Sample Of Community-dwelling Persons Research Articles

Sex and gender differences in clinical and functional indices in subjects with schizophrenia and healthy controls: Data from the baseline and 4-year follow-up studies of the Italian Network for Research on Psychoses

Gender differences in clinical and psychosocial aspects of schizophrenia have been widely reported. Findings have not always been consistent, and some of them need further research. In a large sample of community dwelling persons with schizophrenia, we investigated gender differences in clinical, cognitive and functional indices, as well as their changes over a 4-year follow-up and their impact on real-life functioning. Gender differences in personal resources, cognitive and functional indices were explored also in a sample of healthy controls. Men with respect to women had an earlier age of illness onset, a worse premorbid adjustment in the academic domain, more severe avolition, expressive deficit and positive symptoms, lower prevalence of comorbidity for affective disorders, less frequent use of two coping strategies (‘religion’ and ‘use of emotional support’) and more frequent positive history of substance and alcohol abuse. In addition, men were more impaired in verbal learning, while women in reasoning/problem solving. Some patterns of gender differences observed in healthy controls were not confirmed in patients. Men's disadvantages in the clinical picture did not translate into a worse outcome. This finding may be related to the complex interplay of several factors acting as predictors or mediators of outcome.

Life-Space Constriction in Aging Adults

Community-dwelling aging adults desire to maintain independence and prevent or delay a sequela of declining function and ultimate frailty. Early indicators of potential declines in function and frailty, such as life-space constriction (LSC), are important to identifying early. The purpose of this study was to examine factors associated with LSC and the influence of these factors and LSC on function and frailty. A cross-sectional study using a convenience sample of community dwelling persons 55 and older living in the South was conducted. Results indicated most participants (N = 72) were female (69%; n = 50) and half were White (53.5%; n = 38). LSC explained 34% variance in function (F = 3.805 (8, 59); p = .001) when environmental supports (social network), challenges (driving time it took the participant to get to the nearest full-service grocery store) and individual factors were controlled for. There was a significant difference between Black and White participants with environmental challenges (p = .001) and function (p = .001). Individual factors included challenges (age-related physiological changes, disease burden, and mental health limitations) and buoy (assistive devices), these explained 22% variance in self-reported frailty (F= 3.099 (6, 65); p = .01). Number of assistive devices was the only significant predictor of self-reported frailty.

Life-space constriction in aging adults

BackgroundEarly indicators of declining function and frailty, such as life-space constriction (LSC), are important in identifying those at risk for frailty. PurposeExamine factors associated with LSC and the influence on function and frailty. MethodsA cross-sectional, descriptive study was conducted using a convenience sample of community dwelling persons 55 and older living in the South. ResultsMost participants (N = 72) were female (69%; n = 50) and half were White (53.5%; n = 38). Individual factors including challenges (age-related physiological changes, disease burden, mental health limitations) and buoy (assistive devices, and other compensatory strategies) explained 22% variance in self-reported frailty (F = 3.099 (6, 65); p = .01). LSC explained 34% variance in function (F = 3.805 (8, 59); p = .001) when environmental supports (family ties, and social network) and challenges (area deprivation, built environment, and social disorganization) and individual factors were controlled for. Number of assistive devices was the only significant predictor of frailty.

The Epidemiology of Patient-Reported Hypersomnia in Persons With Advanced Age.

To examine the epidemiology and key demographic and clinical correlates of patient-reported hypersomnia in persons with advanced age. Cross-sectional design. Community. A total of 357 community-dwelling persons from the Yale Precipitating Events Project with a mean age of 84.2 years (range = 78-102 years). We studied patient-reported hypersomnia, defined categorically by an Epworth Sleepiness Scale (ESS) score of 10 or greater; as well as the severity of hypersomnia symptoms, defined continuously by an ESS score range of 0 to 24 (higher scores denote greater sleepiness). In multivariable regression models, we examined cross-sectional associations between key correlates and ESS score, expressed as categorical and continuous variables. Key correlates included: demographics, education, smoking status, body mass index, self-reported medical conditions, Center for Epidemiologic Studies Depression score, Mini-Mental State Examination score, Physical Activity Scale for the Elderly, restless legs syndrome (RLS), self-reported sleep-disordered breathing (SDB), medications, and Insomnia Severity Index. Mean ESS score for all participants was 6.4. Patient-reported hypersomnia (ESS score ≥10) was established in 82 participants (23.0%)-their mean ESS score was 13.0. In multivariable models, male sex, nonwhite race, arthritis, depressive symptoms, low physical activity, RLS, SDB, central nervous system depressant medications, and insomnia severity were cross-sectionally associated with patient-reported hypersomnia (higher adjusted odds ratios, ranging from 1.93-2.86) and/or with the severity of hypersomnia symptoms (higher ESS scores, ranging from 0.11-2.86 points). Patient-reported hypersomnia was prevalent in a sample of community-dwelling persons with advanced age. In addition, based on cross-sectional associations with the ESS score, key demographic and clinical characteristics were identified that may inform screening strategies for hypersomnia in advanced age. J Am Geriatr Soc 67:2545-2552, 2019.

Apathy in Dementia Care

Abstract. Apathy is a diminished goal-directed behavior stemming from a lack of motivation. It is one of the most common symptoms in dementia. While the Apathy Evaluation Scale (AES) has proved to be a psychometrically robust measure for assessing apathy, the German version (AESD) requires further validation. Associations of apathy with important variables in dementia care, such as cognitive impairment or caregiver burden, were repeatedly found, though contradictory findings have also been reported. The present study assessed apathy in 100 community-dwelling persons with dementia. Their informal and formal caregivers used the German informant version of the Apathy Evaluation Scale (AESD-I) to investigate the severity of dementia and cognitive deficits as measured with the Mini-Mental State Examination (MMSE) and Global Deterioration Scale (GDS), respectively. A reliability analysis was performed to estimate the internal consistency of the AESD-I, and the data were tested for potential correlations with results from a shortened version of the AESD-I (AESD16-I). Cronbach’s α was .880 for the AESD-I and .904 for the AESD16-I. The prevalence of apathy was 77%, its severity was on average moderate to high. Significant (p < .05) negative correlations were shown between the AESD16-I, the Barthel Index (BI), and the Quality of Life-Alzheimer’s Disease (QOL-AD). Correlations between the AESD16-I, GDS, and Zarit Burden Interview were positive. After Bonferroni correction, the only correlations that remained significant were between the AESD16-I and BI and QOL-AD. The present study underlines the favorable psychometric properties of the AESD-I and confirms the high prevalence of apathy with considerable severity in the sample of community-dwelling persons with dementia. In addition, it contributes to the diversity of evidence on clinical correlates of apathy which require further clarification.

Visual Analog Scale pain reporting was standardized

Background and Objective Whereas pain is frequently measured using a visual analog scale (VAS) that can examine change over short time intervals in the same subject, such ratings are not useful in analyzing differences across subjects. We created a method for normalizing VAS pain reporting to control for the variation between different populations due to the differences in subjective perception or objective evaluation of pain. Methods A list of 226 pains was gathered from a convenience sample of persons on the street and patients waiting at medical and orthopedic clinics. These pains were ranked according to severity by health professionals and 19 pains with the most stable rankings were selected. These 19 pains were then rated by a sample of community-dwelling persons and a method of VAS standardization was developed, based on six selected pains. Results Individual variations in pain ratings were found to be independent of respondent age and gender, but were correlated with experience of the event or behavior and with self-reported health status. A new scoring method that takes into account these correlations is proposed. Conclusion It is possible to standardize VAS pain ratings to compare pain between different populations.