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Minetou L, Chatzopoulos A, Tzerachoglou A, Priniotakis G, van Hoof J, Sfyroera E, Georgiadou Z, Tyrovola S, Drosos C. Homing wellness: can narrative design transform living spaces for people with dementia into engaging environments enabling communication? Front Public Health 2024; 11:1198253. [PMID: 38292379 PMCID: PMC10827317 DOI: 10.3389/fpubh.2023.1198253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/31/2023] [Indexed: 02/01/2024] Open
Abstract
Interactive design is an emerging trend in dementia care environments. This article describes a research project aiming at the design and development of novel spatial objects with narrative attributes that incorporate embedded technology and textiles to support the wellbeing of people living with dementia. In collaboration with people with dementia, this interdisciplinary research project focuses on the question of how innovative spatial objects can be incorporated into dementia long-term care settings, transforming the space into a comforting and playful narrative environment that can enhance self-esteem while also facilitating communication between people living with dementia, family, and staff members. The research methodologies applied are qualitative, including Action Research. Participatory design methods with the experts by experience-the people with dementia-and health professionals have been used to inform the study. Early findings from this research are presented as design solutions comprising a series of spatial object prototypes with embedded technology and textiles. The prototypes were evaluated primarily by researchers, health professionals, academics, and design practitioners in terms of functionality, aesthetics, and their potential to stimulate engagement. The research is ongoing, and the aim is to evaluate the prototypes by using ethnographic and sensory ethnography methods and, consequently, further develop them through co-design workshops with people living with dementia.
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Affiliation(s)
- Loukia Minetou
- Centre for Environment Dementia and Ageing Research, Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom
| | - Avraam Chatzopoulos
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
| | - Anastasios Tzerachoglou
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
| | - Georgios Priniotakis
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
| | - Joost van Hoof
- Research Group of Urban Ageing, Faculty of Social Work and Education, The Hague University of Applied Sciences, The Hague, Netherlands
- Faculty of Spatial Management and Landscape Architecture, Institute of Spatial Management, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Emmanouela Sfyroera
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
| | - Zoe Georgiadou
- Department of Interior Architecture, School of Applied Arts and Design, University of West Attica, Athens, Greece
| | - Styliani Tyrovola
- Department of Interior Architecture, School of Applied Arts and Design, University of West Attica, Athens, Greece
| | - Christos Drosos
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
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Matos Queirós A, von Gunten A, Rosselet Amoussou J, Martins MM, Verloo H. Relationship Between Depression and Falls Among Nursing Home Residents: Protocol for an Integrative Review. JMIR Res Protoc 2023; 12:e46995. [PMID: 37856175 PMCID: PMC10623236 DOI: 10.2196/46995] [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: 03/05/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Aging exposes individuals to new health disorders and debilitating chronic diseases, yet most older adults, even in functional decline, do not want to leave their homes. Nevertheless, for many, institutionalization in a nursing home (NH) may become essential to ensure their continued safety and health. Depression is one of the most common psychiatric disorders among older adults, especially among those who are institutionalized. Depressed NH residents face a high risk of future functional decline and falls, decreasing their quality of life. The relationship between depression and falls is complex and bidirectional. Previous reviews have focused on home-dwelling older adults or explored the relationship between antidepressant drugs and falls. To the best of our knowledge, no integrative literature reviews have explored the relationship between depression and falls among NH residents. OBJECTIVE Analyze studies on the relationship between depression and falls among NH residents. METHODS We will conduct an integrative literature review of published articles in relevant scientific journals on the relationship between depression and depressive symptomatology and falls among NH residents. As usually defined, we will consider NH residents to be people aged 65 years and older who can no longer live safely and independently in their homes. We will also consider older adults on short-term stays in an NH for rehabilitation after hospital discharge. Retrieved articles will be screened for eligibility and analyzed following previously reported steps. The most pertinent bibliographical databases will be examined for qualitative, quantitative, and mixed methods studies, from inception until August 31, 2023, thus ensuring that all relevant literature is included. We will also hand-search the bibliographies of all the relevant articles found and search for unpublished studies in any language. If appropriate, we will consider conducting a meta-analysis of the studies retrieved. RESULTS A first round of data collection was completed in March 2023. We retrieved a total of 2276 references. A supplementary literature search to ensure the most up-to-date evidence is ongoing. We anticipate that the review will be completed in late September 2023, and we expect to publish results at the end of December 2023. CONCLUSIONS This integrative review will increase knowledge and understanding of the complex relationship between depression and falls in NH environments. Its findings will be important for developing integrated, multidisciplinary models and care recommendations, adaptable to each NH resident's situation and health status, and for creating preventive interventions to help them maintain or recover optimal health stability. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46995.
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Affiliation(s)
- Alcina Matos Queirós
- Department of Health and Social Welfare, University of Lausanne, Lausanne, Switzerland
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Joëlle Rosselet Amoussou
- Medical Library-Cery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Henk Verloo
- Service of Old Age Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Nursing Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland
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Atef RZ, Michalowsky B, Raedke A, Platen M, Mohr W, Mühlichen F, Thyrian JR, Hoffmann W. Impact of Hearing Aids on Progression of Cognitive Decline, Depression, and Quality of Life Among People with Cognitive Impairment and Dementia. J Alzheimers Dis 2023; 92:629-638. [PMID: 36776058 DOI: 10.3233/jad-220938] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Hearing loss is common in people with dementia (PwD) and a modifiable risk factor for cognitive decline. Recent studies revealed that hearing loss could cause social isolation and depression, which is associated with health-related quality of life (HRQoL). However, there is a lack of knowledge about the impact of the utilization of hearing aids on these outcomes. OBJECTIVE To assess whether hearing aids use might be positively associated with the progression of cognitive function, depression, and HRQoL among PwD. METHODS We analyzed two-year follow-up data from 258 PwD (≥70 years, living at home). Cognitive decline was measured with Mini-Mental Status Examination (MMSE), depression using Geriatric Depression Scale (GDS), and HRQoL with Quality of Life in Alzheimer's Disease Scale (QoL-AD). The impact of hearing aid utilization on the progression of outcomes was assessed using multivariate regression models. RESULTS 123 patients had hearing loss (47.7%), from which n = 54 (43.9%) used hearing aids. Patients with hearing loss were older and had a lower HRQoL than those without hearing loss. Use of hearing aids in patients with hearing loss was associated with a lower increase in symptoms (b = -0.74, CI95 -1.46 --0.01, p = 0.047) over time as compared to those not using hearing aids. There was no effect on PwD's cognition, and the association with higher HRQoL was significant after one, but not consistently over two years. CONCLUSION Early detection and intervention of presbycusis using hearing aids might improve mental health and HRQoL in dementia.
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Affiliation(s)
- Roaa Zayed Atef
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Anika Raedke
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Wiebke Mohr
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
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Mentzel C, Glue P, Greco P, Barak Y. Analysing Realistic effects of modifiable risk factors for dementia in a large National Dataset. Arch Gerontol Geriatr 2023; 105:104852. [PMID: 36375272 DOI: 10.1016/j.archger.2022.104852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Modifiable risk factors affect 40% of dementia risk thus creating an opportunity for prevention or delay. The risk factor life-course model of dementia prevention by the Lancet Commission has yet to be tested in the general populations. We aimed to assess the model's assumptions in a large national dataset of older adults assessed for support services. METHODS The interRAI assessment is a comprehensive evidence-based tool encompassing 236 items that is mandatory in New Zealand (NZ) for older adults providing a standardized national dataset. We tested the Lancet model of dementia prevention in a sample of 66,638 participants who underwent an interRAI assessment during the period 2013-2018. There were 59% female interviewees; mean age was 82 years (range: 65-107). Our cross-sectional dataset analysis was performed in using a logistic regression model with diagnosis of dementia as the primary outcome. RESULTS The Lancet prevention model was supported in part. Hypertension, Hearing Impairment and past or present Depression increase risk of dementia. Age - increased risk demonstrated until 85 years; Gender - females at increased risk; BMI - initial effect of high BMI increases risk of dementia. However, exercise, diabetes, vision impairment and smoking as modifiable factors were not associated with dementia risk as predicted by the Lancet model. CONCLUSIONS Limitations of the dataset analysed may have affected our findings. Nevertheless, important modifiable factors are herein confirmed as increasing dementia risk. BMI, hypertension, hearing impairment and depression are risks confirmed in the older NZ population lending credibility to prevention efforts targeted at these variables.
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Affiliation(s)
- Charlotte Mentzel
- Otago University Medical School, Department of Psychological Medicine, Dunedin, New Zealand
| | - Paul Glue
- Otago University Medical School, Department of Psychological Medicine, Dunedin, New Zealand
| | - Philippa Greco
- Quality Lead interRAI, Southern District Health Board, Dunedin, New Zealand
| | - Yoram Barak
- Otago University Medical School, Department of Psychological Medicine, Dunedin, New Zealand.
