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Patel M, Mantri N, Joshi N, Jain Y, Goel AD, Gupta M, Srinivasan S, Yadav V, Joshi V, Singh K, Bhardwaj P. Is anxiety a public health problem among older adults in India: Results from a systematic review and meta-analysis. J Family Med Prim Care 2024; 13:2545-2554. [PMID: 39071033 PMCID: PMC11272018 DOI: 10.4103/jfmpc.jfmpc_1664_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 07/30/2024] Open
Abstract
For medical fraternity, health system and policymakers to undertake effective countermeasures, a comprehensive assessment of the prevalence of anxiety among older adults is required; hence, we conducted a systematic review and meta-analysis using data pooled from surveys across the country. The search strategy was developed using medical subject headings (MeSH) terms and free-text keywords. We searched PubMed and Scopus for articles to report the prevalence of anxiety among older adults. The appraisal tool for cross-sectional studies was used for quality assessment. Prevalence from different studies was pooled together using the inverse variance heterogeneity method. Sensitivity analyses were performed to assess the impact of included studies' methodological quality on pooled results and to investigate potential causes of heterogeneity. Twenty-three studies were included in this systematic review. The overall pooled estimate of the prevalence of anxiety in older adults was 18.7% (95% CI: 2.4, 38.8). The studies had a high degree of heterogeneity. Publication bias was assessed using a Doi plot which showed an luis furuya-kanamori (LFK) index of 1.21 indicating minor asymmetry. Like other parts of the world, India has witnessed a rise in the number of elderly due to lower fertility rates, higher life expectancies and a shift in illness patterns from communicable to non-communicable. The number of elderly people suffering from diseases of mental health is expected to rise dramatically. This review consolidates the existing evidence to showcase anxiety as an upcoming public health problem requiring due focus from policymakers and health systems.
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Affiliation(s)
- Mamta Patel
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Neha Mantri
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Nitin Joshi
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Yogesh Jain
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Manoj Gupta
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Srikanth Srinivasan
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Vikas Yadav
- Environmental Health and Epidemiology, ICMR, Bhopal, Madhya Pradesh, India
| | - Vibha Joshi
- School of Public Health, AIIMS, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
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Dhiman V, Menon GR, Tiwari RR. A systematic review and meta-analysis of prevalence of seven psychiatric disorders in India. Indian J Psychiatry 2023; 65:1096-1103. [PMID: 38249146 PMCID: PMC10795670 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_539_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/29/2023] [Accepted: 10/28/2023] [Indexed: 01/23/2024] Open
Abstract
Background After the National Mental Health Survey in 2016, multiple individual studies showed inconsistencies in the prevalence rates of psychiatric disorders in India. We performed a meta-analysis to estimate an up-to-date pooled estimate of the prevalence of depression, alcohol use disorder (AUD), anxiety disorder (AD), intellectual disability, suicidal attempt/death, autism, and bipolar disorder (BD) in India. Materials and Methods We performed a systematic bibliographic search in Pub Med, Global Health Data Exchange (GHDx), and Google Scholar, along with a manual search for peer-reviewed epidemiological studies reporting the prevalence of depression, AUD, AD, MR, suicidal attempt/death, autism, and BD in India from January 1980 till March 2022. Adopting a random-effects model, we performed the meta-analysis using "MetaXL" software. Results A total of 79 studies were included: depression (n = 28), AUD (n = 14), AD (n = 12), intellectual disability (n = 8), suicidal attempt/death (n = 7), autism (n = 6) and BD (n = 4). The pooled prevalence of depression and AUD was 12.4% (95% CI 9.4-15.9) (P < 0.001, I2 = 100%) and 21.5% (95% CI 14.1-30.0) (P < 0.001, I2 = 100%), respectively. AD, intellectual disability and suicidal attempt/death showed a prevalence of 11.6% (95% CI 8.1-15.7) (P < 0.001, I2 = 99%), 1% (95% CI 0.5-1.6) (P < 0.001, I2 = 98%) and 0.5% (95% CI 0.3-0.8) (P < 0.001, I2 = 100%), respectively. The meta-analysis in autism and BD showed pooled prevalence of 0.3% (95% CI 0.1-0.6) (P < 0.001, I2 = 96%) and 0.3% (95% CI 0.2-0.4) (P < 0.001, I2 = 78%), respectively. Subgroup analysis showed an increased prevalence of AD in the urban [24.3% (95% CI 3.7-52.9)] and younger [16.7% (95% CI 5.1-32.7)] population. The prevalence of depression and AD increased during the last two decades on decadal prevalence analysis. Discussion The findings could be used for appropriate policy measures and guiding subsequent national mental health surveys.
