Geriatric Scale Research Articles

Analysis of Physical-Cognitive Tasks Including Feedback-Based Technology for Alzheimer's Disorder in a Randomized Experimental Pilot Study.

Alzheimer's disease causes great changes, with the prefrontal cortex being the most frequently damaged zone; these changes affect physical and cognitive behavior and compromise autonomy. The objective of this study was to evaluate the effects of physical-cognitive tasks on memory, attention, balance, gait, and risk of falling in Alzheimer's by using feedback-based technology. Forty patients with Alzheimer's were recruited from an Alzheimer's Association; of these, 15 met the inclusion criteria and were included in the pilot RCT (eight in the control group; seven in the experimental group). The Cognitive Mini-Examination Scale, Oddball Test and Attention Network, Berg Scale, Tinetti, Timed Up and Go, and Geriatric Deterioration Scale. The experimental group was treated with physical-cognitive tasks by using combined feedback-based technology (visual, acoustic, simultaneous, immediate, and terminal feedback, as well as knowledge of the results and performance) under the supervision of physiotherapists twice per week for 16 thirty-minute sessions. The control group underwent their usual care (pharmacological treatment, mobility exercises, and cognitive stimulation sessions). In the experimental group, the contrast tests showed differences for the re-test (except in attention), with the significative Timed Up and Go test being significant (p = 0.020). The interaction between groups showed significant differences for the experimental group according to the MEC (p = 0.029; d = 0.14) and Tinetti (p = 0.029; d = 0.68). Memory, balance, gait, and risk of falling improved in the Alzheimer's patients through the use of physical-cognitive tasks involving combined feedback-based technology. The effects on attention were inconclusive. The outcomes should be treated with caution due to the sample. This can promote intergenerational bonds, use at home, and adherence to treatment.

Relationships Between Diverse Forms of Anxiety With Intrapersonal Functioning Among Older Adults.

This study assessed how clinical anxiety, anxiety about aging, and death anxiety related to one another and to intrapersonal functioning. Older adults completed the Geriatric Anxiety Scale, Anxiety About Aging Scale, Death Anxiety Scale-Extended, and Intrapersonal Problems Rating Scale. Clinical anxiety was strongly correlated with anxiety about aging (r = .50) and death anxiety (r = .59), and anxiety about aging and death anxiety were strongly positively correlated with each other (r = .51). Intrapersonal problems were significantly and strongly positively correlated with clinical anxiety (r = .79), anxiety about aging (r = .50), and death anxiety (r = .56). Multiple regression results showed that the three types of anxiety accounted for a large amount of variance in intrapersonal problems. Findings suggest strong comorbidities between diverse forms of anxiety with some unique features. Intrapersonal deficits may be prominent in the presence of diverse forms of anxiety. Screening should consider these relationships.

Adaptation and validation of the Abrams geriatric self-neglect assessment scale among older Chinese people admitted to the hospital.

Elder self-neglect is a global public health problem, and older people admitted to the hospital may have a higher risk of self-neglect due to their deteriorating health conditions. This study aimed to translate, adapt and validate the Abrams geriatric self-neglect assessment scale (AGSS) among older Chinese people admitted to the hospital. Data were derived from a cross-sectional survey of a convenience sample of 452 older people admitted to a general hospital. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the structural validity of the AGSS. Content validity, criterion validity, internal consistency reliability, and test-retest reliability were also conducted to assess the psychometric properties of the scale. EFA yielded a 6-item one-factor model, which was supported by CFA and explained 44.74% of the total variance. The internal consistency was acceptable (Cronbach α = 0.740), and the test-retest reliability with a 14-day interval was good (intraclass correlation coefficient, ICC = 0.966). Significantly positive correlations with the caregiver-rated elder self-neglect assessment scale (r = 0.648) supported the concurrent validity of the scale. Significant differences in scores between respondents with different ages, marital statuses, educational levels and numbers of chronic diseases demonstrated the discriminative validity. The Chinese version of the AGSS is an easy-to-use, reliable and valid measure with satisfactory psychometric properties. Future studies should recruit a more representative sample of older people in China to verify the applicability of the scale. The Chinese version of the AGSS enables clinical staff to accurately screen for and assess elder self-neglect upon hospital admission, which can inform the development of specific interventions and assignment of additional guardianship to those at risk of elder self-neglect.

