1
|
Toulouse É, Carrier D, Villemure MP, Desruisseaux JR, Rochefort CM. The External Validation of the Nursing Homes Short Depression Inventory in Older Adults with Major Neurocognitive Disorders in Long-Term Care Centers. Dement Geriatr Cogn Disord 2023; 52:267-276. [PMID: 37549647 PMCID: PMC10614225 DOI: 10.1159/000533357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Depression is often difficult to detect in long-term care (LTC) patients with major neurocognitive disorders (MNCD), and an observer-rated screening scale could facilitate assessments. This study aimed to establish the external validity and reliability of the Nursing Homes Short Depression Inventory (NH-SDI) in LTC patients with MNCD and to compare its estimates to the Cornell Scale for Depression in Dementia (CSDD), the most used scale for depression in MNCD. METHODS A focus discussion group of experts assessed the content validity of the NH-SDI. Then, a convenience sample of 93 LTC patients with MNCD was observer-rated by trained nurses with the NH-SDI and CSDD. For 57 patients, a medical assessment of depression was obtained, and screening accuracy estimates were generated. RESULTS The prevalence of depression was 8.8% as per reference standard. NH-SDI's content validity was judged acceptable with minor item wording modifications and specifications. The NH-SDI (cut-off ≥3) achieved 100% (95% confidence interval [CI]: 46-100%) sensitivity, 83% (95% CI: 69-91%) specificity, and 36% (95% CI: 14-64%) positive predictive value (PPV). The CSDD (cut-off ≥3) achieved 100% (95% CI: 46-100%) sensitivity, 75% (95% CI: 61-86%) specificity, and 28% (95% CI: 11-54%) PPV. No significant differences in areas under the receiver operating characteristic curve were found between scales. The NH-SDI and CSDD were highly correlated (rs = 0.913; p < 0.001) and reliable (ICC = 0.77; p < 0.001). CONCLUSION The NH-SDI appears valid and reliable in LTC patients with MNCD and quicker than the CSDD to rule out depression in a busy or short-staffed setting.
Collapse
Affiliation(s)
- Élodie Toulouse
- School of Nursing, Faculty of Medicine and Health Sciences, Université De Sherbrooke, Sherbrooke, QC, Canada
| | - Daphnée Carrier
- School of Nursing, Faculty of Medicine and Health Sciences, Université De Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Pier Villemure
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Université De Sherbrooke, Sherbrooke, QC, Canada
| | - Jessika Roy Desruisseaux
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Christian M. Rochefort
- School of Nursing, Faculty of Medicine and Health Sciences, Université De Sherbrooke, Sherbrooke, QC, Canada
- Research Center, Hôpital Charles-Le Moyne, Longueuil, QC, Canada
- Research Centre, Centre Hospitalier Universitaire De Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|
2
|
Fang B, Li D, Yan E, Zhou Y, Yu Z, Hu J. Associated factors of discrepancy between older adults and their family caregivers in reporting elder abuse. J Clin Nurs 2023; 32:688-700. [PMID: 35289011 DOI: 10.1111/jocn.16283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/28/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers. BACKGROUND Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports. METHODS A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed. DESIGN Quantitative study with cross-sectional design. RESULTS Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen's kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist. CONCLUSIONS The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients' victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse. RELEVANCE TO CLINICAL PRACTICE There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.
