Showing papers in "Aging & Mental Health in 2007"

Promoting older adults' well-being through Internet training and use.

Abstract: The purpose of the current research was to test the psychological impact of learning how to use computers and the Internet in old age, hypothesizing that such activities would contribute to seniors’ well-being and personal sense of empowerment. Employing a quasi-experimental research design, we offered a course, conducted in small groups, in computer operation and Internet browsing to 22 older adults (mean age of 80) who went to day-care centers for the elderly or resided in nursing homes. A comparison group of 26 participants (similar in all major respects) was engaged in other activities. Both groups were administered measures of physical functioning, life satisfaction, depression, loneliness and self-control at pre- and post-intervention four months later. Individual semi-structured interviews were conducted with participants who finished the computer course. ANCOVA was employed for controlling the effects of control variables and pre-intervention differences on participants who completed the activitie...

Individualized Piano Instruction enhances executive functioning and working memory in older adults

Abstract: This study evaluates transfer from domain-specific, sensorimotor training to cognitive abilities associated with executive function. We examined Individualized Piano Instruction (IPI) as a potential cognitive intervention to mitigate normal age-related cognitive decline in older adults. Thirty-one musically naive community-dwelling older adults (ages 60–85) were randomly assigned to either the experimental group (n = 16) or control group (n = 15). Neuropsychological assessments were administered at three time points: pre-training, following six months of intervention, and following a three-month delay. The experimental group significantly improved performance on the Trail Making Test and Digit Symbol measures as compared to healthy controls. Results of this study suggest that IPI may serve as an effective cognitive intervention for age-related cognitive decline.

The effects of reminiscence on psychological well-being in older adults: a meta-analysis

Abstract: This paper presents the results of a meta-analysis to assess the effectiveness of reminiscence on psychological well-being across different target groups and treatment modalities. Fifteen controlled outcome studies were included. An overall effect size of 0.54 was found, indicating a moderate influence of reminiscence on life-satisfaction and emotional well-being in older adults. Life-review was found to have significantly greater effect on psychological well-being than simple reminiscence. In addition, reminiscence had significantly greater effect on community-dwelling adults than adults living in nursing homes or residential care. Other characteristics of participants or interventions were not found to moderate effects. It is concluded that reminiscence in general, but especially life review, are potentially effective methods for the enhancement of psychological well-being in older adults. However, a replication of effectiveness studies of the well-defined protocols is now warranted.

Doing as much as I can do: the meaning of activity for people with dementia.

Abstract: While it is assumed that persons with dementia benefit from being involved in meaningful activity, research examining this claim is limited. In particular, how individuals with dementia perceive this involvement is poorly understood. Therefore, the purpose of this research is to determine what constitutes meaningful activity from the perspective of persons with dementia, and to explore how they perceive its significance in their lives. We conducted an interpretive phenomenological analysis of multiple interviews and participant observation conducted with eight community-dwelling elders with mild to moderate dementia. For several participants, the single most important driving force in their lives was being active, doing as much as they possibly could. They were involved in a wide range of activities including leisure pastimes, household chores, work-related endeavors, and social involvements. These activities were meaningful in three ways: Through their involvement, participants experienced feelings of pleasure and enjoyment; felt a sense of connection and belonging; and retained a sense of autonomy and personal identity. Findings suggest that familiarity of the social and physical environment promotes involvement in activities. This provides a sense of continuity for people with dementia, with implications for their quality of life and personhood. Further implications of these findings for dementia care and future research are discussed.

Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: a meta-analysis.