Development and validation of a Sarcopenia Geriatric Scale (SARCO-GS): a new short scale for the screening of sarcopenia.

Sarcopenia is a highly prevalent disease associated with adverse outcomes such as falls, disability, and death. The current international consensuses agree that muscle strength, muscle mass, and gait speed must be included in the definition. However, these proposed criteria require objective measurements that are not available for most populations. Since the timely identification of sarcopenia is a priority, several subjective screening scales have been developed; however, they have some limitations due to their low sensitivity. The objective of this work was to develop and validate SARCO-GS, a new short scale to screen sarcopenia that is affordable, easy, and accessible for all clinical care settings. The development of the SARCO-GS included four stages: (1) Review and analysis of documentary sources, (2) Contextualization of the theoretical model of sarcopenia, (3) Scale conformation, and (4) Reliability and validity analyses. SARCO-GS was validated in the FraDySMex study, which is a longitudinal cohort of community-dwelling adults. In the studied population (n=852), the average age was 68.9 years (SD 10.21) and 80.1% of the participants were women. SARCO-GS is a seven-item scale with an innovative structure that included five subjective questions (gait speed, muscular strength, muscle mass) and two measurements of muscular strength and muscle mass (Chair stand test and calf circumference). The results regarding criterion validity showed that the cut-off point ≥ 3 had good sensitivity (77.68%) versus the EWGSOP2 consensus, with an adequate Area Under the Receiver Operating Characteristic (AUC) (0.73), in addition to showing higher values of sensitivity and AUC than SARC-F and SARC-CalF using as reference the same consensus. Furthermore, SARCO-GS presented good predictive validity for functional dependence (HR=2.22, p=0.046) and acceptable correlation with other related measurements (construct validity). Regarding reliability, the scale showed acceptable internal reliability (correlation between items and total score: 0.50 to 0.70). After the validation analysis, the scale was adapted to English. The SARCO-GS is a novel scale to screen sarcopenia with high sensitivity, good construct, predictive validity, and internal reliability that may be useful for health professionals in different clinical settings and for clinical research.

Risk of Falling level in Stroke Patients at dr. Soekardjo Hospital, Tasikmalaya

Stroke is a disease of blood vessels in the brain. This occurs when the blood supply to the mind is reduced or obstructed for some reason, which triggers an unexpected lack of oxygen at the synapses. The risk of falling is a patient who is in danger of falling which is generally caused by ecological and physiological variables that can cause injury. This study aims to assess the level of risk of falling in stroke patients in Melati Room 2B RSUD dr. Soekardjo City of Tasikmalaya. The research method uses a quantitative descriptive method. The study population was stroke patients undergoing treatment in the Melati 2B room at RSUD dr. Soekardjo Tasikmalaya with accidental sampling technique of 12 respondents. The research was conducted on April 28 - May 7 2022. The data collection instrument used the Morse Fall Scale and the Geriatric scale. The results showed that 50% of respondents were categorized as having a low risk of falling, 33.3% being at moderate risk of falling, and 16.7% with a high risk of falling. Based on these results, it is suggested that nurses periodically conduct fall risk assessments to avoid injury to stroke patients because there is still a risk of falling injury to patients treated in that room.

Hospital Rapid Geriatric Assessment Scale — a new diagnostic tool for frailty screening

Hospital Rapid Geriatric Assessment Scale — a new diagnostic tool for frailty screening

The experience of intergenerational interactions and their influence on the mental health of older people living in residential care.

The mental health of an increasing ageing population is an important part of healthcare. Research has explored means to enrich the lives of older adults living in residential settings, including approaches like the Eden Alternative. This is a cross-sectional, qualitative study with a quantitative component. It looks at common mental health conditions (CMHCs) in residential-living older adults in South Africa and describes their experiences of intergenerational interactions with playschool children. Participants completed a questionnaire which included the Geriatric Depression Scale and Geriatric Anxiety Scale and a semi-structured interview. Anxiety and depression were common in the sample with limited awareness of non-pharmacological therapy available at the facility. The intergenerational interactions were experienced positively with emerging themes of belonging, sense of purpose, reminiscence and positive affective experiences, but influenced by participants' preconceptions of children. The study concludes that intergenerational interactions may serve as adjunctive therapy in managing CMHCs in residential-living older adults. Recommendations are made for successful implementation of such programs.

