Geriatric Depression Scale-Short Form Score Research Articles

Effects of a Hybrid Teaching Program on Lower Limb Muscle Strength, Knee Function, and Depression in Older Adults After Total Knee Replacement: A Randomized Controlled Trial.

The aim of the current study was to evaluate the effects of a nurse-led hybrid teaching program on lower limb strength, knee function, and depression in older adults after total knee replacement (TKR). This was a single-blind, randomized controlled trial. Fifty-two patients who underwent TKR were randomly assigned to either the experimental group (EG; n = 26), which received routine care plus 16 weeks of home rehabilitation through a hybrid teaching program, or the control group (CG; n = 26), which received routine care only. The intervention included pre-discharge face-to-face education, video instructions to follow at home after discharge, and four monthly telephone-based follow ups during the 16 weeks post-surgery. After the 16-week intervention, participants in the EG exhibited improved quadriceps strength, hamstring strength, and Knee Injury and Osteoarthritis Outcome Score (KOOS) compared to those in the CG. Generalized estimating equation analyses revealed a significant group-by-time interaction effect on quadriceps strength, overall KOOS score, and Geriatric Depression Scale-Short Form score. Findings suggest that a nurse-led hybrid teaching program enhances physical and psychological function after TKR when compared to routine care. This hybrid teaching program, involving exercise and postoperative education, proves to be a feasible and cost-effective intervention for improving outcomes in older adults following TKR. Health care teams should consider it as a viable home rehabilitation option for older adults who undergo TKR. [Research in Gerontological Nursing, 17(1), 31-40.].

Quality of Life and Kidney Function in Older Adults: Prospective Data of the SCOPE Study.

A longitudinal alteration in health-related quality of life (HRQoL) over a two-year period and its association with early-stage chronic kidney disease (CKD) progression was investigated among 1748 older adults (>75 years). HRQoL was measured by the Euro-Quality of Life Visual Analog Scale (EQ-VAS) at baseline and at one and two years after recruitment. A full comprehensive geriatric assessment was performed, including sociodemographic and clinical characteristics, the Geriatric Depression Scale-Short Form (GDS-SF), Short Physical Performance Battery (SPPB), and estimated glomerular filtration rate (eGFR). The association between EQ-VAS decline and covariates was investigated by multivariable analyses. A total of 41% of the participants showed EQ-VAS decline, and 16.3% showed kidney function decline over the two-year follow-up period. Participants with EQ-VAS decline showed an increase in GDS-SF scores and a greater decline in SPPB scores. The logistic regression analyses showed no contribution of a decrease in kidney function on EQ-VAS decline in the early stages of CKD. However, older adults with a greater GDS-SF score were more likely to present EQ-VAS decline over time, whereas an increase in the SPPB scores was associated with less EQ-VAS decline. This finding should be considered in clinical practice and when HRQoL is used to evaluate health interventions among older adults.

The Prognostic Utility of a Geriatric Assessment for Patients with Pancreatic Cancer Receiving Gemcitabine-based Chemotherapy: A Prospective Observational Study.

Objective To evaluate the effect of a pretreatment geriatric assessment on the clinical outcomes in older patients with unresectable or recurrent pancreatic ductal adenocarcinoma (PDAC) scheduled to receive gemcitabine (GEM)/GEM+nab-paclitaxel (GnP). Patients Older patients with unresectable PDAC scheduled to receive GEM/GnP who visited Kyorin University Hospital and cooperating institutions were enrolled and followed from April 2015 to March 2020. The maximum observation period was two years. All patients underwent a cancer-specific geriatric assessment (CSGA) and optional geriatric assessment (GA) before treatment initiation and two months after the start of treatment. The patients' background characteristics, tumor progression, tumor site, and regimen (GEM/GnP) were examined in a Cox proportional hazards model. The relationship between the overall survival (OS) and GA score was also determined. Eligible patients (age ≥70 years old with histopathologically confirmed unresectable or recurrent PDAC) were scheduled to receive first-line chemotherapy. Results The performance status (PS) and activities of daily living (ADL)/instrumental ADL (IADL) scores at baseline correlated with the OS. Furthermore, even in cases with normal baseline values, lower Frontal Assessment Battery scores and higher Geriatric Depression Scale-Short Form scores after treatment initiation were significantly correlated with OS. Conclusion The baseline PS, ADL, and IADL may be prognostic factors in older PDAC patients. In addition, a normal frontal lobe function and depression scores prior to treatment initiation that rapidly worsened during treatment were independently associated with a reduced OS. Selecting appropriate interventions and improving the therapeutic environment may prolong the OS in such patients.