Abstract: Objectives: The goal of the present study was to assess the effects of psychotherapy and other behavioral interventions on depressive symptoms in clinically depressed older patients. Methods: We used meta-analysis to examine the effects of 57 controlled intervention studies. Results: On average, self-rated depression improved by d=0.84 standard deviation units and clinician-rated depression improved by d=0.93. Effect sizes were large for cognitive and behavioral therapy (CBT) and reminiscence; and medium for psychodynamic therapy, psychoeducation, physical exercise and supportive interventions. Age differences in treatment effects were not observed. Weaker effects were found in studies that used an active control group and in studies of physically ill or cognitively impaired patients. Studies of samples comprised exclusively of patients suffering from major depression (versus other mood disorders) also yielded weaker intervention effects. On average, 18.9% of participants did not complete the intervention...

Emotional impact of dementia diagnosis: Exploring persons with dementia and caregivers’ perspectives

Abstract: This paper examined the emotional impact of diagnosis disclosure on recently diagnosed people with dementia. Thirty patient/caregiver dyads attending a Geriatric Day Hospital Program in Ottawa, Canada participated in this qualitative exploratory study. Data sources included: (a) audio-tapes of diagnosis disclosure meeting, (b) in-depth interviews with patients and caregivers within one week of disclosure, and (c) focus group interviews with caregivers within one month. Patients exhibited a range of emotional responses which can be divided into three broad categories: (a) responses suggesting a lack of insight and/or an active denial of the diagnosis, (b) grief reactions/emotional crisis related to the experience of actual or anticipated losses associated with dementia, and (c) positive coping responses to maximize the disease outcome. Participants went through stages of emotional response to their diagnosis: not noticing symptoms, noticing & covering up, or noticing & revealing; diagnostic process & disclosure; confirming or shock; denial, crisis, or maximizing; disorganization or adaptation. There is a need to develop a better understanding of the experience of people with dementia at the critical point of diagnosis disclosure in order to design supportive interventions to maximize adaptive coping responses.

Does social participation by the elderly reduce mortality and cognitive impairment

Abstract: Purpose: This longitudinal study examines the effect of social participation on mortality and cognitive impairment for the elderly in Taiwan. Methods: Data were from an elderly population panel in Taiwan ‘The Survey of Health and Living Status of the Elderly’ 1993–1999. Social participation was defined as paid/unpaid job and participating in volunteer and social groups. Logistic regression analysis was used for predicting the influence of social participation to 6-year mortality and cognitive function impairment, by controlling of socioeconomic status and health-related variables. Results: The elderly with continuous paid work were more likely to participate in social groups. Having paid or unpaid work at the baseline year could lower the risk of mortality six years later, especially for men. Having unpaid work was associated with a higher risk of impaired cognitive function compared to that of non-workers. Participating in a religious group reduced the risk of mortality for women and participating in pol...

Escape loneliness by going digital: A quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults

Abstract: Background: This study evaluates the outcomes of an Internet-at-home intervention experiment that intended to decrease loneliness among chronically ill and physically handicapped older adults through introducing them to the use of an electronic communication facility. Method: To determine the effectiveness of the experiment in terms of reducing loneliness, 15 older adults were interviewed three times: shortly before the start, two years later and immediately after termination of the experiment, while their loneliness scores at zero and post-measurement were compared with those of a control group. Results: Both the participants and the control persons experienced a reduction in loneliness over time. However, the reduction was only significant for the intervention participants. Moreover, the changes in loneliness were significantly greater among the participants compared to the control persons. When looking more in detail, the effect of the experiment was only significant regarding emotional loneliness and ...

The use of everyday technology by people with dementia living alone: mapping out the difficulties.

Abstract: While the technological development available to society is taking quantum leaps, we have little knowledge of how people with mild dementia manage to cope with familiar technology at home, such as television and electronic household machines, or new technology, such as remote controls, cell phones and computers. As this technology represents a potential problem area, the aim of this qualitative, exploratory study was to identify and characterize difficulties with and hindrances to using everyday technology, as they appeared in data, for persons with early stage dementia. Eight participants with dementia were included in an extensive data collection consisting of repeated interviews and observations made in the home; the data were analyzed adopting a constant comparative approach. The results exhibit a taxonomy of difficulties in four domains, encompassing conditions that interfere with the use of the technology, deficiencies in knowledge and in the communication between users and their technology, and limitations in the use of instructions. Typically, difficulties appeared in complex combinations. They arose when familiar technology was being used, and not only when new technology was to be used. This raised concerns about the need these people have for support in home and in society. Further research is needed to validate the findings.

