Depression In Older People Research Articles

Nursing Clinical Assessment of Factors Associated with Depression in Older People with Type 2 Diabetes in Primary Care: A Cross-sectional Research

Nursing Clinical Assessment of Factors Associated with Depression in Older People with Type 2 Diabetes in Primary Care: A Cross-sectional Research

Change in the global burden of depression from 1990-2019 and its prediction for 2030

ObjectiveDepression is a global health challenge, but only a few studies have fully assessed and predicted the disease burden. This study described the trend of global depression burden from 1990 to 2019 through age-standardized incidence rate (ASIR), age-standardized disability-adjusted life rate (ASDR), and predicted the number of cases of depression during 2020–2030. MethodsLinear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. The trends of global depression burden from 1990 to 2019 were analyzed by age, sex, and socio-demographic index (SDI) across various regions. Finally, we used the Bayesian age-period-cohort (BAPC) model to predict the disease burden in the coming 10 years. ResultsGlobally, the ASIR of depression decreased from 3681.24 per 100,000 population in 1990 to 3588.25 per 100,000 population in 2019 and the EAPC was −0.29%. ASDR also decreased, following a similar trend as the ASIR. The highest ASDR was observed in adults aged 60–64 years. The burden of depressive illness was higher in women, with the greatest increase in incidence in low SDI areas. BAPC predicted that the worldwide ASIR and ASDR of depression would stabilize from 2020 to 2030, with an increasing number of cases. By 2030, the ASIR was estimated to be 2519.88 per 100,000 men and 3835.11 per 100,000 women. ConclusionFrom 1990 to 2019, the global burden of depression remained significant, especially among women. It is important to address depression in older people, and it is therefore necessary to develop measures for prevention.

Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study.

Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020-December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.

Esketamine for resistant depression in older people with cognitive impairment: a case report

IntroductionDepression represents a significant challenge in terms of disability among the elderly population and its responsiveness to conventional treatment approaches tends to diminish in this population group. Esketamine has shown both effectiveness and safety in addressing treatment-resistant depression in older patients.ObjectivesCurrently, there is a lack of available literature regarding the use of esketamine in the treatment of patients experiencing both cognitive decline and treatment-resistant depression (TRD). We administered esketamine to a 79-year- old patient to evaluate the effectiveness and tolerance of the medication.MethodsWe recruited a 79 year old female referred to the outpatient clinics of Pavia suffering from TRD with current Severe Depressive Episode (scoring 42 on the MADRS) with cognitive impairment (MMSE 16/30). The patient was on a fourth-line treatment. First-line treatment was started with paroxetine 40 mg from september 2021 to May 2022, switched to sertraline 50 mg. Second-line treatment with quetiapine 150 mg from June 2022 to December 2022 failed, despite optimal compliance for both lines of treatment. Then third line treatment with fluoxetine 20 mg, olanzapine 10 mg was initiated from December 2022 to May 2023. Study duration was 12 weeks. Anamnestic data and psychometric (MADRS, HAMD-21, HAM-A) and cognitive (MMSE and MoCA TEST) assessment were collected from medical records at baseline (T0), one month (T1) and three month (T2) follow-ups.ResultsMADRS, HAM-A and HAM-D values decreased significantly at T1 and T2 follow-ups. T0: MADRS 42, HAM-D 33, HAM-A 54; T1: MADRS 18, HAM-D 12, HAM-A 15; T2: MADRS 4, HAM-D 5, HAM-A 10. We also observed an improvement in cognitive test: T0: MMSE 16/30, MoCA test 4/30; T1: MMSE 18/30, MoCA test 6/30; T2: MMSE 20/30, MoCA test 8/30. The patient reported one episode of hypertension treated with clonidine after two moth of treatment, and mild prolonged motor slowing lasting about two hours after esketamine in the first month.ConclusionsThis case documented a successful treatment using intranasal esketamine in combination with an SSRI (Fluoxetine) for an older individual with cognitive impairment and a persistent anxiety-depressive syndrome. This approach was employed as a therapeutic intervention after multiple unsuccessful attempts with other antidepressant medications. Our findings confirmed the safety and tolerability of esketamine in an elderly female with cognitive impairment. Although a minor improvement in cognitive abilities has been noted, secondary dysfunction attributable to vascular-based cognitive decline remained. In terms of cognitive tolerance, derivatives of ketamine could potentially serve as an alternative to electroconvulsive therapy in cases of treatment-resistant depression, potentially improving short-term cognitive outcomes.Disclosure of InterestNone Declared