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Affiliation(s)
- Vikas Dhiman
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India
| | - Geetha R. Menon
- ICMR-National Institute of Medical Statistics (NIMS), Ansari Nagar, New Delhi, Delhi, India
| | - Rajnarayan R. Tiwari
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India
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Gangadhar B, Kumar CN, Sadh K, Manjunatha N, Math SB, Kalaivanan RC, Rao GN, Parthasarathy R, Chand PK, Chandra PS, Thirthalli J, Murthy P, Varghese M, Mathur A, Bairy BK, Kishore C, Gowda GS, Basvaraju V, Harihara SN, Isaac MK, Chaturvedi S. Mental Health Programme in India: Has the tide really turned? Indian J Med Res 2023; 157:387-394. [PMID: 37955215 PMCID: PMC10443714 DOI: 10.4103/ijmr.ijmr_2217_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 11/14/2023] Open
Abstract
Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India's NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
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Affiliation(s)
- B.N. Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Kamaldeep Sadh
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rakesh Chander Kalaivanan
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rajani Parthasarathy
- Department of Health & Family Welfare, Government of Karnataka, Bengaluru, Karnataka, India
| | - Prabhat K. Chand
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Alok Mathur
- General of Health Services, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Bhavya K. Bairy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Chethana Kishore
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Guru S. Gowda
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basvaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Mohan K. Isaac
- Department of Psychiatry, University of Western Australia, Perth, Australia
| | - S.K. Chaturvedi
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
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Liu Y, Yang X, Xu Y, Wu Y, Zhong Y, Yang S. Cognitive Function and Depressive Symptoms among Chinese Adults Aged 40 Years and Above: The Mediating Roles of IADL Disability and Life Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4445. [PMID: 36901451 PMCID: PMC10002125 DOI: 10.3390/ijerph20054445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to investigate the relationship between cognitive function and depressive symptoms among Chinese adults aged 40 years and above, as well as the series of multiple mediating effects of Instrument Activities of Daily Living disability and life satisfaction on this relationship. The data was obtained from the China Health and Retirement Longitudinal Study (CHARLS, 2013-2018), including 6466 adults aged 40 years and above. The mean age of the adults was 57.7 ± 8.5. The SPSS PROCESS macro program was conducted to examine the mediating effects. The results indicated that there was a significant association between cognitive function and depressive symptoms five years later (B = -0.1500, 95%CI: -0.1839, -0.1161), which could also be demonstrated through three mediation pathways: (1) the mediating pathway through IADL disability (B = -0.0247, 95%CI: -0.0332, -0.0171); (2) the mediating pathway through life satisfaction (B = 0.0046, 95%CI: 0.0000, 0.0094); and (3) the chain mediation pathway through IADL disability and life satisfaction (B = -0.0012, 95%CI: -0.0020, -0.0003). Both IADL disability and life satisfaction have been proven to be crucial mediators for the relationship between cognitive function and depressive symptoms five years later. It is necessary to improve individuals' cognitive function and reduce the negative impact of disability on them, which is important to enhance their life satisfaction and prevent depressive symptoms.
