2,309 results
Search Results
2. A feasibility study of antidepressant drug therapy in depressed elderly patients with chronic obstructive pulmonary disease<FNR>†</FNR><FN>Due to an unfortunate series of events, the paper ‘Depression and Anxiety in Elderly Outpatients with Chronic Obstructive Pulmonary Disease: Prevalence and Validation of the BASDEC Screening Questionnaire’ by Yohannes AM, Baldwin RC and Connolly MJ (15 (12): 1090–1096), intended for publication in JAGS , appeared in the December 2000 issue of the International Journal of Geriatric Psychiatry in place of this paper. The editor apologises for this mistake. </FN>
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Yohannes, Abebaw M., Connolly, Martin J., and Baldwin, Robert C.
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FLUOXETINE , *ANTIDEPRESSANTS , *DEPRESSION in old age , *GERIATRIC psychiatry , *OBSTRUCTIVE lung diseases , *PSYCHIATRIC drugs - Abstract
Objectives To examine the acceptability of fluoxetine in elderly depressed patients with chronic obstructive pulmonary disease (COPD). Setting A university teaching hospital. Method Single-blinded (open) study. One hundred and thirty-seven outpatients (69 male) with symptomatic irreversible, moderate to severe COPD were recruited. Major depression was diagnosed using the Geriatric Mental State Schedule. Quality of life was assessed by the Breathing Problems Questionnaire, physical disability by the Manchester Respiratory Activities of Daily Living Questionnaire and severity of depression using the Montgomery Asberg Depression Rating Scale. Exclusion criteria were: use of oral steroids within 6 weeks, acute or chronic confusion, known cancer and known psychosis. Results Fifty-seven patients (42%) (25 males) with a mean age of 72 years (range 60–89 years) were depressed. Fourteen (six male) agreed to undergo therapy with fluoxetine 20 mg/day for 6 months, while 36 (72%) refused antidepressant drug therapy. Only seven subjects completed the trial; of these, four (57%) responded to fluoxetine therapy. Five subjects withdrew because of side-effects. Twenty-two of those who refused treatment (61%) agreed to be interviewed, and of these 19 (86%) were still depressed. Conclusion Patient acceptance of fluoxetine was poor. The reasons for refusing treatment varied but were largely due to misapprehension by the patient. Untreated depression became chronic. Offering antidepressants to COPD patients with depression is not an effective strategy. Why this might be so is discussed. Copyright © 2001 John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]
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- 2001
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3. KEY PAPERS IN OLD AGE PSYCHIATRY SERIES EDITOR: ALISTAIR BURNS.
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Burns, Alistair
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SCHIZOPHRENIA , *PATIENTS , *SENILE dementia , *DIAGNOSIS , *PSYCHOSES - Abstract
The article presents research papers on clinical observations and follow-up patients at the Bethlem Royal Hospital in London, England. There are eight chapters that presents background, aims, method and clinical characteristics of patients. In the first chapter, Felix Post summarizes present knowledge of late paraphrenia, drawing on the clinical descriptions of earlier workers and emphasizing the relative rarity of descriptions of schizophrenia occurring after the age of 50 or 60 and the difficulty early nosologists had in making the differentiation from senile psychosis.
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- 1996
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4. KEY PAPERS IN GERIATRIC PSYCHIATRY.
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Burns, Alistar, Levy, Raymond, and Zubenko, George S.
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GERIATRIC psychiatry , *MENTAL health of older people , *DEMENTIA patients , *PSYCHOTHERAPY patients , *OLD age , *GERIATRICS - Abstract
This article introduces key papers in old age geriatric psychiatry related to peripheral motor nerve conduction in elderly demented and non-demented psychiatric patients. The authors note that studies of patients suffering from dementia in old age have ignored the peripheral nervous system. They note that it is unclear whether dementia in elderly subjects results from some special selective disturbance in an otherwise intact and well preserved nervous system or might merely represent one prominent facet of disturbance in a nervous system with widespread defects a rising from a generalised disruptive process.
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- 1995
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5. Actigraphic measurement of agitated behaviour in dementia<FNR></FNR><FN>Guy Nagels and Sebastiaan Engelborghs contributed equally to this paper. </FN>.