Collapse
Affiliation(s)
- Boye Fang
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Danyu Li
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Elsie Yan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Yi Zhou
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Zhuopeng Yu
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Jian Hu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
3
|
Knippenberg IAH, Leontjevas R, Stoyanov S, Persoon A, Verboon P, Vermeulen H, van Lankveld JJDM, Gerritsen DL. Informal antidepressant strategies for nursing home residents: two group concept mapping studies. Aging Ment Health 2023; 27:251-262. [PMID: 35369803 DOI: 10.1080/13607863.2022.2057427] [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] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To identify and structure potential informal antidepressant strategies that can be used in daily practice for nursing home residents alongside formal treatments. METHODS In a first Group Concept Mapping study, residents, relatives, and professional caregivers (N = 124) brainstormed on strategies residents could use to prevent or alleviate depression. In a second study, the same participants (N = 110) reported strategies for use by others. Furthermore, participants rated the expected effectiveness and feasibility of the suggested strategies. Simultaneously, all strategies were sorted by experts and clustered using multidimensional scaling and hierarchical cluster analysis. RESULTS Six clusters emerged for strategies by residents themselves and five clusters for strategies by others. For residents' strategies, the clusters Being socially connected and Participating in activities were perceived as most effective, as was the cluster Offering personal attention for strategies by others. Participants perceived Creating a healthy living environment as the most feasible cluster executed by residents. Within strategies by others, the clusters Offering personal attention, Using positive treatment/approach, and Using or adapting the physical environment were perceived as the most feasible. CONCLUSION The results indicated the importance of social connectedness, a personalized and positive approach by significant others, and tailored activity programs. The results also suggest that adaptations to the physical environment within nursing homes may be an easy applicable strategy to prevent or alleviate depression in residents. Although more research is needed, these findings may guide daily practice and the development of interventions that include informal strategies. UNLABELLED Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2057427 .
Collapse
Affiliation(s)
- Inge A H Knippenberg
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Slavi Stoyanov
- Faculty of Educational Sciences, Department of Technology Enhanced Learning and Innovation, Open University of the Netherlands, Heerlen, The Netherlands
| | - Anke Persoon
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hester Vermeulen
- IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| |
Collapse
|
4
|
Trevisan C, Welmer AK, Curreri C, Noale M, Maggi S, Sergi G. The impact of falls on the need for hospital care in older people: results from the Pro.V.A. study. JOURNAL OF GERONTOLOGY AND GERIATRICS 2023. [DOI: 10.36150/2499-6564-n406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
5
|
Incidence and Predictive Factors of Functional Decline in Older People Living in Nursing Homes: A Systematic Review. J Am Med Dir Assoc 2022; 23:1815-1825.e9. [DOI: 10.1016/j.jamda.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/26/2022] [Accepted: 05/01/2022] [Indexed: 11/23/2022]
|
6
|
Gedde MH, Husebo BS, Mannseth J, Kjome RLS, Naik M, Berge LI. Less Is More: The Impact of Deprescribing Psychotropic Drugs on Behavioral and Psychological Symptoms and Daily Functioning in Nursing Home Patients. Results From the Cluster-Randomized Controlled COSMOS Trial. Am J Geriatr Psychiatry 2021; 29:304-315. [PMID: 32753339 DOI: 10.1016/j.jagp.2020.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate the impact of medication reviews using collegial mentoring and systematic clinical evaluation on psychotropic prescriptions, behavioral and psychological symptoms of dementia (BPSD), and activities of daily living (ADL). DESIGN Four-month multicenter, multicomponent, cluster-randomized, single-blinded controlled trial. SETTING Thirty-three Norwegian nursing homes including 67 nursing home wards (clusters). PARTICIPANTS A total of 723 enrolled patients, of which 428 participated in the study; 217 were randomized to the intervention and 211 to care as usual (control). INTERVENTION The COSMOS intervention consisted of Communication, Systematic pain management, Medication reviews, Organization of activities, and Safety. During medication review, the nursing home physician evaluated treatment with colleagues systematically using the results from validated clinical assessments. MEASUREMENTS Mean changes from baseline to month 4 in the number of prescribed psychotropic drugs (antipsychotics, anxiolytics, hypnotics or sedatives, antidepressants, and antidementia drugs); Neuropsychiatric Inventory Nursing Home Version (NPI-NH) and Cornell Scale of Depression in Dementia (CSDD); Lawton and Brody's Physical Self Maintenance Scale (PSMS). RESULTS Compared to control, the mean change in prescribed psychotropic drugs was reduced both in total and regular number, while mean changes in NPI-NH and CSDD scores did not differ between the groups. Mean change in PSMS showed improvement in the intervention group, and deterioration in the control group. CONCLUSION Medication reviews using collegial mentoring and systematic clinical evaluation led to safe deprescribing, as the reductions in psychotropic drug use did not negatively affect BPSD, while ADL improved.