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Marmamula S, Kumbham TR, Shidhaye R, Modepalli SB, Barrenkala NR, Yellapragada R, Keeffe J. Multimorbidity and multi-disability among the elderly in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES). Sci Rep 2022; 12:11779. [PMID: 35821044 PMCID: PMC9276822 DOI: 10.1038/s41598-022-15943-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022] Open
Abstract
We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60-108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8-40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2-26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
- Department of Biotechnology, Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Jill Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
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Zhang C, Chang Y, Yun Q, Lu J, Zheng X, Xue Y, Zhao X, Yuan W, Zou J, Zheng J. The impact of chronic diseases on depressive symptoms among the older adults: The role of sleep quality and empty nest status. J Affect Disord 2022; 302:94-100. [PMID: 35085671 DOI: 10.1016/j.jad.2022.01.090] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is the most prevalent mental disorder among older adults. This study aimed to explore the mediating effect of sleep quality on the relationship between chronic diseases and depressive symptoms, and the moderating role of empty nest status in the mediating model. METHODS A cross-sectional survey was conducted among 3637 older adults from Taiyuan, China, using a multi-stage random cluster sampling method. The data was collected with the general questionnaire for the elderly, with the Short Form Geriatric Depression Scale (GDS-15), and the Pittsburgh Sleep Quality Index (PSQI). The Bootstrap program and simple slope method were used to test the mediating effect of sleep quality and the moderating effect of empty nest status. RESULTS The overall prevalence of depressive symptoms in the population was 33.4%. The mediating effect analysis showed that chronic diseases had a significant direct impact on depressive symptoms in the elderly (β = 0.431, P < 0.001). Sleep quality as a mediation effect of 43.4% between chronic diseases and depressive symptoms was proven. The further moderating effect found that chronic diseases had a more significant impact on the sleep quality of the elderly who are in the empty nest status than those who are not (β = -0.431, P < 0.05 ). LIMITATIONS Given the cross-sectional study, the results cannot explain the causal relationships among the study variables. CONCLUSIONS Chronic diseases had a major impact on the depressive symptoms of the elderly. Sleep quality mediated the relationship between chronic diseases and depressive symptoms, and the empty nest status moderated the first half of the path in the mediation model. Therefore, to reduce the incidence of the depressive symptoms of the elderly, sleep quality and empty nest status should be the primary concern.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
| | - Yunqi Chang
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
| | - Qilong Yun
- Department of Mathematics, New York University, New York, NY, USA
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Xinyue Zhao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenpei Yuan
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiayu Zou
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jianzhong Zheng
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
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Kumar M, Srivastava S, Muhammad T. Relationship between physical activity and cognitive functioning among older Indian adults. Sci Rep 2022; 12:2725. [PMID: 35177736 PMCID: PMC8854730 DOI: 10.1038/s41598-022-06725-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/28/2022] [Indexed: 12/11/2022] Open
Abstract
In a culturally different and low-resource setting, where lifestyle habits, including dietary pattern and physical activities differ from those in high-income countries, the association between physical activity and cognition is expected to differ. We aimed to investigate the association between physical activity and cognitive functioning after controlling for potential confounders among older adults in India. Furthermore, gender differences in this relationship were analyzed. Using a national-level data from the Longitudinal Ageing Study in India (2017-2018), this paper employed propensity score matching (PSM) approach to examine the association between physical activities and cognitive functioning among Indian older adults. Cognitive impairment was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming). We limit our sample to older adults aged 60 + years, and our final dataset contains 31,464 participants (men = 16,366, and women = 15,098). The results indicated that older adults who engaged in frequent physical activity have greater cognitive functioning than older adults without physical activity after adjusting for various individual, health, lifestyle, and household factors. This association holds true for both older men and older women. The results from the PSM revealed that the cognitive function score was increased by 0.98 and 1.32 points for the frequently physically active older men and women population, respectively. The results demonstrate the possible beneficial effects of frequent physical activity on cognitive functioning among older adults. Thus, regular physical activity can be considered as an effective lifestyle factor to promote healthy cognitive aging.
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Affiliation(s)
- Manish Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088.