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Nagels, Guy, Engelborghs, Sebastiaan, Vloeberghs, Ellen, Van Dam, Debby, Pickut, Barbara A., and De Deyn, Peter Paul
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DEMENTIA , *NEUROBEHAVIORAL disorders , *ACTIGRAPHY , *PATIENT monitoring , *AGITATION (Psychology) - Abstract
Objectives This study examines the correlation between actigraphic measures and a validated assessment scale of agitated behaviour in dementia, the Cohen-Mansfield Agitation Inventory (CMAI). Methods A total of 110 patients were included. Patients either suffered from Alzheimer dementia (AD), mixed dementia (MXD), frontotemporal dementia (FTD) or diffuse Lewy body disease (DLB). All patients underwent actigraphic recordings for 48 h. CMAI was scored by professional caretakers, who were responsible for the patient during his or her actigraphic recording. Results Patients with high total CMAI scores (≥ 50) clearly had higher levels of activity during the day as measured by means of actigraphy than patients with low total CMAI scores (ANOVA, F = 126.75, p < 0.0001). Patients with low MMSE scores (< 20) also had higher activity levels during the day than patients with higher MMSE scores (ANOVA, F = 85.74, p < 0.0001). Correlations between actigraphic data and CMAI total scores were moderate but highly significant. Conclusion We conclude that actigraphy is a useful tool to examine agitated behaviour in dementia. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2006
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6. An evidence-based proposal for the classification of neuropsychiatric disturbance in Alzheimer's disease<FNR></FNR><FN>An earlier version of this paper was presented at the 18 March, 2000 meeting of the FDA Psychopharmacological Drugs Advisory Committee. </FN>
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Lyketsos, Constantine G., Breitner, John C. S., and Rabins, Peter V.
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NEUROBEHAVIORAL disorders , *ALZHEIMER'S disease , *DEMENTIA , *MEDICAL research - Abstract
Discusses information on a proposal for the classification of neuropsychiatric disturbance in patients with Alzheimer's disease. Method of empirical categorization of disturbances; Comparison of the frequency of individual neuropsychiatric symptoms with or without dementia based on the Cache County study of memory and aging in Utah; List of the proposed diagnostic criteria for Alzheimer's disease-associated neuropsychiatric disturbance; Relevance of the proposed criteria to clinical research and practice.
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- 2001
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7. Galantamine: a randomized, double-blind, dose comparison in patients with Alzheimer's disease<FNR></FNR><FN>The authors have requested that this paper be dedicated to the memory of Dr T. Venkateswarlu who died on the 28th March 1997. </FN>.
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Wilkinson, D. and Murray, J.
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ALZHEIMER'S disease , *ACETYLCHOLINESTERASE , *DEMENTIA , *DRUG dosage , *NICOTINIC receptors - Abstract
Objectives To investigate whether Galantamine significantly improves the core symptoms of Alzheimer's disease (AD). Background Galantamine is a reversible, competitive, selective inhibitor of acetylcholinesterase (AChE) that also allosterically modulates nicotinic acetylcholine receptors. This dual mechanism of action provided the rationale for a phase II trial of galantamine in AD. Method A multicentre, randomized, parallel, double-blind, placebo-controlled trial was carried out to evaluate the efficacy and tolerability of galantamine 18, 24 and 36 mg/day administered for 3 months in 285 patients with mild-to-moderate probable AD. The primary outcome measure was the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog); secondary outcome measures were the Clinical Global Impression of Change (CGIC) and the Progressive Deterioration Scale (PDS). Results Patients treated with galantamine 24 mg/day had a significantly better outcome than placebo on ADAS-cog; the treatment difference was 3 points on the intention-to-treat (ITT) analysis ( p = 0.01) and 4.2 points on per protocol analysis ( p = 0.001). Per protocol analysis showed that galantamine had a significantly better outcome than placebo on PDS ( 24-mg/day dose, p < 0.05) and CGIC (36-mg/day dose, p < 0.05). Galantamine was well tolerated at the lower doses of 18 and 24 mg/day where it produced mild, transient effects typical of cholinomimetic agents. Conclusion This study shows that, relative to placebo, galantamine significantly improves the core symptoms of Alzheimer's disease. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2001
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8. ‘Pressing issues in the dementias and dementia services’ symposium 28–29 January 1999 Royal College of Physicians, London. Priorities in dementia services: the interaction of purchasers and providers<FN>Paper from Dementia Symposium, at Royal College of Psychiatrists on 28/29 January 1999 </FN>
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Murphy, Elaine
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DEMENTIA , *CONFERENCES & conventions , *ELDER care , *MENTAL health services - Abstract
Presents an article on pressing issues in the dementia and dementia services symposium at the Royal College of Physicians in London, England on January 28 to 29, 1999. Geographical inequities involving care for the elderly; Information on a survey conducted by the Alzheimer's Disease Society on Health Authorities' plans and purchasing intentions for dementia services.
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- 2000
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9. Dementia in developing countries. A consensus statement from the 10/66 Dementia Research Group.<FN>Contributors from the 10/66 Dementia Research Group are listed at the end of the position paper following this article. </FN>.
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Prince, M.
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DEMENTIA , *NEUROBEHAVIORAL disorders , *PSYCHOSES , *RESEARCH ,DEVELOPING countries - Abstract
Less than one-tenth of all population-based research into dementia is directed towards the two-thirds or more of cases living in developing parts of the world. The 10/66 Dementia Research Group has been formed to redress this imbalance, encouraging active research collaboration between centres in different developing countries and between developed and developing countries. The 10/66 group consisted initially of researchers attending a symposium on dementia research in developing countries, held at the 1998 Alzheimer's Disease International conference. They noted a growing interest in this area, with many active researchers and others wishing to start new studies. There was felt to be an urgent need for more research: quantifying prevalence and incidence, exploring regional variations in international collaborations using harmonized methodologies, describing care arrangements for people with dementia, quantifying the impact on caregivers and evaluating the effectiveness of any newly implemented services. Methodological problems need to be addressed, particularly development of culture- and education-fair dementia diagnostic procedures. Good-quality research can generate awareness, pioneer service development and influence policy. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2000
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10. DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers (DETERMIND): A protocol paper.