Effect of Exercise Using an Exoskeletal Hip-Assist Robot on Physical Function and Walking Efficiency in Older Adults.

Robotic technology has developed rapidly in recent years, and several robotic devices have been applied to improve physical, sensory, intellectual, psychological, and social functioning in the elderly and people with disabilities. In this study, we investigated the effects of EX1-assisted exercise in various environments on physical function, muscle strength, and walking efficiency in older adults. We designated four experimental conditions and randomly assigned participants to one of four groups: A (overground walking without an EX1), B (overground walking using the resistance mode of EX1), C (stair ascent using the assistance mode of EX1), and Group D (inclined treadmill walking using the assistance mode of EX1). A total of 60 community-dwelling elderly persons participated in 10 exercise intervention sessions for 4 weeks, and all participants were assessed before and after the exercise intervention. Physical function was measured by the 10-meter walk test for self-selected velocity (10MWT-SSV), short physical performance battery (SPPB), Berg balance scale (BBS), timed up and go (TUG), functional reach test (FRT), geriatric depression scale-short form (GDS-SF), and muscle strength of trunk and lower extremity. Cardiopulmonary metabolic energy efficiency was measured using a portable telemetric gas analyzer system. A significant increase in the 10MWT-SSV and TUG test was observed in groups B, C, and D. A statistically significant improvement in the SPPB and FRT was seen only in group D, and GDS-SF scores decreased significantly after exercise with an EX1 in groups B and D. Trunk and lower limb muscle strength increased more in the groups that exercised with EX1 assistance than those without an EX1, particularly in group B. The net metabolic energy costs and energy expenditure measurement during walking significantly improved in exercise groups C and D. The findings in this study support the application of the EX1 to physical activity and exercise to improve age-related changes in physical function, muscle strength, and walking efficiency among older adults. In addition, personalized exercise programs using different modes and training environments with an EX1 can enhance physical performance and walking efficiency in the elderly.

Developing Multimodal IoMT Monitoring System of Geriatric Depression: A Feasibility Study

The Internet of Medical Things (IoMT) is a promising tool to monitor depression and relevant symptoms. However, the multimodal IoMT monitoring system has been rarely developed considering the characteristics of older adults, particularly living in the community. Therefore, it is necessary to know how to develop multimodal IoMT monitoring systems tailored for older adults and evaluate the feasibility for research and practice. We developed a multimodal IoMT monitoring system that included a smartphone for facial and verbal expressions, smartwatch for activity and heart rates, and ecological momentary assessment (EMA) application. A convenience sample of 21 older Korean adults aged over 65 years was recruited from a community center, and 19 participants completed it. The data were collected in four weeks using self-report questionnaires, IoMT devices, and semi-structured interviews between July and December 2020 and were analyzed in mixed methods. Based on the Geriatric Depression Scale-Short Form scores, eight participants were classified in the depressive group (38.1%) and 13 in the non-depressive group (61.9%). A total of 1,505 (70.72%) EMA data were collected, and 1,277 (60.00%) were analyzed. Furthermore, 1,421 (66.78%) facial expression data were collected and labeled, including anger, happiness, neutral, sadness, surprise, and exception. Voice dialogues were transformed into 5,264 scripts. The depressive group showed lower user acceptance relative to the non-depressive group. However, both groups experienced positive emotions, had regular life patterns, and increased their self-interest. Thus, our multimodal IoMT monitoring system is a feasible and useful measure for acquiring mental health information in older adults’ depression.

Association between swallowing function, malnutrition and frailty in community dwelling older people.