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Yang G, D'Arcy C. The changing relationship between health risk behaviors and depression among birth cohorts of Canadians 65+, 1994-2014. Front Psychiatry 2022; 13:1078161. [PMID: 36620694 PMCID: PMC9810750 DOI: 10.3389/fpsyt.2022.1078161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The older adult residents of Canada form an increasingly larger proportion of the population and are becoming better educated and have more income. Depression is a common mental disorder, particularly among seniors. Several health risk behaviors-physical inactivity, tobacco use, and alcohol consumption-are linked to mental health problems. This study examines whether these health risk behaviors and their association with depression among Canadians 65+ born in eight cohorts between 1910-1914 and 1945-1949, have changed. METHODS Pooled data drawn from 11 nationally representative health surveys conducted by Statistics Canada between 1994 and 2014 are analyzed-88,675 survey participants met inclusion criteria. Depression was assessed by the Composite International Diagnostic Interview-Short Form. Health risk behaviors examined were physical activity/inactivity, smoking, and alcohol use. A Cochran Armitage trend test for categorical outcomes and a log-binomial modeling for binary outcomes were used to estimate the risk ratios across cohorts. RESULTS The proportions of Canadians 65+ who are physically active, regular drinkers, and regular smokers have increased; however, depression prevalence fluctuated non-significantly. Depression increased among all health risk behaviors, particularly in recent birth cohorts. Depression among physically inactive seniors, current smokers, and non-drinkers was significantly higher than among active, non-smokers, and regular drinkers (all P < 0.05). Physical inactivity and smoking-attributable depression risk showed an increasing linear trend across birth cohorts (RR = 1.67, P < 0.001; RR = 1.79, P < 0.001). For seniors born between 1915 and 1944, regular drinking was associated with a significant decrease in depression (all P < 0.001), but the protective effects of regular drinking became non-existent in the most recent 1945-1949 birth cohort (RR = 1.09, P < 0.05, after adjusting for covariates). CONCLUSION Inactivity and smoking were consistently associated with a significantly increased risk of depression among Canadian residents 65+, with smoking becoming more firmly connected to depression risk in more recent birth cohorts. In contrast, moderate alcohol use was associated with a decreased risk of depression, but that protective effect ceased in most recent birth cohort. Identifying the changing relationships between health risk behaviors and depression is meaningful for developing prevention strategies for depression and other emotional and mental health problems.
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Affiliation(s)
- Guang Yang
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Chaudhury S, Khan A, Vijay P, Sowmya AV, Chaudhari B, Saldanha D, Menon P. Prevalence of psychiatric morbidity in elderly hospitalized patients. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_922_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Petrova NN, Khvostikova DA. Prevalence, Structure, and Risk Factors for Mental Disorders in Older People. ADVANCES IN GERONTOLOGY 2021. [PMCID: PMC8654500 DOI: 10.1134/s2079057021040093] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.
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Affiliation(s)
- N. N. Petrova
- St. Petersburg State University, 199106 St. Petersburg, Russia
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Xue B, Xiao A, Luo X, Li R. The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial. Int J Methods Psychiatr Res 2021; 30:e1887. [PMID: 34291527 PMCID: PMC8633942 DOI: 10.1002/mpr.1887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to explore whether game training could improve cognitive functioning and depression symptoms in the elderly affected by mild cognitive impairment (MCI). METHODS A non-blinded randomized controlled trial was conducted. Participants were 72 patients with MCI and depression from a nursing home in Wuhan. Participants were randomized to either the intervention group or the control group (n = 36 each). The intervention group received regular nursing care plus game training for 50 min, three times per week for 8 weeks, whereas the control group received only regular nursing care during the same research period. Cognitive functioning and depression symptoms were tested in both groups at baseline and at the end of the 8-week intervention. We used the Montreal Cognitive Assessment and the 15-item Geriatric Depression Scale to assess cognitive functioning and depression symptoms, respectively. RESULTS The 8-week game training intervention significantly improved the cognitive and depression scores when compared with the control group and baseline scores (p < 0.05). No significant difference was observed in the control group (p > 0.05). CONCLUSIONS Our results suggest that the implementation of game training can improve the cognitive functioning and depression symptoms of the elderly with MCI, indicated that can be widely used.
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Affiliation(s)
- Bing Xue
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ao Xiao
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xianwu Luo
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China.,Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| | - Rui Li
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
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12
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Ge M, Zhu D, Lee H. WITHDRAWN: Health risk assessment of rural older population. Work 2021:WOR205350. [PMID: 34275921 DOI: 10.3233/wor-205350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Minshu Ge
- The school of Finace, RenMin University of China, Beijing, China
| | - Dan Zhu
- Shanghai National Accounting Institute, Shanghai, China
| | - Hallie Lee
- Economic management Department, DePauw University, Greencastle, USA
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13
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Kafczyk T, Hämel K. Primary mental health care for older persons in India: how age-inclusive are public policies? Health Policy Plan 2021; 36:1371-1383. [PMID: 34137820 DOI: 10.1093/heapol/czab067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/22/2021] [Accepted: 06/05/2021] [Indexed: 12/18/2022] Open
Abstract
The need to improve the primary mental healthcare system in India has gained increasing public health attention. Concomitantly, efforts to frame and develop appropriate public mental health care through legislation and related strategies and programmes have been undertaken. Because older people in India are particularly prone to mental health problems, this study explores the inclusiveness of Indian public policies in addressing the primary mental health care needs of older people from a cross-policy perspective. The basis of this thematic document analysis is 41 key national strategic documents (1999-2018) from different thematically grouped policy fields. In the context of population ageing, socio-economic challenges for older people and changing family norms, the policies delineate a pronounced interest in old-age-inclusive primary mental health care, whereas international policies are regarded as important reference points. While some of the policies address older persons as a vulnerable group in general, others delineate a more differentiated picture of the older population. Moreover, as new rights with implications for old-age mental health care, including community-based access to mental health care, have emerged, an integrated old-age mental healthcare policy spanning across sectors remains absent. Although old-age-inclusive primary mental health care is an emerging trend in India, its development as a cross-cutting policy issue remains in its infancy. Accordingly, unambiguous integrated policy approaches are needed to address the complex mental healthcare needs of older persons, and further research should be undertaken to focus on mental healthcare strategies and approaches at the primary care level.