Effectiveness of Slow Stroke Back Massage (SBBM) on blood pressure, anxiety, and depression among older people with hypertension: A quasi-experimental study

Background: The high incidence of hypertension among older adults requires the efforts of healthcare workers to prevent complications that can worsen the condition. Hypertension can also lead to anxiety and depression due to a combination of factors, such as a physiological decline in physical condition. One of the non-pharmacological therapies considered for reducing blood pressure, anxiety, and depression is slow stroke back massage (SSBM). Objectives: The study aimed to examine the effectiveness of SSBM in reducing blood pressure, anxiety, and depression among older adults with hypertension. Methods: This study utilized a quasi-experimental pretest-posttest control group design. The research was conducted in March 2023 with 50 respondents aged 60-74. Aneroid Sphygmomanometer, Geriatric Depression Scale (GDS), and Geriatric Anxiety Scale (GAS) were used for data collection. Mann-Whitney and Wilcoxon tests were used to analyze data. Results: The SSBM therapy in the experimental group was effective compared to the standard therapy in the control group in reducing blood pressure, anxiety, and depression. Conclusion: SSBM therapy is an effective complementary therapy for reducing blood pressure, anxiety, and depression in older adults. Therefore, it can be utilized as a preventive measure against complications that may arise in the older adult population.

Accumulation of Chronic Disease Among Survivors of Childhood Cancer Predicts Early Mortality.

Cancer survivors develop cancer and treatment-related morbidities at younger than normal ages and are at risk for early mortality, suggestive of an aging phenotype. The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) is specifically designed to describe the accumulation of comorbidities over time with estimates of severity such as total score (TS) which is a sum of possible conditions weighted by severity. These severity scores can then be used to predict future mortality. CIRS-G scores were calculated in cancer survivors and their siblings from Childhood Cancer Survivor Study cohort members from two time points 19 years apart and members of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. CIRS-G metrics were analyzed using Cox proportional hazards regression to determine subsequent mortality risk. In total, 14,355 survivors with a median age of 24 (IQR, 18-30) years and 4,022 siblings with a median age of 26 (IQR, 19-33) years provided baseline data; 6,138 survivors and 1,801 siblings provided follow-up data. Cancer survivors had higher median baseline TS than siblings at baseline (5.75 v 3.44) and follow-up (7.76 v 4.79), all P < .01. The mean increase in TS from baseline to follow-up was significantly steeper in cancer survivors (2.89 males and 3.18 females) vs. siblings (1.79 males and 1.69 females) and NHANES population (2.0 males and 1.94 females), all P < .01. Every point increase in baseline TS increased hazard for death by 9% (95% CI, 8 to 10) among survivors. Application of a geriatric rating scale to characterize disease supports the hypothesis that morbidity accumulation is accelerated in young adult survivors of childhood cancer when compared with siblings and the general population.

Prevalence and Predictors of Suicide Ideation among Elderly Mentally Ill Population in a Tertiary Psychiatric Hospital