Collapse
Affiliation(s)
- Marie H Gedde
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway; Haraldsplass Deaconess Hospital, Bergen, Norway.
| | - Bettina S Husebo
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway; Municipality of Bergen, Bergen, Norway
| | - Janne Mannseth
- Section for Epidemiology and Medical Statistic, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reidun L S Kjome
- Centre for Pharmacy/Department for Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mala Naik
- Haraldsplass Deaconess Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Line I Berge
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway; NKS Olaviken Gerontopsychiatric Hospital, Bergen, Norway
| |
Collapse
|
7
|
Fang B, Liu H, Yang S, Xu R, Chen G. Impact of Social Isolation on Subsequent Peptic Ulcer Recurrence in Older Adults With Mild Cognitive Impairment: The Role of Change in Severity of Depression. Psychosom Med 2021; 82:197-207. [PMID: 31794441 DOI: 10.1097/psy.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to examine the association between social isolation, change in severity of depression, and subsequent recurrence of peptic ulcer disease (PUD) in older adults with mild cognitive impairment. METHODS Older adults (≥55 years) with mild cognitive impairment and Helicobacter pylori-infected PUD (N = 2208) were recruited between 2010 and 2014 from 12 hospitals in the People's Republic of China. H. pylori was eradicated and PUD was cleared in 2015 participants by the end of 2014; 1900 of these were followed up for up to 36 months. The Kaplan-Meier method was used to assess how PUD recurrence varied with social engagement levels and changes in depression severity. Multivariate Cox proportional hazard models were used to examine associations between social isolation, changes in depression severity, and PUD recurrence. RESULTS PUD recurrence was more prevalent in socially isolated (10.8%) than in socially engaged participants (5.5%). However, the rates of PUD were lower in socially isolated individuals without (absence of) depression (7.2%) and those with decreased depression (8.2%), whereas socially isolated individuals with unchanged and increased depression had substantially higher rates of PUD (16.3% and 17.8%, respectively; the social isolation by depression group for PUD recurrence was significant (p < .001). Specifically, although social isolation was associated with PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 2.665 [1.602-4.518]), it did not increase PUD recurrence risk in participants without depression or with reduced depression. However, in participants with unchanged or increased depression, PUD recurrence was more likely to occur in socially isolated (HR = 1.587 [1.125-2.588]; HR = 1.886 [1.012, 3.522] respectively) than in socially engaged participants. CONCLUSIONS Social isolation is associated with a greater risk of PUD recurrence; however, the absence of or decreased severity of depression may alter this relationship.
Collapse
Affiliation(s)
- Boye Fang
- From the School of Sociology and Anthropology, Sun Yat-Sen University (Fang), Guangzhou, Guangdong; Department of Sociology, Central South University (Liu), Changsha, Hunan, People's Republic of China; Department of Social Work, Hong Kong Baptist University (Yang), Kowloon Tong, Hong Kong; and Department of General Surgery, The Second Affiliated Hospital, Shantou University Medical College (Xu, Chen), Shantou, Guangdong, People's Republic of China
| | | | | | | | | |
Collapse
|
8
|
Luo H, Lou VWQ, Chen C, Chi I. The Effectiveness of the Positive Mood and Active Life Program on Reducing Depressive Symptoms in Long-Term Care Facilities. THE GERONTOLOGIST 2020; 60:193-204. [PMID: 30295729 DOI: 10.1093/geront/gny120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Depression is prevalent among long-term care facility (LTCF) residents. However, interventions are not normally part of the management of these residents due to a shortage of mental health professionals. On the basis of Lewinsohn's behavioral model of depression, we developed a 12-week pleasant activity scheduling intervention, the Positive Mood and Active Life (PMAL) program. This study evaluated the effectiveness of the PMAL program on reducing depressive symptoms and improving quality of life among at-risk LTCF residents. RESEARCH DESIGN AND METHODS We adopted a cluster randomized controlled trial design. Four LTCFs were randomly assigned as treatment sites and three provided care as usual. At-risk LTCF residents (N = 68) were identified using the Mood Resident Assessment Protocol from the Minimum Data Set 2.0. The PMAL program was delivered to 34 residents. The primary and secondary outcomes were depressive symptoms and quality of life, as measured by the Geriatric Depression Scale-15 (GDS-15) and the World Health Organization Quality of Life scale-BREF (WHOQoL-BREF), respectively. RESULTS After 12 weeks, the GDS-15 score in the intervention group showed a reduction from 7.59 to 5.67, with a significant treatment by time effect (p = .006), based on the mixed model analysis; the WHOQoL-BREF score also substantially increased from 69.83 to 86.61 (p = .000). DISCUSSION AND IMPLICATIONS The PMAL program is effective in reducing depressive symptoms of at-risk LTCF residents. It is a feasible intervention that requires minimum resources and can be integrated with standardized assessment systems.