An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer's Disease.

Abstract: This study aimed to investigate the long-term effects of group music therapy on agitation manifested by nursing home residents with Alzheimer's disease. A non-randomised experimental design was employed with one group receiving weekly music therapy (n = 26) and another group receiving standard nursing home care (n = 19). Agitation levels were measured five times over one year using the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, J. (1989). Agitation in the elderly. In N. Billig & P. V. Rabins (Eds.), Issues in geriatric psychiatry (pp. 101-113). Basel, Switzerland: Karger). Although music therapy participants showed short-term reductions in agitation, there were no significant differences between the groups in the range, frequency, and severity of agitated behaviours manifested over time. Multiple measures of treatment efficacy are necessary to better understand the long-term effects music therapy programs have on this population.

Mapping the maze of terms and definitions in dementia-related wandering.

Abstract: Purpose: An operational definition of dementia-related wandering is proposed to aid in clinical recognition, to promote research precision and validity, and to provide a pathway toward standardization of language in wandering science. Design and Methods: (1) One-hundred-and-eighty-three journal articles from multiple databases (Medline, OVID, CSA Journals, OCLC First Search, Google Scholar, PubMed, EBSCO) were reviewed to extract alternative terms and definitions for wandering or wandering-related behaviours; (2) terms and definitions were ordered alphabetically into a glossary; (3) a consensus approach was used to group glossary terms with related meanings into possible domains of wandering; (4) four domains (locomotion, drive, space and time) were found sufficient to encompass all wandering definitions; (5) wandering terms were placed into a conceptual map bounded by the four domain concepts and (6) a new provisional definition of wandering was formulated. Results: An empirically-based, operational defi...

The relationship of optimism, pain and social support to well-being in older adults with osteoarthritis

Abstract: Improving the psychological well-being of individuals with osteoarthritis (OA) is an important concern because the condition is highly prevalent and has no known cure. Few studies have assessed the joint contribution of social, personality, and physical factors in relation to well-being for OA patients. In a cross-sectional sample of older adults with OA (n = 73, 73% female), we assessed the role of support perceptions, optimism and pain in depressive symptoms and life satisfaction. Greater optimism and support were significantly related to both greater life satisfaction and lower depressive symptoms. Further, optimism partially mediated the relationship of pain to life satisfaction, while support partially mediated the role of pain in depressive symptoms. The interplay of these variables in relation to well-being is discussed in the context of chronic illness and older adulthood.

A cognitive intervention to enhance institutionalized older adults’ social support networks and decrease loneliness

Abstract: Nearly all older adults experience social losses, which can disrupt their social support networks and impair their quality of life. Events such as retirement, an inability to drive, death of a spouse and/or close life-long friends, or moving to an elder care facility may negatively affect the quality of older adults' social support networks. Low levels of perceived social support are associated with increased depression, impaired immune functioning and reduced life expectancy. Moreover, social interactions can be cognitively stimulating and may help older adults preserve their cognitive abilities. In the present study, institutionalized older adults were exposed to either a cognitive enhancement programme designed to enhance social networks or a control group. Measures of perceived social support and loneliness were administered before and after a 3-month, group-based intervention. There was a significant interaction between group and time. Those who did not participate in the intervention experienced a decrease in perceived social support and an increase in perceived loneliness. Participants in the intervention group stayed the same on the above measures. Helping older adults increase or maintain the quality of their social networks may lead to enhanced cognitive functioning, decreased depression and improved quality of life. Recommendations to help assisted living facilities, nursing homes, retirement communities and senior centres develop social and cognitive interventions are provided.

Reliability generalization of responses by care providers to the Zarit Burden Interview

Abstract: The Zarit Burden Interview (ZBI) is believed to be the most commonly used measure of caregiver burden. Originally developed more than 20 years ago for use with informal caregivers of community dwelling persons with Alzheimer disease, it has subsequently been administered to a diverse range of patient populations, formal or paid caregivers, and translated into numerous languages. Given that the ZBI is now used more broadly than it was initially intended and first validated, the current study applies the reliability generalization meta-analytic procedure to examine the psychometric properties of responses to the ZBI across populations. Multiple regression with categorical variables was performed to identify factors associated with error variance in ZBI reliability estimates (N=138 data points). Number of items, residence of the care recipient (community) and the Hebrew version each contributed significantly to prediction of internal consistency. These differences, however, were found to be relatively small and within accepted parameters. Generally, responses to the ZBI appear reliable across populations of caregivers and patients. Only versions of the ZBI with more or less than 22-items (nonstandard formats) reflect both statistical and meaningful differences in reliability. Where feasible, it is recommended that the 22-item version of the ZBI be used in future research and clinical practice.

Living with dementia from the perspective of older people: is it a positive story?

Abstract: Dementia, even at an early stage, may pose problems and challenge one's quality of life. Having accurate knowledge of what one experiences when living with dementia is important for developing proactive care for individuals with dementia and their families. The aim of our Grounded Theory study was to explore what it means for elderly people to live with early-stage dementia. We interviewed 20 elderly people with probable mild dementia and their family members. Living with dementia was often presented as a positive narrative, one that told of only minor problems and which stressed abilities and contentment with life. Being valued, rather than losing one's cognition or identity was central in their experience. More in-depth analyses of participants' narratives revealed, however, that they were constantly balancing their feelings of value and worthlessness, struggling to remain someone of value. This struggle was prompted by threats posed by dementia and by the persons' interactions with others. Superficially, a positive narrative may be understood as a lack of awareness or as denial due to cognitive loss. Our findings suggest, however, that we should look beyond this superficial view and seek to understand the narrative as an expression of one's attempt to counterbalance devaluation.

Treatment of minor depression in older adults: A pilot study comparing sertraline and exercise

Abstract: The purpose of this study was to conduct a pilot clinical trial to test the feasibility and efficacy of an exercise program and anti-depressant treatment compared with usual care in improving the emotional and physical functioning of older adults with minor depression. Participants were 37 older adults with minor depression who were randomized to exercise, sertraline, or usual care; 32 participants completed the 16-week study. Outcomes included measures of both emotional (clinician and self-report) and physical (observed and self-report) functioning. There were trends for the superiority of the exercise and sertraline conditions over usual care in improving SF-36 mental health scores and clinician-rated depression scores. Individuals in the exercise condition showed greater improvements in physical functioning than individuals in the usual care condition. Both sertraline and exercise show promise as treatments for late-life minor depression. However, exercise has the added benefit of improving physical functioning as well.

Mindfulness-based cognitive therapy for recurring depression in older people: A qualitative study

Abstract: Mindfulness-based Cognitive Therapy (MBCT) is a meditation-based intervention designed to reduce recurrence in people with histories of relapsing unipolar major depression. MBCT is an eight-session course delivered to groups of participants who are currently not (or only mildly) depressed. We sought to determine whether MBCT is suitable for older people, and what modifications they may require. We recruited 38 participants aged over 65, of whom 30 completed an MBCT course. Their responses at assessment, post-course and one-year follow-up interviews, plus comments at three-monthly 'reunion' meetings, provided data for thematic analysis. Main themes emerging for participants as a group are considered, as are individuals' understandings and uses of MBCT, and how these developed during and following the course. We found MBCT promising as a cost-effective addition to clinicians' repertoire for addressing depression in old age, and identified issues for further research. Participants' comments indicated that they considered MBCT a helpful intervention for older sufferers from recurring depression.