BACKGROUND&#x0D; Suicide attempts in elderly people has higher risk of mortality. The elderly are more vulnerable to depression and other psychological and social factors that may contribute to higher risk of suicide. Studies have suggested that suicide in elderly is strongly associated with depression and lack of social support. Factors that increase risk of suicide are also found to increase the risk for suicide ideation. Suicide ideation is an important predictor of suicide attempts and completed suicide.&#x0D; Aims: Our study aims at estimating the prevalence of suicide ideation among mentally ill geriatric population and identifying potential predictors of suicide ideation among elderly.&#x0D; METHODS&#x0D; A cross-sectional study involving 50 persons with mental illness aged above 60 years and 50 persons with no previous psychiatric history. The was conducted at a tertiary psychiatric hospital. Geriatric Suicide Ideation Scale, Geriatric Depression scale and other psychopathology assessment tools were used.&#x0D; RESULTS&#x0D; The GSIS scores were significantly higher among those elderly persons with mental illness and the scores were higher in our study when compared to the community-dwelling elderly persons without psychiatric illness. It was observed that geriatric depression was an important predictor of suicide ideation followed by previous suicide attempt. The study also finds significant difference in the subscales of GSIS and we constructed an ROC for optimal cut-off point for the Indian population.&#x0D; CONCLUSIONS&#x0D; Geriatric suicide ideation is a less studied area with suicide ideation in elderly person with mental illness having various determinants and risk factors. It is for further research to identify feasible means of assessing suicide ideation among the elderly person receiving care from primary care physicians.

Characterization of data-driven geriatric syndrome clusters in older people with HIV: a Mexican multicenter cross-sectional study

As living with HIV has been proposed as a condition that may accelerate aging, the main objective of this work was to estimate the prevalence of geriatric syndromes (GS) among older Mexicans with HIV dwelling in the community. Secondly, to evaluate whether the accumulation of GS could be associated with an adverse HIV-related clinical profile, independent of chronological age. Multicenter, cross-sectional study including 501 community-dwelling people aged ≥50 years with HIV. The overall prevalence of nine selected GS and their cumulative number were estimated. An Age-Independent Cumulative Geriatric Syndromes scale (AICGSs) was constructed, and correlations between the AICGSs and HIV-related parameters assessed. Finally, k-mean clustering analyses were performed to test the secondary objective. Median age 56 (IQR: 53-61) years, 81.6% of men. Polypharmacy (74.8%), sensorial deficit (71.2%), cognitive impairment (53.6%), physical disability (41.9%), pre-frailty (27.9%), and falls (29.7%), were the more prevalent GS. A significant negative correlation was found between the AICGSs and normalized values of CD4+ nadir cell counts (r=-0.126; 95%: CI:-0.223 to-0.026, p<0.05). Similarly, a significant inverse adjusted association between the CD4+ nadir cells and the AICGSs was observed on linear regression analysis (β-0.058; 95%: CI:-0.109 to-0.007, p=0.03). Cluster analysis identified three differentiated groups varying by age, metabolic comorbidities, AICGSs, and HIV-related parameters. An elevated prevalence of GS was observed in the studied population. Moreover, the accumulation of GS was associated with adverse HIV-related profiles, independent of age. Thus, early detection and management of GS are crucial to promote healthier aging trajectories in people with HIV. This work was funded in part by the National Center for the Prevention and Control of HIV/AIDS in Mexico (CENSIDA)-National Ministry of Health.

Exploring Loneliness, Fear and Depression among Older Adults during the COVID-19 Era: A Cross-Sectional Study in Greek Provincial Towns.

With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression. To explore the presence and severity of depression in older adults in Greek provincial towns during the pandemic and to explore any possible relationships with loneliness and fear. A convenience sample of 200 participants aged >65, completed a socio-demographic form, the Revised UCLA Loneliness Scale, the Geriatric Depression-15 Scale (GDS-15) and the COVID-19 Fear Scale (FCV-19S). Data were collected from April to May 2022. The average age of participants was 76.6 years and 35.5% of the participants presented depressive symptoms (mean prevalenceof depression 5 ± 3.7). A moderate to low level of loneliness (mean value 39 ± 11.3) and a moderate level of COVID-19 fear (mean value 18.9 ± 6.5) were also experienced. Higher levels of loneliness were found among participants with lower perceived health status and among those participants registered in Primary Health and Social Care (PHSC) services. Loneliness was positively correlated with depression (r = 0.7, p < 0.001), and increased loneliness and depression were associated with an increase in fear of COVID-19 (r = 0.2, p = 0.01 for both). During the pandemic, older adults experienced loneliness, fear of COVID-19 and depression which were positively associated with each other. It is imperative to develop PHSC policies that are aimed at addressing the mental health problems of the older population, which have been caused by the COVID-19 pandemic, through developing their resilience, offering psychological support and promoting social connections.