Swallowing function decreases with age and impacts nutritional state and frailty. The aim of the study was to test the relationship between swallowing function, dysphagia, frailty, malnutrition and depression in community dwelling older participants. Community dwelling older participants (n=180), were enrolled (74 men aged 75.9±7.8, 65-91 years, and 107 women aged 75.9±8.0, 65-95 years). Swallowing function was assessed by the Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST). Dysphagia was identified using Hebrew 10-Item Eating Assessment Tool (H-EAT-10). Frailty was assessed by grip strength and the FRAIL Questionnaire. The Mini Nutritional Assessment - Short Form (MNA-SF) was used to identify nutritional status. Depression was screened with the Geriatric Depression Scale - Short Form (GDS-SF). 18.3% of the participants had a score of 3 or above in H-EAT-10, indicating suspected dysphagia. 17.8% of the participants were malnourished or at risk of malnutrition, and 48.3% were defined as frail or pre-frail. The odds of being malnourished/at risk of malnutrition were 3 times greater in those with suspected dysphagia. The odds of being frail/pre-frail were also 3 times greater in those with suspected dysphagia. Moreover, suspected dysphagia and frail/pre-frail health status coincided in 69.7% of participants. Participants that were malnourished/at risk of malnutrition required more masticatory cycles (p<.05) and more time (p<.05) to eat a cracker and drink 150mL of water (p<.05), and had reduced swallowing capacity (volume/sec) in the TWST (p<.05) than those who were at normal nutritional statues. Similar results were found for frail/pre-frail participants versus robust health status. A decrease in grip strength was associated with increased (worse) frailty score, decreased nutritional score, decreased chewing function in TOMASS and decreased water drinking function in TWST (p<.05). MNA-SF score, age, GDS-SF score and EAT-10 were the best predictors of FRAIL score. A simple multi-dimensional screen should be employed by trained allied health professionals, nurses and their assistants to improve early identification and early referral to relevant health providers in order to provide preventive intervention for dysphagia, nutrition, frailty and depression.

Effects of Citicoline as an Adjunct Treatment for Alzheimer’s Disease: A Systematic Review

A critical strategy in the management of Alzheimer's disease (AD) is optimizing the effects of currently available pharmacologic therapies such as citicoline (CC). The purpose of this study was to determine the effects of CC as adjunct therapy to cholinesterase inhibitors (AChEI) in the treatment of AD. We identified relevant studies by electronic search until April 2020. We considered studies with a comparator group that enrolled elderly patients with a diagnosis of AD and employed CC as an adjunct therapy to AChEIs compared to AChEI monotherapy or comparisons of different AChEIs combined with CC. Methodological quality assessment was done using the Newcastle-Ottawa Scale. Out of 149 articles identified, two retrospective cohort studies involving 563 elderly patients affected with AD were included. After 3 months and 9 months, better Mini-Mental Status Examination scores were observed in the "AChEIs + CC" group versus "AChEIs alone" group. CC combined with donepezil may be better in improving cognition than when combined with rivastigmine. No significant difference was noted in terms of activities of daily living (ADL) and instrumental-ADL. Neuropsychiatric Inventory and Geriatric Depression Scale-short form scores appeared to be lower in the combination treatment versus monotherapy. The adverse events of combined treatment were self-limiting and included occasional excitability, gastric intolerance, and headache. Limited evidence from pooled data of two observational studies suggests that CC used in adjunct with AChEIs in the treatment of AD was well-tolerated and showed improvement in cognition, mood, and behavioral symptoms compared to treating with AChEIs alone.

Screening of undiagnosed depression among elderly primary care patients: a cross-sectional study from the Republic of Srpska, Bosnia and Herzegovina.

Aim To examine the prevalence of undiagnosed depression among primary care elderly patients in the entity of the Republic of Srpska (Bosnia and Herzegovina) as well as the sociodemographic and clinical risk factors associated with depression. Methods A cross-sectional study was conducted between April and June 2019 in nine towns of the Republic of Srpska. The study sample included 1,198 primary care patients older than 65 years of age. Research instruments included a sociodemographic questionnaire and Geriatric Depression Scale - Short Form (GDS-SF). Results Positive screening test (GDS-SF score > 5), which indicates depression was found in 484 (40.4%) participants. Multivariate regression analysis showed that lower education levels [OR = 1.565, 95% CI (1.13-2.17)], divorced and widowed [OR = 1.366, 95% CI (1.16-1.62)], poor financial situation [OR = 1.690 , 95% CI (1.25-2.29)], non-home residents [OR = 2.200, 95% CI (1.41- 3.44)], non-hobby patients [OR = 2.115, 95% CI (1.54-2.91) ], non-friends [OR = 3.881, 95% CI (2.70-5.57)], patients suffering from chronic pain [OR = 2.414, 95% CI (1.72-3.39)], patients with daily life limitation activities [OR = 1.415, 95% CI (1.03-1.95)], patients with three or more chronic diseases [OR = 1.593, 95% CI (1.12-2.27)], patients using five or more drugs [OR = 1.425. 95% CI (1.00-2.03)], and patients with history of previous depression [OR = 2.858, 95% CI (1.94-4.21)] were at higher risk for depression. Conclusion The prevalence of undiagnosed depression in the elderly in Republic of Srpska is high. Future strategies are needed to strengthen screening of geriatric depression in primary health care.