Collapse
Affiliation(s)
- Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong.,Department of Computer Science, The University of Hong Kong.,Sau Po Centre on Ageing, Department of Social Work and Social Administration, The University of Hong Kong
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong.,Sau Po Centre on Ageing, Department of Social Work and Social Administration, The University of Hong Kong
| | - Chunhua Chen
- Sau Po Centre on Ageing, Department of Social Work and Social Administration, The University of Hong Kong
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| |
Collapse
|
9
|
Falci DM, Mambrini JVDM, Castro-Costa É, Firmo JOA, Lima-Costa MF, de Loyola AI. Use of psychoactive drugs predicts functional disability among older adults. Rev Saude Publica 2019; 53:21. [PMID: 30726502 PMCID: PMC6390663 DOI: 10.11606/s1518-8787.2019053000675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/29/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Investigate whether the use of psychoactive drugs would be a predictor of incidence of functional disability among seniors living in community. METHODS It is a population-based longitudinal study, developed between January 1, 1997 and December 31, 2011, with older adults living in community. The association between the use of psychoactive drugs and the development of functional disability for instrumental (IADLs) and basic (BADLs) activities of daily living was tested using the extended Cox proportional hazards model, which considers the measure of exposure of interest throughout the follow-up period. The analyses were stratified by sex and adjusted by sociodemographic characteristics, health behavior and health conditions. RESULTS After multivariate adjustment, the use of two or more psychoactive drugs in the female stratum was associated with disability for both IADLs (HR = 1.58; 95%CI 1.17-2.13) and BADLs (HR = 1.43; 95%CI 1.05-1.94), the use of benzodiazepines was associated with disability for IADLs (HR = 1.32; 95%CI 1.07-1.62), and the use of antidepressants was associated with disability for both IADLs (HR = 1.51; 95%CI 1.16-1.98) and BADLs (HR = 1.44; 95%CI 1.10-1.90). In the male stratum, the use of antipsychotics was associated with disability for IADLs (HR = 3.14; 95%CI 1.49-6.59). CONCLUSIONS The study showed a prospective association between the use of psychoactive drugs and functional disability. These results indicate the need to carefully assess the prescription of psychoactive drugs for older adults and monitor their usage in order to detect damages to the health of users.
Collapse
Affiliation(s)
- Denise Mourão Falci
- Instituto René Rachou. Fundação Oswaldo Cruz. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Juliana Vaz de Melo Mambrini
- Instituto René Rachou. Fundação Oswaldo Cruz. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Instituto René Rachou. Fundação Oswaldo Cruz. Núcleo de Estudos em Envelhecimento e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Érico Castro-Costa
- Instituto René Rachou. Fundação Oswaldo Cruz. Núcleo de Estudos em Envelhecimento e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Josélia Oliveira Araújo Firmo
- Instituto René Rachou. Fundação Oswaldo Cruz. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Instituto René Rachou. Fundação Oswaldo Cruz. Núcleo de Estudos em Envelhecimento e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Instituto René Rachou. Fundação Oswaldo Cruz. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Instituto René Rachou. Fundação Oswaldo Cruz. Núcleo de Estudos em Envelhecimento e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Antônio Ignácio de Loyola
- Instituto René Rachou. Fundação Oswaldo Cruz. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Instituto René Rachou. Fundação Oswaldo Cruz. Núcleo de Estudos em Envelhecimento e Saúde Pública. Belo Horizonte, MG, Brasil
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Aplicada. Belo Horizonte, MG, Brasil
| |
Collapse
|
10
|
Relationships of depressive behavior and sertraline treatment with walking speed and activity in older female nonhuman primates. GeroScience 2017; 39:585-600. [PMID: 29080976 DOI: 10.1007/s11357-017-9999-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 10/15/2017] [Indexed: 01/08/2023] Open
Abstract