Assessing late-life anxiety in Japanese older adults: psychometric evaluation of the Japanese version of the Geriatric Anxiety Scale.

This study developed a Japanese version of the Geriatric Anxiety Scale (GAS-J) and its short form (GAS-10-J) to evaluate anxiety in Japanese older adults and assess its psychometric properties using a cross-sectional design. A total of 331 community-dwelling older adult participants (208 men, 116 women, seven unknowns; mean age = 73.47 ± 5.17 years, range = 60-88 years) recruited from two Silver Human Resources Centres in the Kanto region, Japan, answered a set of self-report questionnaires. Of these respondents, 120 participated in a follow-up survey to evaluate test-retest reliability. Confirmatory factor analysis suggested that, as with the original GAS, the GAS-J had a three-factor structure and the GAS-10-J had a unifactor structure with high standardised factor loadings. Test-retest correlations and internal consistency analyses indicated that these scales were reliable. Correlations between the GAS-J/GAS-10-J with the Geriatric Anxiety Inventory, Generalised Anxiety Disorder-7, Geriatric Depression Scale-15, World Health Organization-Five Well-Being Index, and Kihon Checklist were mostly consistent with our hypotheses, thereby supporting the construct validity of the GAS-J/GAS-10-J. The findings indicate that the GAS-J and GAS-10-J have robust psychometric properties for assessing late-life anxiety in Japanese older adults. Further GAS-J studies are required for clinical groups.

Unmet Needs in Geriatric Oncology.

Nikhil PathiIndia's population is aging, with the number of people aged 60 and over projected to reach 340 million by 2050. This is expected to lead to an increase in the number of older adults with cancer. Geriatric oncology is a rapidly growing field in India that is facing several challenges. Some of these include inadequate access to cancer screening and early detection programs in elderly, leading to late diagnoses and poor outcomes, lack of specialized geriatric oncology services, cancer-specific treatment guidelines and protocols in elderly, limited availability of treatment options due to accessibility, finances and other logistic issues, lack of trained healthcare professionals with expertise in geriatric oncology, lack of awareness, and access to early integrated palliative care services. There are several challenges faced by elderly in this journey like financial dependency, social isolation, difficulty in transportation to healthcare for treatments, and psychosocial aspects attributed to cancer. Awareness about availability of resources, patient assistance programs to reduce financial burdens, education campaigns, use of telemedicine and telehealth services to bypass transportation issues in remote and underserved areas, and integration of geriatric oncology into mainstream oncology services might be some solutions. Additionally, there is a need for more research on the unique characteristics and needs of older cancer patients in India, as well as the development of culturally appropriate interventions to address these needs. Development of India-specific geriatric assessment scales encompassing medical, psychosocial, and functional problems in elderly identifies areas of vulnerability. A multidisciplinary team-based decision-making is required at various levels. There is a need for increased investment in geriatric oncology research, training, and integrated palliative care services in India. Geriatric oncology is slowly being recognized as a separate subspeciality and more geriatric oncology centers and clinics are being set up in major cities in India that should be the way forward.

Predictors of life satisfaction in elders living at home in the Czech Republic.

The aim of this cross-sectional study was to determine the life satisfaction of older people living in a home environment and to find out what predictors influence it. The research involved 1,121 older people 60 years and above from the Moravian-Silesian region who live in a home environment. The short form of the Life Satisfaction Index for the Thirds Age (LSITA-SF12) was used to assess life satisfaction. The Geriatric depression scale (GDS-15), the Geriatric Anxiety Inventory Scale (GAI), The Sense of Coherence Scale (SOC-13), and the Rosenberg Self-Esteem Scale (RSES) were used to evaluate related factors. In addition, age, gender, marital status, education, social support, and subjective health assessment were evaluated. The overall life satisfaction score was found to be 36.34 (s = 8.66). The satisfaction of older people was classified into four grades: high satisfaction (15.2%), moderate satisfaction (60.8%), moderate dissatisfaction (23.4%), and high dissatisfaction (0.6%). The predictors of the longevity of the lives of older people were confirmed, both health factors (subjective health assessment, anxiety, and depression [Model 1: R = 0.642; R2 = 0.412; p<0.000]) and psychosocial factors (quality of life, self-esteem, sense of coherence, age, and social support [Model 2: R = 0.716; R2 = 0.513; p<0.000]). In implementing policy measures, these areas should be emphasized. The availability of educational and psychosocial activities (e.g. reminiscence therapy, music therapy, group cognitive behavioural therapy, cognitive rehabilitation) within the community care of the older people and university of third age is appropriate to increase the life satisfaction of the older people. An initial depression screening is also required as part of preventive medical examinations to ensure early diagnosis and treatment of depression.