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Farina, Nicolas, Hicks, Ben, Baxter, Kate, Birks, Yvonne, Brayne, Carol, Dangoor, Margaret, Dixon, Josie, Harris, Peter R., Hu, Bo, Knapp, Martin, Miles, Eleanor, Perach, Rotem, Read, Sanna, Robinson, Louise, Rusted, Jennifer, Stewart, Rob, Thomas, Alan, Wittenberg, Raphael, and Banerjee, Sube
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MEDICAL care costs ,DEMENTIA ,QUALITY of life ,CARE of dementia patients ,CHANGE theory ,TREATMENT of dementia ,MEDICAL quality control ,RESEARCH ,CAREGIVERS ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,SOCIOECONOMIC factors ,COMPARATIVE studies ,COST effectiveness ,RESEARCH funding - Abstract
Objectives: DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) is designed to address fundamental, and, as yet unanswered questions about inequalities, outcomes and costs following diagnosis with dementia. These answers are needed to improve the quality of care and equity of access to care, and therefore the quality of life, of people with dementia and their carers.Method: DETERMIND is a programme of research consisting of seven complementary workstreams (WS) exploring various components that may result in unequal dementia care: WS1: Recruitment and follow-up of the DETERMIND cohort-900 people with dementia and their carers from three geographically and socially diverse sites within six months following diagnosis, and follow them up for three years. WS2: Investigation of the extent of inequalities in access to dementia care. WS3: Relationship between use and costs of services and outcomes. WS4: Experiences of self-funders of care. WS5: Decision-making processes for people with dementia and carers. WS6: Effect of diagnostic stage and services on outcomes. WS7: Theory of Change informed strategy and actions for applying the research findings.Outcomes: During the life of the programme, analysing baseline results and then follow-up of the DETERMIND cohort over 3 years, we will establish evidence on current services and practice. DETERMIND will deliver novel, detailed data on inequalities in dementia care and what drives positive and negative outcomes and costs for people with dementia and carers, and identify factors that help or hinder living well with dementia. [ABSTRACT FROM AUTHOR]- Published
- 2020
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11. KEY PAPERS IN GERIATRIC PSYCHIATRY SERIES EDITOR: ALISTAIR BURNS.
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Burns, Alistair
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GERIATRIC psychiatry , *MENTAL health , *GENERAL practitioners , *DISEASES in older people , *PEOPLE with mental illness , *MENTAL health services , *MEDICAL care - Abstract
This article presents information on research work related to geriatric psychiatry. The depressed subjects for this study were drawn from two groups. The first consisted of 100 elderly patients referred to the psychogeriatric service at Goodmayes and the London Hospital, all of whom had experienced onset of depression in the year prior to interview. To this group was added 19 who were found in the general population sample, drawn from local General Practitioners' lists, with a similar psychiatric history. The comparison group (controls) consisted of elderly subjects on this list who were free of psychiatric disorder. In view of the well identified influence on depression of age and sex, the groups were matched on those variables.
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- 1996
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12. INVITED PAPER: Towards a Consensus on Continuing Care for Older Adults with Psychiatric Disorder: Report of a Meeting on 27 March 1995 at the Royal College of Psychiatrists.
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Wattis, John P. and Fairbairn, Andrew
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LONG-term health care , *MENTAL illness , *PSYCHIATRY , *DEMENTIA , *NEUROBEHAVIORAL disorders , *MENTAL health of older people - Abstract
This meeting explored the role of the NHS in providing long-term care for older people with mental illness, principally those with dementia. NHS continuing care units medically supervised by a specialist consultant were an essential part of a system of assessment, treatment and care that must be sensitive to the needs of patients and carers. This system also involved family and friends, the independent sector, general practitioners, social services and other NHS providers. NHS long-stay units should be training centres and models of quality care linked to consultant-led multidisciplinary community mental health teams for older adults. Characteristics of patients likely to need admission to NHS units included: (a) sustained or frequently recurrent difficult behaviour arising from dementia or other serious psychiatric disorder which could not be managed elsewhere except with inappropriate sedation; (b) physical illness and sensory problems associated with the problems above if the needs of the patient could not better be met in another setting; (c) dementia or other serious psychiatric disorder with failure to cope or more rapid deterioration in other care settings. The extent and impact of the current wide local variations in NHS long-stay provision and the feasibility and benefits of general practice registers of patients with dementia were identified as areas for further investigation. [ABSTRACT FROM AUTHOR]
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- 1996
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13. KEY PAPERS IN GERIATRIC PSYCHIATRY SERIES EDITOR: ALISTAIR BURNS: AUTHOR'S RETROSPECTIVE.
