent, treat and manage the psychosocial problems among this risk groups. Further, health care providers working in geriatric problems or psychosocial health need to conduct regular screening programs for the early diagnosis and treatment of these problems.
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Affiliation(s)
- Sunita Poudyal
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Kalpana Sharma
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | | | - Ramesh Subba
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
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Merritt SH, Zak PJ. Continuous remote monitoring of neurophysiologic Immersion accurately predicts mood. Front Digit Health 2024; 6:1397557. [PMID: 39157805 PMCID: PMC11327156 DOI: 10.3389/fdgth.2024.1397557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/10/2024] [Indexed: 08/20/2024] Open
Abstract
Mental health professionals have relied primarily on clinical evaluations to identify in vivo pathology. As a result, mental health is largely reactive rather than proactive. In an effort to proactively assess mood, we collected continuous neurophysiologic data for ambulatory individuals 8-10 h a day at 1 Hz for 3 weeks (N = 24). Data were obtained using a commercial neuroscience platform (Immersion Neuroscience) that quantifies the neural value of social-emotional experiences. These data were related to self-reported mood and energy to assess their predictive accuracy. Statistical analyses quantified neurophysiologic troughs by the length and depth of social-emotional events with low values and neurophysiologic peaks as the complement. Participants in the study had an average of 2.25 (SD = 3.70, Min = 0, Max = 25) neurophysiologic troughs per day and 3.28 (SD = 3.97, Min = 0, Max = 25) peaks. The number of troughs and peaks predicted daily mood with 90% accuracy using least squares regressions and machine learning models. The analysis also showed that women were more prone to low mood compared to men. Our approach demonstrates that a simple count variable derived from a commercially-available platform is a viable way to assess low mood and low energy in populations vulnerable to mood disorders. In addition, peak Immersion events, which are mood-enhancing, may be an effective measure of thriving in adults.
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Affiliation(s)
- Sean H. Merritt
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States
| | - Paul J. Zak
- Center for Neuroeconomics Studies and Drucker School of Management, Claremont Graduate University, Claremont, CA, United States
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Lai CYY, Chen LH, Lai FHY, Fung AWT, Ng SSM. The association between satisfaction with life and anxiety symptoms among Chinese elderly: a moderated mediation analysis. BMC Geriatr 2023; 23:855. [PMID: 38097936 PMCID: PMC10722706 DOI: 10.1186/s12877-023-04490-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Previous studies have suggested that certain personal psychological variables (e.g., life satisfaction and cognitive function) and physical variables (e.g., body mass index [BMI]) are significantly associated with individuals' anxiety symptoms. However, relevant research on elderly is lagging and no studies have yet investigated the combined impact of these variables on anxiety. Thus, we conducted the present study to investigate the potential moderator role of BMI and the potential mediator role of cognitive function underlying the relationship between life satisfaction and anxiety symptoms in Chinese elderly based in Hong Kong. METHODS Sixty-seven elderly aged 65 years old and above were recruited from the local elderly community centres in this pilot study. Each participant underwent a systematic evaluation using the Satisfaction with Life Scale (SWLS), Hong Kong Version of the Montreal Cognitive Assessment (HK-MoCA), and the Hamilton Anxiety Rating Scale (HAM-A) and were measured for their body weight and height. Regression analysis using the bootstrapping method was employed to test the hypothesized moderated mediation model. RESULTS Our findings demonstrated the overall model accounted for 23.05% of the variance in scores of HAM-A (F (8, 57) = 2.134, p = 0.047) in Chinese elderly. There was a significant association between life satisfaction and anxiety symptoms (p = 0.031), indicating that individuals with higher life satisfaction were associated with less anxiety symptoms. Moreover, this relationship was positively moderated by BMI (b = 0.066, 95% CI [0.004, 0.128]), especially in Chinese elderly with BMI at a lower level (b = -0.571, 95% CI [-0.919, -0.224]) and an average level (b = -0.242, 95% CI [-0.460, -0.023]). No significant mediator role was detected for cognitive function (b = -0.006, 95% CI [-0.047, 0.044]) in our model. CONCLUSIONS Our findings suggest that increased life satisfaction can reduce anxiety symptoms among Chinese elderly as their BMI decreases (when BMI ranged between "mean - 1SD" and "mean" of the population). The significant interaction between psychological and physical factors underlying anxiety symptoms found in this study, presents a promising opportunity for translation into multi-level psychological and physical interventions for the management of anxiety in ageing patients during clinical practice.
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Affiliation(s)
- Cynthia Y Y Lai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lu Hua Chen
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong SAR, China.
- Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Frank H Y Lai
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, The Northumbria University, Newcastle upon Tyne, UK
| | - Ada W T Fung
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Suhas S, Jayasankar P, Patley R, Manjunatha N, Rao GN, Gururaj G, Varghese M, Benegal V. Nationally representative epidemiological study of social anxiety disorder from India. Indian J Psychiatry 2023; 65:1261-1268. [PMID: 38298869 PMCID: PMC10826865 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_826_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background Social anxiety disorder (SAD), also termed as social phobia, is a disabling psychiatric condition with limited epidemiological research on it in India. This study, using data from the National Mental Health Survey (NMHS), 2016, is the first to explore its current prevalence and associated factors in India. Materials and Methods The NMHS in India used a comprehensive population-based study with subjects selected through a multistage stratified random cluster sampling technique across 12 states. The study included 34,802 adults interviewed with the Mini-International Psychiatric Interview 6.0.0. Firth penalized logistic regression (FPLR) was used to estimate covariate odds ratios (ORs), and the treatment gap for SAD and disability measured using Sheehan's disability scale was calculated. Results The study found a 0.47% prevalence of SAD, with an average age of 35.68 years (standard deviation (SD) = 15.23) among those affected. Factors, such as male gender, unemployment, and living in urban areas, were associated with higher odds of SAD, while the elderly had lower odds. A significant proportion of individuals with SAD experienced disability in work (63%), social life (77%), and family life (68%). They spent a median of ₹ 2500 per month on treatment and had a high rate of comorbid psychiatric disorders (58%). The treatment gap was substantial at 82%. Conclusions A considerable portion of India's population (approximately >65 lakhs) is affected by SAD. Surprisingly, the NMHS 2016 report indicates a higher risk of SAD among males compared with females, a trend that warrants further investigation. SAD in India is linked to significant disability and a considerable treatment gap, emphasizing the need for innovative approaches to address this large, affected population, especially in light of the scarcity of mental health professionals.
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Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pavithra Jayasankar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rahul Patley
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, WHO Collaborative Centre for Injury Prevention and Safety Promotion, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiciton Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Edwards N, Walker S, Paddick SM, Prina AM, Chinnasamy M, Reddy N, Mboya IB, Mtei M, Varghese M, Nakkasuja N, Guerra M, Sapkota N, Dotchin C. Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis. J Affect Disord 2023; 325:656-674. [PMID: 36681304 DOI: 10.1016/j.jad.2023.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted. METHODS Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression. RESULTS One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings. LIMITATIONS The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis. DISCUSSION A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.
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Affiliation(s)
- N Edwards
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
| | - S Walker
- Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - S-M Paddick
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Population Health Sciences Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - A M Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Chinnasamy
- Bradford Primary Care NHS Foundation Trust, Bradford, UK
| | - N Reddy
- Newcastle University, Newcastle-Upon-Tyne, UK
| | - I B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Mtei
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Nakkasuja
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - M Guerra
- Memory and Depression Centre, Cayetano Heredia Peruvian University, Peru
| | - N Sapkota
- B.P Koirala Institute of Health Sciences, Dhahran, Eastern Nepal, Nepal
| | - C Dotchin
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
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Physical multimorbidity predicts the onset and persistence of anxiety: A prospective analysis of the Irish Longitudinal Study on Ageing. J Affect Disord 2022; 309:71-76. [PMID: 35452758 DOI: 10.1016/j.jad.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aims of the present study were to examine prospective associations of multimorbidity (i.e., ≥2 chronic conditions) at baseline with incident and persistent anxiety over a two-year follow-up period among Irish older adults, and to quantify the extent to which sleep, pain, and disability mediate the multimorbidity-anxiety relationship. METHODS Data from The Irish Longitudinal Study on Aging (TILDA) conducted between 2009 and 2011 with a follow-up after two years were analyzed. Anxiety referred to score ≥ 8 on the anxiety section of the Hospital Anxiety and Depression Scale. Lifetime diagnosis of 14 chronic conditions was obtained. Outcomes were incident and persistent anxiety at two-year follow-up. RESULTS Data on 5871 adults aged ≥50 years at baseline were analyzed [Mean (SD) age 63.3 (9.0) years; 51.2% women]. After adjustment for potential confounders, compared to no chronic physical conditions at baseline, ≥3 chronic conditions were associated with a significant 1.89 (95% CI = 1.16-3.08) times higher risk for new onset anxiety at follow-up. Furthermore, having 1, 2, and ≥3 conditions at baseline were associated with significant 1.48 (95% CI 1.02, 2.14), 1.74 (95% CI 1.19, 2.53), and 1.84 (95% CI 1.27, 2.68) times higher risk for persistent anxiety at follow-up. Sleep problems, pain, and disability were identified as significant mediators, explaining 22.9%-37.8% of the associations. CONCLUSION Multimorbidity was associated with both new onset and persistent anxiety among Irish older adults. Future interventional studies should examine whether addressing the identified mediators may lead to lower risk for incident or persistent anxiety among those with physical multimorbidity.