Depression is the most common mental health problem in aging persons and is a leading risk factor for physical disability, especially in women. Though antidepressant drugs such as serotonin reuptake inhibitors (SSRI) are commonly prescribed, epidemiological evidence reveals mixed effects of long-term antidepressant use on physical function and activity, possibly depending on depressive status. The purpose of this preclinical trial was to determine the relationships of depressive behavior and the potential for an SSRI treatment to modulate walking speed and activity patterns in older adult female cynomolgus monkeys (Macaca fascicularis). We evaluated the effects of depression and a commonly prescribed SSRI, sertraline HCl (20 mg/kg/day p.o.), on (a) walking speed, (b) accelerometry-derived activity (counts) and sedentariness (daytime 60-s sedentary epochs), and (c) observed locomotor and sedentary behaviors (% time) in adult female depressed and nondepressed monkeys (n = 42; 17.2 ± 1.8 years) during an 18 month pre-treatment phase and an 18 month treatment phase using a longitudinal, stratified placebo-control study design. Monkeys that were depressed prior to treatment (19/42) subsequently had slower walking speeds (F D [1, 38] = 4.14; p ≤ 0.05) and tended to be more sedentary during the daytime (F D [1, 38] = 3.63; p ≤ 0.06). Sertraline did not affect depressive behaviors, walking speed, accelerometry-derived physical activity or sedentariness, or time observed in total locomotor or sedentary behavior (all p > 0.10). This study provides the first experimental demonstration of relationships between nonhuman primate behavioral depression and walking speed, activity, and sedentariness and provides evidence for a lack of an effect of SSRI treatment on these phenotypes.
Collapse
|
11
|
Petzold MB, Bischoff S, Rogoll J, Plag J, Terán C, Brand R, Ströhle A. Physical activity in outpatients with mental disorders: status, measurement and social cognitive determinants of health behavior change. Eur Arch Psychiatry Clin Neurosci 2017; 267:639-650. [PMID: 28194516 DOI: 10.1007/s00406-017-0772-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/23/2017] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Physical activity (PA) can play an important role in improving the mental and physical health in patients with mental disorders but is not well studied in this population. The aim of this study was to assess the status of PA in outpatients with mental disorders, compare the convergence of self-rating and accelerometer measurement and examine the influence of social cognitive variables from the Motivation-Volition (MoVo) model and clinical measures on PA. METHODS Eighty-four patients were recruited from three psychiatric outpatient clinics and local psychiatrists (Distribution of ICD-10-Diagnoses: F3.x = 59.5%, F4.x = 20.2%, F2.x = 17.9%, F1.x = 2.4%). PA, Self-efficacy, Outcome-expectancies, Intention, Self-concordance, Action- and Coping-planning, Health-related Quality of Life (SF-12) and Psychiatric Symptoms (SCL-27) were assessed through questionnaires. PA was assessed objectively by accelerometers. RESULTS Most of the participants did not reach PA recommendations. Subjective and objective measurement of PA showed good accordance for total PA on group level but lower accordance on individual level. Motivational and volitional determinants of health behavior change showed a similar pattern of correlations with PA as in populations without mental disorders. CONCLUSION Outpatients with mental disorders have the ability and are willing to perform PA but a large proportion of our sample did not meet PA recommendations. To assess group levels of PA, subjective and objective measurement seem equally apt, for individual diagnostics, a combination of both should be considered. Social cognitive determinants of health behavior change seem to be as helpful for the design of PA interventions for patients with mental disorders as they are in other populations.
Collapse
Affiliation(s)
- Moritz B Petzold
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sophie Bischoff
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Janina Rogoll
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christina Terán
- Department of Psychiatry, St. Hedwig Klinikum, Große Hamburger Straße 5-11, 10115, Berlin, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| |
Collapse
|
12
|
Dombrowsky TA. Relationship between engagement and level of functional status in older adults. SAGE Open Med 2017; 5:2050312117727998. [PMID: 28904793 PMCID: PMC5588797 DOI: 10.1177/2050312117727998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 07/31/2017] [Indexed: 12/23/2022] Open
Abstract
Functional status is an important component of quality of life for older adults and for their caregivers. Factors associated with level of functional status include age, comorbidity, cognitive status, depression, social support, and activity. Of the types of activity linked with functional status, the strongest evidence is for physical exercise, with weaker evidence for social and productive activity. Engagement is a construct including motivation, commitment, and participation.