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Affiliation(s)
- Tom Kafczyk
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitaetsstrasse 25, Bielefeld 33651, Germany
| | - Kerstin Hämel
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitaetsstrasse 25, Bielefeld 33651, Germany
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14
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Xue Y, Lu J, Zheng X, Zhang J, Lin H, Qin Z, Zhang C. The relationship between socioeconomic status and depression among the older adults: The mediating role of health promoting lifestyle. J Affect Disord 2021; 285:22-28. [PMID: 33621711 DOI: 10.1016/j.jad.2021.01.085] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression is the most frequent psychiatric disorder among the older adults, the purpose of this study is to explore the mediation effect of health promoting lifestyle on the relationship between Socioeconomic Status (SES) and depression, so as to provide practical reference for effectively preventing and alleviating depression of the older adults. METHODS A multi-stage random sampling method was conducted in Shanxi Province. A total 8526 older adults were included in the analysis. Regression analysis was used to explore the relationship between the socioeconomic status, health promoting lifestyle and depression, and the mediation effect test process was used to verify the mediating mechanism of health promoting lifestyle on this relationship. RESULTS 62.1% of the older adults had depression symptoms in this study, and there were significant differences in depression scores among the older adults with gender, age, residence, marital status, endowment pattern, self-care ability, exercise frequency, physical examination frequency, daily diet rules(P<0.05). The results of mediating effect analysis showed that health promoting lifestyle as mediation effect between social economic status and depression was established, and the mediating effect was accounted for (a*b/c) 63.1%. LIMITATIONS Given the cross-sectional study, it is not possible to make causal inferences. CONCLUSIONS There were different degrees of depression in the older adults. The lower the SES is, the higher the risk of depression is. This result once again confirms the social causation theory. Combined with the theory of health risk behavior, the study further confirmed the applicability of lifestyle mechanism in the intermediate mechanism of the relationship between SES and depression in the elderly. Thus, in addition to providing material support and financial assistance, helping the elderly develop a healthy lifestyle is also effective measure to improve their depression.
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Affiliation(s)
- Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao Lu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- Department of prevention and health care, Shantou Central Hospital/Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China
| | - Zuguo Qin
- Health Publicity and Education Center of Guangdong Province, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University Guangzhou, Guangdong, China.
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15
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Assariparambil AR, Noronha JA, Kamath A, Adhikari P, Nayak BS, Shankar R, George A. Depression among older adults: a systematic review of South Asian countries. Psychogeriatrics 2021; 21:201-219. [PMID: 33319427 DOI: 10.1111/psyg.12644] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 12/20/2022]
Abstract
The world's population has been evolving rapidly; every country in the world is facing this drastic progression in the number and the percentage of the elderly in their net population. As the chronological age advances, physiological and psychosocial decline will be evident among all older adults. The potentially relevant literature was identified using appropriate search terms in electronic databases such as PubMed MEDLINE, Scopus, ProQuest, Web of Science, CINAHL, IndMed, and Google Scholar. Articles published from 2006 to 2019, reported the prevalence and the risk factors for depression among older adults living in the community, old age homes, or hospitals of the South Asian countries. Articles were published in the languages other than English and those reporting the categorised or mean depressive scores were excluded from the review. After quality check for all the retrieved articles from different databases, 120 articles were included for the meta-analysis. The data were extracted based on a validated data extraction form, and the reviewer contacted the authors for clarification of the missing data whenever required. The estimates were pooled using the random effect model for meta-analyses. Sub-group and sensitivity analyses were also performed. The overall pooled estimate (random effect models) of the prevalence of depression among the elderly was 42.0% (95% CI: 0.38-0.46), Chi-squared P-value <0.001, and I2 99.14%. The pooled estimate of the prevalence was higher in the community settings than the old age homes (44.0%; 95% CI: 39.0-49.0 vs. 42.0%; 95% CI: 34.0-49.0). Depression is a common problem among the elderly population and the pooled estimate of depression would give directions to the healthcare providers, policymakers, and future researchers to plan some measures (either pharmacological or non-pharmacological interventions) to effectively tackle the burden of geriatric depression in the future.
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Affiliation(s)
- Anil R Assariparambil
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal, MAHE, Manipal, India.,Manipal College of Nursing, Manipal, MAHE, Manipal, India
| | | | - Asha Kamath
- Department of Data Science, PSPH, MAHE, Manipal, India
| | - Prabha Adhikari
- Department of Medicine, Yenapoya Medical College, Mangaluru, India
| | - Baby S Nayak
- Manipal College of Nursing, Manipal, MAHE, Manipal, India.,Department of Child Health Nursing, Manipal College of Nursing, Manipal, MAHE, Manipal, India
| | - Ravi Shankar
- Department of Data Science, PSPH, MAHE, Manipal, India
| | - Anice George
- Manipal College of Nursing, Manipal, MAHE, Manipal, India
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16
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Orozco JL, Valderrama-Chaparro JA, Pinilla-Monsalve GD, Molina-Echeverry MI, Pérez Castaño AM, Ariza-Araújo Y, Prada SI, Takeuchi Y. Parkinson's disease prevalence, age distribution and staging in Colombia. Neurol Int 2020; 12:8401. [PMID: 32774822 PMCID: PMC7378539 DOI: 10.4081/ni.2020.8401] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/01/2020] [Indexed: 11/30/2022] Open
Abstract
Parkinson’s disease (PD) has the second highest prevalence among neurodege - nerative diseases. In Colombia, PD population dynamics are currently unknown. Health records offer a unique resource to study frequency and multi-morbidity of chronic diseases. The aim of this research is to estimate prevalence and staging using administrative data (AD) provided by Health Maintenance Organizations (HMOs). A cross-sectional study was conducted using 2015 AD from two Colombian HMOs (4.312.928 beneficiaries, 9.01% of the affiliated Colombian population). PD prevalence and severity was estimated by age and sex. Prevalence was adjusted to WHO demographics. Age-adjusted PD prevalence was 205.89 per 100.000 inhabitants. Prevalence increment of 62.13% was found between those aged ≥40 years and those aged ≥50 years. Similarly, each extra decade (50-80+) represented an increment of 83.65%, 80.95%, and 35.10%. Between 40 and 89 years, males exhibited a significantly higher PD prevalence compared to females. Advanced PD was more frequent as age increased from 3.77% in the group between 40 to 49 years to 25.86% in those older than 89 years. More common related comorbidities were arterial hypertension, diabetes, and psychiatric disorders; the first two increased their frequency with age, and the last one maintained its prevalence across all age groups. AD sets are useful to estimate the prevalence and staging of PD. Prevalence of PD in Colombia is higher in men and increases with age, as well as disease severity.