Fast systematic geriatric assessment in acute heart failure patients admitted in Cardiology

BackgroundHeart failure prevalence is increasing in elder adults. These patients usually present geriatric syndromes, especially frailty. The effect of frailty on heart failure is under discussion but there are few data about the clinical characterization of frail patients who are admitted for acute heart failure decompensation. ObjectiveThe purpose of this study was to study the differences in clinical baseline variables and geriatric scales between frail and non-frail patients admitted to the Cardiology unit via the Emergency Department for acute heart failure. MethodsWe enrolled all patients with acute heart failure who were admitted to the Cardiology unit from the Emergency Department of our hospital from July 2020 through May 2021. A multidimensional and comprehensive geriatric assessment was performed at the moment of admission. We studied differences in baseline variables and geriatric scales according to the frailty status determined by the FRAIL scale. ResultsA total of 202 patients were included. In the whole population, 68 (33.7%) patients presented frailty defined by a FRAIL score ≥ 3. The frail patients were older (80±9 vs. 69±12 years; p<0.001), and had a worse quality of life (58.31±12.18 vs.39.26±13.71 points; p<0.001) according to the Minnesota scale, presented high comorbidity (47 (69.1%) vs. 67 (50.4%) patients; p = 0.011) defined as ≥3 points according to the Charlson scale and were more dependent (40 (58.8%) vs. 25 (18.8%) patients; p<0.001) according to the Barthel scale. The frail patients presented higher MAGGIC risk scores (24.09±4.99 vs. 18.89±6.26; p<0.001). Despite this adverse profile, the treatments prescribed during the admission and at the hospital discharge were similar. ConclusionsThe prevalence of geriatric syndromes, especially frailty, is very high in patients admitted for acute heart failure. Frail patients with acute heart failure had an adverse clinical profile with more prevalence of concomitant geriatric syndromes. Therefore, we consider that a geriatric assessment should be performed during the admission of acute heart failure patients to improve care and attention.

Evaluation of the relationship between the geriatric anxiety and COVID-19 anxiety and fear levels in geriatric dental patients during the COVID-19 pandemic.

Illness, social isolation and loneliness may cause different psychological problems in the geriatric population, including depression and anxiety. Factors such as anxiety and fear can negatively affect dental treatment processes and prognoses. Thus, in terms of dental approach to geriatric individuals, it is important to be aware of the emotional processes the elderly may have experienced during the pandemic. This study aimed to determine the relationship between the geriatric anxiety levels and the coronavirus disease 2019 (COVID-19) anxiety and fear levels in the geriatric population. In this correlational study, 129 geriatric individuals were selected through the convenience sampling method. To gather the data, the Geriatric Anxiety Scale (GAS), the COVID-19 Anxiety Scale (CAS), the COVID-19 Fear Scale (CFS), and a questionnaire assessing demographic variables were used. Simple linear regression and Pearson's correlation coefficients were used to evaluate the relationships between the variables. The sample consisted of 70.5% males and 29.5% females aged ≥65 years. The GAS total score (15.64 ±9.34) and its 3 subscale scores were strongly correlated with the CAS and CFS scores. The GAS total score and its subscale scores had a significant linear regression with both the CAS and CFS scores (p < 0.001). An increase in the anxiety and fear levels associated with the pandemic was observed in geriatric individuals. Thus, it should be considered that geriatric individuals may encounter some difficulties during dental treatment and prosthetic rehabilitation after the pandemic. Therefore, it is important to normalize the anxiety levels with the help of professionals, and to implement interventions such as socialization, physical activity and meditation to help balance the anxiety levels.