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Roth, Martin
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MENTAL health of older people , *MENTAL illness , *OLD age , *GERIATRIC psychiatry , *MENTAL health , *PSYCHIATRY - Abstract
Presents the author's retrospective of his interest in the mental disorders of the aged. Review of studies on brain pathology regarding the types of mental illness that confronted older people; Identification of the frequency of concomittant chronic physical illness with weakness.
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- 1996
14. Key Papers in Geriatric Psychiatry: mini-mental state: a practical method for grading the cognitive state of patients for the clinician. M. Folstein, S. Folstein and P. McHugh, Journal of Psychiatric Research , 1975, 12 , 189-198.
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Burns, Alistair, Brayne, Carol, and Folstein, Marshal
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MENTAL status examination , *COGNITION disorders , *DIAGNOSIS , *PATHOLOGICAL psychology , *NEUROLOGIC examination - Abstract
Discusses the development and use of the Mini-Mental State (MMS) Examination in diagnosing cognitive disorders. Method used in assessing the validity of MMS results; Background on different versions of MMS tests; Applications of MMS.
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- 1998
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15. Key papers in geriatric psychiatry. Computed tomography in the elderly.
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Burns, Alistair and Jacoby, Robin
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TOMOGRAPHY , *GERIATRIC psychiatry , *DIAGNOSTIC imaging , *DEMENTIA , *MENTAL health of older people - Abstract
Focuses on the use of computed tomography (CT) in geriatric psychiatry. Application of CT to discriminate patients with dementia from normal elderly controls; Evolution of medical diagnostic imaging systems; Significance of CT to dementia management.
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- 1998
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16. A systematic review of studies reporting on neuropsychological and functional domains used for assessment of recovery from delirium in acute hospital patients.
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McCartney, Haruno, Noble, Erin, MacLullich, Alasdair M. J., Davis, Daniel H. J., Evans, Jonathan, Shenkin, Susan D., Muniz‐Terrera, Graciela, Sandeman, Daisy, and Tieges, Zoë
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HOSPITALS ,CINAHL database ,MEDICAL databases ,HOSPITAL patients ,MEDICAL information storage & retrieval systems ,FUNCTIONAL status ,CONVALESCENCE ,SYSTEMATIC reviews ,NEUROPSYCHOLOGICAL tests ,DELIRIUM ,RESEARCH funding ,MEDLINE - Abstract
Objectives: Assessing for recovery in delirium is essential in guiding ongoing investigation and treatment. Yet, there is little scrutiny and no research or clinical consensus on how recovery should be measured. We reviewed studies which used tests of neuropsychological domains and functional ability to track recovery of delirium longitudinally in acute hospital settings. Methods/Design: We systematically searched databases (MEDLINE, PsycInfo, CINAHL, Embase, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials), from inception to October 14th, 2022. Inclusion criteria were: adult acute hospital patients (≥18 years) diagnosed with delirium by a validated tool; 1+ repeat assessment using an assessment tool measuring domains of delirium/functional recovery ≤7 days from baseline. Two reviewers independently screened articles, performed data extraction, and assessed risk of bias. A narrative data synthesis was completed. Results: From 6533 screened citations, we included 39 papers (reporting 32 studies), with 2370 participants with delirium. Studies reported 21 tools with an average of four repeat assessments including baseline (range 2–10 assessments within ≤7 days), measuring 15 specific domains. General cognition, functional ability, arousal, attention and psychotic features were most commonly assessed for longitudinal change. Risk of bias was moderate to high for most studies. Conclusions: There was no standard approach for tracking change in specific domains of delirium. The methodological heterogeneity of studies was too high to draw firm conclusions on the effectiveness of assessment tools to measure delirium recovery. This highlights the need for standardised methods for assessing recovery from delirium. Key points: Assessing for recovery is an essential part of delirium care, to guide clinicians' ongoing investigation and treatment and to provide accurate information to patients and carers.It is unclear what assessment tools are used to measure delirium recovery on a longitudinal basis, specifically which neuropsychological and functional domains should be assessed.A total of 21 assessment tools measuring 15 different symptom domains of delirium were used in the included studies, however, there was no standard approach for tracking change in these domains over time.The symptom domains most frequently assessed for longitudinal change in the included studies were general cognition, functional ability, arousal, attention and psychotic features. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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17. KEY PAPERS IN GERIATRIC PSYCHIATRY SERIES EDITOR: ALISTAIR BURNS: COMMENTARY.
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Christie, Sandy
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MENTAL health of older people , *MENTAL illness , *OLD age , *GERIATRIC psychiatry , *MENTAL health , *PSYCHIATRY - Abstract
Comments on the article "The Natural History of Mental Disorder in Old Age," by Martin Roth, which appeared in a 1955 issue of the "Journal of Mental Science." Definition of affective psychosis; Problems and controversy on mental disorder; Significance of the article to aged with Alzheimer's disease.