Prevalence and Psychosocial Risk Factors Associated with Depression in Older People in A Rural Community

Depression is a multifactorial disease that globally impacts all ages and sectors of the population. In this sense, it has become a public health problem, since it affects 280 million people in the world, according to information from the World Health Organization. Older adults represent 5.7% of the population that experiences this disease, with the moderate to severe stage being the one that most impacts their health, and, therefore, quality of life. For this reason, the objective of the research is to know the prevalence and psychosocial risk factors associated with depression in older people in the community of Santa Cruz, Hecelchakán, Campeche. The methodology used is with a quantitative approach because information was collected, based on the application of the Yesavage scale of geriatric depression, and the sociodemographic registry of 60 older adults of both sexes, in order to measure the percentage of prevalence through its respective epidemiological formula. Likewise, it is cross-sectional because it collected data in a single time: November 2022 – October 2023. Results: 46.7% experienced mild depression, 41.7% moderate depression and 11.6% severe depression. 55% of those interviewed were male and 45% female. The actual prevalence of depression is 100%. Likewise, the psychosocial risk factors identified were: the absence of recreational activities and social support networks, the economy, health services and family disintegration. Finally, it is necessary to design and implement socio-health intervention projects in the locality and with a socio-cultural perspective that impacts this age group, the family and from an intergenerational perspective, with the promotion of mental health being a priority goal in their execution.

Somatic disease burden and depression risk in late life: a community-based study.

Co-occurring somatic diseases exhibit complex clinical profiles, which can differentially impact the development of late-life depression. Within a community-based cohort, we aimed to explore the association between somatic disease burden, both in terms of the number of diseases and their patterns, and the incidence of depression in older people. We analysed longitudinal data of depression- and dementia-free individuals aged 60+years from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression diagnoses were clinically ascertained following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision over a 15-year follow-up. Somatic disease burden was assessed at baseline through a comprehensive list of chronic diseases obtained by combining information from clinical examinations, medication reviews and national registers and operationalized as (i) disease count and (ii) patterns of co-occurring diseases from latent class analysis. The association of somatic disease burden with depression incidence was investigated using Cox models, accounting for sociodemographic, lifestyle and clinical factors. The analytical sample comprised 2904 people (mean age, 73.2 [standard deviation (SD), 10.5]; female, 63.1%). Over the follow-up (mean length, 9.6years [SD, 4years]), 225 depression cases were detected. Each additional disease was associated with the occurrence of any depression in a dose-response manner (hazard ratio [HR], 1.16; 95% confidence interval [CI]: 1.08, 1.24). As for disease patterns, individuals presenting with sensory/anaemia (HR, 1.91; 95% CI: 1.03, 3.53), thyroid/musculoskeletal (HR, 1.90; 95% CI: 1.06, 3.39) and cardiometabolic (HR, 2.77; 95% CI: 1.40, 5.46) patterns exhibited with higher depression hazards, compared to those without 2+ diseases (multimorbidity). In the subsample of multimorbid individuals (85%), only the cardiometabolic pattern remained associated with a higher depression hazard compared to the unspecific pattern (HR, 1.71; 95% CI: 1.02, 2.84). Both number and patterns of co-occurring somatic diseases are associated with an increased risk of late-life depression. Mental health should be closely monitored among older adults with high somatic burden, especially if affected by cardiometabolic multimorbidity.

Demographic and clinical correlates of depression among older adults with arthritis in Nigeria.

Older adults have a high prevalence of chronic conditions like arthritis with morbidities, especially depression ranging up to 40% - 70%. Therefore, it is important to explore depression in older adults with arthritis. This study aimed to determine if any demographic and clinical factors are associated with depression in older adults aged ≥ 60 years with arthritis attending a rheumatology clinic. This is a cross-sectional study conducted over 6 months among 127 older adults on follow-up care in a university teaching hospital in the North-Eastern region of Nigeria. A clinical proforma with information about the type of arthritis, duration of illness, hospitalisation, use of medications, co-morbidity was utilised for the data collection. The Geriatric Depression Scale (GDS-30), sociodemographic questionnaire and clinical proforma were administered. Data were analysed using Statistical Product and Service Solutions (SPSS) version 26.0 with the level of significance set as 0.05. The mean age (± standard deviation [s.d.]) was 66.6 (± 5.5) years, with males constituting 57.5%. The prevalence of depression was 57.8%. Osteoarthritis 30.2%, while 69.8% had rheumatoid arthritis. Sociodemographic factors associated with depression include age (p = 0.049), marital status (p = 0.001), and level of education (p = 0.001). Duration of illness (p = 0.02), hospitalisation (p = 0.03), and number of medications (p = 0.01) were clinical factors associated with depression score. The prevalence of depression in older people with arthritis is high and was associated with females, the widowed, no formal education; and those with long duration of illness, those using multiple medications, and those with repeated hospitalisation. This finding can enhance the suspicion index for depression to establish standard operating procedures, which will help to improve therapeutic practice for caring for the older adult age group.