The effects of slow-stroke back massage on anxiety and sleep problems in elderly stroke patients

Background: The increasing population of the elderly may cause a large burden of health problems, such as poor sleep quality and anxiety. It was reported that as many as 20 percent – 50 percent of the elderly population in Indonesia experienced sleep problems, and 35 percent of the elderly who had anxiety also had the same problems. Slow Stroke Back Massage (SSBM) may be given as a non-pharmacological to increase sleep quality.Purpose: To analyze the effect of SSBM on sleep quality and anxiety in the elderly at the Tresna Wreda As-Salaam Social Institution, Cirebon City.Method: The pre-experimental design with one group pretest and posttest design. The 15 elderly was the sample, as a total sampling technique was used. The Pittsburgh Sleep Quality Index (PSQI) and Geriatric Anxiety Scale (GAS) questionnaires were used as instruments for measuring sleep quality and anxiety levels. The sleep quality was analyzed by Wilcoxon test and Paired sample t-test was used to analyze anxiety variables.Results: Before the SSBM, all the elderly (100 percent) had poor sleep quality and the majority (93,3 percent) had moderate anxiety levels. Whereas after the intervention, the majority (93,3 percent) had good sleep quality and mild anxiety levels (73,3 percent). The p-value of the Wilcoxon test was 0,001 for sleep quality, and the p-value of paired sample t-test was 0,000 for anxiety.Conclusion: This study indicated that there was a positive effect of SSBM on sleep quality and anxiety levels in the elderly. It is recommended for nurses to widely implement SSBM to help reduce the elderly’s anxiety and sleep problems.

Ginkgo biloba Extract EGb 761 in the Treatment of Patients with Mild Neurocognitive Impairment: A Systematic Review.

Many clinical trials testing Ginkgo biloba extract EGb 761 in patients with mild forms of cognitive impairment were conducted before widely accepted terms and diagnostic criteria for such conditions were available. This makes it difficult to compare any results from earlier and more recent trials. The objective of this systematic review was to provide a descriptive overview of clinical trials of EGb 761 in patients who met the diagnostic criteria for mild neurocognitive disorder (mild NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). MEDLINE, PubMed and EMBASE were searched for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning. All trials involving patients who met retrospectively applied diagnostic criteria for mild NCD were included. Trials of primary prevention of dementia and trials of combinations of medical treatments were excluded. Among 298 records found in databases and 76 further records related to EGb 761 in references of systematic reviews, 9 reports on clinical trials involving 946 patients met the pre-specified criteria for inclusion. Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies), scales for neuropsychiatric symptoms (3 of 3 studies), geriatric rating scales (1 of 2 studies) and global ratings of change (1 of 1 study). Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning). Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved. No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events. The included studies demonstrate treatment benefits of Ginkgo biloba extract EGb 761, mainly on cognitive deficits and neuropsychiatric symptoms, in patients with mild NCD. The drug was safe and well tolerated.

Age images of older patients with psychiatric diseases -The importance of attachment and mentalization

Objectives: The emergence and effects of self-perception of ageing (SPA) are central gerontological research topics. SPA has an influence on numerous psychological, cognitive and physical parameters.The question of its significance for mental illness in old age, which was investigated in the present study, has so far remained in the background. Of particular interest was the connection to attachment and mentalization. Method: A clinical sample (N = 150) was compared with a non-clinical sample (N = 153). Both were divided into three age groups (40-54, 55-69 and over 70 years).The survey instruments used were the Attitude to Own Ageing subscale of the Philadelphia Geriatric Center Moral Scale (PGCMS) and a mentalizing and an attachment questionnaire (MZQ and ECR). Results:The clinical sample showed significantly lower scores in all age groups (more negative SWA), but only the non-clinical sample showed a decrease in age across the three age groups, thus the SPA became more negative. In the regression analytic evaluation, a more negative SPA was associated with an avoidant attachment orientation as well as reduced mentalizing skills. Conclusions: The results highlight the importance of SWA as a clinically and therapeutically significant variable. Finally, therapeutic implications are discussed.