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Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312786. [PMID: 34886512 PMCID: PMC8657712 DOI: 10.3390/ijerph182312786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Research on anxiety in oldest-old individuals is scarce. Specifically, incidence studies based on large community samples are lacking. The objective of this study is to assess age- and gender-specific incidence rates in a large sample of oldest-old individuals and to identify potential risk factors. The study included data from N = 702 adults aged 81 to 97 years. Anxiety symptoms were identified using the short form of the Geriatric Anxiety Inventory (GAI-SF). Associations of potential risk factors with anxiety incidence were analyzed using Cox proportional hazard models. Out of the N = 702 older adults, N = 77 individuals developed anxiety symptoms during the follow-up period. The incidence rate was 51.3 (95% CI: 41.2-64.1) per 1000 person-years in the overall sample, compared to 58.5 (95% CI: 43.2-72.4) in women and 37.3 (95% CI: 23.6-58.3) in men. Multivariable analysis showed an association of subjective memory complaints (HR: 2.03, 95% CI: 1.16-3.57) and depressive symptoms (HR: 3.20, 95% CI: 1.46-7.01) with incident anxiety in the follow-up. Incident anxiety is highly common in late life. Depressive symptoms and subjective memory complaints are major risk factors of new episodes. Incident anxiety appears to be a response to subjective memory complaints independent of depressive symptoms.
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Arpacıoğlu S, Yalçın M, Türkmenoğlu F, Ünübol B, Çelebi Çakıroğlu O. Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey. Psychogeriatrics 2021; 21:881-891. [PMID: 34545664 PMCID: PMC8661814 DOI: 10.1111/psyg.12762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The geriatric population is supposed to be at high risk for psychological distress as well as adverse outcomes and mortality during the COVID-19 pandemic. This study aimed to investigate the levels of depression, anxiety, death anxiety and life satisfaction levels and factors related to life satisfaction in individuals aged 65 years and older during the pandemic and to compare these variables between nursing home (NH) and community-dwelling older adults. METHOD This study has a cross-sectional and descriptive design, and a total of 133 nursing NH and community-dwelling older adults were enrolled in the study. Turkish death anxiety scale (TDAS), life satisfaction scale (SLS) and depression anxiety stress scale-21 (DASS-21) were used for the assessment. RESULTS The majority of the older adults had no or mild depression, anxiety and stress symptoms in spite of the prolonged confinements, and were slightly satisfied with their lives. However, depression, anxiety, stress and TDAS levels were higher in participants aged 80 years and older. Residents of NHs had higher TDAS, depression and anxiety levels and lower SLS levels than community-dwelling older adults. Participants who were meeting their children and/or grandchildren less than 2 h a week, were found to have significantly lower SLS and higher depression scores. The increase in depression and TDAS scores predicted a decrease in SLS scores in older adults. CONCLUSIONS As NH resident older adults have higher psychological distress and decreased life satisfaction due to the social isolation caused by the prolonged confinements, NH staff should be regularly informed on both preventive measures and mental health consequences of the pandemic, and should be trained for basic therapeutic interventions. Older adults should be supported to use telecommunication technologies to contact their families and friends, and participate in safe and accessible person-centred activity programs.
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Affiliation(s)
- Selim Arpacıoğlu
- Department of Psychiatry, School of MedicineAltınbaş UniversityIstanbulTurkey
| | - Murat Yalçın
- Department of PsychiatryUniversity of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research HospitalIstanbulTurkey
| | | | - Başak Ünübol
- Department of PsychiatryUniversity of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research HospitalIstanbulTurkey
| | - Oya Çelebi Çakıroğlu
- Department of Nursing Administration, Faculty of Health SciencesIstanbul Medeniyet UniversityIstanbulTurkey
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Sirin H, Ahmadi AA, Ketrez G, Ozbeyaz C, Dikmen AU, Ozkan S. Assessment of anxiety in elderly population during the COVID-19 pandemic and the impact of compulsory home-stay in the central districts of Ankara, Turkey: A quantitative, qualitative mixed method study. Int J Geriatr Psychiatry 2021; 36:1785-1794. [PMID: 34231924 PMCID: PMC8420385 DOI: 10.1002/gps.5600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to determine the level of anxiety in elderly individuals during the COVID-19 pandemic in Ankara province of Turkey and determine its associated factors. METHODS A quantitative, qualitative mixed-method study performed in 1-10 June 2020 during the compulsory home-stay for elderly people in Turkey. The quantitative study was conducted using a structured online questionnaire with 278 participants aged 65 or older. The Geriatric Anxiety Inventory (GAI) was used to assess the anxiety. An in-depth interview with 20 participants was used to fill the gap of face-to-face interview due to pandemic situation and strengthen the results of quantitative survey. Qualitative and quantitative data were analyzed separately. RESULTS Of all participants, 88 (31.7%) had a score above the cut-off point for GAI. The prevalence of Generalized Anxiety Disorder (GAD) was significantly higher in female (37.8%) than in male (23.8%). Female gender, economic loss, uncertainty, and the time participants expend to follow news about COVID-19 pandemic were risk factors of GAD. On the other hand, higher education level, hobbies, and regular physical activity were protective factors against GAD. CONCLUSION During the pandemic, social isolation and lockdown for elderly people make serious risk factor for their mental well-being. Measures must be taken to support the psychological well-being of elderly by promoting physical activity and hobbies at home, and reducing their economic concerns.
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Affiliation(s)
- Hulya Sirin
- Public Health DepartmentUniversity of Health SciencesAnkaraTurkey
| | | | - Gamze Ketrez
- Public Health DepartmentUniversity of Health SciencesAnkaraTurkey
| | - Cagri Ozbeyaz
- Public Health DepartmentUniversity of Health SciencesAnkaraTurkey
| | | | - Secil Ozkan
- Public Health DepartmentGazi UniversityAnkaraTurkey
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Yurumez Korkmaz B, Gemci E, Cosarderelioglu C, Yigit S, Atmis V, Yalcin A, Varli M, Aras S. Attitudes of a geriatric population towards risks about COVID-19 pandemic: in the context of anxiety and depression. Psychogeriatrics 2021; 21:730-737. [PMID: 34132456 PMCID: PMC8447059 DOI: 10.1111/psyg.12731] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND A curfew for elderly people was announced in Turkey to protect the geriatric population during the COVID-19 pandemic. Although this may have the beneficial effect of preventing infection, psychological distress may also increase with prolongation of the pandemic. METHODS Geriatric patients were interviewed by telephone due to the ongoing curfew. Demographical characteristics, comorbidities, personal risk perception of COVID-19, common concerns related to COVID-19, and experiences of delayed hospital admission due to the pandemic were recorded. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological distress, anxiety, and depression. RESULTS Participants (n = 136; 82 females, 60.3%) had a mean age of 73.4 ± 5.9 years. The most common comorbidity was hypertension (75%). Approximately 80% of the participants reported a decrease in physical activity during the curfew period. The HADS scores indicated rates of anxiety as 25.7% and depression as 16.9%. Anxiety was significantly more common in females than males (P = 0.002). Sleep problems (P = 0.000), fatigue (P = 0.000), and hopelessness (P = 0.000) were more common in participants with depression and anxiety. Logistic regression analyses showed an association between a delay in hospital admission and the presence of depression (P = 0.0029, R2 = 0.146). Personal risk perception of COVID-19 was statistically significantly higher among patients with anxiety (P = 0.0027, R2 = 0.157). CONCLUSION Decreased adaptation to external and internal factors among older individuals may facilitate unfavourable outcomes of the pandemic. These results indicate that the geriatric population was mentally and physically affected by the restrictions and isolation.
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Affiliation(s)
- Busra Yurumez Korkmaz
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emine Gemci
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Caglar Cosarderelioglu
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seher Yigit
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Volkan Atmis
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Yalcin
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Murat Varli
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sevgi Aras
- Division of Geriatrics, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
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12
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Soori S, Heirani A, Rafie F. Effects of the aerobic and Pilates exercises on mental health in inactive older women. J Women Aging 2021; 34:429-437. [PMID: 33998393 DOI: 10.1080/08952841.2021.1924576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to compare the effect of the Aerobic and Pilates exercises on mental health in inactive older women. Seventy-five inactive aged women were randomly divided into three groups (n = 25); aerobic (62.48 ± 2.87 years), Pilates (62.66 ± 1.68 years), and control group (63.80 ± 3.35 years). The Goldberg General Health Questionnaire assessed mental health. The exercise program was performed for 12 weeks. The results indicate that Pilates exercises are more valuable than aerobic training in depression (p ≤ .05). However, in other mental health components, the difference between the two exercise groups was not statistically significant. According to our results, physical activity, particularly Pilates and aerobic exercises, improves physical health and has a close correlation with the mental health of inactive older women. These results highlight the role of these physical exercise training in older women.