Cognition and depression in older people with diabetes

Cognitive dysfunction, dementia and depression are typical comorbidities of diabetes and are more common in older people with diabetes than in the general population. Both comorbid diseases have asubstantial impact on the therapy of diabetes and lead to areduction of the functional level in everyday life, the quality of life and are associated with increased mortality. This article summarizes the most important results on the etiology of cognitive dysfunction and depression and their consequences for clinical practice.

Effect of Vestibular Rehabilitation on Sleep Quality and Depression in the Elderly With Chronic Dizziness: A Prospective Study.

Dizziness and the accompanying complaints, including sleep disorders and depression, are common among the elderly. This study investigated the effect of vestibular rehabilitation on complaints of dizziness, sleep problems, and the severity of depression in older people with chronic dizziness. The study included 25 participants with chronic dizziness accompanied by comorbid sleep disturbance (Pittsburgh Sleep Quality Index [PSQI] global score >5). Participants completed the Dizziness Handicap Inventory (three sub-scales: physical, emotional, and functional), the PSQI, and the Persian version of the shortened Beck Depression Inventory (BDI-13) before and after the vestibular rehabilitation. The findings showed that the handicap caused by dizziness, the severity of depression, and the quality of sleep in the study participants improved significantly after the intervention (p<0.05). Vestibular rehabilitation is an effective intervention to reduce dizziness handicap, comorbid sleep disturbance, and depression.

P209: Psychological therapies for depression in older adults residing in long-term care settings: Are they effective?

Objectives:This systematic review and meta-analysis aimed to (1) assess the effectiveness of psychological therapies for depression in older people living in long-term care (LTC) settings, and (2) investigate differences in effectiveness between types of psychological treatments.Methods:We included randomised controlled trials (RCTs) with participants aged 65 years and older. Participants were required to present with (a) major depressive disorder (MDD) or (b) symptoms of depression based on a score over a cut-point on a validated depression measure. The study setting was LTC facilities, including nursing homes, assisted-living facilities, and residential aged care facilities, where some level of day-to-day care was provided by staff employed in the facility. Treatments were grouped and classified as cognitive-behavioural therapy, behaviour therapy, or reminiscence therapy.Results:The literature review identified 19 studies for the qualitative synthesis: 18 were included in a meta-analysis. Results indicated a benefit for psychological treatments on depressive symptoms at end-of-intervention (standardized mean difference (SMD) -1.04, 95% CI -1.49 to -0.58; 18 trials, 644 participants), and at a medium-term follow-up (SMD -0.43, 95% CI -0.81 to -0.06; 8 RCTs, 355 participants), but not in the longer-term (SMD -0.16, 95% CI -0.58 to 0.27; 2 RCTs, 92 participants). There was no difference in outcomes between therapy types.Conclusion:This systematic review demonstrated positive impacts of psychological therapies on symptoms of depression in older people living in LTC, both immediately after therapy and in the medium term, but longer-term impacts were not demonstrated.

P3: The care of older people with depression in Nigeria: experience in primary care settings.

