Showing papers by "Louise M. Waite published in 1999"

Informant-based staging of dementia using the clinical dementia rating.

Abstract: Summary:The staging of dementia is ideally based on both an examination of the patient and a history taken from an informant. However, in some circumstances, only an informant history is possible. The aim of this study was to assess the validity of the Clinical Dementia Rating (CDR) when the rating

Impact of chronic systemic and neurological disorders on disability, depression and life satisfaction.

Abstract: Objective. To assess the effects of a range of chronic systemic and neurological disorders on three life quality indicators: disability, depressive symptoms and life satisfaction. Methods. As part of the Sydney Older Persons Study, a community survey was carried out with 434 non-demented people aged 75 or over living in Sydney, Australia. Subjects were given a medical examination covering the following disorders: heart disease, chronic lung disease, bone and joint disease, stroke, visual loss, peripheral vascular disease, obesity, other systemic diseases, gait ataxia, gait slowing (including Parkinsonism) and cognitive impairment short of dementia. They were also assessed on a clinician-rated disability scale and given self-report depression and life satisfaction scales. Results. Gait slowing affected all three indicators of life quality. Heart disease and chronic lung disease affected disability and depressive symptoms, but not life satisfaction. These associations were present when the effects of age, sex, education and all other disorders were controlled in multiple regression analyses. However, when disability was also controlled, none of the physical disorders predicted life satisfaction and only heart disease continued to predict depressive symptoms. Conclusion. Of the physical disorders considered in the study, gait slowing, heart disease and chronic lung disease had the greatest impact on life quality. These disorders affect depressive symptoms and life satisfaction largely because they increase disability. Copyright © 1998 John Wiley & Sons, Ltd.

Carer distress in the general population: results from the Sydney Older Persons Study.

Abstract: Objective: to assess distress in a sample of carers who were selected from a community survey rather than recruited via community-service agencies. Methods: a community survey was carried out on 630 people aged 75 or over living in Sydney, Australia. Informants nominated by these elderly people were divided into full carer ( n= 21), partial carer ( n= 187) and noncarer groups ( n= 344). Informants completed the General Health Questionnaire (a continuous measure of psychiatric symptoms), the life satisfaction index (a measure of well-being) and the interpersonal bonding measure (a measure of quality of the relationship with the elderly person). Elderly participants had a medical examination, were assessed for disability and were questioned about use of services. Results: elderly people who had a full carer were more disabled and had more medical diagnoses. Full, but not partial, carers reported more psychiatric symptoms and lower life satisfaction. In multivariate analysis, the main determinant of carer distress was a relationship in which the carer felt controlled by the elderly person. Conclusion: when carers are selected from a population-based sample, only those who are full carers are more distressed. However, relationship factors are the most important determinant of distress.

A longitudinal study of chronic disease and depressive symptoms in a community sample of older people

Abstract: Previous research on the association between illness and depression in older people has relied on self-reported diagnoses with their inherent limitations in scope and reliability. This longitudinal study examined the association between depressive symptoms and medically-diagnosed chronic physical and neurodegenerative diseases and disability in community-living older people. In 1992, a random sample of 299 people aged 75 years and older underwent a clinical interview and medical examination by a physician experienced in geriatric medicine. This was repeated in 1995. The examination included diagnoses of chronic active physical illness, a standardized neurological examination, an assessment of functional disability and an abbreviated neuropsychological assessment. Depressive symptoms were assessed by the Centre for Epidemiological Studies - Depression scale. Multivariate analyses of concurrent associations, longitudinal associations and the impact of incident disease showed very few independent connections...

Transportation Needs of Community-living Older People in Sydney

Abstract: Objectives: To assess difficulty of access to both private and public transport experienced by older people living in the community in Sydney, to identify demographic and disability-related risk factors for poor access to transport, and to gauge the extent to which transport needs were met by assistance from relatives and friends. Method: An interview survey of a random sample of 620 people aged 75 years and older living in the community was conducted in the inner western suburbs of Sydney between August 1991 and September 1993. Questions covered demographic background, self-perceived disability, difficulty of access to transport, and assistance given by relatives and friends. Results: Slightly over half of the respondents said that access to private transport was difficult or impossible for them; one-third said that using public transport was difficult; 29% had difficulty with both forms of transport; yet only a quarter received help from relatives or friends. Fifteen per cent of all respondents were transport deprived in that they found access to both forms of transport difficult but did not receive any assistance. In general, the severely disabled were not significantly at risk of transport deprivation. Conclusions: There was a sizeable group of older people living in the community for whom access to transport posed considerable difficulties and who received no transport assistance from relatives or friends. Further research is needed on the impact of transport deprivation and the extent to which this is ameliorated by formal services.

Satisfaction With Medical and Allied Health Services Among Aged People in Sydney

Abstract: Objectives: To assess satisfaction with medical and allied health services among community-living aged persons and to determine whether satisfaction had changed over a three-year period. Method: An interview survey of a random sample of 320 people aged 75 years and older was conducted in the inner western suburbs of Sydney between August 1991 and September 1993 and repeated between August 1994 and October 1996 with 227 surviving members of the cohort. Questions covered the use of, and satisfaction with, medical and allied health services during the preceding 12 months. Results: The proportion Very satisfied’ with general practitioner (GP) surgery attendances and house calls over the two surveys ranged between 88% and 100%. The proportion ‘;very satisfied’ with specialist medical services ranged between 87% and 91%. The proportion ‘;very satisfied’ with allied health services ranged from 69% for optometry in 1992 to 93% for audiometry in 1995. There was no significant change over time. Conclusions: These older people displayed high levels of satisfaction with allied health services and very high levels of satisfaction with medical services.