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5
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Borza T, Selbæk G, Lichtwarck B, Benth JŠ, Bergh S. The Course of Depressive Symptoms Over 36 Months in 696 Newly Admitted Nursing Home Residents. J Am Med Dir Assoc 2022; 23:1838-1844.e2. [PMID: 36116536 DOI: 10.1016/j.jamda.2022.08.007] [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: 02/26/2022] [Revised: 08/05/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the course of depressive symptoms in newly admitted nursing home (NH) residents and how resident characteristics were associated with the symptoms. To identify groups of residents following the same symptom trajectory. DESIGN An observational, multicenter, longitudinal study over 36 months with 7 biannual assessments. SETTING AND PARTICIPANTS Representing 47 Norwegian NHs, 696 residents were included at admission to a NH. METHODS Depressive symptoms were assessed with the Cornell Scale for Depression in Dementia (CSDD). We selected severity of dementia, functional impairment, physical health, pain, use of antidepressants, age, and sex as covariates. Time trend in CSDD score was assessed by a linear mixed model adjusting for covariates. Next, a growth mixture model was estimated to investigate whether there were groups of residents following distinct trajectories in CSDD scores. We estimated a nominal regression model to assess whether the covariates at admission were associated to group membership. RESULTS There was a nonlinear trend in CSDD score. More severe dementia, a lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher CSDD scores. Growth mixture model identified 4 groups: (1) persistent mild symptoms (32.6%), (2) persistent moderate symptoms (50.8%), (3) increasing symptoms (5.1%), and (4) severe but decreasing symptoms (11.6%). A lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher odds for belonging to the severe but decreasing symptoms group compared with the persistent mild symptoms group. CONCLUSIONS AND IMPLICATIONS Most NH residents were in trajectory groups with persistent mild or moderate depressive symptoms. Residents with more severe dementia, lower levels of functioning, poor physical health, severe pain, younger age at admittance, and who are using antidepressants should be monitored closely and systematically with respect to depression. Taking actions toward a more personalized treatment for depression in NHs is a priority and should be investigated in future studies.
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Affiliation(s)
- Tom Borza
- Research Center for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.
| | - Geir Selbæk
- Norwegian National Center for Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Bjørn Lichtwarck
- Research Center for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Jūratė Šaltytė Benth
- Research Center for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Research Center for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway; Norwegian National Center for Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Angevaare MJ, Joling KJ, Smalbrugge M, Hertogh CMPM, Twisk JWR, van Hout HPJ. The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents. J Am Med Dir Assoc 2022; 23:1608.e9-1608.e18. [PMID: 35964663 PMCID: PMC9276644 DOI: 10.1016/j.jamda.2022.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/10/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
Objectives We aimed to explore the effects of the Dutch COVID-19 lockdown (March 20–May 25, 2020) on mood, behavior, and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively. Design Mixed methods: historically controlled longitudinal cohort study and focus groups. Setting and Participants Residents of Dutch LTCFs. Methods Residents who were assessed during and prior to the lockdown were compared to residents of the same wards with 2 assessments prior to the lockdown. We used mixed models and generalized estimating equation analyses to explore differences in changes in mood, withdrawal and aggressive behavior, loneliness and conflict, and cognition and delirium. We also explored whether the effect of the lockdown differed for different subgroups. In 2 online focus groups, LTCF care professionals, ranging from care staff to physicians, reflected on their experiences of the effect of the lockdown and the cohort study results. Results The lockdown group of 298 residents was compared to the control group of 625 residents. Self-reported mood symptoms showed a slightly greater increase during the lockdown. During the first half of the lockdown, the level of conflict with other residents decreased whereas it increased in the control group. The subgroup with moderate-severe cognitive impairment showed a decrease in withdrawal during the lockdown, whereas the group with no-mild cognitive impairment showed a statistically nonsignificant relative increase. Professionals described great individual variation in the effects of the lockdown on residents. Facilities attempted to preserve the experienced positive effects, for example, by promoting tranquility in shared rooms and continuing to organize individualized ward-based activities. Conclusions and Implications We did not find clinically relevant negative effects of the lockdown on mood, behavior, and social and cognitive functioning in older residents of LTCFs at the group level. Possibly, staff mitigated the negative effects at the group level. Meanwhile, they learned lessons that they continue to apply to enhance resident well-being.
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Affiliation(s)
- Milou J Angevaare
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Karlijn J Joling
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hein P J van Hout
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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7
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Feng L, Wu D, Lin J, Li Y, Zhao Y, Zhang P, Yao Y, Fu S. Associations between age-related hearing loss, cognitive decline, and depression in Chinese centenarians and oldest-old adults. Ther Adv Chronic Dis 2022; 13:20406223221084833. [PMID: 35342536 PMCID: PMC8949803 DOI: 10.1177/20406223221084833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/14/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Age-related hearing loss (ARHL) and age-related cognitive decline (ARCD) are leading causes of disability in older adults. ARHL may increase ARCD risk and cause depression development. This study aimed to explore the associations of ARHL with ARCD and depression in Chinese centenarians and oldest-old adults. Methods: A household survey was conducted on 859 centenarians and oldest-old adults residing in 16 cities and counties in China. Basic information was collected using interview questionnaires, physical examinations, and blood tests conducted by systematically trained local doctors and nurses. Results: In total, 501 (58.3%), 649 (75.6%), and 211 (24.6%) participants had ARHL, ARCD, and depression, respectively. The prevalence of ARCD and depression was significantly higher in participants with ARHL than in those without ARHL (all p < 0.05). Participants with ARHL had significantly lower Mini-Mental State Examination (MMSE) scores indicative of more cognitive decline, and significantly higher 15-item version of the Geriatric Depression Scale (GDS-15) scores suggesting greater levels of depression, than those without ARHL (all p < 0.05). Multivariate logistic regression analyses (Stepwise) indicated that ARHL was significantly and positively associated with ARCD [odds ratio (OR): 1.594, 95% confidence interval (CI): 1.132, 2.245] and depression (OR: 1.623, 95% CI: 1.139, 2.314; all p < 0.05). Multivariate linear regression analyses (Stepwise) indicated that ARHL was significantly and inversely associated with MMSE scores (B: −2.520, 95% CI: −3.356, −1.684) and significantly and positively associated with GDS-15 scores (B: 0.713, 95% CI: 0.328, 1.098; all p < 0.05). Conclusion: ARHL is independently associated with ARCD and depression in Chinese centenarians and oldest-old adults.
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Affiliation(s)
- Long Feng
- Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Di Wu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Jieqiong Lin
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Yulong Li
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University, Durham, NC, USA
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
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Hirdes JP, Morris JN, Perlman CM, Saari M, Betini GS, Franco-Martin MA, van Hout H, Stewart SL, Ferris J. Mood Disturbances Across the Continuum of Care Based on Self-Report and Clinician Rated Measures in the interRAI Suite of Assessment Instruments. Front Psychiatry 2022; 13:787463. [PMID: 35586405 PMCID: PMC9108209 DOI: 10.3389/fpsyt.2022.787463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/25/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Mood disturbance is a pervasive problem affecting persons of all ages in the general population and the subset of those receiving services from different health care providers. interRAI assessment instruments comprise an integrated health information system providing a common approach to comprehensive assessment of the strengths, preferences and needs of persons with complex needs across the continuum of care. OBJECTIVE Our objective was to create new mood scales for use with the full suite of interRAI assessments including a composite version with both clinician-rated and self-reported items as well as a self-report only version. METHODS We completed a cross-sectional analysis of 511,641 interRAI assessments of Canadian adults aged 18+ in community mental health, home care, community support services, nursing homes, palliative care, acute hospital, and general population surveys to develop, test, and refine new measures of mood disturbance that combined clinician and self-rated items. We examined validity and internal consistency across diverse care settings and populations. RESULTS The composite scale combining both clinician and self-report ratings and the self-report only variant showed different distributions across populations and settings with most severe signs of disturbed mood in community mental health settings and lowest severity in the general population prior to the COVID-19 pandemic. The self-report and composite measures were strongly correlated with each other but differed most in populations with high rates of missing values for self-report due to cognitive impairment (e.g., nursing homes). Evidence of reliability was strong across care settings, as was convergent validity with respect to depression/mood disorder diagnoses, sleep disturbance, and self-harm indicators. In a general population survey, the correlation of the self-reported mood scale with Kessler-10 was 0.73. CONCLUSIONS The new interRAI mood scales provide reliable and valid mental health measures that can be applied across diverse populations and care settings. Incorporating a person-centered approach to assessment, the composite scale considers the person's perspective and clinician views to provide a sensitive and robust measure that considers mood disturbances related to dysphoria, anxiety, and anhedonia.
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Affiliation(s)
- John P Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Margaret Saari
- SE Research Centre, SE Health and Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gustavo S Betini
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Hein van Hout
- Department of General Practice and Medicine for Older Persons, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shannon L Stewart
- Faculty of Education, Western University (Canada), London, ON, Canada
| | - Jason Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Abstract
OBJECTIVES Hearing loss is the most common sensory loss in humans and carries an enhanced risk of depression. No prior studies have attempted a contemporary machine learning approach to predict depression using subjective and objective hearing loss predictors. The objective was to deploy supervised machine learning to predict scores on a validated depression scale using subjective and objective audiometric variables and other health determinant predictors. DESIGN A large predictor set of health determinants from the National Health and Nutrition Examination Survey 2015-2016 database was used to predict adults' scores on a validated instrument to screen for the presence and severity of depression (Patient Health Questionnaire-9 [PHQ-9]). After model training, the relative influence of individual predictors on depression scores was stratified and analyzed. Model prediction performance was determined by prediction error metrics. RESULTS The test set mean absolute error was 3.03 (95% confidence interval: 2.91 to 3.14) and 2.55 (95% confidence interval: 2.48 to 2.62) on datasets with audiology-only predictors and all predictors, respectively, on the PHQ-9's 27-point scale. Participants' self-reported frustration when talking to members of family or friends due to hearing loss was the fifth-most influential of all predictors. Of the top 10 most influential audiometric predictors, five were related to social contexts, two for significant noise exposure, two objective audiometric parameters, and one presence of bothersome tinnitus. CONCLUSIONS Machine learning algorithms can accurately predict PHQ-9 depression scale scores from National Health and Nutrition Examination Survey data. The most influential audiometric predictors of higher scores on a validated depression scale were social dynamics of hearing loss and not objective audiometric testing. Such models could be useful in predicting depression scale scores at the point-of-care in conjunction with a standard audiologic assessment.
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Matos Queirós A, von Gunten A, Martins M, Wellens NIH, Verloo H. The Forgotten Psychopathology of Depressed Long-Term Care Facility Residents: A Call for Evidence-Based Practice. Dement Geriatr Cogn Dis Extra 2021; 11:38-44. [PMID: 33790939 PMCID: PMC7989823 DOI: 10.1159/000514118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction As Earth's population is rapidly aging, the question of how best to care for its older adults suffering from psychiatric disorders is becoming a constant and growing preoccupation. Depression is one of the most common psychiatric disorders among older adults, and depressed nursing home residents are at a particularly high risk of a decreased quality of life. The complex requirements of supporting and caring for depressed older adults in nursing homes demand the development and implementation of innovative clinical and organizational models that can ensure early identification of the disorder and high-quality multidisciplinary services for dealing with it. This perspective article aims to provide an overview of the literature and the state of the art of and the urgent need for research on the epidemiology and clinical treatment of depression among older adults. Method In collaboration with a medical librarian, we conducted literature and bibliometric reviews of published articles in Medline Ovid SP from inception until September 30, 2020, to identify studies related to depression, depressive symptoms, mood disorders, dementia, cognitive disorders, and health complications in long-term care facilities and nursing homes. Results We had 38,777 and 40,277 hits for depression and dementia, respectively, in long-term care facilities or nursing homes. The search equation found 536 and 1,447 studies exploring depression and dementia, respectively, and their related health complications in long-term care facilities or nursing homes. Conclusion Depression's relationships with other health complications have been poorly studied in long-term care facilities and nursing homes. More research is needed to understand them better.
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Affiliation(s)
- Alcina Matos Queirós
- Department of Health and Social Welfare, Lausanne, Switzerland.,Escola Superior de Enfermagem do Porto/Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Manuela Martins
- Escola Superior de Enfermagem do Porto/Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Higher School of Nursing of Porto, Porto, Portugal
| | - Nathalie I H Wellens
- Department of Health and Social Welfare, Lausanne, Switzerland.,Department of Public Health and Primary Care, Lausanne, Switzerland
| | - Henk Verloo
- Service of Old Age Psychiatry, Lausanne University Hospital, Prilly, Switzerland.,Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais/Wallis, Sion, Switzerland
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11
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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12
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Amare AT, Caughey GE, Whitehead C, Lang CE, Bray SC, Corlis M, Visvanathan R, Wesselingh S, Inacio MC. The prevalence, trends and determinants of mental health disorders in older Australians living in permanent residential aged care: Implications for policy and quality of aged care services. Aust N Z J Psychiatry 2020; 54:1200-1211. [PMID: 32746615 DOI: 10.1177/0004867420945367] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mental health disorders are a major health concern in older people and are associated with a higher risk of disability, frailty and early mortality. This study aimed to conduct a contemporary population-based assessment of the prevalence, trends and factors associated with mental health disorders in individuals who are living in permanent residential aged care (PRAC) in Australia. METHODS A retrospective cross-sectional study was conducted using national data from the Registry of Senior Australians, a national cohort of older Australians who had aged care eligibility assessment and entered PRAC between 2008 and 2016. Stepwise multivariate logistic regression modeling was applied to identify factors associated with mental health disorders. RESULTS Of 430,862 individuals included in this study, 57.8% had at least one mental health disorder. The prevalence of depression, phobia/anxiety and psychosis were as follows: 46.2% (95% confidence interval = [46.0%, 46.3%]), 14.9% (95% confidence interval = [14.8%, 15.0%]) and 9.7% (95% confidence interval = [9.6%, 9.8%]), respectively. The likelihood of having a mental health disorder was higher for those who were (adjusted odds ratio [95% confidence interval]) relatively younger, specifically for every 10-year increment in age, the odds of having mental health disorders was 44.0% lower (0.56, [0.55, 0.56]); female (1.33 [1.32, 1.35]); having increasing numbers of physical health comorbidities, 6-10 (1.26 [1.24, 1.29]) or 11-15 (1.48 [1.45, 1.51]) or more than 15 (1.64 [1.58, 1.71]) compared to people having less than five comorbidities; having limitations related to health care tasks (1.05 [1.04, 1.07]), meals (1.04 [1.02, 1.05]) or social and community participation (1.10 [1.08, 1.12]). CONCLUSION The burden of mental health disorders in older Australians living in PRAC was high and individuals with these conditions tend to be younger, with several physical comorbidities and/or functional limitations. Understanding the profile of individuals with mental health disorders at entry into PRAC can be used as evidence for baseline resource allocation for this population and evaluation of future needs of mental health services.
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Affiliation(s)
- Azmeraw T Amare
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Gillian E Caughey
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Craig Whitehead
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Catherine E Lang
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Sarah Ce Bray
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Maria C Inacio
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
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13
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Deng XF, Shi GQ, Guo LL, Zhu CA, Chen YJ. Analysis on Risk Factors of Depressive Symptoms in Occupational Noise-induced Hearing Loss Patients: A Cross-sectional Study. Noise Health 2020; 21:17-24. [PMID: 32098927 PMCID: PMC7050233 DOI: 10.4103/nah.nah_16_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective The aim of this study was to evaluate the risk factors of depressive symptoms in occupational noise-induced hearing loss (NIHL) patients. Methods A total of 106 patients were divided into depressive symptoms (ONHLPD) and without depressive symptoms (non-ONHLPD) according to the Self-rating Depression Scale. Questionnaires and laboratory data were collected and analyzed. Data were analyzed with independent t-test, Wilcoxon test, Pearson correlation analysis and multiple linear regression models. Results The prevalence of depressive symptoms was 53.8% in occupational NIHL patients. In ONHLPD, duration of the hearing loss, level of serum cortisol, scores of Pittsburgh Sleep Quality Index and Tinnitus Handicap Inventory were all significantly higher than those of non-ONHLPD. Conclusion The prevalence of depressive symptoms was relatively high in occupational NIHL patients. Duration of the hearing loss, sleep quality and tinnitus severity were the risk factors for occupational NHIL patients with depressive symptoms.
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Affiliation(s)
- Xiao-Feng Deng
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong; Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong Province, PR China
| | - Guo-Qi Shi
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, PR China
| | - Li-Li Guo
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, PR China
| | - Chuan-An Zhu
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, PR China
| | - Yong-Jun Chen
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, PR China
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14
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Fornaro M, Solmi M, Stubbs B, Veronese N, Monaco F, Novello S, Fusco A, Anastasia A, De Berardis D, Carvalho AF, de Bartolomeis A, Vieta E. Prevalence and correlates of major depressive disorder, bipolar disorder and schizophrenia among nursing home residents without dementia: systematic review and meta-analysis. Br J Psychiatry 2020; 216:6-15. [PMID: 30864533 DOI: 10.1192/bjp.2019.5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The elderly population and numbers of nursing homes residents are growing at a rapid pace globally. Uncertainty exists regarding the actual rates of major depressive disorder (MDD), bipolar disorder and schizophrenia as previous evidence documenting high rates relies on suboptimal methodology. AIMS To carry out a systematic review and meta-analysis on the prevalence and correlates of MDD, bipolar disorder and schizophrenia spectrum disorder among nursing homes residents without dementia. METHOD Major electronic databases were systematically searched from 1980 to July 2017 for original studies reporting on the prevalence and correlates of MDD among nursing homes residents without dementia. The prevalence of MDD in this population was meta-analysed through random-effects modelling and potential sources of heterogeneity were examined through subgroup/meta-regression analyses. RESULTS Across 32 observational studies encompassing 13 394 nursing homes residents, 2110 people were diagnosed with MDD, resulting in a pooled prevalence rate of 18.9% (95% CI 14.8-23.8). Heterogeneity was high (I2 = 97%, P≤0.001); no evidence of publication bias was observed. Sensitivity analysis indicated the highest rates of MDD among North American residents (25.4%, 95% CI 18-34.5, P≤0.001). Prevalence of either bipolar disorder or schizophrenia spectrum disorder could not be reliably pooled because of the paucity of data. CONCLUSIONS MDD is highly prevalent among nursing homes residents without dementia. Efforts towards prevention, early recognition and management of MDD in this population are warranted.
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Affiliation(s)
- Michele Fornaro
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Marco Solmi
- Neuroscience Department, Psychiatry Unit, University of Padua; Psychiatry Unit, Azienda Ospedaliera di Padova, Padua Hospital, Italy; and Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust; and Health Service and Population Research Department and the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Francesco Monaco
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neuroscience, University of Salerno, Italy
| | - Stefano Novello
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Andrea Fusco
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | | | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Italy
| | - André F Carvalho
- Department of Psychiatry, University of Toronto; and Centre for Addiction & Mental Health (CAMH), Canada
| | - Andrea de Bartolomeis
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Eduard Vieta
- Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
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15
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Incidence of depression in people with newly diagnosed tuberculosis in Ethiopia: a cohort study. Glob Ment Health (Camb) 2020; 7:e1. [PMID: 32076571 PMCID: PMC7003520 DOI: 10.1017/gmh.2019.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 09/17/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cross-sectional studies show that the prevalence of comorbid depression in people with tuberculosis (TB) is high. The hypothesis that TB may lead to depression has not been well studied. Our objectives were to determine the incidence and predictors of probable depression in a prospective cohort of people with TB in primary care settings in Ethiopia. METHODS We assessed 648 people with newly diagnosed TB for probable depression using Patient Health Questionnaire, nine-item (PHQ-9) at the time of starting their anti-TB medication. We defined PHQ-9 scores 10 and above as probable depression. Participants without baseline probable depression were assessed at 2 and 6 months to measure incidence of depression. Incidence rates per 1000-person months were calculated. Predictors of incident depression were identified using Poisson regression. RESULTS Two hundred and ninety-nine (46.1%) of the participants did not have probable depression at baseline. Twenty-two (7.4%) and 26 (8.7%) developed depression at 2 and 6 months of follow up. The incidence rate of depression between baseline and 2 months was 73.6 (95% CI 42.8-104.3) and between baseline and 6 months was 24.2 (95% CI 14.9-33.5) per 1000 person-months respectively. Female sex (adjusted β = 0.22; 95% CI 0.16-0.27) was a risk factor and perceived social support (adjusted β = -0.14; 95% CI -0.24 to -0.03) was a protective factor for depression onset. CONCLUSION There was high incidence of probable depression in people undergoing treatment for newly diagnosed TB. The persistence and incidence of depression beyond 6 months need to be studied. TB treatment guidelines should have mental health component.
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16
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Kouvatsou K, Iliadou M, Kalatzi P, Evanthia S, Christos P, Maria K, Tziaferi S. Depression Among Elderly Users of Open and Closed Care Facilities in a Rural Region of Greece: an Important Public Health Issue. Mater Sociomed 2020; 32:35-40. [PMID: 32410889 PMCID: PMC7219719 DOI: 10.5455/msm.2020.32.35-40] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction: It is estimated that 5.7% of the total Greek population suffers from depressive disorders. Elderly may be particularly prone to depression compared to younger people. In Greece, there is a paucity of literature regarding the correlation between the existence of chronic diseases, sociodemographic features, participation in open/ closed structures, and the presence of depression or depressive symptoms, among seniors. The purpose of this study was to explore potential correlations between the above- mentioned variables, as a whole. Methods: This was a cross- sectional, questionnaire survey of 200 elderly aged 65 or above and were members of 12 Open Care Centers for the Elderly (OCCE) or residents in 2 nursing homes located in the rural region of Epirus, in Greece. Data collection took place in the form of structured individual interviews. For the identification of independent factors associated with the existence of depressive symptoms, stepwise logistic regression analysis was performed. Results: A total of 81 (40.5%) seniors experienced depressive symptoms, though only 39 of them (19.5%) had been diagnosed for depression. Depression rates were higher for those with more chronic diseases (p=0.01) and at divorced, widowed and single seniors compared to married ones (50.5% vs. 28.1% respectively, p=0.002). The prevalence of depression was higher among the elderly who lived in nursing homes compared to the participants who were registered members of the OCCE (50% vs. 35.6% respectively, p=0.049), while elderly who often participated in the social activities of OCCE, had significantly lower rates of depressive symptoms compared to those who scarcely were involved in these activities (23% vs. 46.2% respectively, p=0.019). Participants who suffered from osteoporosis were more likely of displaying depressive symptoms compared to those who didn’t; OR (95% Confidence Interval) = 2.61 (1.28-5.33), p=0.009. Conclusions: The existence of an action plan that includes education and training of health professionals on mental health of the elderly and the satisfactory operation of public facilities to promote the wellbeing of seniors and offer more incentives for activity participation, may reduce depression rates and the under-diagnosis of the disease.
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Affiliation(s)
- Katerina Kouvatsou
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
| | - Maria Iliadou
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece.,Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Aigaleo, Athens, Greece
| | - Panagiota Kalatzi
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
| | - Sakellari Evanthia
- Department of Public and Community Health, Faculty of Public Health University of West Attica, Athens, Greece
| | - Prapas Christos
- Department of Public and Community Health, Faculty of Public Health University of West Attica, Athens, Greece
| | - Kalafati Maria
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Styliani Tziaferi
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
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17
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Helvik AS, Barca ML, Bergh S, Šaltytė-Benth J, Kirkevold Ø, Borza T. The course of depressive symptoms with decline in cognitive function - a longitudinal study of older adults receiving in-home care at baseline. BMC Geriatr 2019; 19:231. [PMID: 31443638 PMCID: PMC6708209 DOI: 10.1186/s12877-019-1226-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/25/2019] [Indexed: 11/26/2022] Open
Abstract
Background Depressive symptoms in old age are common, but the prevalence, persistence, and incidence of depressive symptoms in older adults with and without dementia receiving in-home care is less well studied, and descriptions of the relationship between severity of cognitive decline and depressive symptoms over time is, to our knowledge, lacking. The aim of the present study was to describe the prevalence, incidence and persistence of depressive symptoms over a 36-month follow-up period among older adults receiving in-home care at baseline, and to explore the association between cognitive function and the course of depressive symptoms over time. Methods In all, 1001 older people (≥ 70 years) receiving in-home care were included in a longitudinal study with three assessments over 36 months. Depressive symptoms were assessed using the Cornell Scale for Depression in Dementia. Clinical Dementia Rating Scale, diagnosis of dementia and mild cognitive impairment, general medical health, personal and instrumental activities of daily living, neuropsychiatric symptoms and the use of psychotropic medication were evaluated during the three assessments. Baseline demographic characteristics and information on nursing home residency at follow-up were recorded. Linear mixed models were estimated. Results The baseline prevalence and cumulative incidence of single depressive symptoms were higher in those with dementia at baseline than in those without dementia. The persistence of depressive symptoms did not differ between those with or without dementia at baseline. The severity of cognitive impairment and mean depressive symptom score assessed simultaneously were positively associated, but the strength of the association changed over time and was not significant at the last assessment. Furthermore, being younger, female, in very poor physical health, with neuropsychiatric symptoms and not becoming a nursing home resident were associated with more depressive symptoms when assessed simultaneously. Conclusion The baseline prevalence and cumulative incidence of depressive symptoms in those with and without dementia at baseline, as well as the relationship we found between the degree of cognitive decline and depressive symptoms over time show that depression and dementia are interconnected. Nurses and clinicians should pay attention to cognitive status when observing or evaluating depression among older adults receiving in-home care.
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Affiliation(s)
- Anne-Sofie Helvik
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, NO-7491, Trondheim, Norway. .,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,St Olavs University Hospital, Trondheim, Norway.
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Jūratė Šaltytė-Benth
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.,Institute of Clinical Medicine, University of Oslo, Campus Ahus, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.,Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Tom Borza
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
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18
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Edwards L, Ellis B, Donnellan C, Osman H, Haboubi N, Jones M, Sunman W, Pinnington L, Phillips MF. Prevalence of unmet needs for spasticity management in care home residents in the East Midlands, United Kingdom: a cross-sectional observational study. Clin Rehabil 2019; 33:1819-1830. [PMID: 31266351 DOI: 10.1177/0269215519859621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To establish the prevalence of unmet need for spasticity management in care home residents in two counties of the United Kingdom. DESIGN Cross-sectional observational study with a six-month follow-up arm for participants with identified unmet needs. SETTING 22 care homes in Derbyshire and Nottinghamshire. SUBJECTS 60 care home residents with upper motor neuron syndrome-related spasticity. INTERVENTIONS No intervention. When unmet needs around spasticity management were identified, the participant's general practitioner was advised of these in writing. MAIN MEASURES Resistance to Passive Movement Scale to assess spasticity; recording of (a) the presence of factors which may aggravate spasticity, (b) potential complications of spasticity, (c) spasticity-related needs and (d) current interventions to manage spasticity. Two assessors judged the presence or absence of needs for spasticity management and whether these needs were met by current care. RESULTS Out of 60 participants, 14 had no spasticity-related needs; 46 had spasticity-related needs; 11 had needs which were being met by current care and 35 participants had spasticity-related needs at baseline which were not being met by their current care. These were most frequently related to the risk of contracture development or problems with skin hygiene or integrity in the upper limb. In total, 6 participants had one or more pressure sores and 35 participants had one or more established joint contractures. A total of 31 participants were available for follow-up. Informing general practitioners of unmet needs resulted in no change to spasticity management in 23/31 cases. CONCLUSION Care home residents in this study had high levels of unmet need for spasticity management.
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Affiliation(s)
- Laura Edwards
- University of Nottingham, Division of Medical Sciences and Graduate Entry Medicine, Derby, UK
| | | | - Clare Donnellan
- Linden Lodge Neuro-Rehabilitation Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Hanan Osman
- The Walton Centre NHS Foundation Trust and The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Naseer Haboubi
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Michael Jones
- Derby Clinical Trials Support Unit, University Hospitals of Derby and Burton, Derby, UK
| | - Wayne Sunman
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lorraine Pinnington
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
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Wells TS, Nickels LD, Rush SR, Musich SA, Wu L, Bhattarai GR, Yeh CS. Characteristics and Health Outcomes Associated With Hearing Loss and Hearing Aid Use Among Older Adults. J Aging Health 2019; 32:724-734. [PMID: 31092107 PMCID: PMC7586498 DOI: 10.1177/0898264319848866] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: This study recruited older adults to explore physical and
psychosocial conditions and other health outcomes associated with hearing loss (HL) and
hearing aid use. Method: Survey data were used to categorize 20,244
participants into five groups: no HL, unaided mild HL, aided mild HL, unaided severe HL,
and aided severe HL. Results: Individuals with unaided severe HL were more
likely to report poor-fair self-rated health and were less likely to leave the home, or
exercise 4 to 7 days per week, while there were no such associations for those with aided
mild or severe HL. In addition, those with aided hearing were less likely to report
depression, low social support, or mobility limitations. Discussion: In
several instances, hearing aid use reduced associations between HL and negative
psychosocial and physical characteristics, and health outcomes. More research using
longitudinal study designs is needed to better understand the true implications of these
findings.
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Affiliation(s)
- Timothy S. Wells
- Optum, Ann Arbor, MI, USA
- Timothy S. Wells, Associate Director, Research for
Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
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20
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Yu A, Liljas AEM. The relationship between self-reported sensory impairments and psychosocial health in older adults: a 4-year follow-up study using the English Longitudinal Study of Ageing. Public Health 2019; 169:140-148. [PMID: 30904768 DOI: 10.1016/j.puhe.2019.01.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/15/2019] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To explore cross-sectional and longitudinal relationships between self-reported hearing and vision impairments and self-rated health, quality of life (QoL) and depressive symptoms at 4-year follow-up. STUDY DESIGN The study involved cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing. METHODS Community-dwelling adults (n = 3931) aged ≥50 years from the English Longitudinal Study of Ageing participated in this study. Self-reported hearing and vision were defined as good or poor. Self-rated health was treated as a dichotomous variable (good and poor health). QoL was based on the 19-item Critical Appraisal Skills Programme and treated as a continuous variable (score 0-57). Depressive symptoms were assessed using the eight-item Center for Epidemiologic Studies Depression Scale (CES-D8) and defined as CES-D≥3. Relationships between sensory impairments and self-rated health and depressive symptoms were analysed using logistic regression. Linear regression was used to assess the relationships between sensory impairments and QoL. RESULTS In cross-sectional analyses, both self-reported hearing and vision impairment were positively associated with all outcomes assessed. In longitudinal analyses, self-reported poor hearing and vision were associated with increased risks of poor self-rated health (hearing: odds ratio [OR] 1.65, 95% confidence interval [CI] 1.32, 2.05; vision: OR 1.57, 95% CI 1.16, 2.12) and depressive symptoms (hearing: OR 1.35, 95% CI 1.07, 1.71; vision: OR 1.44, 95% CI 1.09, 1.90) after adjustment for sociodemographic and lifestyle factors, chronic illness, mobility limitations and cognition. Poor hearing and poor vision were not associated with reduced QoL after adjustment for covariates. CONCLUSIONS The findings stress the importance of identifying and addressing sensory impairments in older adults to improve their health and well-being.
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Affiliation(s)
- A Yu
- Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, United Kingdom
| | - A E M Liljas
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, NW3 2PF, United Kingdom.
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Lawrence BJ, Jayakody DMP, Bennett RJ, Eikelboom RH, Gasson N, Friedland PL. Hearing Loss and Depression in Older Adults: A Systematic Review and Meta-analysis. THE GERONTOLOGIST 2019; 60:e137-e154. [DOI: 10.1093/geront/gnz009] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 12/31/2022] Open
Abstract
AbstractBackground and ObjectivesStudies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence.Research Design and MethodsA search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494).ResultsA total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.”Discussion and ImplicationsOlder adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
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Affiliation(s)
- Blake J Lawrence
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Dona M P Jayakody
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia
| | - Peter L Friedland
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Otolaryngology Head Neck Skull Based Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
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22
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Zhang D, Yang Y, Wu M, Zhao X, Sun Y, Xie H, Li H, Li Y, Wang K, Zhang J, Jia J, Su Y. The moderating effect of social support on the relationship between physical health and suicidal thoughts among Chinese rural elderly: A nursing home sample. Int J Ment Health Nurs 2018; 27:1371-1382. [PMID: 29359382 DOI: 10.1111/inm.12436] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2017] [Indexed: 12/25/2022]
Abstract
Suicide rate is relatively high among Chinese rural elderly. While there has been some exciting work on reporting and preventing suicide among community-dwelling elderly, only a few published studies have addressed the issues of rural nursing homes in China. This study aimed to investigate the relationship among perceived social support, physical health, and suicidal thoughts of the elderly living in Chinese rural nursing homes. It also examined the moderating effects of social support on the path from physical health to suicidal thoughts of the rural institutional elderly in China. This study investigated 205 participants aged 60 years and above in Chinese rural nursing homes. Participants' suicidal thoughts, perceived social support, and physical health were assessed. This study conducted descriptive analysis, Student's t-test, and Pearson's chi-square test to test how physical health and social support predicted suicidal thoughts, as well as the moderating effects of family's, friends', and others' social support on physical health and suicidal thoughts. Both physical health and perceived social support were significantly related to suicidal thoughts. Perceived social support from family, friends, and significant others moderated the relationship between physical health and suicidal thoughts. Findings of this study suggested that increasing social support and improving physical health would be effective in both suicide prevention and intervention for the residents in Chinese rural nursing homes.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Hongkai Li
- School of Mathematics, Beijing University, Beijing, China
| | - Yuqin Li
- School of Philosophy and social development, Shandong University, Jinan, Shandong, China.,College of Humanities, Shandong Management University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, Shandong, China.,Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
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23
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Hu SH, Chuang YH, Ting YF, Lin KY, Hsieh CJ. Prevalence of depressive symptoms in older nursing home residents with intact cognitive function in Taiwan. Res Nurs Health 2018; 41:292-300. [PMID: 29574780 DOI: 10.1002/nur.21873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/24/2018] [Indexed: 12/21/2022]
Abstract
The investigators aimed to explore the prevalence of depressive symptoms and associated factors among older residents with intact cognitive function in nursing homes in Taiwan. A cross-sectional descriptive and correlational research design was used. A convenience sample of 178 older residents without cognitive impairment was recruited from 36 nursing homes in Southern Taiwan. The questionnaires included demographic data; the Barthel Index, which assesses the ability to perform activities of daily living; and the Geriatric Depression Scale Short Form. Among older residents in nursing homes with intact cognitive function, 39.3% had depressive symptoms. Age, religion, previous living status, previous working status, being totally dependent in physical function, and being severely dependent in physical function were significant predictors of depressive symptoms among cognitively intact older residents. The findings highlight the critical mental healthcare issues among older residents with intact cognitive function in nursing homes. Practical strategies for preventing the occurrence of depressive symptoms and caring for those who have depressive symptoms should be developed, especially for younger or dependent older residents or residents who have never been employed, have no religious beliefs, or have lived alone before they moved into an institution.
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Affiliation(s)
- Sophia H Hu
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeh-Feng Ting
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Yu Lin
- Furoto Medical and Welfare Co. Kaohsiung, Kaohsiung, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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24
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Musavi M, Mohammadian S, Mohammadinezhad B. The effect of group integrative reminiscence therapy on mental health among older women living in Iranian nursing homes. Nurs Open 2017; 4:303-309. [PMID: 29085656 PMCID: PMC5653382 DOI: 10.1002/nop2.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/07/2017] [Indexed: 12/04/2022] Open
Abstract
AIM The present study aimed to determine the impact of group integrative reminiscence therapy on mental health of older women living in Iranian nursing home in 2016. DESIGN A quasi-experimental design pre- and post-test was used in the present study. Purposive sampling was used to recruit participants who met the study criteria. METHOD The statistical population included 60 older women living in nursing home, among whom 46 having the inclusion criteria were selected as the sample. After completing the Goldberg's General Health Questionnaire, the older people were divided into intervention (N = 23) and control (N = 23) group by using block randomization method. The intervention groups were trained by integrative reminiscence therapy for 60-90 min 10 sessions, twice a week. Descriptive statistics and ANOVA were used for data analysis by SPSS software. RESULTS The results indicated that group integrative reminiscence therapy significantly affected general mental health and physical dimensions, anxiety and insomnia, social functions and depression.
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Affiliation(s)
- Motahareh Musavi
- Department of Nursing and MidwiferyDezful University of Medical SciencesDezfulIran
| | - Sara Mohammadian
- Department of Nursing and MidwiferyDezful University of Medical SciencesDezfulIran
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25
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Zhang D, Yang Y, Sun Y, Wu M, Xie H, Wang K, Zhang J, Jia J, Su Y. Characteristics of the Chinese rural elderly living in nursing homes who have suicidal ideation: A multiple regression model. Geriatr Nurs 2017; 38:423-430. [PMID: 28347559 DOI: 10.1016/j.gerinurse.2017.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Chinese rural elderly are at higher risk of committing suicide. However, little is known about the suicidal ideation (SI) of institutional elderly residents in rural China. METHODS 250 participants aged 60 or above living in Chinese rural nursing homes were recruited. Data were collected on subjects' SI, social-demographic characters, physical illness and psychological factors. Univariate comparisons and path analysis were conducted then. RESULTS 19.5% (40/205) of the participants reported a current SI. Hopelessness and depression had significant direct impacts on SI, and self-esteem and loneliness can impact SI through the mediating of depression and hopelessness. Visiting frequency of children, number of physical illnesses and social activities can also affect SI through the mediating of loneliness or self-esteem. CONCLUSION As the first study on path analysis of SI of rural institutional elderly, the findings are significant. All these factors in our model should be considered when interventions are being conducted.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250012, Shandong, China; Department of Sociology, State University of New York Buffalo State, Buffalo, NY, 14222, USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yonggang Su
- School of Foreign Languages and Literature, Shandong University, Jinan, 250100, Shandong, China; School of Nursing, Shandong University, Jinan, 250012, Shandong, China.
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26
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Holmes SD, Galik E, Resnick B. Factors that Influence Physical Activity among Residents in Assisted Living. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2017; 60:120-137. [PMID: 27982744 PMCID: PMC6311414 DOI: 10.1080/01634372.2016.1269035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to examine factors that influence physical activity among residents in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from 4 assisted living facilities. Using structural equation modeling, we found that mood, satisfaction with staff and activities, and social support for exercise were directly associated with time spent in physical activity. Gender, cognition, depression, and comorbidities were indirectly associated with physical activity and accounted for 13% of the total variance in physical activity. Implications for future research and social work practice are presented.
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Affiliation(s)
- Sarah D. Holmes
- Department of Gerontology, University of Maryland, Baltimore, Maryland; USA
| | - Elizabeth Galik
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
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27
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Mikkola TM, Polku H, Sainio P, Koponen P, Koskinen S, Viljanen A. Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults. BMC Geriatr 2016; 16:182. [PMID: 27821075 PMCID: PMC5100231 DOI: 10.1186/s12877-016-0356-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 10/26/2016] [Indexed: 12/02/2022] Open
Abstract
Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, health promotion groups, vision test, hearing test, mammography, PSA test) and perceived unmet health care needs. Multivariable logistic regression analyses were used. Results After adjusting for socio-economic and health-related confounders, persons with hearing loss (hearing level of better ear 0.5–2 kHz > 40 dB) were more likely to have used mental health services than those with non-impaired hearing (OR = 3.2, 95 % CI 1.3–7.9). Self-reported hearing difficulty was also associated with higher odds for mental health service use (OR = 2.1 95 % CI 1.2–3.5). Hearing was not associated with use of the other health services studied, except presenting for a hearing test. Persons with self-reported hearing difficulty were more likely to perceive unmet health care needs than those without hearing difficulty (OR = 1.7, 95 % CI 1.4–2.1). Conclusions Older adults with hearing loss or self-reported hearing difficulty are as likely to use most health services as those without hearing loss. However, self-reported hearing difficulty is associated with experiencing unmet health care needs. Adequate health services should be ensured for older adults with hearing difficulties. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0356-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tuija M Mikkola
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland. .,Folkhälsan Research Center, Helsinki, Finland.
| | - Hannele Polku
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland
| | - Päivi Sainio
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Viljanen
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, P.O. Box 35, Viveca, Jyvaskyla, 40014, Finland
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28
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Luque-Reca O, Augusto-Landa JM, Pulido-Martos M. Emotional intelligence and depressive symptoms in Spanish institutionalized elders: does emotional self-efficacy act as a mediator? PeerJ 2016; 4:e2246. [PMID: 27547553 PMCID: PMC4963214 DOI: 10.7717/peerj.2246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background. This work examines the relationship between emotional intelligence (EI) and depressive symptomatology in institutionalized older adults, delving into the mechanisms underlying this relationship. Considering that previous evidence of the variation of the EI-depression relationship depending on whether the emotional ability or the perception of that ability is evaluated, a model of multiple mediation was tested in which the dimensions of emotional self-efficacy (ESE) act as mediators in the relationship between ability EI and depressive symptomatology. Methods. The sample consisted of 115 institutionalized older adults (47.82% women; 80.3 ± 7.9 years of age) from the province of Jaén (Spain) who completed a test of ESE, a measure of ability EI, and a self-administered questionnaire of depressive symptoms. Results. The results showed a positive association between older adults’ emotional performance and depressive symptomatology, finding stronger associations with ESE than with EI abilities. In addition, multiple mediation analyses showed that two of the four dimensions of ESE fully mediated the relationship between ability EI and depressive symptoms. Discussion. These findings suggest that older adults’ high levels of emotional competence generate a feeling of ESE which can protect them against depressive symptoms. This work supports the predictive validity of emotional abilities and ESE for the mental health of a group that is particularly vulnerable to depression, institutionalized older adults. The limitations of the work are discussed, and future lines of research were considered.
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Affiliation(s)
- Octavio Luque-Reca
- Faculty of Humanities and Education Sciences, Department of Psychology, University of Jaén, Jaén,Spain
| | - José María Augusto-Landa
- Faculty of Humanities and Education Sciences, Department of Psychology, University of Jaén, Jaén,Spain
| | - Manuel Pulido-Martos
- Faculty of Humanities and Education Sciences, Department of Psychology, University of Jaén, Jaén,Spain
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Abstract
BACKGROUND Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory. METHODS This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model. RESULTS Three clusters of depression symptom trajectory were found that described "lower," "intermediate," and "higher" levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment. CONCLUSIONS The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.
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30
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Gan P, Xie Y, Duan W, Deng Q, Yu X. Rumination and Loneliness Independently Predict Six-Month Later Depression Symptoms among Chinese Elderly in Nursing Homes. PLoS One 2015; 10:e0137176. [PMID: 26334298 PMCID: PMC4559426 DOI: 10.1371/journal.pone.0137176] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/14/2015] [Indexed: 01/10/2023] Open
Abstract
Background Previous studies conducted in Western countries independently demonstrated that loneliness and rumination are remarkable risk factors of depression among the elderly in both community and nursing homes. However, knowledge on the relationship between these three constructs among the elderly in Eastern countries is scarce. The current study aims to determine the relationship between loneliness, rumination, and depression among Chinese elderly in nursing homes. Methods A total of 71 elderly participants with an average age of 82.49 years completed this six-month longitudinal study. Physical reports indicated that none of the participants were clinically depressed before the study. At Time 1, their loneliness and rumination were measured using UCLA-8 Loneliness Scale and Ruminative Responses Scale. Six months later, the participants completed the Center for Epidemiologic Studies Depression Scale to assess depressive symptoms (Time 2). Results Multiple regression analysis revealed that both loneliness and rumination at Time 1 were the predictors of depression symptoms at Time 2 among the Chinese elderly in nursing homes. However, in the mediation analysis using PROCESS, the indirect effect between loneliness at Time 1 and depression symptoms at Time 2 was insignificant. Conclusions Results suggest that previous loneliness and rumination thinking are predictors of future depression symptoms among the Chinese elderly in nursing homes. However, the insignificant mediation further suggests that the differences between loneliness and rumination should be explored in future studies. Findings have important implications for mental health professionals in nursing homes in China.
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Affiliation(s)
- Pei Gan
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Yan Xie
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
- * E-mail: (YX); (WD)
| | - Wenjie Duan
- Department of Applied Social Sciences, City University of Hong Kong, Hong Kong SAR, P. R. China
- * E-mail: (YX); (WD)
| | - Qing Deng
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiuli Yu
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
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Hsu YT, Liao CC, Chang SN, Yang YW, Tsai CH, Chen TL, Sung FC. Increased Risk of Depression in Patients with Parkinson Disease: A Nationwide Cohort Study. Am J Geriatr Psychiatry 2015; 23:934-40. [PMID: 25529799 DOI: 10.1016/j.jagp.2014.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 10/20/2014] [Accepted: 10/30/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The association between Parkinson disease (PD) and depression remains unclear, particularly in the Asian population. The purpose of this study is to investigate the risk of depression in patients with PD using population-based data. METHODS Based on the National Health Insurance Research Database of Taiwan, we identified 1,698 patients with PD aged 40 years or older diagnosed in 2000-2003. With frequency matching procedure, we randomly selected 6,792 subjects without PD stratified by sex and age. Both cohorts were followed until the end of 2008 or diagnosis of depression. Risk of depression associated with PD was estimated in the multivariate Cox hazards regressions. Diabetes, hypertension, and hyperlipidemia were more prevalent at baseline in patients with PD. RESULTS Compared with the cohort without PD, the hazard ratio (HR) for depression in PD patients was 4.06 (95% CI: 3.15-5.23), which increased to 4.26 (95% CI: 3.29-5.51) after adjustment for age, sex, urbanization, income, and coexisting medical conditions. In the sex stratification, the HR of depression for men with PD was 4.42 (95% CI: 2.93-6.67) compared with men without PD. The HR for the association between PD and depression in women was 4.22 (95% CI: 3.02-5.88). CONCLUSION This study suggests that patients with PD are at an elevated risk of depression, particularly for men. Integrated care for early identification and treatment of depression are crucial for patients with PD.
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Affiliation(s)
- Yi-Ting Hsu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Chang Liao
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Ni Chang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Wan Yang
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
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Kim Y, Kwak Y, Kim JS. The association between suicide ideation and sensory impairment among elderly Koreans. Aging Ment Health 2015; 19:658-65. [PMID: 25495960 DOI: 10.1080/13607863.2014.989812] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The purpose of this cross-sectional study was to examine the relationship between sensory impairment and suicide ideation among elderly Koreans. METHODS Data from the 2010-2012 Korea National Health and Nutrition Examination Survey V was used. Participants included 3636 older adults (≥65 years) who received hearing and vision tests; participants also completed assessments of covariates and suicide ideation. RESULTS The risk of suicide ideation was 1.43-1.65 times higher among participants with visual impairment than in those without impairment. Moreover, the risk was 1.60-1.76 times higher among those with both auditory and visual impairments than the risk for those without any impairment. CONCLUSION This study found an association between sensory impairment and suicide ideation in elderly individuals. Therefore, it seems necessary that interventions that reduce or prevent sensory impaired elders' suicide ideation are needed, which may be an indicator of mental health problems or poor quality of life.
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Affiliation(s)
- Yoonjung Kim
- a Red Cross College of Nursing , Chung-Ang University , Seoul , Republic of Korea
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Borza T, Engedal K, Bergh S, Barca ML, Benth JŠ, Selbæk G. The course of depressive symptoms as measured by the Cornell scale for depression in dementia over 74 months in 1158 nursing home residents. J Affect Disord 2015; 175:209-16. [PMID: 25638794 DOI: 10.1016/j.jad.2014.12.053] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/21/2014] [Accepted: 12/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depressive symptoms and depression are common in nursing home residents. However, longitudinal studies of depression in nursing home residents are scarce and the sample sizes are small. This study aimed to investigate the course of depressive symptoms as measured by the Cornell Scale for Depression in Dementia (CSDD) and associated explanatory demographic and clinical variables. METHODS A longitudinal study over 74 months of 1158 nursing home residents aged 50 years and older from twenty six nursing homes in Norway where data was collected at five time points. RESULTS "Irritability" was the most prevalent, incident and persistent CSDD symptom. Compared with the baseline assessment, the likelihood of the mood symptoms "suicidal ideation," "pessimism" and "delusions" being present was lower at all subsequent assessments. This persisted after adjusting for the severity of dementia. The severity of depression as measured by CSDD decreased over 74 months when adjusting for relevant resident variables. Poorer physical health, higher number of medications, more severe dementia and use of antidepressants were associated with higher depression score. LIMITATIONS Depression and dementia were not diagnosed according to standardized diagnostic criteria. The use of CSDD did not include a clinician׳s interview with the patient. This could have implications for the generalization of the results. CONCLUSION This study adds important knowledge about the long-term course of depressive symptoms and depression for residents in nursing homes, and underlines the importance to pay close attention to the overlap between depression and dementia symptoms when evaluating depression in this setting.
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Affiliation(s)
- Tom Borza
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Knut Engedal
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Sverre Bergh
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Jūratė Šaltytė Benth
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway; HØKH, Research Centre, Akershus University Hospital, Norway
| | - Geir Selbæk
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway; Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
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Vicente F, Espirito-Santo H, Cardoso D, Silva FD, Costa M, Martins S, Torres-Pena I, Pascoal V, Rodrigues F, Pinto A, Moitinho S, Guadalupe S, Vicente HT, Lemos L. Estudo longitudinal dos fatores associados à evolução de sintomas depressivos em idosos institucionalizados. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos : Constatando que a depressão é comum em idosos institucionalizados, associando-se à solidão, à ansiedade e à afetividade, pretendemos descrever a evolução da depressão durante dois anos e verificar que fatores se associam a essa evolução. Métodos : Em um estudo de coorte prospectivo em dois momentos (2011 e 2013), avaliamos 83 idosos institucionalizados, com idade no primeiro momento entre os 60 e os 100 anos, sendo 79,5% mulheres, 86,7% sem companheiro(a), e 72,3% com algum grau de escolaridade. Usamos a Escala Geriátrica da Depressão (GDS), a Escala de Solidão (UCLA-L), o Inventário Geriátrico de Ansiedade (GAI) e a Lista de Afetos Positivos e Negativos (PANAS). Resultados: Verificamos que 59,0% mantiveram a depressão e 10,8% desenvolveram depressão. Os idosos com depressão tiveram significativamente piores resultados na UCLA, GAI e PANAS, e os não depressivos tiveram afetos positivos mais altos. Quanto à evolução da depressão, os idosos que mantiveram depressão tiveram inicialmente pontuações elevadas no GDS, GAI, UCLA e na subescala PANAS negativo e pontuações baixas na subescala PANAS positivo. Esses idosos apresentaram associadamente um agravamento dos sentimentos de solidão, dos sintomas ansiosos e do afeto negativo ao longo dos dois anos. Os que desenvolveram depressão tiveram, no primeiro momento, pontuações elevadas na UCLA. Conclusões: Os sintomas de depressão com ou sem solidão no momento inicial, o agravamento da solidão, a ansiedade, o afeto negativo e o baixo afeto positivo poderão ser fatores de risco para a manutenção da depressão. A solidão poderá ainda ser um fator de risco para o desenvolvimento de depressão.
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Affiliation(s)
| | - Helena Espirito-Santo
- Instituto Superior Miguel Torga, Portugal; Instituto Superior Miguel Torga, Portugal
| | | | | | | | | | - Inês Torres-Pena
- Instituto Superior Miguel Torga, Portugal; Instituto Superior Miguel Torga, Portugal
| | | | | | - Ana Pinto
- Instituto Superior Miguel Torga, Portugal
| | | | | | | | - Laura Lemos
- Instituto Superior Miguel Torga, Portugal; Instituto Superior Miguel Torga, Portugal
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Li CM, Zhang X, Hoffman HJ, Cotch MF, Themann CL, Wilson MR. Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010. JAMA Otolaryngol Head Neck Surg 2014; 140:293-302. [PMID: 24604103 DOI: 10.1001/jamaoto.2014.42] [Citation(s) in RCA: 247] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Depression among hearing impaired US adults has not been studied previously. OBJECTIVE To estimate the prevalence of and risk factors for depression among adults with hearing loss. DESIGN, SETTING, AND PARTICIPANTS Adults aged 18 years or older (N = 18 318) who participated in the National Health and Nutrition Examination Survey (NHANES), 2005-2010, a nationally representative sample. INTERVENTIONS Multistage probability sampling of US population. MAIN OUTCOMES AND MEASURES Depression, assessed by the 9-item Patient Health Questionnaire (PHQ-9) scale, and hearing impairment (HI), assessed by self-report and audiometric examination for adults aged 70 years or older. RESULTS The prevalence of moderate to severe depression (PHQ-9 score, ≥10) was 4.9% for individuals reporting excellent hearing, 7.1% for those with good hearing, and 11.4% for participants who reported a little trouble or greater HI. Using excellent hearing as the reference, after adjusting for all covariates, multivariate odds ratios (ORs) for depression were 1.4 (95% CI, 1.1-1.8) for good hearing, 1.7 (1.3-2.2) for a little trouble, 2.4 (1.7-3.2) for moderate trouble, 1.5 (0.9-2.6) for a lot of trouble, and 0.6 (0.1-2.6) for deaf. Moderate HI (defined by better ear pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz within the range 35- to 49-dB hearing level) was significantly associated with depression among older women (OR, 3.9; 95% CI, 1.3-11.3), after adjusting for age, sex, race/ethnicity, lifestyle characteristics, and selected health conditions. CONCLUSIONS AND RELEVANCE After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. Health care professionals should be aware of an increased risk for depression among adults with hearing loss.
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Affiliation(s)
- Chuan-Ming Li
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
| | - Xinzhi Zhang
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Howard J Hoffman
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Christa L Themann
- Hearing Loss Prevention Team, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
| | - M Roy Wilson
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland5Office of the President, Wayne State University, Detroit, Michigan
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Vogel I, van de Looij-Jansen PM, Mieloo CL, Burdorf A, de Waart F. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health. PLoS One 2014; 9:e98912. [PMID: 24897078 PMCID: PMC4045887 DOI: 10.1371/journal.pone.0098912] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 05/08/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. METHODS A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. RESULTS About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. CONCLUSIONS Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people's health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed.
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Affiliation(s)
- Ineke Vogel
- Dept of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Dept of Youth Policy, Municipal Public Health Service for Rotterdam Area, Rotterdam, the Netherlands
| | | | - Cathelijne L. Mieloo
- Dept of Youth Policy, Municipal Public Health Service for Rotterdam Area, Rotterdam, the Netherlands
| | - Alex Burdorf
- Dept of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Frouwkje de Waart
- Dept of Youth Policy, Municipal Public Health Service for Rotterdam Area, Rotterdam, the Netherlands
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Observer-rated depression in long-term care: Frequency and risk factors. Arch Gerontol Geriatr 2014; 58:332-8. [DOI: 10.1016/j.archger.2013.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 11/10/2013] [Accepted: 11/21/2013] [Indexed: 11/19/2022]
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van Houwelingen AH, Cameron ID, Gussekloo J, Putter H, Kurrle S, de Craen AJM, Maier AB, den Elzen WPJ, Blom JW. Disability transitions in the oldest old in the general population. The Leiden 85-plus study. AGE (DORDRECHT, NETHERLANDS) 2014; 36:483-493. [PMID: 23990275 PMCID: PMC3889888 DOI: 10.1007/s11357-013-9574-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 07/22/2013] [Indexed: 05/30/2023]
Abstract
Transitions between disability states in older people occur frequently. This study investigated predictors of disability transitions in the oldest old and was performed in the Leiden 85-plus study, a population-based prospective cohort study among 597 participants aged 85 years. At baseline (age 85 years), data on sociodemographic characteristics and chronic diseases were obtained. Disabilities in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were measured annually for 5 years with the Groningen Activities Restriction Scale (GARS). Mortality data were obtained. A statistical multi-state model was used to assess the risks of transitions between no disabilities, IADL disability, BADL disability, and death. At baseline, 299 participants (50.0 %) were disabled in IADL only, and 155 participants (26.0 %) were disabled in both BADL and IADL. During 5-year follow-up, 374 participants (62.6 %) made >1 transition between disability states, mostly deterioration in disability. Males had a lower risk of deterioration [hazard ratio (HR), 0.75 (95 % CI, 0.58-0.96)] compared to females. No gender differences were observed for improvement [HR, 0.64 (95 % CI, 0.37-1.11)]. Participants with depressive symptoms were less likely to improve [HR, 0.50 (95 % CI, 0.28-0.87)]. Participants with depressive symptoms [HR, 1.46 (95 % CI, 1.12-1.91)], >1 chronic disease [HR, 1.60 (95 % CI, 1.27-2.01)], and with cognitive impairment [HR, 1.60 (95 % CI, 1.20-2.13)] had the highest risk of deteriorating. Disability is a dynamic process in the oldest old. Deterioration is more common than improvement. Older men are less likely to deteriorate than women. The presence of depressive symptoms, chronic disease, and cognitive impairment predicts deterioration.
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Affiliation(s)
- Anne H. van Houwelingen
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Ian D. Cameron
- Rehabilitation Studies Unit, Sydney Medical School-Northern, University of Sydney, Ryde, New South Wales Australia
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Hein Putter
- Department of Medical Statistics and BioInformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - Susan Kurrle
- Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Health Service, Hornsby, New South Wales Australia
| | - Anton J. M. de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrea B. Maier
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Section of Gerontology and Geriatrics, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Wendy P. J. den Elzen
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Jeanet W. Blom
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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Mener DJ, Betz J, Genther DJ, Chen D, Lin FR. Hearing loss and depression in older adults. J Am Geriatr Soc 2013; 61:1627-9. [PMID: 24028365 DOI: 10.1111/jgs.12429] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David J Mener
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Affiliation(s)
- Robert Stewart
- Institute of Psychiatry, King's College London, London SE5 8AF, UK.
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Factors associated with depressive symptoms in older Taiwanese adults in a long-term care community. Int Psychogeriatr 2013; 25:1013-21. [PMID: 23506786 DOI: 10.1017/s1041610213000240] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study was to examine culturally based factors as potential predictors of depressive symptoms in older Taiwanese adults living in eight long-term care institutions in southern Taiwan. METHOD A cross-sectional, exploratory design study was used with a purposive sample of 156 participants with a mean age of 79.80 ± 7.14 years. Measurements included filial responsibility expectation questions, two questions about degrees of acceptance of institutionalization, Perceived Stress Scale, Self-Transcendence Scale, and Geriatric Depression Scale. RESULTS An elder's willingness to be institutionalized, an elder's willingness to remain institutionalized, perceived stress, and self-transcendence were significantly associated with depressive symptoms (r = -0.35; -0.49; 0.60; and -0.67, respectively). Although no evidence for the relationship between filial responsibility and depressive symptoms was found in this study, there was evidence that filial responsibility was highly valued. Self-transcendence was the strongest predictor of depressive symptoms, accounting for 45% of the variance. CONCLUSION These findings provide insight into the cultural factors associated with depressive symptoms and support the need of timely interventions for institutionalized Taiwanese elderly population.
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