Background:There is a large treatment gap for mental health conditions in sub-Saharan Africa where most of affected persons who receive any care do so from non-physician primary health care workers (PHCW). We examined the experience of PHCW who provide care for older people with depression in Nigerian primary health care (PHC) settings.Methods:Using in-depth key informant interviews, we explored the views of 15 PHCWs, 11 of whom were community health workers (CHWs) and 4 were community health extension workers (CHEWs), selected from 10 rural and urban PHCs in South-Western Nigeria. Two additional focus group discussions, each comprising eight participants drawn from across different cadres of PHCW (N=16), were also conducted. Thematic analysis was carried out using a three-staged constant comparison technique to refine and categorise the data.Results:Four overall themes were identified around PHCWs’ experience of caring for older people with depression who presented to PHCs: depression presentation, treatment options, community outreach, and value of mobile technology. Participants identified depression in older people as being characterized by a range of behavioural, cognitive, sleep and bodily symptoms, which were often triggered by economic challenges and poor social support. Common treatment options used by PHCW included general advice and counselling, as well as vitamins and occasional sedatives. Although community outreach and follow-ups are parts of their expected work schedule, PHCW rarely implement these due to non-availability of transport facilities. Mobile technology was identified as a possible way of overcoming this constraint to providing community based mental healthcare for older people.Conclusion:Our findings suggest that mobile technology could be a viable way to expand the quality of service provided to older persons with depression by including community outreach and follow-up.

Family members’ perspective of depression in old people in Vietnam

The most prevalent disorders that lead to emotional distress in older people are depression and its disorders. Older people’s sadness is usually misinterpreted and misdiagnosed in this demographic. The effectiveness of the illness’ treatment will certainly be impacted by family members who frequently care for depressed older people. The purpose of this research is to analyze the perspectives and experiences of family members with regard to older people’s depression. In this study, a total of 804 caregivers of senior patient with depression in the province of Quang Ngai received a questionnaire that contained a total of 26 items. The questionnaire was distributed in Quang Ngai province, Vietnam. The most important finding was that the majority of family members who provide care for elderly patients exhibiting depressive symptoms were aware of the factors that contribute to the development of depression in older people and used their own coping mechanisms in order to provide care for them.

The trajectory of non-depressed suicidal ideation in community-dwelling older people in a rural area in Japan: a prospective longitudinal study with a 3-year follow-up.

Suicidal ideation is closely related to severe suicidal behaviour and is an important predictor of suicide attempt and completion, including in older people. Older people tend to have many opportunities to be conscious of death, and may have vague suicidal ideation because of various loss experiences, even if they are not depressed. We hypothesised that suicidal ideation among older people might be a risk factor for later transition to depression. The present study aimed to clarify risk factors that predict the incidence of depression in older people 3 years post-baseline in a rural area of Japan, and to examine the subsequent course of depression among non-depressed older people with suicidal ideation. In 2015 and 2018, survey questionnaires were mailed to residents aged 65 years and over living in a rural area in Japan. Participants were divided into a depression group and a non-depression group using 15-item Geriatric Depression Scale scores 3 years post-baseline. Logistic regression analysis was used to identify predictive factors of late-life depression 3 years post-baseline. We received 597 valid responses, with a 3-year follow-up rate of 78.8%. Regarding suicidal ideation, 6.7% of non-depressed older people exhibited suicidal ideation at baseline. Of these, 9.8% exhibited depression after 3 years post-baseline. Logistic regression analysis indicated that development of late-life depression is significantly associated with suicidal ideation, being female, and poor health-related quality of life (HRQOL). The results revealed that suicidal ideation, being female, and poor HRQOL were predictive factors of the development of late-life depression 3 years post-baseline in a rural area of Japan. These findings provide novel information regarding the transition to depression among community-dwelling older people who are not depressed but have suicidal ideation. Whereas suicidal ideation is considered to be a symptom of depression, the current results suggest that suicidal ideation may precede depression in some older people.

Managing depression in frail older people; too little too late or pathologising loss?

It is testament to the advances of modern medicine that we have a population with more older people than ever before. While we are increasingly adept at managing their physical comorbidities, we have made relatively little progress in addressing the psychological impact of ageing. In this article we consider the prevalence and complex aetiology of depression in older people who often have to deal with profound loss, while simultaneously managing multiple comorbidities. We consider the challenges of diagnosing depression faced by healthcare professionals including access to resources and training, and what differentiates depression from socially appropriate low mood. Finally, we discuss treatment options and the difficulties that clinicians face when they have only limited resources and skills available, but a desire to help. We consider the role for antidepressants, and when not to prescribe, before addressing the challenges of providing talking therapies and social interventions.