Effects of Brief Cognitive Behavioral Therapy for Insomnia on Improving Depression Among Community-Dwelling Older Adults: A Randomized Controlled Comparative Study.

Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve depressive symptoms in older adults with comorbid insomnia and depression. However, it remains unclear whether brief CBT-I is effective for improving depressive symptoms in community-dwelling older adults with insomnia symptoms of varying severity. This study sought to examine the effectiveness of a brief CBT-I intervention delivered by public health nurses to improve depressive symptoms among older adults recruited from a community setting. This randomized controlled study compared sleep status and depression at baseline and a 3-month follow-up using a wait-list control design. Depression was evaluated using the Geriatric Depression Scale short form (GDS-SF). The GDS-SF scores in the CBT-I group improved over time (p<.01), with an effect size (Cohen's d) of 0.34 (95% CI [0.16, 0.58]). The results demonstrated the effectiveness of a brief CBT-I intervention for depression, although the effect size was small. A brief CBT-I intervention consisting of sleep hygiene education, stimulus control, sleep restriction, cognitive restructuring, and relaxation is effective for improving depressive symptoms among older adults in the community.

Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity.

Sarcopenia, obesity, and sarcopenic obesity are various features of the ageing process that can cause important health issues. The present study was undertaken to investigate the interrelationship between those body composition changes, including their clinical components and the quality-of-life variables. A total of 423 individuals aged 65 years or older was included in this cross-sectional study. Sarcopenia was diagnosed according to The European Working Group on Sarcopenia in Older People criteria. Body composition parameters were measured with a bioelectrical impedance analyser, and Turkish population-based cut-off points were preferred for diagnosis of sarcopenia. Comprehensive geriatric assessment was performed on all patients. A logistic regression analysis was performed to identify important factors for sarcopenia and sarcopenic obesity. The prevalence of sarcopenic, obese and sarcopenic obese subjects was 14%, 35% and 11% respectively. The lowest mean gait speed and hand grip strength values were seen in the sarcopenic obese group (0.6 ± 0.3 m/s and 19.7 ± 9.8 kg respectively). Sarcopenic obese participants were associated with the highest rate for fall risk. The scores for domains of health-related quality of life were worse in both obesity and sarcopenic obesity when compared to others. Body mass index (BMI), number of drugs used, total body fat ratio and geriatric depression scale-short form scores were negatively correlated with all dimensions of SF-36 quality-of-life scale. Sarcopenia, obesity and sarcopenic obesity are associated with many negative health outcomes, such as high fall risk and low health-related quality of life in geriatric population.

Cross-cultural validation of the Modified Falls Efficacy Scale in Serbian community-dwelling women at risk for osteoporotic fracture.