Predictors of burden and depression among nursing home family caregivers.

Abstract: This study identified predictors of caregiver burden and depression among family caregivers to nursing home residents. Pearlin's stress process model was used as a theoretical framework. Structured interviews were conducted with 103 family caregivers to nursing home residents. Multiple regression analysis was used to determine the relationship of contextual variables (caregiver age, income, health), caregiving stressors (resident's memory and behaviour problems, caregiving tasks, satisfaction with nursing home), and social support with caregiver burden and depression. All three domains of predictor variables were significantly related to caregiver burden. Only contextual factors and social support predicted depression. Depression levels were elevated in this sample, with the mean falling above the cutoff for clinical depression. Family members of nursing home residents are at risk for caregiver burden and depression and each outcome has unique predictors in this population. Understanding factors associated with greater burden and depression can guide nursing home staff and mental health professionals in working with family members. Older family members, those in poor physical health or with low incomes are at highest risk, particularly for depression; while families of more impaired residents are at higher risk for burden. Social support is an important factor in alleviating burden and promoting positive mental health.

Comparison of depressive symptoms between homebound older adults and ambulatory older adults.

Abstract: Due to the social isolation imposed by chronic illness and functional limitations, homebound older adults are more vulnerable to depression than their mobility-unimpaired peers. In this study, we compared 81 low-income homebound older adults, aged 60 and older, with their 130 ambulatory peers who attended senior centers, with respect to their depressive symptoms, depression risk and protective factors, and self-reported coping strategies. Even controlling for sociodemographics, health problems, and other life stressors, being homebound, as opposed to participating in senior centers, was significantly associated with higher depressive symptoms. However, when the coping resources–social support and engagement in frequent physical exercise, in particular–were added to the regression model, the homebound state was no longer a significant factor, showing that the coping resources buffered the effect of the homebound state on depressive symptoms. In terms of self-reported coping strategies, even among the depressed respondents, only a small proportion sought professional help, and that was largely limited to consulting their regular physician and social workers, who may not have had professional training in mental health interventions.

Age differences in coping and emotional responses toward SARS: a longitudinal study of Hong Kong Chinese.

Abstract: This study examined age-related emotional responses and coping at the peak and the end of the SARS outbreak in Hong Kong. Three hundred and eighty-five Hong Kong Chinese, aged 18-86 years, rated the extent that they experienced 'shock', 'sadness', 'anger' and 'fear' in the face of SARS. They also completed selected items from Brief COPE (Carver, 1997). The results showed that older adults consistently experienced less anger than did their younger counterparts. Younger adults used more emotion-focused coping than did middle-aged and older adults at the peak of SARS; yet they exhibited the lowest increase in this form of coping throughout the outbreak, such that the age differences had reversed by the end of the outbreak. Findings of this study suggest that older adults may be better at emotional regulation than are their younger counterparts, they react to a crisis with less anger and are better able to adapt their coping strategies to the changing environment.

Modification of dysfunctional thoughts about caregiving in dementia family caregivers: description and outcomes of an intervention programme.

Abstract: Among the diverse group of interventions developed to help dementia family caregivers cognitive-behavioural approaches show especially promising results. Objectives: This study describes a cognitive-behavioural group intervention aimed principally at the modification of dysfunctional thoughts associated with caregiving (MDTC). The efficacy of the MDTC intervention in reducing caregivers’ depressive symptomatology, together with the frequency and appraisal of problem behaviours, is compared to that of a waiting-list control group (WL). Furthermore, the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers’ depressive symptomatology is analyzed. Of the 74 dementia caregivers who were randomized to one of two conditions (MDTC and WL), 39 completed the post-intervention assessment. Statistical analyses were performed on an intention-to-treat basis, using last observation carried forward. The results reveal that the MDTC intervention is successful i...

Investigating the ways that older people cope with dementia: a qualitative study

Abstract: Understanding the way that older people cope with dementia has important implications for the enhancement of the psychological well-being and quality of life of this group of people. This qualitative study explored how older people cope with dementia, by engaging 12 people with early-stage dementia in semi-structured interviews. Interpretative phenomenological analysis (IPA) was used to identify the shared themes in participants' accounts. Three major themes emerged: "managing identity in relation to dementia", "making sense of dementia", and "coping strategies and mechanisms" (the latter theme divided into "everyday, individual strategies", "coping in relation to others", and "personal attitude/approach"). There were also two additional themes in relation to process issues: issues of "conflict and control" which were evident across all other themes, as was individuality and the importance of "context" in coping with dementia. These findings are discussed in the relation to previous research in this field, and suggestions for further research and clinical practice are outlined.

Enriching opportunities for people living with dementia in nursing homes: an evaluation of a multi-level activity-based model of care.

Abstract: This paper reports on the evaluation of the Enriched Opportunities Programme in improving well-being, diversity of activity, health, and staff practice in nursing home care for people with dementia Participants were 127 residents with a diagnosis of dementia or enduring mental health problems in three specialist nursing homes in the UK A repeated measures within-subjects design was employed, collecting quantitative and qualitative data at three points over a twelve-month period in each facility with follow-up 7 to 14 months later Two-way ANOVAs revealed a statistically significant increase in levels of observed well-being and in diversity of activity following the intervention There was a statistically significant increase in the number of positive staff interventions but no change in the number of negative staff interventions overall There was a significant reduction in levels of depression No significant changes in anxiety, health status, hospitalisations, or psychotropic medication usage were observed The Enriched Opportunities Programme demonstrated a positive impact on the lives of people with dementia in nursing homes already offering a relatively good standard of care, in a short period of time The refined programme requires further evaluation to establish its portability

Effectiveness of staff training programs for behavioral problems among older people with dementia

Abstract: This paper reviewed studies on staff training programs to address the behavioral problems associated with dementia among older people in residential care. The papers were classified according to whether or not the studies included a control group in the research design. The results of the review demonstrate that there has been a wide range of psychosocial and educational interventions to reduce behavioral problems among older people with dementia, with inconsistent results being obtained. However, many of these studies suffer from problems in their research design that make it difficult to evaluate their effectiveness. Problems in conducting research in the nursing home setting are highlighted, and suggestions for future research in this area are discussed.

The attenuating effect of personal mastery on the relations between stress and Alzheimer caregiver health: A five-year longitudinal analysis

Abstract: The objectives of this study were to evaluate the impact of personal mastery and caregiving stress on caregiver depressive symptoms and health over time and to examine the moderating effect of mastery on the relations between stress and these outcomes. A total of 130 spousal Alzheimer caregivers completed yearly assessments of personal mastery, role overload, health symptoms and depressive symptoms. Random regression was used to evaluate the relations between time-varying values for stress and mastery in predicting depressive and health symptoms. It was found that variation in depressive symptoms over time was significantly related to role overload (p<0.05) and personal mastery (p<0.001). A significant overload-by-mastery interaction was found for predicting depressive symptoms (p=0.002) and caregiver health (p=0.008), whereby mastery attenuated the effect of stress on these outcomes. We conclude that personal mastery appears to reduce the effects of stress on depression and health outcomes over time.

The influence of stressors, appraisal and personal conditions on the burden of spousal caregivers of persons with dementia

Abstract: Objectives: The aim of this study was to explore the main and mediating influences of stressors, a caregiver's appraisal, coping, personal conditions and social resources on the burden of dementia caregivers. Method: The study sample consisted of 95 spousal caregivers of non-institutionalized persons with dementia. A path-analytic approach was used to test the conceptual model. Results: The most important factors that were related to burden were the social and behavioural problems of the person with dementia; perceiving the caregiver role as a threat; perceived instrumental support; and the caregiver's functional health status and self-efficacy. The results showed no support for the mediating role of appraisal and coping on the relationship between the demands of the caregiving situation and burden. Conclusion: Although we found insufficient support for the empirical tenability of the hypothesised model, this study revealed some new findings of practical interest. The relationships found suggest that it m...