Depression and loneliness symptoms in Brazilian older people during the COVID-19 pandemic: a network approach

Objectives Depression and loneliness in older people were a global challenge during the COVID-19 pandemic. Causal mechanisms to trigger depression might vary across different life events. We aimed to apply network analysis in a sample of Brazilian older people during the first wave of the COVID-19 pandemic, to investigate if loneliness and depression symptoms were connected within a psychological network. We explored how symptoms manifested and interacted, to discuss possible interventions that could mitigate late-life depression and loneliness symptoms in face of the COVID-19 pandemic. Method We collected data from 384 Brazilian older people who answered an online protocol to assess sociodemographic data, loneliness symptoms (assessed by the short version of UCLA-BR), and depression symptoms (assessed by the PHQ-2). Results ‘Lack of companionship’ was the bridge symptom connecting loneliness and depression communities. ‘I feel shut out and excluded by others’ and ‘People are around me, but not with me’ were the most predictable symptoms of loneliness. Conclusion Interventions aimed to promote older people’s social participation and skills, combined with strategies to expand their sources of social support and combat ageism, might be relevant to mitigate symptoms of loneliness and depression in older people during a crisis like the COVID-19 pandemic.

Cognitive Behavior Therapy (CBT) sebagai Terapi Tingkat Depresi pada Lansia

This study aims to determine the effect of Cognitive Behavior Therapy (CBT) on reducing depression in older people in Gumpang Village. This research method uses a quantitative approach in the form of a pre-experiment with one-group pretest-post-design research conducted from November 2022 to December 2022. Respondents in this study were 87 elderly respondents in Gumpang Village, Kartasura District, Sukoharjo Regency. Respondents were taken using the Accidental Sampling Technique. Respondents were selected according to the discussion criteria as samples. Data collection used a research instrument in the form of a GDS-15 questionnaire with a total of 15 questions. The results of this study indicate that the p-value = 0.000 ≤ α = 0.05 (the p-value is smaller than α = 0.05). In conclusion, there are significant differences in depression before and after CBT therapy. Giving CBT has a substantial impact on reducing the level of depression in older people in Gumpang Village.&#x0D; &#x0D; Keywords: Depression, Elderly, Cognitive Therapy

Stress and older people

British Journal of Community NursingVol. 28, No. 4 EditorialStress and older peoplePatricia RobinsonPatricia RobinsonE-mail Address: [email protected]Senior Lecturer, Independent Prescribing Team, School of Sport and Health Sciences, University of Brighton; Board Member of the British Journal of Community NursingSearch for more papers by this authorPatricia RobinsonPublished Online:29 Mar 2023https://doi.org/10.12968/bjcn.2023.28.4.161AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Age UK. Your mind matters: Thinking about your mental health. 2022. https://www.ageuk.org.uk/globalassets/age-uk/documents/information-guides/ageukig56_your_mind_matters_inf.pdf (accessed 3 March 2023) Google ScholarFrost R, Beattie A, Bhanu C, Walters K, Ben-Shlomo Y. Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies. Br J Gen Pract. 2019;69(680):e171-e181. https://doi.org/10.3399/bjgp19x701297 Crossref, Medline, Google ScholarGaggero A, Fernandez-Perez A, Jiménez-Rubio D. Effect of the COVID-19 pandemic on depression in older adults: a panel data analysis. Health Policy. 2022;126(9):865-871. https://doi.org/10.1016/j.healthpol.2022.07.001 Crossref, Medline, Google ScholarGould RL, Coulson MC, Howard RJ. Cognitive behavioral therapy for depression in older people: a meta-analysis and meta-regression of randomized controlled trials. J Am Geriatr Soc. 2012;60(10):1817-1830. https://doi.org/10.1111/j.1532-5415.2012.04166.x Crossref, Medline, Google ScholarLakra DC, Ng R, Levy BR. Increased longevity from viewing retirement positively. Ageing Soc. 2012;32(8):1418-1427. https://doi.org/10.1017/S0144686X11000985 Crossref, Google ScholarMcManus E, Haroon H, Duncan NW, Elliott R, Muhlert N. The effects of stress across the lifespan on the brain, cognition and mental health: a UK biobank study. Neurobiol Stress. 2022;18:100447. https://doi.org/10.1016/j.ynstr.2022.100447 Crossref, Medline, Google ScholarMental Health Foundation. How to manage and reduce stress. 2016. https://www.mentalhealth.org.uk/explore-mental-health/publications/how-manage-and-reduce-stress (accessed 3 March 2023) Google ScholarMoult A, Burroughs H, Kingstone T, Chew-Graham CA. How older adults self-manage distress - does the internet have a role? A qualitative study. BMC Fam Pract. 2018;191:185. https://doi.org/10.1186/s12875-018-0874-7 Crossref, Medline, Google ScholarNational Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. 2019. https://www.nice.org.uk/guidance/cg113 (accessed 2 March 2023) Google ScholarNHS Digital. Psychological therapies: annual report on the use of IAPT services 2017—18. 2018. https://digital.nhs.uk/data-and-information/publications/statistical/psychological-therapies-annual-reports-on-the-use-of-iapt-services/annual-report-2017—18/content.old (accessed 2 March 2023) Google ScholarWetherell JL, Hershey T, Hickman S et al. Mindfulness-based stress reduction for Older Adults With Stress Disorders and Neurocognitive Difficulties: A Randomized Controlled Trial. J Clin Psychiatry. 2017;78(7):e734-e743. https://doi.org/10.4088/jcp.16m10947 Crossref, Medline, Google ScholarWorld Health Organization. Mental health of older adults. 2017. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults (accessed 2 March 2023) Google ScholarWorld Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 2022. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide (accessed 2 March 2023) Google ScholarYoung LA, Baime MJ. Mindfulness-based stress reduction: effect on emotional distress in older adults. Complement Health Pract Rev. 2010;15(2):59-64. https://doi.org/10.1177/1533210110387687 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 April 2023Volume 28Issue 4ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 29 March 2023 Published in print 2 April 2023 Information© MA Healthcare LimitedPDF download