Cross-cultural validation of the Serbian version of the Modified Falls Efficacy Scale (MFES). This cross-sectional study involved 257 women aged 65 years and above who were referred for dual-energy x-ray absorptiometry examination at the Railway Healthcare Institute in Belgrade, Serbia, between January and April 2016. Data collection comprised of a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF) questionnaire, and data related to fractures, level of physical activity, use of medications that can increase the risk of falls, and frequency of falls in the past 12 months. None of the study participants had been previously treated for osteoporosis. The internal consistency of the questionnaire items was assessed via Cronbach's alpha, whereas the interclass correlation coefficient (ICC) was used to calculate test-retest reliability based on the sample of 257 women. We also evaluated concurrent, convergent, and construct validity. Cronbach's alpha for the total assay score was 0.98. Correlations among the items ranged from 0.84 to 0.93. While ICC for the scale as a whole was 0.99 (95% confidence interval 0.98-0.99), ICC pertaining to individual items ranged from 0.82 to 0.99. Concurrent validity analysis revealed a significant positive correlation between MFES scores and the reported level of physical activity (ρ = 0.34; P < 0.01). Convergent validity was tested through the ratio of MFES and sociodemographic variables. The findings indicated presence of a significant negative correlation between the MFES scores and age (ρ = -0.32; P < 0.01), age of menopause onset (ρ = -0.16; P = 0.01), and GDS-SF scores (ρ = -0.12; P = 0.04), and positive correlation between MFES and the level of social activity (ρ = 0.22; P < 0.01). Significant differences were noted between the MFES scores of participants who had no history fractures and those who did (U = 5277.50; P < 0.01), and between scores of women who reported falling in the past 12 months and those who did not (U = 4968.50; P < 0.01). Similarly, significant differences (P < 0.01) in the scores pertaining to each MFES item were observed between women who had experienced falls in the past (n = 101) and those who had not (n = 156). The Serbian version of the MFES is a reliable and valid instrument that can be used in both clinical practice and research to describe and measure self-perceived fear of falling in older individuals.

White Matter Integrity and Subclinical Depression: A Diffusion Tensor Imaging Study

Author(s): Huffman, Nicole; Bennett, Ilana | Abstract: Major Depressive Disorder (MDD) is characterized by the persistent presence of at least fivedepressive symptoms over a two-week period. These symptoms must include either depressedmood, or loss of interest or pleasure. Early identification, and ultimately treatment, of depressionmay be accomplished by identifying neural markers of individuals at risk for MDD, including thosewith subclinical depressive symptoms. Neuroimaging studies have shown that MDD is associatedwith impairments to integrity in white matter tracts such as the corpus callosum and internal capsule.However, it is unclear whether these same structures also are disrupted in subclinical depression. Thepresent study sought to examine this question through utilizing diffusion tensor imaging to assesswhite matter integrity as a function of Geriatric Depression Scale Short Form (GDS-SF) scores.Using a median split of GDS-SF scores, statistical analyses revealed no difference in white matterintegrity between low risk and high risk depression groups. However, there was a nonsignificant trend(p=0.072) such that higher GDS-SF scores were associated with decreased white matter integritylocalized to the corpus callosum, right internal capsule, left cingulum, external capsule and fornix.This finding extends previous research on MDD by providing evidence for similar neural correlatesof subclinical depression. This may provide insight into the development of MDD and ultimately aiddiagnostic and treatment efforts with early identification and intervention.

Music therapy as group singing improves Geriatric Depression Scale score and loneliness in institutionalized geriatric adults with mild depression: A randomized controlled study

Aims: This study was conducted with an aim to evaluate the effect of group music therapy in the form of group singing, led by a music therapist, on depressive symptoms and loneliness in institutionalized geriatric individuals having mild depression. Settings and Design: The study was conducted as a randomized control trial at St. Mary's Home for the aged, Cuddalore, Tamil Nadu. The study was conducted as a randomized control trial. Subjects and Methods: The experiment group (n = 40) received daily music therapy in the form of group singing lead by a music therapist for 3 weeks. The control group (n = 40) did not receive any specific intervention. Baseline and weekly Geriatric Depression Scale-Short Form (GDS-SF) and UCLA Loneliness Scale scores were recorded in both groups. Statistical Analysis Used : Measures of Central Tendency, Mann-Whitney U-test, and Wilcoxon W value. Results: Statistically significant improvement (P < 0.05) was seen in both the scores at the end of 3 weeks in the experiment group as compared to the control group. On intragroup comparison, both scores showed statistically significant improvement (P < 0.001) in the experiment group at the end of 3 weeks as compared to baseline but not in the control group. No adverse event was reported. Conclusions: Group singing significantly improves GDS-SF scores and loneliness in institutionalized geriatric adults having mild depression at the end of 3 weeks. Further research in this area is desirable which could contribute to the well-being of the aged population.

The Prevalence of Depressive Symptoms and Risk Factors among Older Adults Admitted to the Geriatrics Outpatient Clinic: A Natural Result of Normal Aging or Not?