Differences in stress and coping models of emotional distress among Korean, Korean-American and White-American caregivers

Abstract: This study compares path models of emotional distress among three groups of caregivers for elderly patients with dementia: 64 Koreans residing in Korea, and 53 Korean-Americans and 54 White-Americans living in the USA. The results support a common core model throughout the three groups: patient's disruptive behavior leads to caregiver burden, which then affects caregivers' depression and anxiety. Instrumental support was found to be an important factor for Korean caregivers and emotional support was important for Korean-Americans. Only Korean-American caregivers appraised all three patient's problems--patient's disruptive behaviors, memory problems, and depression as burdensome. These findings suggest that stress and coping processes in caregivers from different cultures involve a common core with important differences in the effects of the patient's problems and of social support.

The relationship between self-reported health and mental health problems among older adults in New Zealand: Experiential avoidance as a moderator

Abstract: This study sought to examine the influence of experiential avoidance (EA) as a moderating variable between reported physical health problems and anxiety and depression among older adults. Experiential avoidance has been found in previous studies to be strongly associated with a number of psychological disorders in younger adults but has received minimal attention in older populations. Two-hundred-and-eight individuals from New Zealand between the ages of 70 and 92 years old participated in this study. The Geriatric Anxiety Inventory, the Geriatric Depression Scale and the Acceptance and Action Questionnaire were used to measure anxiety, depression and EA, respectively. It was hypothesized that self-reported health (SRH) and EA would be associated with depression and anxiety at the zero order level. We also hypothesized that EA would be a unique predictor of depression and anxiety and would moderate the relationships between SRH and both depression and anxiety. Multiple regression analyses indicated that EA explained 8% of the unique variance in depression, 20% in anxiety and moderated the relationships between SRH and both depression and anxiety. This study also found that the relationships involving EA were more pronounced with anxiety as compared with depression in this elderly sample. The theoretical and practical applications of these findings are discussed.

Self-report measures of anxiety: Are they suitable for older adults?

Abstract: Objectives: To assess the performance of four self-report measures of anxiety in an older adult population. Method: Forty older adults with current or previous anxiety symptoms completed four self-report measures of anxiety (Beck Anxiety Inventory, State Trait Anxiety Inventory, Hospital Anxiety and Depression Scale and Visual Analogue Scale) and received an independent diagnostic assessment and rating of anxiety severity. After a minimum of four months, participants were re-assessed on all measures. Results: The self-report measures most suited for anxiety screening and assessing severity when compared to the independent assessment were the Beck Anxiety Inventory (BAI), the anxiety scale from the Hospital Anxiety and Depression Scale (HADS-A) and State Trait Anxiety Inventory-Trait form (STAI-T). However, participants made an unacceptably high number of errors using the STAI-T, making the BAI and HADS-A the most suitable measures for older adults. The Visual Analogue Scale (VAS) performed poorly in both ...

The prevalence and recognition of major depression among low-level aged care residents with and without cognitive impairment

Abstract: Previous research has demonstrated a high level of depression in nursing homes. The current study was designed to determine the prevalence of depression, using a structured diagnostic interview, among older people with and without mild-moderate cognitive impairment residing in low-level care facilities. The results demonstrated that, consistent with previous research in nursing homes, 16.9% of older people were diagnosed with major depressive disorder. Less than half of these cases had been detected or treated. Individuals with moderate cognitive impairment were more likely to be depressed, but cognitive impairment did not appear to act as a strong impediment to the detection of depression by general practitioners. A low awareness of their use of antidepressant medications was demonstrated among older people prescribed this treatment, including those with normal cognitive function. Reasons for the poor recognition of depression among older people are discussed.