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Affiliation(s)
| | - Ali Heirani
- Department of Motor Behavior, Faculty of Sports Sciences, Razi University, Kermanshah, Iran
| | - Forouzan Rafie
- Neuroscience Research Center, Medical Science University of Kerman, Kerman, Iran
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13
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Shati M, Mortazavi SS, Taban M, Malakouti SK, Mehravaran S, Norouzi A, Pachana NA. Psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form. Med J Islam Repub Iran 2021; 35:47. [PMID: 34268235 PMCID: PMC8271228 DOI: 10.47176/mjiri.35.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Despite studies about anxiety in the older adult, the prevalence of anxiety in this age group is not exactly clear, which may be due to the use of tools and criteria that were not born for this age group. One of the instruments designed to assess anxiety in the elderly is the Geriatric Anxiety Inventory (GAI). The aim of this research was to analyze the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form (GAI-PV-SF) in a sample of older adults in Iran. Methods: In this cross-sectional study, a sample of 150 community-dwelling and a psychogeriatric sample of 48 adults older than 60 years completed the GAI-PV and GAI-PV-SF, the anxiety sub-scale of the General Health Questionnaire (GHQ-28), the Geriatric Depression Scale (GDS-15), and the Structured Clinical Interview for DSM-IV (SCID-I). Different types of validity and reliability were evaluated for GAI-PV and GAI-PV-SF using SPSS and the LISREL software. Results: Both the GAI-PV and GAI-PV-SF exhibited excellent internal consistency (over 80 %) and desirable concurrent validity against GHQ-28 and GDS-15. The optimal cutpoint score to detect current generalized anxiety disorder (GAD) was 10/11 and 13/14 for GAI-PV in the community-dwelling and psychogeriatric samples, respectively, and 3/4 for GAI-PV-SF in both study samples. Good test-retest reliability (correlation coefficient: 0.96 and 0.88 for GAI-PV and GAI-PV-SF, respectively) and a single-factor structure were also demonstrated. Conclusion: Sound psychometric properties of the GAI-PV in both subsamples suggest that the instrument could be used successfully as an accurate screening instrument in the elderly Iranian population.
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Affiliation(s)
- Mohsen Shati
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Seyede Salehe Mortazavi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry) Iran University of Medical Sciences, Tehran, Iran
- Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Taban
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kazem Malakouti
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva Mehravaran
- ASCEND Center for Biomedical Research, Morgan State University, Baltimore, MD, USA
| | - Ali Norouzi
- Medical Education Department, Medical School, Tehran University of Medical Sciences, Tehran, Iran
- Education Development Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nancy A. Pachana
- School of Psychology, University of Queensland, Brisbane, Australia
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14
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Lowe R, Menzies R, Onslow M, Packman A, O'Brian S. Speech and Anxiety Management With Persistent Stuttering: Current Status and Essential Research. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:59-74. [PMID: 33400555 PMCID: PMC8608149 DOI: 10.1044/2020_jslhr-20-00144] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/16/2020] [Accepted: 10/22/2020] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this review article is to provide an overview of the current evidence base for the behavioral management of stuttering and associated social anxiety. Method We overview recent research about stuttering and social anxiety in the context of contemporary cognitive models of social anxiety disorder. That emerging evidence for self-focused attention and safety behavior use with those who stutter is considered in relation to current treatment approaches for stuttering: speech restructuring and social anxiety management. Results The emerging information about social anxiety and stuttering suggests a conflict between the two clinical approaches. For those clients who wish to control their stuttering and where speech restructuring is deemed the most suitable approach, it is possible that speech restructuring may (a) induce or increase self-focused attention, (b) promote the use of safety behaviors, and (c) become a safety behavior itself. This conflict needs to be explored further within clinical and research contexts. Conclusions The issues raised in this review article are complex. It appears that evidence-based speech treatment procedures are in conflict with current best-practice treatment procedures that deal with social anxiety. In this review article, we propose directions for future research to inform the development of improved treatments for those who stutter and recommendations for interim clinical management of stuttering.
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Affiliation(s)
- Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
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15
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Van Assche L, Van de Ven L, Vandenbulcke M, Luyten P. Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life. Aging Ment Health 2020; 24:898-905. [PMID: 30739477 DOI: 10.1080/13607863.2019.1571017] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: Research suggests that vulnerability for anxiety and depression in late life results from a complex interaction between (neuro)biological and environmental factors. In this context, there is growing evidence for the role of childhood trauma on vulnerability for both anxiety and depression throughout the course of life, mainly through its effects on attachment as a biologically based neurodevelopmental stress regulation system. Yet, the impact of childhood trauma on depression and anxiety in late life specifically remains unclear. The current study therefore aims to investigate the association between retrospectively reported childhood interpersonal trauma, attachment dimensions and levels of anxiety and depression in late life.Method: A sample of 81 community dwelling older adults completed measures of early and current adversity, attachment dimensions, and levels of anxiety and depression.Results: The occurrence and frequency of childhood trauma, but not later negative adult life events, was associated with late life anxiety and depression. Both attachment anxiety and avoidance were related to anxiety and depression. Only attachment anxiety affected the association between childhood trauma, and emotional neglect in particular, and late life anxiety and depression.Conclusion: Childhood trauma may be associated with anxiety and depression in late life. Part of this association is probably indirect, via the effect of insecure attachment and high levels of attachment anxiety in particular.
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Affiliation(s)
- Lies Van Assche
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Luc Van de Ven
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Mathieu Vandenbulcke
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium.,Research Department of Clinical Educational and Health Psychology, University College London, London, UK
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16
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Menta C, Bisol LW, Nogueira EL, Engroff P, Cataldo Neto A. Prevalence and correlates of generalized anxiety disorder among elderly people in primary health care. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To examine the prevalence of generalized anxiety disorder (GAD) and its associations with sociodemographic and health factors. Methods A cross-sectional study with a population-based sample of 578 individuals aged 60 years or older from the Family Health Strategy (FHS) program of Porto Alegre, RS, Brazil. Home visit screening and general data collection were made by trained Community Health Workers (CHWs). Diagnoses of psychiatric disorders were made by board-certified psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus) in the Hospital São Lucas of the Pontifical University of Rio Grande do Sul (PUCRS). Results GAD was found in 9% of the sample (n = 52; CI 95% = 6.9-11.6). The main results of the multivariate analysis show associations between GAD and retirement (PR: 0.43, CI: 0.25-0.76), history of falls (PR: 2.52, CI: 1.42-4.49), cohabitation with four or more people (PR: 1.80, CI: 1.04-3.13), having more than one hospitalization in the last year (PR: 2.53, CI: 1.17-5.48) and self-perception of health as regular (PR: 2.75, CI: 1.02-7.47). Retirement in the elderly shows 2.32x less risk of GAD, although confounding factors may have overestimated this finding and underestimated the association with female gender (PR: 1.61, CI: 0.83-3.10). Conclusions We estimate a high prevalence of GAD in this population. Associations were found between GAD and health self-perceived as regular, cohabitation with four or more people, history of falls and more than one hospitalization in the last year. These epidemiological data from the Family Health Strategy are important to develop further strategies for this age group that could improve the health care practice.
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Affiliation(s)
- Caroline Menta
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | | | - Eduardo Lopes Nogueira
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - Paula Engroff
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - Alfredo Cataldo Neto
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
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17
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Zhu X, Hu Z, Nie Y, Zhu T, Chiwanda Kaminga A, Yu Y, Xu H. The prevalence of poor sleep quality and associated risk factors among Chinese elderly adults in nursing homes: A cross-sectional study. PLoS One 2020; 15:e0232834. [PMID: 32413064 PMCID: PMC7228093 DOI: 10.1371/journal.pone.0232834] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes. Methods A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined. Results The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70–79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86). Conclusions The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.