Introduction: Depression is a common geriatric syndrome. It is usually underdiagnosed and inadequately treated. The objective of this study was to investigate the frequency of depression and to examine its predictors in patients older than 75. Methods: One hundred and eighty-six patients (123 female) older than 75 years of age were included in the study. All subjects were evaluated via ‘Geriatric Depression Scale-Short Form (GDS-SF).’ Multiple linear regressions were used to study the effects of continuous variables such as age, body mass index, marital status, who one lives with, having one’s own room at home, frequency of contact with relatives, exercise, chewing problems, difficulties in swallowing, having a special diet, fear of falling, involuntarily waking up early, urinary incontinence, constipation, impairment in cognition, nutritional status (Mini Nutritional Assessment-Short Form, MNA-SF), frailty, number of illnesses, and number of drugs. Results: The mean GDS-SF score was 3.49 ± 3.30, of which 30.7% of patients had ‘mild’ depression. There was no significant difference between male and female groups. In multivariate regression analyses, low levels of exercise, chewing problem, involuntarily waking up early and constipation showed significantly associations with depression (p<0.05). Conclusion: We observed mild depression in nearly one-third of patients older than 75. For clinicians dealing with this population, it is important to assess depressive symptoms and predictors in geriatric patients.

Effect of music intervention on the cognitive and depression status of senior apartment residents in Taiwan.

ObjectiveTo identify the effect of music intervention on cognitive function and depression status of residents in senior citizen apartments based on the existing evidence regarding music therapy.MethodsAn experimental study was conducted from November 2008 to December 2009. Sixty healthy senior apartment residents over 65 years of age were recruited and separated into two groups. According to their opinion, 41 took part in the music intervention group and 19 in the comparison group. The music intervention involved Buddhist hymns. The short-term effects were evaluated based on the measurement of cognitive function and depression level using the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale-short form (GDS-SF) at the baseline, 1 month, and 4 months.ResultsThe means of the initial and the 1-month MMSE and GDS-SF scores did not differ between the two groups. The 4-month MMSE score significantly declined compared with the initial level in the comparison group, whereas no significant change was observed in the experimental group. Moreover, the 4-month GDS-SF score significantly improved in both groups compared with the initial level.ConclusionMusic intervention may postpone cognitive decline in healthy residents preferring Buddhist hymns in the senior citizen apartments in 4 months follow-up, and intense contact with participants may improve their mood status.

Longitudinal Association of Dementia and Depression.

Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition. Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013). 34 Alzheimer Disease research centers. 27,776 subjects with dementia, MCI, or normal cognition. Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5. Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N= 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI= 21.7%, dementia= 24.7%, normal cognition= 10.5%. MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression.

The prevalence of dementia and depression in Taiwanese institutionalized leprosy patients, and the effectiveness evaluation of reminiscence therapy—a longitudinal, single‐blind, randomized control study

This study investigated the prevalence of depression and dementia in long-term institutionalized older leprosy patients in Taiwan. We then examined the effectiveness of reminiscence group therapy on depressive symptoms and cognitive function in this population. We recruited 129 long-term institutionalized older leprosy patients in Taiwan and used the Geriatric Depression Scale-Short Form (GDS-SF), the mini mental state examination (MMSE), and the Clinical Dementia Rating (CDR) scale for outcome measurement. We then conducted a single-blind, randomized, longitudinal quasi-experimental analysis comparing the pre-test and post-test results of two equivalent groups at a 24-week intervention interval. The intervention in the experimental group was three sessions of reminiscence group therapy per week, whereas that in the control group was weekly individual supportive interviews. The prevalence of dementia was 45.7-50.4% according to a CDR score ≥ 0.5 and an MMSE score < 25, and the prevalence of depression was 25% based on a GDS-SF score ≥ 7. According to the Wilcoxon signed-rank test, the GDS-SF scores in the experimental group decreased significantly (p = 0.02) after intervention as compared with that in the control group (p = 0.22), whereas the MMSE scores in both groups remained steady. The prevalence of dementia and depression in long-term institutionalized older leprosy patients in Taiwan is high. Reminiscence group therapy has been confirmed effective on depression in this population, but its effectiveness on cognitive function requires further verification.