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Affiliation(s)
- Jorge Luis Orozco
- Departamento de Neurología, Fundación Valle del Lili, Cali.,Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali
| | | | | | | | | | | | - Sergio I Prada
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali.,PROESA, Universidad Icesi, Cali, Colombia
| | - Yuri Takeuchi
- Departamento de Neurología, Fundación Valle del Lili, Cali.,Facultad de Ciencias de la Salud, Universidad Icesi, Cali
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17
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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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Barhwal KK, Boppana S, Vashishtha V, Mahapatra SC. Conscious Abstinence from Smokeless Tobacco Evokes Higher Withdrawal Response and Impairs Cognitive Performance Independent of Sympathetic Response. Ann Neurosci 2020; 27:29-39. [PMID: 32982097 PMCID: PMC7499824 DOI: 10.1177/0972753120927515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION High consumption of smokeless tobacco in adult Indian population increases the risk of developing oral cancers leading to high morbidity and mortality. Though the influence of abstinence from smoking on cognitive performance has been widely studied, the effect of smokeless tobacco on cognitive performance and its association with withdrawal symptoms is less understood. This study comparatively investigates the effect of short-term conscious abstinence and distraction during abstinence from smokeless tobacco consumption on the craving, withdrawal symptoms, sympathetic response, and cognitive performance in tobacco addicts. METHODS Age, sex, education and socioeconomic status matched control (N = 15) and smokeless tobacco addicts (N = 60) were recruited from residential areas in Bhubaneswar for the study. Following randomization of the addicts, conscious abstinence (N = 30) was induced by informed abstinence from tobacco consumption for 8 hours, while distracted cessation (N = 30) was induced by involving the participants in a cognitively engaging task for 8 hours during uninformed tobacco abstinence. RESULTS The results of the study show higher withdrawal symptoms and reduced cognitive performance in volunteers with conscious abstinence which was positively correlated. The decreased cognitive performance in conscious cessation was independent of tobacco-induced increase in the LF:HF ratio and cotinine concentration in saliva. CONCLUSION While conscious abstinence results in higher withdrawal symptoms, distraction during abstinence lowers these symptoms. Inclusion of distraction sessions during cessation can, therefore, be a new element in tobacco control strategies.
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Affiliation(s)
- Kalpana Kumari Barhwal
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Sujwal Boppana
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | | | - Sushil Chandra Mahapatra
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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19
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Cherubal AG, Suhavana B, Padmavati R, Raghavan V. Physical activity and mental health in India: A narrative review. Int J Soc Psychiatry 2019; 65:656-667. [PMID: 31478452 DOI: 10.1177/0020764019871314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apart from its evident impact on physical health, physical activity also has a role to play in mental health. Individuals engaged in physical inactivity have been found to have higher morbidity and health care expenditure. In order to combat these issues and preserve mental health, interventions of exercise are typically advocated. This review aimed to assess the benefits of physical activity on common and severe mental disorders in the Indian context. MATERIALS AND METHODS A Boolean search was carried out using both relevant keywords and MeSH terms. Articles were sourced from online databases including PubMed, ScienceDirect, Cochrane Database, PsycINFO and Google Scholar. All studies included in the review were peer-reviewed articles exclusively from India with Indian subjects reporting the relationship between physical activity and at least one mental health outcome including depression, anxiety, psychosis, stress, self-esteem and cognitive functioning. RESULTS Nineteen articles were found eligible for the narrative review. Out of these, 7 were cross-sectional studies and 12 were intervention studies. CONCLUSION Existing literature from India has shown promising results towards the impact of physical activity in mental health disorders. However, more research is needed in the assessment of physical activity and physical activity interventions suitable to the Indian context. This review found that exercise and yoga are effective in reducing mean scores for both severe and common mental disorders. Yoga had a more significant impact on patients with schizophrenia than exercise or no intervention. To confirm that exercise is an effective add-on treatment, further research is required.
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Ning H, Harrison TC, Zhao Y, Hu H, Chen H, Liao L, Yu R, Wu S, Feng H. Correlates of Depressive Symptoms Among Older Adults With Physical Functional Limitations: A Cross-Sectional Study in China. Res Gerontol Nurs 2019; 12:133-146. [DOI: 10.3928/19404921-20190306-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/31/2019] [Indexed: 12/20/2022]
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Mukaetova-Ladinska EB, Cosker G, Chan M, Coppock M, Scully A, Kim SY, Kim SW, McNally RJQ, Teodorczuk A. Delirium Stigma Among Healthcare Staff. Geriatrics (Basel) 2018; 4:E6. [PMID: 31023974 PMCID: PMC6473673 DOI: 10.3390/geriatrics4010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 11/16/2022] Open
Abstract
Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals' own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.
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Affiliation(s)
- Elizabeta B Mukaetova-Ladinska
- Institute of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, UK.
- The Evington Centre, Leicestershire Partnership NHS Trust, Leicester General Hospital, Gwendolen Rd, Leicester LE5 4QG, UK.
| | - Glynis Cosker
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Mahathir Chan
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Michael Coppock
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Ann Scully
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Seon-Young Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Sung-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Richard J Q McNally
- Institute of Health & Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Andrew Teodorczuk
- School of Medicine and Health Institute for the Development of Education and Scholarship (Health IDEAS), Griffith University, Queensland 4122, Australia.
- The Prince Charles Hospital, Metro North, Brisbane, Queensland 4032, Australia.
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