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Affiliation(s)
- Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Nie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunhan Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- * E-mail:
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18
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Anbari-Nogyni Z, Bidaki R, Madadizadeh F, Sangsefidi ZS, Fallahzadeh H, Karimi-Nazari E, Nadjarzadeh A. Relationship of zinc status with depression and anxiety among elderly population. Clin Nutr ESPEN 2020; 37:233-239. [PMID: 32359749 DOI: 10.1016/j.clnesp.2020.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/24/2019] [Accepted: 02/15/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Population aging is a global challenge. Old populations are prone to zinc deficiency. This study aimed to determine the association of zinc status with depression and anxiety among men and women aged 60+ years old. METHODS In this cross-sectional study, 297 elderly participants (144 males and 153 females) were studied. The dietary and serum zinc were assessed using a three-day dietary record and an auto-analyzer, respectively. Depression and anxiety were measured using Geriatric Depression Scale and Hamilton Anxiety Rating Scale, respectively. Chi-squared test was used to compare qualitative variables. Multiple logistic regression analysis was conducted to assess relationship between zinc status and depression/anxiety. RESULTS The total zinc deficiency based on serum values was 23.2%. Dietary intake of zinc in 72.4%of participants was less than of the Estimated Average Requirement (EAR). The total depression prevalence was 42.2%. Moreover, 52.5% of the participants suffered from anxiety. The odds of depression among participants in the third tertile of serum zinc concentration was 51% lower than those in the first tertile (OR = 0.49, CI = 0.25-0.96, p = 0.03). No significant relationship was found between zinc intake and depression. Furthermore, serum or dietary zinc levels were not related to anxiety. CONCLUSIONS This study showed a considerable zinc deficiency and depression/anxiety in the old population. A significant relation was found between serum zinc concentration and depression. Further surveys, especially cohort studies and clinical trials are needed to confirm these results.
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Affiliation(s)
- Zainab Anbari-Nogyni
- Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Bidaki
- Psychiatrist Associate Professor, Research Center of Addiction and Behavioral Sciences, Yazd, Iran; Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farzan Madadizadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Departments of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zohreh Sadat Sangsefidi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Departments of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Karimi-Nazari
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Prevalence and Characterization of Specific Phobia Disorder in People over 65 Years Old in a Madrid Community Sample (Spain) and its Relationship to Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061915. [PMID: 32183487 PMCID: PMC7143732 DOI: 10.3390/ijerph17061915] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 12/17/2022]
Abstract
The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of older people, the age of onset of specific phobia disorder, and the duration of episodes. In total, 555 community-dwelling people aged between 65 and 84 years who lived in Madrid (Spain) were assessed (Composite International Diagnostic Interview for people over 65 years (CIDI65+), WHO Disability Assessment Schedule (WHODAS II), Health of the Nation Outcome Scales for Older Adults (HoNOS65+), World Health Organization Quality of Life Brief (WHOQOL-BREF). Prevalence rates and odds ratio, t-tests, binary logistic regression, and point-biserial correlations were calculated. A total of 12.07% of the sample suffered a specific phobia disorder over the last year. The average age at onset of the specific phobia was 38.78 (sd = 21.61) years. The mean duration of the phobia was approximately 20 (sd = 20) years. A significant effect of the specific phobia was found for the current levels of functioning and quality of life: WHOQOL-BREF total score (p < 0.05), WHODAS II overall score (p < 0.01), and HoNOS65+ total score (p < 0.001). Having specific phobia disorder decreased the level of functioning and negatively affected the quality of life. These data suggest the need for primary healthcare professionals to include the detection of specific phobia disorders in their protocols because people do not receive treatment for this problem, and they might carry it throughout their lives.
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20
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Patel M, Bhardwaj P, Nebhinani N, Goel AD, Patel K. Prevalence of psychiatric disorders among older adults in Jodhpur and stakeholders perspective on responsive health system. J Family Med Prim Care 2020; 9:714-720. [PMID: 32318408 PMCID: PMC7113956 DOI: 10.4103/jfmpc.jfmpc_1016_19] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/12/2020] [Accepted: 01/22/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Ageing is an inescapable reality of human existence. The elderly population of India is steadily increasing with growing mental health needs which pose many challenges for the health care system. The aim of this study is to assess anxiety, depression, and cognitive disorders among urban and rural elderly and to explore the availability of social support mechanisms and a responsive health system for elderly. Methods: This study is a mixed-method approach. For a quantitative study, a community-based cross-sectional survey is conducted in Jodhpur, Rajasthan. A total of 330 elderly persons aged 60 years and above are randomly screened for depression (GDS), anxiety (GAD), and cognitive impairment (HMSE). Further for a qualitative study, in-depth interviews are conducted with 7 key informants including policy and program managers, service providers, and facilitators from the state. For quantitative data analysis, Excel and SPSS are used and for Qualitative data analysis, Thematic Framework Approach is used. Results: The mean age of the respondents is 67.9 ± 7.8. The prevalence of severe depression is 17%, severe anxiety is 10.3%, and cognitive impairment is 51.2%. The prevalence of all the three is more in rural elderly as compared to urban elderly as well as more in female individuals as compared to males. Qualitative analysis revealed that there are challenges in early identification of mental disorders at both the levels: service providers and elderly. Psychological and financial issues are also seen in elderly who are not supported by their children. There are cases of fear for elder abuse and influence of western culture in the society. Conclusion: There is a sizeable prevalence of psychological issues in elderly population. Therefore, there is a need to adopt holistic and integrated psychogeriatric services for the improvement of quality of life in elderly.
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Affiliation(s)
- Mamta Patel
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India.,Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | | | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
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21
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Schiel JE, Spiegelhalder K. [Interaction of insomnia in old age and associated diseases : Cognitive, behavioral and neurobiological aspects]. Z Gerontol Geriatr 2020; 53:112-118. [PMID: 32020285 DOI: 10.1007/s00391-020-01694-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/19/2019] [Indexed: 12/16/2022]
Abstract
The prevalence of insomnia is particularly high in old age. Sleep disturbances and impaired daytime functioning reflected in mood swings and concentration difficulties are often accompanied by other mental disorders such as depression. The objective of this article is to shed light on the role of insomnia in the context of frequent comorbidities in middle and old age. The focus is on the identification of linkage points between insomnia and associated diseases on a neurobiological level; however, possible distinguishing features are also named and deliberations on cognitive behavioral aspects and integrative theories, such as the hyperarousal theory are discussed. In order to provide an outlook for future research opportunities, the UK Biobank is presented as a promising resource of long-term data. Finally, the contents of the preceding deliberations are critically reflected and practical implications for the treatment of older patients with insomnia are derived.
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Affiliation(s)
- J E Schiel
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität, Hauptstr. 6, 79104, Freiburg, Deutschland.
| | - K Spiegelhalder
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität, Hauptstr. 6, 79104, Freiburg, Deutschland
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22
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Azevedo DSS, Lima EP, Gunn V, Muntaner C, Ng E, Assunção AA. Anxiety and contradictory class position in the hierarchy of Brazilian firefighters. Am J Ind Med 2019; 62:1007-1013. [PMID: 31483067 DOI: 10.1002/ajim.23046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Workers holding intermediate hierarchical positions in an institution may have a higher risk of occupational stress-related, ill health. This study examined the prevalence rates and odds ratios (ORs) of anxiety disorders among a hierarchical group of firefighters. METHODS This cross-sectional study samples firefighters from Minas Gerais, Brazil, who answered a structured questionnaire in 2011 (survey completion rate = 89.5%). The outcome of interest was a medical diagnosis of anxiety disorder. Bivariate and multivariate analyses were conducted among five hierarchical occupational positions: privates (lowest position), corporals, sergeants (intermediate position), sub lieutenants, and officers (highest position). RESULTS Overall, 8.4% of the sample reported an anxiety disorder, with the highest rate observed among intermediate workers (sergeants = 14.2%), followed by corporals (10%), privates (5.6%), sub lieutenants (5%), and officers (2.1%). Compared with privates, the unadjusted OR for sergeants was 2.49 (95% confidence interval, 1.35, 4.58). This finding remained statistically significant after adjustment for several control variables but was eliminated by age. CONCLUSION The mental health of firefighters is affected by social class position. Mental health promotion efforts should focus on longitudinal research and work toward interventions aimed at modifying the hierarchical structure of workplaces.
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Affiliation(s)
| | - Eduardo P. Lima
- Department of Preventive MedicineFaculty of Medicine at UFMG Belo Horizonte Brazil
| | - Virginia Gunn
- Department of Preventive Medicine, Lawrence S. Bloomberg Faculty of NursingUniversity of Toronto Toronto Ontario Canada
| | - Carles Muntaner
- Department of Preventive Medicine, Lawrence S. Bloomberg Faculty of NursingUniversity of Toronto Toronto Ontario Canada
| | - Edwin Ng
- Department of Preventive Medicine, School of Social WorkUniversity of Waterloo Waterloo Ontario Canada
| | - Ada A. Assunção
- Department of Preventive MedicineFaculty of Medicine at UFMG Belo Horizonte Brazil
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23
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Grenier S, Payette MC, Gunther B, Askari S, Desjardins FF, Raymond B, Berbiche D. Association of age and gender with anxiety disorders in older adults: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2019; 34:397-407. [PMID: 30444008 DOI: 10.1002/gps.5035] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/03/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To provide an estimate of 12-month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age. METHODS/DESIGN A systematic review and meta-analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender. RESULTS A total of 6464 studies were identified, and 16 studies were included in the meta-analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12-month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post-traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively). CONCLUSIONS Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups.
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Affiliation(s)
- Sébastien Grenier
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.,Département de psychologie, Université de Montréal, Montréal, Quebec, Canada
| | - Marie-Christine Payette
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Bruno Gunther
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.,Département de psychologie, Université de Montréal, Montréal, Quebec, Canada
| | - Sorayya Askari
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Frédérique F Desjardins
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.,Département de psychologie, Université de Montréal, Montréal, Quebec, Canada
| | - Béatrice Raymond
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Djamal Berbiche
- Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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24
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Welzel FD, Stein J, Röhr S, Fuchs A, Pentzek M, Mösch E, Bickel H, Weyerer S, Werle J, Wiese B, Oey A, Hajek A, König HH, Heser K, Keineidam L, van den Bussche H, van der Leeden C, Maier W, Scherer M, Wagner M, Riedel-Heller SG. Prevalence of Anxiety Symptoms and Their Association With Loss Experience in a Large Cohort Sample of the Oldest-Old. Results of the AgeCoDe/AgeQualiDe Study. Front Psychiatry 2019; 10:285. [PMID: 31139097 PMCID: PMC6518947 DOI: 10.3389/fpsyt.2019.00285] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Anxiety in adults is a common mental health problem. However, studies on anxiety in the oldest-old are lacking. We sought to identify the age- and gender-specific prevalence of anxiety symptoms in a large sample of general practice patients. Furthermore, we investigated relevant associations of anxiety specifically with respect to recent experience of loss. Methods: Based on the German Study on Ageing, Cognition and Dementia in general practice patients, a sample of 897 patients aged 82 years and older was assessed. Anxiety was assessed using the short form of the Geriatric Anxiety Inventory (GAI-SF). For the assessment of loss, patients were asked whether there were cases of death in their closer social environment since the last assessment. Descriptive and logistic regression analyses were run. Results: Of the oldest-old individuals (aged 82+ years, mean age: 86.8), 14.5% (95% CI 12.4-16.8) suffered from anxiety symptoms. Highest prevalence rates were found for 82- to 85-year-old women (17.2%, 95% CI 12.6-22.1) and for 86- to 90-year-old patients (both sexes) in general (15.9%, 95% CI 12.6-19.2). Older individuals who experienced cases of death in their close social environment within the last 18 months had almost twice the odds [odds ratio (OR) 1.91, 95% confidence interval (CI) 1.15-3.17] of reporting anxiety compared to those without a recent loss. As expected, depression and impaired cognitive status were associated with the presence of anxiety symptoms. No relation was found between social network, gender, age, frailty, or physical illness and anxiety in regression analysis. Conclusions: This study provides for the first time age- and gender-specific prevalence rates of anxiety symptoms and associated risk factors among a large population-based sample of oldest-old primary care attenders. Anxiety is highly prevalent in individuals aged 82 years and older. Depression, impaired cognitive status, and recent experience of loss are associated with late-life anxiety. Our findings support the idea that recent experience of loss should be taken seriously in the context of clinical practice with respect to diagnosing and treating anxiety in old age.
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Affiliation(s)
- Franziska D Welzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Birgitt Wiese
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Luca Keineidam
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin van der Leeden
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
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25
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Cisneros GE, Ausín B. [Prevalence of anxiety disorders in people over 65 years-old: A systematic review]. Rev Esp Geriatr Gerontol 2018; 54:34-48. [PMID: 30340781 DOI: 10.1016/j.regg.2018.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 10/28/2022]
Abstract
Anxiety is an emotional problem that causes discomfort and suffering to those that suffer from it. Anxiety disorders can affect the functioning in different facets of a person's life. Studies on the prevalence of anxiety disorders in people over 65 years show variable results, ranging between 0.1% and 17.2%. Most of these studies include samples of the general population, in which the population of people over 65 years is under-represented. These studies evaluate older people with the same diagnostic tools used to assess anxiety disorders in people under 65 years, and collect data from people between 65 and 75 years old, leaving out people aged 75 and over. A systematic review of the prevalence studies of anxiety disorders in elderly people is presented. It is concluded that when representative samples of people over 65 years are used and evaluated with suitable tools, the prevalence rate of these disorders in the elderly is much higher than previously thought, reaching an annual prevalence rate of 20.8%.
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Affiliation(s)
| | - Berta Ausín
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, España.
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26
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Creighton AS, Davison TE, Kissane DW. The prevalence, reporting, and treatment of anxiety among older adults in nursing homes and other residential aged care facilities. J Affect Disord 2018; 227:416-423. [PMID: 29154158 DOI: 10.1016/j.jad.2017.11.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/29/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Little is known about anxiety in aged care populations, despite its increase in this frail population. This study investigated the prevalence, recording, and treatment rate of anxiety disorders among aged care residents. METHODS A cross-sectional, observational design was used to assess 180 elderly residents from 12 aged care facilities in Melbourne, Australia. Participants were assessed for threshold and subthreshold anxiety disorders and comorbid depression using the MINI for DSM-5. Medical files were also reviewed to determine whether there was any indication that anxiety had previously been detected, and what treatment those with a threshold/subthreshold diagnosis were receiving. RESULTS Overall prevalence of threshold and subthreshold anxiety disorders was 19.4% and 11.7%, respectively. Generalized anxiety disorder was the most common threshold disorder and agoraphobia was the most prevalent subthreshold anxiety disorder. While less than half of those with a threshold or subthreshold anxiety disorder had an indication of anxiety in their file, the majority received psychotropic medication. Cognitive impairment was not significantly associated with the prevalence or treatment of anxiety. CONCLUSIONS The prevalence of threshold and subthreshold anxiety in aged care settings is high, but remains under-reported by staff and GPs. Facility staff and GPs should ensure they are aware of how anxiety presents in elderly residents and routinely screen for this common mental health issue. This cohort had poor access to psychological treatments for their condition.
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Affiliation(s)
- Alexandra S Creighton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Tanya E Davison
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia; Institute for Health & Ageing, Australian Catholic University, Melbourne, Victoria, Australia
| | - David W Kissane
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia.
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27
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Bakkane Bendixen A, Hartberg CB, Selbæk G, Engedal K. Symptoms of Anxiety in Older Adults with Depression, Dementia, or Psychosis: A Principal Component Analysis of the Geriatric Anxiety Inventory. Dement Geriatr Cogn Disord 2018; 42:310-322. [PMID: 27811466 DOI: 10.1159/000452272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS The primary aim of this study was to examine anxiety symptoms as measured by the Geriatric Anxiety Inventory (GAI) in older patients with depression, dementia, or psychotic disorders. The secondary aim was to conduct a principal component analysis (PCA) of the GAI and to examine whether its subscales differ between the 3 disorders. METHODS We included data from 428 patients who were admitted to a department of geriatric psychiatry and examined according to a standardized protocol. The GAI was used to measure current anxiety symptoms. RESULTS The GAI symptoms occurred more frequently in the group with depression than in the other 2 groups. The PCA of the GAI with oblimin rotation resulted in a 2-component solution, labelled as "worries" (explained variance 46.3%, Cronbach's α 0.92) and "physical symptoms" (explained variance 7.1%, Cronbach's α 0.85). CONCLUSION The results indicate that in old age, anxiety is especially prevalent in depression. The 2-component solution indicates that the GAI measures 2 different aspects of anxiety with different symptomatology.
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28
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Burke SL, O'Driscoll J, Alcide A, Li T. Moderating risk of Alzheimer's disease through the use of anxiolytic agents. Int J Geriatr Psychiatry 2017; 32:1312-1321. [PMID: 27805724 PMCID: PMC5441966 DOI: 10.1002/gps.4614] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/24/2016] [Accepted: 09/27/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Anxiety diagnoses occur in 17.1% in people age 65 years and older. Individuals with anxiety may be at a higher risk of the development of probable Alzheimer's disease (AD). Previous literature has suggested that anxiolytic medications may exacerbate the risk of AD development. This study explored anxiolytic medication as a potential moderator of AD risk in older adults. METHODS A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was undertaken, analyzing observations from 12,083 participants with normal cognition at the first visit. Survival analysis was utilized to examine if anxiolytic medication use by those with anxiety and/or APOE ɛ4 moderates the hazard of AD and/or MCI development. RESULTS The hazard of probable AD (HR = 3.50, [2.77 - 4.44], p < .0001) or MCI (HR = 2.13, [1.85-2.44], p < .0001) development was statistically significant for those with anxiety. This hazard was no longer statistically significant when specific anxiolytics were used. ɛ4 carriers experienced a statistically significant hazard of AD (HR = 1.92, [1.52-2.41], p < .001) and MCI (HR = 1.17, [1.04-1.32], p < .05) development. This effect was moderated by the use of anxiolytics. DISCUSSION The results of this study suggest that anxiolytics may moderate the effect of anxiety on MCI and AD development, specifically indicating a neutralized hazard for those with ɛ4 carriers with anxiety. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shanna L Burke
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, FL, USA
| | - Janice O'Driscoll
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, FL, USA
| | - Amary Alcide
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, FL, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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29
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Cybulski M, Cybulski L, Krajewska-Kulak E, Cwalina U. Self-assessment of the mental health status in older adults in Poland: a cross-sectional study. BMC Psychiatry 2017; 17:383. [PMID: 29191171 PMCID: PMC5709832 DOI: 10.1186/s12888-017-1557-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/24/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Demographic aging of society poses numerous challenges, including the provision of health care to the elderly population. According to World Health Organization data, the most frequent mental disorders in the senior population are: dementia, depression, and drug and alcohol addiction. The aim of this study was to subjectively assess mental health status (the severity of non-psychotic symptoms of mental functions and depressive symptoms) in older adults of Bialystok (Poland). METHODS The study included 300 people - inhabitants of Bialystok and its surrounding areas - aged over 60: 100 residents of a nursing home, 100 senior students of the University of the Third Age in Bialystok, and 100 senior students of the University of a Healthy Senior. Two standardized psychometric scales were used in the study: the General Health Questionnaire (GHQ-28) and the Beck Depression Inventory (BDI). RESULTS The median GHQ total point value equaled 26 points, which indicated possible non-psychotic mental disorders. The overall BDI score showed that respondents had a subjective feeling of depressive symptom intensification at the level of 11 points out of 63 points, which indicated minor depressive disorders. Positive and statistically significant correlations were observed between suspicion of non-psychotic mental disorders and the occurrence of depressive symptoms both without distribution into groups and with distribution into sex, group affiliation, and age. CONCLUSIONS Subjective assessment of mental health status in older adults, inhabitants of Bialystok, was negative. Social and demographic characteristics (sex, group affiliation, age) analyzed in the study, played no significant role in the assessment of depressive and non-psychotic mental symptom occurrence. Residents of the nursing home were characterized negatively in terms of subjective assessment mental health status from the other two study groups.
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Affiliation(s)
- Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland.
| | - Lukasz Cybulski
- 0000 0001 2149 6795grid.412607.6National Security student, Faculty of Social Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Elzbieta Krajewska-Kulak
- 0000000122482838grid.48324.39Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Urszula Cwalina
- 0000000122482838grid.48324.39Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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30
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Carreira Capeáns C, Facal D. [Anxiety in a representative sample of the Spanish population over 50 years-old]. Rev Esp Geriatr Gerontol 2017; 52:197-200. [PMID: 28559095 DOI: 10.1016/j.regg.2017.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/14/2017] [Accepted: 02/21/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Anxiety is common throughout the ageing process. The objective of this study is to estimate the prevalence of anxiety in a representative sample of the Spanish population over 50 years-old. MATERIAL AND METHODS The data of this study come from the Pilot Study developed within the Longitudinal Ageing Study in Spain (ELES), in which a representative sample of the non-institutionalised Spanish population was evaluated. An analysis was performed on the data of 1086 people who answered the question «I am now going to read a list with a series of diseases or health problems. I would like you to tell me if your doctor has diagnosed any of them». The tools used were a questionnaire consisting of 218 questions, along with standardised tests, such as the Spanish version of the Mini-Mental State Examination. RESULTS Anxiety was reported to have been diagnosed at some time in 14.3% of the sample. The prevalence was higher in women than in men (77.8 vs. 22.2%), decreasing with age, and related to different chronic diseases. CONCLUSIONS The results show that the prevalence of anxiety throughout the lifespan is noticeable in people over 50 years, and should be taken into account, especially in the female population and in those with chronic diseases.
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Affiliation(s)
- Cecilia Carreira Capeáns
- Departamento de Psicoloxía Evolutiva e da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, España
| | - David Facal
- Departamento de Psicoloxía Evolutiva e da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, España.
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31
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Aggarwal R, Kunik M, Asghar-Ali A. Anxiety in Later Life. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2017; 15:157-161. [PMID: 31975848 DOI: 10.1176/appi.focus.20160045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The spectrum of anxiety disorders occurring in later life is diverse and includes the same disorders that occur with younger adults-such as generalized anxiety disorder, panic disorder, specific phobias, and social anxiety disorder-but also unique presentations, including a fear of falling and the anxiety often seen in various neurocognitive disorders. Therefore, diagnosis and treatment are arguably more challenging in older populations. In addition, many older adults have subthreshold symptoms that can benefit from proper management. This article summarizes the literature on anxiety disorder presentations in later life and offers key recommendations to assist clinicians working with this growing population.
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Affiliation(s)
- Ruchi Aggarwal
- The authors are with the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston. Dr. Aggarwal is also with the Mental Health Careline, Michael E. DeBakey Veterans Affairs Medical Center (VAMC), Houston. Dr. Asghar-Ali is also with the South Central Mental Illness Research, Education and Clinical Center, and Dr. Kunik is also chief of the Behavioral Health and Implementation Program, VA Health Services Research and Development (HSR&D) Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VAMC
| | - Mark Kunik
- The authors are with the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston. Dr. Aggarwal is also with the Mental Health Careline, Michael E. DeBakey Veterans Affairs Medical Center (VAMC), Houston. Dr. Asghar-Ali is also with the South Central Mental Illness Research, Education and Clinical Center, and Dr. Kunik is also chief of the Behavioral Health and Implementation Program, VA Health Services Research and Development (HSR&D) Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VAMC
| | - Ali Asghar-Ali
- The authors are with the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston. Dr. Aggarwal is also with the Mental Health Careline, Michael E. DeBakey Veterans Affairs Medical Center (VAMC), Houston. Dr. Asghar-Ali is also with the South Central Mental Illness Research, Education and Clinical Center, and Dr. Kunik is also chief of the Behavioral Health and Implementation Program, VA Health Services Research and Development (HSR&D) Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VAMC
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32
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Creighton AS, Davison TE, Kissane DW. The correlates of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review. Int J Geriatr Psychiatry 2017; 32:141-154. [PMID: 27753141 DOI: 10.1002/gps.4604] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 08/29/2016] [Accepted: 09/15/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To synthesize and summarize the studies examining the correlates and predictors of anxiety in older adults living in residential aged care. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to peer-reviewed literature published in English. Eligible studies examined the association between at least one correlate/factor and anxiety disorders or symptoms in aged care residents aged 50+ years. RESULTS A total of 3741 articles were identified, of which 34 studies (with a total of 1 543 554 participants) were included in this review. Correlates associated with anxiety included pain, use of anti-depressants/lithium, depression, and lower perceived quality of life. Less consistent and/or less studied variables included younger age, female gender, higher educational level, functional dependence, subjective health status, more prescribed medications, impaired vision, insomnia, external locus of control, fear of falling, attachment, hope, meaning in life, and the influence of social, environmental, and staff/policy correlates. CONCLUSIONS While several variables were found to have strong associations with anxiety in aged care residents, a number of factors have been examined by only one or two studies. Further research (preferably prospective studies) is therefore needed to reliably confirm findings and to help plan and develop preventative and intervention strategies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Alexandra S Creighton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Tanya E Davison
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - David W Kissane
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
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Abstract
OBJECTIVES Our aims were to explore prevalence of anxiety among patients admitted to departments of geriatric psychiatry for treatment of various diagnoses and to examine how often anxiety was registered as a previous or ongoing diagnosis. METHOD In all, 473 patients admitted to one of five departments of geriatric psychiatry were included in a quality register and examined according to a standardized protocol. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety during the first week after admission. Diagnoses were made at discharge. RESULTS Using a cutoff on the GAI of 8/9, the prevalence of anxiety for the following diagnostic groups was depression 65.3%, psychosis 28%, dementia 38.8% and mania 33.3%. Of 24 patients with a primary diagnosis of anxiety, 66.7% scored above 8 on the GAI. Of 236 patients with a GAI score above 8, only 22 (9.3%) were reported to have a comorbid anxiety disorder by the treating psychiatrist. In a multiple regression analysis, we found that the severity of depression (beta 0.585, p < 0.001), being female (beta 0.096, p 0.028) and the use of antipsychotic drugs (beta 0.129, p 0.006) and anxiolytic drugs (beta 0.129, p 0.005) were associated with a higher GAI score. CONCLUSION Anxiety is common in geriatric psychiatric patients, regardless of the primary diagnosis. Our findings suggest that anxiety is often a hidden comorbidity in various psychiatric disorders. A high score on the GAI was associated with the severity of depression, female gender and the use of antipsychotic and anxiolytic drugs.
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Affiliation(s)
- Anette Bakkane Bendixen
- a Department of Geriatric Psychiatry , Diakonhjemmet Hospital, University of Oslo , Oslo , Norway
| | - Knut Engedal
- b Norwegian Advisory Unit of Aging and Health , Vestfold Hospital Trust, Toensberg, University of Oslo , Oslo , Norway
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Abdul Manaf MR, Mustafa M, Abdul Rahman MR, Yusof KH, Abd Aziz NA. Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study. PLoS One 2016; 11:e0156937. [PMID: 27280529 PMCID: PMC4900557 DOI: 10.1371/journal.pone.0156937] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 05/23/2016] [Indexed: 11/19/2022] Open
Abstract
Background and Purpose Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. Methods It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. Results The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. Conclusions Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.
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Affiliation(s)
- M. Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
- * E-mail:
| | - Madihah Mustafa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Rizam Abdul Rahman
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Khairul Hazdi Yusof
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Noor Azah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
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Creighton AS, Davison TE, Kissane DW. The prevalence of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review. Int J Geriatr Psychiatry 2016; 31:555-66. [PMID: 26552603 DOI: 10.1002/gps.4378] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/16/2015] [Accepted: 09/23/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To synthesize and summarize the studies examining the prevalence rate of anxiety disorders and symptoms in older adults living in residential aged care. METHODS Using the PRISMA guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to literature published in English. Eligible studies examined the prevalence of anxiety disorders or symptoms in aged care residents aged 50+ years. RESULTS A total of 2249 articles were identified, of which 18 studies (with a total of 5927 participants) were included in this review. The rate of overall anxiety disorders ranged from 3.2% to 20%, with the highest quality studies estimating a prevalence rate of 5% to 5.7%. Generalized anxiety disorder and specific phobias were found to be the most common anxiety disorders among aged care residents, while clinically significant anxiety symptoms were found to be more frequent (6.5% to 58.4%) than threshold disorders. CONCLUSIONS Anxiety disorders and anxiety symptoms are common in older aged care residents. Given the paucity and overall quality of research examining anxiety within this population and the heterogeneity found in studies, further research is needed to help clarify this issue.
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Affiliation(s)
- Alexandra S Creighton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Tanya E Davison
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - David W Kissane
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
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Machado MB, Ignácio ZM, Jornada LK, Réus GZ, Abelaira HM, Arent CO, Schwalm MT, Ceretta RA, Ceretta LB, Quevedo J. Prevalência de transtornos ansiosos e algumas comorbidades em idosos: um estudo de base populacional. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Avaliar a prevalência de transtornos ansiosos e fatores associados em uma amostra populacional de idosos do Sul de Santa Catarina. Métodos Estudo transversal com base em dados populacionais, que avaliou 1.021 indivíduos idosos entre 60 e 79 anos. Foram realizadas entrevistas domiciliares para aferição de variáveis sobre transtornos ansiosos, por meio do questionário MINI, dados sociodemográficos, hipertensão arterial sistêmica (HAS), infarto agudo do miocárdio (IAM) e dosagem de colesterol. Resultados As prevalências entre os transtornos ansiosos foram de 22,0% para o transtorno de ansiedade generalizada (TAG); 14,8% para fobia social (FS); 10,5% para transtorno do pânico (TP); e 8,5% para o transtorno obsessivo-compulsivo (TOC). Além disso, 40,5% dos indivíduos apresentaram pelo menos um transtorno de ansiedade. A distribuição dos transtornos foi semelhante nos dois gêneros; TAG foi mais prevalente nos indivíduos de menor escolaridade; TOC foi mais presente em indivíduos casados ou em união estável. Em relação às variáveis clínicas, HAS foi associada à presença de TOC; FS foi associada com IAM; TOC e FS foram associados com HDL > 40 mg/dL. Conclusão Os dados demonstram que os quadros de ansiedade são muito frequentes em idosos da comunidade, se sobrepõem de forma significativa e estão associados a algumas variáveis clínicas cardiovasculares.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - João Quevedo
- Universidade do Extremo Sul Catarinense; The University of Texas Health Science Center at Houston, USA; The University of Texas Health Science Center at Houston, USA; The University of Texas, USA
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Saraçlı Ö, Akca ASD, Atasoy N, Önder Ö, Şenormancı Ö, Kaygisız İ, Atik L. The Relationship between Quality of Life and Cognitive Functions, Anxiety and Depression among Hospitalized Elderly Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2015; 13:194-200. [PMID: 26243848 PMCID: PMC4540029 DOI: 10.9758/cpn.2015.13.2.194] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/11/2015] [Accepted: 03/06/2015] [Indexed: 12/02/2022]
Abstract
Objective Older people seek not only a longer life, but also a better quality of life (QOL). Our aim was to find out the relationship between QOL and socio-demographic factors, social activities, cognitive status, depression and anxiety symptoms among medically ill and hospitalized elderly people in Turkey. Methods Two hundred forty three patients age 65 years or older were examined. The Socio-demographic Data Survey, the Mini Mental State Examination (MMSE), the Geriatric Depression Scale-short form (GDS-15), the Beck Anxiety Inventory (BAI) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) were applied to participants. The independent samples t-test and analysis of variance (ANOVA) were used to analyze quantitative data. Pearson’s correlation and linear regression analysis were performed. Results The total score for QOL was significantly higher for those who saw their family members and relatives frequently rather than rarely (p=0.002), who were always busy with social activities rather than rarely or never (p<0.001), who had more years of education (p=0.003), and who were frequently exercising (p=0.023). According to linear regression analysis, the WHOQOL-OLD total score increased by 0.295 and −0.936 units, while MMSE and GDS-15 scale scores increased one unit respectively (β=0.295, t=1.979, p=0.04; β=−0.936, t=−4.881, p<0.001). Conclusion Cognitive disabilities, depression, and other psychiatric problems along with medical disease negatively affect the QOL of elderly patients. While performing medical assessment regarding elders, detecting and treating cognitive disabilities and depression is very valuable in improving the QOL of elderly patients.
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Affiliation(s)
- Özge Saraçlı
- Departments of Psychiatry, Bulent Ecevit University Faculty of Medicine, Turkey
| | - Ayşe Semra Demir Akca
- Departments of Family Medicine, Bulent Ecevit University Faculty of Medicine, Turkey
| | - Nuray Atasoy
- Departments of Psychiatry, Bulent Ecevit University Faculty of Medicine, Turkey
| | | | - Ömer Şenormancı
- Departments of Psychiatry, Bulent Ecevit University Faculty of Medicine, Turkey
| | - İsmet Kaygisız
- Departments of Psychiatry, Bulent Ecevit University Faculty of Medicine, Turkey
| | - Levent Atik
- Departments of Psychiatry, Bulent Ecevit University Faculty of Medicine, Turkey
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Klenfeldt IF, Karlsson B, Sigström R, Bäckman K, Waern M, Östling S, Gustafson D, Skoog I. Prevalence of obsessive-compulsive disorder in relation to depression and cognition in an elderly population. Am J Geriatr Psychiatry 2014; 22:301-8. [PMID: 23567423 DOI: 10.1016/j.jagp.2012.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 09/15/2012] [Accepted: 09/26/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population. SETTINGS AND PARTICIPANTS Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women). MEASUREMENTS Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV. RESULTS The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample. CONCLUSIONS We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable.
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Affiliation(s)
- Isak Fredén Klenfeldt
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Björn Karlsson
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Robert Sigström
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Kristoffer Bäckman
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Margda Waern
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Svante Östling
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Deborah Gustafson
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden.
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Olvera-Hernández S, Chavira R, Fernández-Guasti A. Sex- and endocrine-stage-differences in middle-aged rats in an animal model of OCD. Prog Neuropsychopharmacol Biol Psychiatry 2013; 44:81-7. [PMID: 23395768 DOI: 10.1016/j.pnpbp.2013.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/28/2013] [Accepted: 01/31/2013] [Indexed: 01/12/2023]
Abstract
Various clinical studies suggest that many features of OCD are influenced by sex, age and fluctuations in hormonal levels. Animal models have confirmed these differences, and suggest they are mediated by the serotonergic system. We compared the perseveration behavior in a T-maze after the administration of the 5-HT1A agonist, 8-OH-DPAT (2.0 mg/kg) and the preventive action of subchronic fluoxetine (10 mg/kg, 3 times) in middle-aged (11-14 months) males and female rats in two endocrine states: irregular cycles (tested in diestrus) or persistent diestrus. After 8-OH-DPAT, females with persistent diestrus presented higher perseveration scores than males and females with irregular cycles. Fluoxetine produced an anticompulsive-like effect only in females with persistent diestrus. Females in persistent diestrus showed higher estradiol levels than those in irregular cycles or males. In all groups 8-OH-DPAT increased ambulation and fluoxetine did not modify this action. In males, the combined administration of fluoxetine and 8-OH-DPAT impaired motor coordination. Data are discussed on the basis of estradiol levels and sex differences.
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Uysal-Bozkir Ö, Parlevliet JL, de Rooij SE. Insufficient cross-cultural adaptations and psychometric properties for many translated health assessment scales: A systematic review. J Clin Epidemiol 2013; 66:608-18. [DOI: 10.1016/j.jclinepi.2012.12.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 11/27/2012] [Accepted: 12/07/2012] [Indexed: 11/28/2022]
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Sahingoz M, Uguz F, Gezginc K. Prevalence and related factors of mood and anxiety disorders in a clinical sample of postmenopausal women. Perspect Psychiatr Care 2011; 47:213-9. [PMID: 21950368 DOI: 10.1111/j.1744-6163.2010.00296.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The purpose of the study was to investigate the prevalence and related factors of mood and anxiety disorders in postmenopausal women attending a gynecological outpatient clinic. METHODS The study sample included 269 postmenopausal women. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition was performed to determine the disorders. RESULTS Ninety-two (34.2%) women had at least one mood or anxiety disorder. The most common specific disorder was generalized anxiety disorder (15.6%). The existence of any mood or anxiety disorder was associated with poorer economic level. CONCLUSIONS Mood and anxiety disorders were frequently observed in postmenopausal women who were admitted to a gynecology outpatient clinic.
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Affiliation(s)
- Mine Sahingoz
- Department of Psychiatry, Meram Research and Training Hospital, Konya, Turkey
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Jordan KD, Okifuji A. Anxiety Disorders: Differential Diagnosis and Their Relationship to Chronic Pain. J Pain Palliat Care Pharmacother 2011; 25:231-45. [DOI: 10.3109/15360288.2011.596922] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ribeiro O, Paúl C, Simões MR, Firmino H. Portuguese version of the Geriatric Anxiety Inventory: transcultural adaptation and psychometric validation. Aging Ment Health 2011; 15:742-8. [PMID: 21656405 DOI: 10.1080/13607863.2011.562177] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The Geriatric Anxiety Inventory (GAI) is a recently developed anxiety instrument designed to assess the severity of anxiety symptoms across a range of presentations in older adults. In this study, the authors examined the validity of the Portuguese version of the GAI and assessed its psychometric properties. METHOD A cross-sectional study was designed using a sample of 152 community-dwelling older adults, and a geriatric psychiatric sample of outpatients with clinical diagnoses of depression (n = 32), anxiety disorders (n = 23), and early Alzheimer's disease (n = 10). RESULTS The Portuguese version of the GAI required linguistic and transcultural adaptations, particularly on the somatic expressions of anxiety. It exhibited sound internal consistency and demonstrated good concurrent validity against the state half of the Spielberg State-Trait Anxiety Inventory, the Geriatric Depression Scale (GDS-30), and the General Health Questionnaire (GHQ-12). The optimal cut-off point to detect severe anxiety symptoms was 8/9, but no optimal cut-off point for Generalized Anxiety Disorder could be estimated. CONCLUSION These findings provide initial evidence that the Portuguese version of the GAI is a valid and reliable measure for assessing late-life anxiety and highlights the need for possible modifications of the instrument before being used in other languages and cultural groups.
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Affiliation(s)
- Oscar Ribeiro
- Research and Education Unit on Ageing (UNIFAI/ICBAS-UP), University of Porto, Portugal.
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Skoog I. Psychiatric disorders in the elderly. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:387-97. [PMID: 21835102 DOI: 10.1177/070674371105600702] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality.
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Affiliation(s)
- Ingmar Skoog
- Institute of Neuroscience and Physiology, Section for Psychiatry Section, Unit of Neuropsychiatric Epidemiology, University of Gothenburg, Sweden.
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Sigström R, Östling S, Karlsson B, Waern M, Gustafson D, Skoog I. A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds. J Anxiety Disord 2011; 25:148-53. [PMID: 20869844 DOI: 10.1016/j.janxdis.2010.08.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 08/25/2010] [Accepted: 08/25/2010] [Indexed: 02/05/2023]
Abstract
This population-based study reports on the prevalence and characteristics of specific phobia (SP) and phobic fears in an elderly population. A representative population sample of Swedish 70-year-olds without dementia (N = 558) was examined using semi-structured interviews. Phobic fears included fear of animals, natural environment, specific situations, blood-injection-injury and 'other'. Mental disorders, including SP, were diagnosed according to DSM-IV. Phobic fears (71.0% vs. 37.9%) and SP (13.8% vs. 4.5%) were more common in women than in men. Among those with phobic fears, more than 80% reported onset before age 21. Of those with SP, 35.7% had another DSM-IV diagnosis compared to 8.5% of those reporting no fear. Fear of specific situations and 'other' fears were related to SP and other anxiety disorders. SP was related to lower global functioning. We conclude that specific phobia in the elderly should receive attention from health professionals as it is common and associated with a decrease in global functioning.
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Affiliation(s)
- Robert Sigström
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.
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Abstract
BACKGROUND Differential diagnosis implies identifying shared and divergent characteristics between clinical states. Clinical work with older adults demands not only the knowledge of nosological features associated with differential diagnosis, but also recognition of idiosyncratic factors associated with this population. Several factors can interfere with an accurate diagnosis of specific phobia in older cohorts. The goal of this paper is to review criteria for specific phobia and its differential diagnosis with panic disorder, agoraphobia, post-traumatic stress disorder and obsessive compulsive disorder, while stressing the specific factors associated with aging. METHODS A literature search regarding specific phobia in older adults was carried out using PubMed. Relevant articles were selected and scanned for further pertinent references. In addition, relevant references related to differential diagnosis and assessment were used. RESULTS Etiologic factors, specificity of feared stimulus or situation, fear predictability and the nature of phobic situations are key points to be assessed when implementing a differential diagnosis of specific phobia. CONCLUSIONS First, age-related sensory impairments are common and interfere both with information processing and communication. Second, medical illnesses create symptoms that might cause, interfere with, or mimic anxiety. Third, cohort effects might result in underreporting, through the inability to communicate or recognize anxiety symptoms, misattributing them to physical conditions. Finally, diagnostic criteria and screening instruments were usually developed using younger samples and are therefore not adapted to the functional and behavioral characteristics of older samples.
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Uguz F, Sahingoz M, Gezginc K, Karatayli R. Obsessive-compulsive disorder in postmenopausal women: prevalence, clinical features, and comorbidity. Aust N Z J Psychiatry 2010; 44:183-7. [PMID: 20113307 DOI: 10.3109/00048670903393639] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Studies about obsessive-compulsive disorder (OCD) during the postmenopausal period have been insufficient. The purpose of the current study was therefore to examine the prevalence rate, clinical characteristics, and comorbidity of OCD in postmenopausal women. METHODS A total of 269 consecutive postmenopausal women admitted to a gynaecology outpatient clinic were included in the study. OCD and comorbid disorders was diagnosed by means of the Structured Clinical Interview for DSM-IV. The Yale-Brown Obsessive- Compulsive Scale was used to determine the types of obsessions and compulsions. RESULTS The prevalence rate of OCD was 7.1% in the sample. Two women (0.7%) reported that OCD developed during the postmenopausal period. The most common obsessions were contamination and symmetry/exactness, whereas the most common compulsions were cleaning/washing and checking. OCD was unrelated to variables examined in the present study. The comorbidity rate of other psychiatric disorders was 63.2% in OCD patients. The most common comorbid disorder was generalized anxiety disorder. CONCLUSIONS OCD was not rare in postmenopausal women admitted to a gynaecology outpatient clinic. In addition, OCD appears to be frequently comorbid with depressive or other anxiety disorders in the postmenopausal period.
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Affiliation(s)
- Faruk Uguz
- Department of Psychiatry, Selçuk University, Konya, Turkey.
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Abstract
Psychoneuroimmunology (PNI) is a relatively new discipline within the field of neuroscience which researches the relationship between emotional states, the central and peripheral nervous systems, and the endocrine and immune systems. Negative psychological states, such as stress, anxiety, and depression, may alter immune system regulation and modulation of peripheral cytokines. A plethora of PNI studies have shown that increased psychological stress and depression are associated with an alteration of immune functioning and worsened health outcomes for many conditions. To date, application of PNI methodology has not been reported for ocular diseases. This article provides an historical perspective on the origins of the rift between the emotional and spiritual from physical aspects of disease. A review of how stress is mediated through sympathetic adrenomedullary and hypothalamic pituitary axis activation with shifts in immunity is provided. The literature which supports spirituality in healing is presented. Finally, ocular diseases which would be most amenable to a PNI approach are discussed.
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Affiliation(s)
- Lori M Ventura
- University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL USA
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Psychoneuroimmunology: application to ocular diseases. J Ocul Biol Dis Infor 2009; 2:84-93. [PMID: 19672468 PMCID: PMC2723676 DOI: 10.1007/s12177-009-9028-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 07/09/2009] [Indexed: 01/18/2023] Open
Abstract
Psychoneuroimmunology (PNI) is a relatively new discipline within the field of neuroscience which researches the relationship between emotional states, the central and peripheral nervous systems, and the endocrine and immune systems. Negative psychological states, such as stress, anxiety, and depression, may alter immune system regulation and modulation of peripheral cytokines. A plethora of PNI studies have shown that increased psychological stress and depression are associated with an alteration of immune functioning and worsened health outcomes for many conditions. To date, application of PNI methodology has not been reported for ocular diseases. This article provides an historical perspective on the origins of the rift between the emotional and spiritual from physical aspects of disease. A review of how stress is mediated through sympathetic adrenomedullary and hypothalamic pituitary axis activation with shifts in immunity is provided. The literature which supports spirituality in healing is presented. Finally, ocular diseases which would be most amenable to a PNI approach are discussed.
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