Residential status and depression among Korean elderly people: a comparison between residents of nursing home and those based in the community

The purposes of this study were: (i) to compare the extent of depression in the nursing home and community-dwelling elderly people, and (ii) to find the variables including residential status and other related variables explaining depression in Korea. Two sets of secondary data were combined and used to achieve the objectives of this study. One data set relating to elderly people in nursing homes was from a part of 2002 Kyunggi Long-term Care System Construction Study by Kyunggi Research Institute, Kyunggi province, Korea. The other data set for community-dwelling elderly people was from a part of 2001 National Long-term Care Study by Korea Institute for Health and Social Affairs. The data set for this study included 307 elderly people living in nursing homes and 166 elderly people living in the community. Depression was measured and determined using the geriatric depression scale-short form (GDS-SF) Korean version, with scores of 8 or higher to indicate possible depression. A total of 39.3%[95% confidence interval (CI); 32.1-46.9%] of the sample in the community elderly showed symptoms of depression, higher than the rate found in the nursing home elderly (24.0%) (95% CI; 19.5-29.2%). The mean (standard deviation) GDS-SF score for the elderly in the nursing home was 6.1 (3.4), and 7.4 (4.3) for elderly in the community, the difference being statistically significant [t (275.5) = -3.33; P < 001]. As a result of multiple logistic regression analysis, residential status has appeared as an important predictor after controlling other related variables. The adjusted odds ratio of depression associated with the nursing home residents in residential status, all other factors being equal, was 3.14 (95% CI; 1.30-7.58). Community-dwelling elderly people have higher odds of depression. These findings suggest that there is a need to provide adequate health-related care services for the elderly people in the community.

What Is the Association Between Self-Neglect, Depressive Symptoms and Untreated Medical Conditions?

ABSTRACTObjective. There have been no studies describing the occurrence of untreated medical condition(s) in elders with depression who self-neglect. This study compares the prevalence of depression as indicated by an abnormal score (≥5) on the Geriatric Depression Scale-Short Form (GDS-SF) between self-neglecters and matched non self-neglecting community-dwelling elders. It also describes the relationship between untreated medical condition(s) associated with self-neglect and abnormal scores on the GDS-SF.Methods. The two samples consisted of 50 self-neglect cases validated by Adult Protective Services and 50 matched non-self-neglecters recruited from a hospital geriatric unit. The cases and controls were matched on age, gender, ethnicity and socio-economic status when possible. All were assessed in their home. Each participant received a comprehensive geriatric assessment, which included the Geriatric Depression Scale-Short Form, the Mini-Mental State Exam, the Self-Rated Health and Mortality question, and the Physical Performance Test. A laboratory blood analysis was also conducted. Untreated medical condition(s) was determined during the assessment by a geriatric nurse practitioner.Results. There was a statistically significant difference in the distribution of abnormal GDS-SF scores between the self-neglect (n = 25, 51%) versus the control group (n = 14, 28%; χ2 = 5.49, df = 1, p = .019). Self-neglecters with scores indicative of depression were also significantly more likely (56% vs. 21%) to have untreated medical condition(s) compared to self-neglecters scoring normal on the GDS-SF (OR = 4.84,95% CI = 1.37–17.09).Conclusion. Clinicians should anticipate untreated medical condition(s) in elderly patients with depressive symptomatology who self-neglect.

Predictive factors of self-care capacity in veterans care institution residents.

The aim of this research is to determine which factors affect the self-care capacity of veterans self-pay care institution residents and to build a predictive model of their level of independence. Our study included 404 residents of a veterans care institution. Our data collection involved an integrated, multidisciplinary approach. The tools used by each group were all of high validity and reliability. The resulting data was entered into SPSS statistic software, and then analyzed by related coefficients, Mann- Whitney test, Kruskal-Wallis H test, and stepwise multiple regression. This analysis showed that 12.1% of residents were self-care dependent. Residents medical conditions (stoke, arthritis), physical function (tinnitus, fall), cognitive function (Mini-Mental State Examination score, Geriatric Depression Scale Short-Form score, Acute Confusion Behavior Scale score), and social function (frequency of exercise per week, frequency of visitors), showed correlation with self-care capacity. The predictive model of self-care capacity was built as follows: Self-care predictive value = 93.022 -.274 x GDS score +.196 x MMSE score - 3.222 x Stroke - 1.262 x Arthritis +.225 x Exercise per week. This model explained 10.5% of the total variance. The results of this research can act as a basis for elderly admission to and transfer from veterans care institutions and can be a reference for recommending relevant nursing service. This research also provides important information for those who wish to improve the self-care capacity of care institution residents.