Collapse
Affiliation(s)
- Thomas A Dombrowsky
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| |
Collapse
|
13
|
Affiliation(s)
- B Fougère
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
| | | |
Collapse
|
14
|
Hou Z, Jiang W, Yin Y, Zhang Z, Yuan Y. The Current Situation on Major Depressive Disorder in China: Research on Mechanisms and Clinical Practice. Neurosci Bull 2016; 32:389-97. [PMID: 27237579 DOI: 10.1007/s12264-016-0037-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/11/2016] [Indexed: 12/12/2022] Open
Abstract
Depression is the most disabling disorder worldwide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only ~50% of patients respond to frontline antidepressants, and <33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Furthermore, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.
Collapse
Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatic Medicine, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatic Medicine, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatic Medicine, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China
| | - Zhijun Zhang
- Department of Neurology, Institute of Neuropsychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatic Medicine, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China.
| |
Collapse
|
15
|
Fedecostante M, Dell'Aquila G, Eusebi P, Volpato S, Zuliani G, Abete P, Lattanzio F, Cherubini A. Predictors of Functional Changes in Italian Nursing Home Residents: The U.L.I.S.S.E. Study. J Am Med Dir Assoc 2015; 17:306-11. [PMID: 26715356 DOI: 10.1016/j.jamda.2015.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To identify independent predictors of the risk of functional decline in older nursing home (NH) residents. DESIGN A longitudinal observational study. SETTING Thirty-one NHs participating in the U.L.I.S.S.E. project, distributed throughout Italy. PARTICIPANTS All older (≥65 years) long-term NH residents without complete disability and with at least one follow-up evaluation during the 12-month study period (n = 1263). MEASUREMENTS All participants underwent a standardized comprehensive evaluation using the Italian version of the Minimum Data Set for NHs. The activities of daily living (ADLs) Long-Form scale was used to evaluate functional status. Facility characteristics were collected using an ad hoc designed questionnaire. RESULTS Of the NH residents, 40.4% experienced a decline in the ADL during the follow-up. The mixed effect logistic regression model showed that depression (odds ratio [OR] 1.45, confidence interval [CI] 1.16-1.81, P = .005) and the use of antipsychotics (OR 1.30, CI 1.06-1.60, P = .016) were associated with a higher probability of ADL decline, whereas the presence of a geriatrician (OR 0.60, CI 0.41-0.88, P = .015) and a higher than median hour per resident per week of nursing care (OR 0.55, CI 0.37-0.80, P = .006) were associated with a lower risk. CONCLUSIONS Our findings suggest that preventing functional decline in NH residents might be possible by optimizing the management of depression and by reducing the current high prescription rate of antipsychotics. Moreover, the presence of a geriatrician, associated with an adequate amount of nursing care, seem to be important facilities characteristics to achieve this goal. These findings should be tested in large-scale pragmatic clinical trials.
Collapse
Affiliation(s)
| | - Giuseppina Dell'Aquila
- Department of Medicine, Geriatrics and Geriatric Emergency Care, IRCCS-INRCA, Ancona, Italy
| | - Paolo Eusebi
- Epidemiology Department, Regional Health Authority of Umbria, Perugia, Italy
| | - Stefano Volpato
- Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology, and Clinical Nutrition, University of Ferrara, Ferrara, Italy
| | - Giovanni Zuliani
- Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology, and Clinical Nutrition, University of Ferrara, Ferrara, Italy
| | - Pasquale Abete
- Dipartimento di Scienze Mediche Traslazionali, Università di Napoli "Federico II", Naples, Italy
| | | | - Antonio Cherubini
- Department of Medicine, Geriatrics and Geriatric Emergency Care, IRCCS-INRCA, Ancona, Italy.
| |
Collapse
|