Acceptability of a behavioural intervention to mitigate the psychological impacts of COVID-19 restrictions in older people with long-term conditions: a qualitative study

ObjectivesThe COVID-19 pandemic heightened the need to address loneliness, social isolation and associated incidence of depression among older adults. Between June and October 2020, the Behavioural Activation in Social IsoLation...

Association of Tooth Loss Dementia and Cognitive Decline among the Older Adults of the West Godavari District – A Questionnaire Study

Abstract Introduction: Teeth loss is a confounding factor that may have an impact on the early stages of dementia. It affects the nutritive, cognitive, and psychological aspects of the individual, which are getting major concerns, especially in older dwelling communities. Tooth loss, age, and systemic diseases have a complex relationship which has a considerable role in getting mild forms of dementia. Aims and Objectives: The aim is to find the most prevailing factors in the West Godavari district of Andhra Pradesh state in association with tooth loss, dementia, and cognitive decline among the older dwelling community by using questionnaires concerning their nutritive, cognitive, and psychological aspects. Materials and Methods: A structured self-administered questionnaire was used modified versions of Mini Nutritional Assessment, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS) to collect the nutritive, cognitive, and psychological aspects of tooth loss and distributed to 300 people Microsoft Excel (Microsoft) was used for data processing and data chart generation. International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp) was used to analyze the data. Results: The total study had an equal male-to-female ratio. Periodontal problems (72%), diabetes (15%), and caries (13%) were the most opted reason for tooth loss. Individuals who lost teeth more than 5 years ago showed considerable effects of malnourishment (7.1250 ± 1.68767), risk of cognitive decline (13.6452 ± 3.26890), and depression (6.1944 ± 1.90967). Individuals with systemic diseases, especially diabetes and hypertension, had shown severe signs of cognitive decline above the normal limits. Conclusion: This study found a link between reduced cognitive function and edentulism. To address the rising issue of dementia and cognitive impairment in our society, this study aims to highlight the value of proper dental cleanliness and care as one potential preventive approach, among many others. Alzheimer’s disease and cognitive decline are both made more likely by periodontal disease. Furthermore, this study found a significant prevalence of depression in older people, and it was associated with experiencing dry mouth during both MMSE and GDS assessments and tooth loss between assessments.

Effectiveness of reminiscence therapy interventions for older people: Evidence mapping and qualitative evaluation.

INTRODUCTION: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long-term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. The present study aimed to systematically identify, synthesize and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence-mapping approach. Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP and SinoMed, were searched from inception till 31 March 2022. The study type was restricted to SRs with or without meta-analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesize information on the study population, intervention category, original study sample size and classification of findings. A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomized controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications) and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorized as either "beneficial" or "potentially beneficial." The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life and categories of positive psychology (e.g., life satisfaction, happiness and self-esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual) and intervention intensity. The intervention settings/contexts were mainly community and long-term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either "Low" or "Critically Low." Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardize the reporting process for the evaluation of reminiscence intervention systems. Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies.