Measuring Health: A Guide to Rating Scales and Questionnaires

Research Interviewing: Context and Narrative

Emerging evidence has shown that COVID-19 survivors could suffer from persistent symptoms. However, it remains unclear whether these symptoms persist over the longer term. This study aimed to systematically synthesise evidence on post-COVID symptoms persisting for at least 12 months. We searched PubMed and Embase for papers reporting at least one-year follow-up results of COVID-19 survivors published by 6 November 2021. Random-effects meta-analyses were conducted to estimate pooled prevalence of specific post-COVID symptoms. Eighteen papers that reported one-year follow-up data from 8591 COVID-19 survivors were included. Fatigue/weakness (28%, 95% CI: 18–39), dyspnoea (18%, 95% CI: 13–24), arthromyalgia (26%, 95% CI: 8–44), depression (23%, 95% CI: 12–34), anxiety (22%, 95% CI: 15–29), memory loss (19%, 95% CI: 7–31), concentration difficulties (18%, 95% CI: 2–35), and insomnia (12%, 95% CI: 7–17) were the most prevalent symptoms at one-year follow-up. Existing evidence suggested that female patients and those with more severe initial illness were more likely to suffer from the sequelae after one year. This study demonstrated that a sizeable proportion of COVID-19 survivors still experience residual symptoms involving various body systems one year later. There is an urgent need for elucidating the pathophysiologic mechanisms and developing and testing targeted interventions for long-COVID patients.

/pdf/long-term-sequelae-of-covid-19-a-systematic-review-and-meta-1lp10sjx.pdf

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of One-Year Follow-Up Studies on Post-COVID Symptoms

BackgroundNutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (P...

Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure

Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”. This diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed. The multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

/pdf/vascular-depression-consensus-report-a-critical-update-3bg7t20auh.pdf

Vascular depression consensus report - a critical update.

Background: Depression is a prevalent and disabling condition in older persons (≥60 years) that increases the risk of mortality and negatively influences quality

/pdf/depression-and-quality-of-life-in-older-persons-a-review-1ndnuv1p2t.pdf

Depression and Quality of Life in Older Persons: A Review

Background/Aims: The aim of this study was to compare the presence and severity of dementia in two large cross-sectional samples of nursing home residents from 2004/2005 and 2010/2011. Methods: Demographic information as well as data on the type of nursing home unit, length of stay before assessment, physical health, regularly used prescribed drugs and Clinical Dementia Rating scale scores were used in the analyses. Logistic and linear regression models for hierarchical data were estimated. Results: The odds of the occurrence and of a greater severity of dementia were higher in 2010/2011 than in 2004/2005. Independent of the time of study, married men had more severe dementia than single men, and single women had more severe dementia than single men. Conclusion: The findings may reflect the increase in the need for more nursing home beds designed for people with dementia between 2004/2005 and 2010/2011.

Prevalence and Severity of Dementia in Nursing Home Residents.

Nutritional risk screening in hospitalized patients with heart failure.

Background

Studies revealed that misuse of drugs and alcohol is an increasing phenomenon among older people (aged 65 years and above), and we know that such misuse is a risk factor for mortality and morbidity. Furthermore, we do not know to what extent older people have experiences, understanding and knowledge about the use and misuse of alcohol and psychotropic drugs.



Aim

To investigate older peoples' experiences with and reflections on the use and misuse of alcohol and psychotropic drugs among older people.



Method

Qualitative interviews with 16 older people were performed during 2013 and 2014. The sample included informants aged from 65 to 92 years from 11 municipalities. The data were analysed by using the phenomenological hermeneutic method.



Findings

The first theme that arose from the informants' narratives was to be a part of a culture in change that details the informants' experiences with and reflections on the cultural changes regarding the use and misuse of alcohol and psychotropic drugs. This theme is divided into three subthemes: to use and attitudes toward use, to trivialise use and risks of use, and to disclaim responsibility for use and misuse. The second theme, to explain use and misuse involved reasons for the use and misuse of alcohol and psychotropic drugs. It included the subthemes: to be afraid, to be lonely, and to be informed.



Conclusion

The study revealed that most informants had experiences with the use of alcohol and psychotropic drugs, but disclaimed any challenges with their use. The use was trivialised and seen as something older people just do. They disclaimed responsibility for their own psychotropic use as their general practitioners were defined as the responsible persons. Moreover, the study showed that the informants had poor knowledge about the risk of use and misuse of alcohol and psychotropic drugs.

Older peoples' narratives of use and misuse of alcohol and psychotropic drugs.

Articles describing older persons’ experiences of coping with severe depression are, to our knowledge, lacking. This article is methodologically grounded in phenomenological hermeneutics, inspired by Paul Ricoeur, and applies a descriptive design with in-depth interviews for producing the data. We included 18 older persons, 13 women and 5 men, with a mean age of 77.9 years, depressed to a severe or moderate degree, 1–2 weeks after admission to a hospital for treatment of depression. We found the metaphor “being in a vice” to capture the essence of meaning from the participants’ stories, and can be understood as being stuck in an immensely painful existence entirely dominated by depression in late life. This is the first article where coping in older men and women experiencing the most severe phase of depression is explored. Key words: Lived experience, depression, older people, coping (Published: 26 June 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27187 - http://dx.doi.org/10.3402/qhw.v10.27187

Anne-Sofie Helvik

Papers

Depression and Quality of Life in Older Persons: A Review

Prevalence and Severity of Dementia in Nursing Home Residents.

Nutritional risk screening in hospitalized patients with heart failure.

Older peoples' narratives of use and misuse of alcohol and psychotropic drugs.

Being stuck in a vice: The process of coping with severe depression in late life