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- 1996
18. Participatory action research: An exploration from a Freirean perspective of research involving people with dementia.
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O'Connor, Deborah, Sakamoto, Mariko, Phinney, Alison, Chaudhury, Habib, and Mann, Jim
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PSYCHIATRY ,HUMAN research subjects ,TEACHING ,DISCRIMINATION (Sociology) ,SOCIAL stigma ,DEMENTIA patients ,EXPERIENCE ,CONCEPTUAL structures ,ACTION research ,REFLECTION (Philosophy) - Abstract
Background: Researchers are increasingly being called upon to involve people with dementia in research that pertains to them. Participatory Action Research (PAR) has been one of the approaches that has been utilized to do this. How people understand and apply the ideas behind this approach however has often been atheoretical and diverse. This has implications for how purpose, power, voice and agency are conceived and actualized. Objectives: This paper will examine how theoretical construction of PAR can inform the process of meaningfully involving people living with dementia in research. Specifically, drawing on the work of Paulo Freire, this paper will articulate a way of conceptualizing PAR that is explicitly critical and then demonstrate how these ideas informed a PAR study focused on addressing stigma and discrimination with people living with dementia. Conclusion: The purpose of the paper is to engage researchers and people with lived expertise in critical reflection of what it actually means to involve people with dementia in research. Key points: The importance of meaningfully engaging people with dementia in research about and for them is becoming well‐accepted but an understanding of what this means and how to do this is far less developed.Paulo Friere's critical pedagogy provides a useful framework for conceptualizing and carrying out reflective and empowering Participatory Action Research (PAR) that challenges oppression and discrimination.A Frierien‐based approach challenges conventional research relationships, promotes critical awareness of the link between personal experiences and broader structural systems of oppression and discrimination, focuses on developing a collective understanding of issues, and prioritizes the voices of those with lived experience of oppression to take action.The
project provides an example of how these ideas were put into practice to take action against dementia‐based stigma and discrimination. [ABSTRACT FROM AUTHOR] - Published
- 2023
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19. Dementia care navigation: A systematic review on different service types and their prevalence.
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Giebel, Clarissa, Reilly, Siobhan, Gabbay, Mark, Dickinson, Julie, Tetlow, Hilary, Hogan, Hayley, Griffiths, Alys, and Cooper, Claudia
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TREATMENT of dementia ,ONLINE information services ,SOCIAL support ,HEALTH services accessibility ,SYSTEMATIC reviews ,PATIENT-centered care ,MEDICAL care ,COMPARATIVE studies ,DISEASE prevalence ,RESEARCH funding ,MEDLINE - Abstract
Background: Dementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing service formats, and to synthesise evidence regarding their implementation and impacts. Methods: The review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN service, defined as a service in which non‐clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst. Results: We included 14 papers reporting on six studies. All services were US‐based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well‐being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions and studies employing different outcome measures. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages. Conclusions: DCN services have the potential to effectively provide non‐clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar established outcome measures are required. Key points: Evidence on the impact of Dementia Care Navigators (DCNs) is limited but shows promising benefits for people living with dementia and their carers.More research needs to be conducted in countries other than the US, where all evidence was reported, and with similar outcome measures to allow comparison.DCNs are a highly useful professional group without medical training, who can navigate people living with dementia and their carers to support and provide support themselves. [ABSTRACT FROM AUTHOR]
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- 2023
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20. Comparing international dementia research priorities-Systematic review.
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Logan, Monica, Leitch, Stephanie, Bosakh, Zainab, Beishon, Lucy, and Quinn, Terence J.
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Objectives: Research priority setting aims to collate stakeholder opinion to determine the most pressing research questions. Priority setting exercises influence decisions around research funding, development and policy. We compared published dementia research priority setting exercises from international healthcare systems.Methods: Four multidisciplinary, international, electronic databases were searched for relevant studies (2010 until 2021). Priorities were extracted, coded and assigned to categories using thematic analysis. The Nine Common Themes of Good Practice (9CTGP) and the Reporting guideline for priority setting of health research (REPRISE) checklists were used to assess methodological and reporting quality respectively.Results: From 265 titles, 10 priority setting exercises (1179 participants, 147 priorities) were included. Studies spanned four continents and the majority included people living with dementia and their care-givers in the priority setting process (68%). Only one paper met all the best practice indicators. Issues around inclusiveness, implementation and evaluation of the priorities were apparent in nine papers. We categorised priorities under eight themes: caregivers (25%, n = 37), support (24%, n = 35), awareness and education (16%, n = 24), drugs and interventions (14%, n = 21), diagnosis (8%, n = 12), pathology (6%, n = 9), research design (5%, n = 7), and prevention (1%, n = 2). Priorities varied by geographical region, with awareness and education of higher priority in low-middle income countries, compared to caregivers and support in high income countries.Conclusions: Key priorities were identified with some commonality around themes considered of greatest importance. There is scope to improve the process and reporting of priority setting. Priorities differed according to contextual factors and so, priorities specific to one healthcare setting may not be applicable to others. [ABSTRACT FROM AUTHOR]- Published
- 2022
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21. Effects of virtual reality on moods in community older adults. A multicenter randomized controlled trial.
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Chan, Joyce Y. C., Chan, Tak Kit, Wong, Michael P. F., Cheung, Ruby S. M., Yiu, Karen K. L., and Tsoi, Kelvin K. F.
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OLDER people ,VIRTUAL reality ,RANDOMIZED controlled trials ,SENIOR centers ,PHYSICAL fitness mobile apps ,CROSSOVER trials ,RESEARCH ,AFFECT (Psychology) ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,RESEARCH funding ,QUESTIONNAIRES - Abstract
Introduction: Virtual reality (VR) technology is a potential method to use in cognitive intervention, but the use of VR in cognitive stimulation intervention for older adults has not been investigated. Therefore, the aim of this study was to investigate the mood change of older adults after participating in the VR cognitive stimulation activity.Methods: This is a multicenter randomized controlled, cross-over trial. The intervention was a VR cognitive stimulation activity, and the control was a paper-and-pencil activity. The participants were older adults with age over 60 and recruited in the elderly community centers. The Positive and Negative Affect Score (PANAS) was used to measure mood change. Mean difference (MD) with 95% confidence interval (95% CI) was calculated. The Simulator sickness questionnaire was used to measure adverse events.Results: A total of 236 participants from 19 community centers were recruited. After the VR activity, the participants had a significant increase in total PANAS positive affect score (MD = 2.09, 95% CI = 0.69 to 3.49), and a significant reduction in total negative affect score (MD = -1.99, 95% CI = -2.55 to -1.43). The reduction in negative affect score was significantly larger in VR activity than paper-and-pencil activity (MD = -0.48, 95% CI = -0.98 to 0.00). Besides, only three participants reported severe advance events after VR activity.Conclusions: The use of VR technology is well accepted by older adults. Therefore, the use of VR technology through smartphone and a mobile app can be a potential method for future cognitive training interventions. [ABSTRACT FROM AUTHOR]- Published
- 2020
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22. How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review.
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Thijssen, Marjolein, Daniels, Ramon, Lexis, Monique, Jansens, Rianne, Peeters, José, Chadborn, Neil, Nijhuis‐van der Sanden, Maria W. G., Kuijer‐Siebelink, Wietske, and Graff, Maud
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DEMENTIA ,CAREGIVERS ,ONLINE databases ,SOCIAL participation ,DATABASE searching - Abstract
Objectives: To describe and explain the outcomes of community dementia friendly initiatives (DFIs) for people with dementia and their caregivers to inform the development and tailoring of DFIs. Methods: Literature searches on DFIs were performed through two systematic online database searches of PubMed, Embase, ASSIA, CINAHL and Google scholar. Papers were only included if they evaluated outcomes using empirical data from people with dementia or caregivers. Data collection and analysis were guided by the categorization in the DEM‐FACT taxonomy and RAMESES guidelines for realist reviews. Results: Of 7154 records identified, 22 papers were included with qualitative, mixed method and quantitative study designs. The synthesis led to a description of programme theories addressing caring, stimulating and activating communities. Outcomes for people with dementia and caregivers included having contact with others, enjoyment and decrease of stress and, lastly, support. This synthesis also indicated how people with dementia participated in a specific role in DFIs, such as patient, team member or active citizen. Conclusions: DFIs generate different outcomes for people with dementia and caregivers, depending on the kind of initiative and the specific role for people with dementia. These findings could be a catalyst for initiation and further development of DFIs in a dementia friendly community (DFC). This draws attention to the multiple aspects of DFCs and supports reflection on their essential principles. Key points: This is the first synthesis of the outcomes and mechanisms of dementia friendly initiatives (DFIs) using studies with empirical data from the perspective of people with dementia or caregivers.DFIs generate different outcomes for both people with dementia and caregivers.DFIs have different outcomes for people with dementia participating in different specific roles (i.e. patient, team member or active citizen).DFI outcomes according to people with dementia and caregivers support both the practical development and research of how dementia friendly communities (DFCs) succeed in fulfilling their purpose. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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23. Has COVID‐19 affected dementia diagnosis rates in England?
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Hazan, Jemma, Liu, Kathy Y., Isaacs, Jeremy D., Burns, Alistair, and Howard, Robert
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DIAGNOSIS of dementia ,COVID-19 ,MILD cognitive impairment ,PRIMARY health care ,NATIONAL health services ,MEDICAL referrals ,DISEASE prevalence ,QUALITY of life ,RESEARCH funding ,QUALITY assurance ,DEMENTIA ,PSYCHIATRIC hospitals ,MEDICAL coding - Abstract
Background: The COVID‐19 pandemic impacted on the provision of care and routine activity of all National Health Service (NHS) services. While General Practitioner referrals to memory services in England have returned to pre‐pandemic levels, the estimated dementia diagnosis rate (DDR) fell by 5.4% between March 2020 and February 2023. Methods: In this paper we explore whether this reduction is accurate or is an artefact of the way the NHS collects data. Results: We explore the processes that may have affected national dementia diagnosis rates during and following the COVID‐19 pandemic. Conclusions: We discuss what action could be taken to improve the DDR in the future. Key points: Despite General Practitioner (GP) referrals to memory services in England returning to levels seen before the pandemic, there was a decline of 5.4% in the estimated dementia diagnosis rate (DDR) from March 2020 to February 2023.This paper explores the factors which may have affected the national DDR reduction. These include a backlog in dementia referrals, a reduction in coding of diagnoses, or a decrease in true dementia prevalence secondary to excess COVID‐19 deaths which has yet to be reflected in the DDR denominator.Further work is suggested to accurately capture dementia prevalence in the United Kingdom (UK). These include an up‐to‐date multicentre population‐based cohort study and adjusting the DDR denominator for factors known to affect dementia susceptibility such as deprivation, rurality, and ethnicity. [ABSTRACT FROM AUTHOR]
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- 2023
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24. Key papers in geriatric psychiatry. Pernicious anemia and reversible dementia: Strachan and Henderson 30 years later.
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Rabins, Peter
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PERNICIOUS anemia , *DEMENTIA , *MENTAL health of older people , *VITAMIN B12 deficiency , *OLD age , *GERIATRIC psychology - Abstract
Discusses the concept of reversible dementia and pernicious anemia in old age. Influence of pernicious anemia on the development of dementia; Correlation between vitamin B12 deficiency and dementia; Overview of studies on the etiology of dementia.
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- 1998
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25. Psychiatric comorbidities in older adults with posttraumatic stress disorder: A systematic review.
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Baltjes, Froukje, Cook, Joan M., van Kordenoordt, Maaike, and Sobczak, Sjacko
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MENTAL illness risk factors ,ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,CINAHL database ,MEDICAL information storage & retrieval systems ,SUBSTANCE abuse ,SYSTEMATIC reviews ,POST-traumatic stress disorder ,RISK assessment ,MENTAL depression ,RESEARCH funding ,MEDLINE ,ALCOHOLS (Chemical class) ,ANXIETY ,WOUNDS & injuries ,COMORBIDITY ,DISEASE risk factors ,OLD age - Abstract
Background: Psychiatric comorbidity is high in adults with posttraumatic stress disorder (PTSD), with up to 90% having at least one additional condition, and two‐thirds having two or more other diagnoses. With an increasing aging population in industrialized counties, knowing which psychiatric disorders frequently co‐occur in older adults with PTSD can have implications to improve diagnosis and treatment. This systematic literature review explores the current empirical literature on psychiatric comorbidity in older adults with PTSD. Method: Literature databases PubMed, Embase, PsycINFO, and CINAHL were searched. The following inclusion criteria were applied: research done since 2013, PTSD diagnosis based on diagnostic criteria according to Diagnostic and Statistics Manual‐Fifth Edition, International Classification of Diseases—10th Revision (ICD‐10), or ICD‐11, and studies include individuals aged 60 years or older. Results: Of 2068 potentially relevant papers identified, 246 articles were examined based on titles and abstracts. Five papers met the inclusion criteria and were included. Major depressive disorder and alcohol use disorder were the most frequently studied and diagnosed psychiatric comorbidities in older adults with PTSD. Conclusions and implications: Screening for depression and substance use in older adults should include an assessment of trauma and PTSD. Additional studies in the general older adult population with PTSD and a broader range of comorbid psychiatric disorders are needed. Key points: Major depressive disorder and alcohol use disorders are the most frequently studied and diagnosed psychiatric comorbidities in older adults with PTSD.Based on this, screening for trauma and PTSD should be included in older adults with depression and substance useQualitative epidemiological studies on psychiatric comorbidities, such as personality disorders, in older adults with PTSD are limited and needed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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26. KEY PAPERS IN OLD AGE PSYCHIATRY.
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Burns, Alistar
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GERIATRIC psychiatry , *PERIODICALS , *PUBLISHING , *MENTAL health of older people , *CITATION indexes , *INFORMATION technology - Abstract
This article introduces research papers published in the October 1995 issue of the "International Journal of Geriatric Psychiatric." These papers have not been drawn from any citation index or published review but from those papers which experts regard as important. The current explosion in information technology and publishing provides the reader with a bewildering variety and unmanageable number of papers with which one should be familiar. The format of the series was conceived simply.
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- 1995
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27. A systematic review of the effects of psychosocial interventions on social functioning for middle-aged and older-aged adults with severe mental illness.
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Smart, Emily L., Brown, Laura, Palmier‐Claus, Jasper, Raphael, Jessica, Berry, Katherine, and Palmier-Claus, Jasper
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MIDDLE-aged persons ,MENTAL illness ,META-analysis ,OLDER people ,SOCIAL skills education - Abstract
Objectives: The number of older adults with severe mental health problems such as schizophrenia is likely to double in the next 20 years. The needs of this patient group change across the life course, but difficulties with social functioning persist into older age. Poorer social functioning is associated with poorer outcomes and has been identified as a priority for intervention by patients themselves. This paper systematically reviews studies examining the effectiveness of psychosocial interventions on social functioning for people with severe mental health problems in later life.Methods: A systematic review of peer-reviewed journal articles was conducted and databases were searched from inception to December 2017. The review was limited to psychosocial interventions, for mid to older aged adults (≥40 years of age) with severe mental illness that included a validated measure of social functioning.Results: Fifteen studies (17 papers) met inclusion criteria. There was evidence to support skills training interventions that primarily focused on social skills training or integrated mental and physical health interventions. There was not sufficient evidence to recommend any other interventions.Conclusions: The results highlight the limited nature of interventions designed specifically for older people with severe mental health problems that target social functioning and the need for more robust, large-scale studies in the area. Current evidence suggests that cognitive behaviour therapy can be effective in targeting social functioning in younger age groups, but, as yet, there is insufficient evidence to recommend this intervention for an older population. [ABSTRACT FROM AUTHOR]- Published
- 2020
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28. The use of positron emission tomography/magnetic resonance imaging in dementia: A literature review.
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Lorking, Nicole, Murray, Alison D., and O'Brien, John T.
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MAGNETIC resonance imaging ,POSITRON emission tomography ,DEMENTIA ,DEFAULT mode network ,MILD cognitive impairment - Abstract
Objectives: Positron emission tomography–magnetic resonance imaging (PET/MRI) is an emerging hybrid imaging system in clinical nuclear medicine. Research demonstrates a comparative utility to current unimodal and hybrid methods, including PET‐computed tomography (PET/CT), in several medical subspecialities such as neuroimaging. The aim of this review is to critically evaluate the literature from 2016 to 2021 using PET/MRI for the investigation of patients with mild cognitive impairment or dementia, and discuss the evidence base for widening its application into clinical practice. Methods: A comprehensive literature search using the PubMed database was conducted to retrieve studies using PET/MRI in relation to the topics of mild cognitive impairment, dementia, or Alzheimer's disease between January 2016 and January 2021. This search strategy enabled studies on all dementia types to be included in the analysis. Studies were required to have a minimum of 10 human subjects and incorporate simultaneous PET/MRI. Results: A total of 116 papers were retrieved, with 39 papers included in the final selection. These were broadly categorised into reviews (12), technical/methodological papers (11) and new data studies (16). For the current review, discussion focused on findings from the new data studies. Conclusions: PET/MRI offers additional insight into the underlying anatomical, metabolic and functional changes associated with dementia when compared with unimodal methods and PET/CT, particularly relating to brain regions including the hippocampus and default mode network. Furthermore, the improved diagnostic utility of PET/MRI, as reported by radiologists, offers improved classification of dementia patients, with important implications for clinical management. Key Points: Combined positron emission tomography–magnetic resonance imaging (PET/MRI) is an emerging imaging technique in clinical nuclear medicine.PET/MRI is predominantly used as a research tool in dementia.Improved diagnostic accuracy of PET/MRI compared to unimodal methods and PET/CT is demonstrated in other subspecialities.Awareness of the clinical utility of PET/MRI in dementia is growing, with earlier diagnosis having important implications for patient management. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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29. Problem Adaptation Therapy (PATH) to Treat Depression in Older Adults With Cognitive Impairment: A Systematic Review of Treatment Effects.
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Collyer, Sarah and Dorstyn, Diana
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COGNITION disorders treatment , *PREVENTION of mental depression , *PSYCHOTHERAPY , *MEDICAL information storage & retrieval systems , *PSYCHOLOGICAL adaptation , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *CONFIDENCE intervals , *COMPARATIVE studies , *TREATMENT effect heterogeneity , *MENTAL depression , *PSYCHOLOGY information storage & retrieval systems , *COGNITION - Abstract
Objectives: Problem adaptation therapy (PATH) is a relatively new psychotherapy that recognises the importance of simultaneously targeting cognitive impairment and functional disability in the treatment of late‐life depression. This is the first systematic review to examine the effectiveness of PATH. Methods: Ageline, Embase, Medline, PsycINFO, Scopus and ProQuest databases were searched from 2010 until 5 April 2024, for studies that evaluated PATH for older people. Where possible, effect sizes (Hedges' g) with 95% confidence intervals and p values were calculated and pooled using a random effects model. The reporting quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal tools and certainty of the evidence behind each result assessed with The Grading of Recommendations Assessment, Development and Evaluation method. Results: Twelve papers, from seven independent studies and a pooled sample of 579 older adults with multiple comorbidities, were included in this review. PATH participants experienced immediate reductions in depression symptom ratings (gw = 0.72, p < 0.01, Nstudies = 5), alongside small improvements in disability (gw = 0.61, p = 0.04, Nstudies = 4) compared to peers that received supportive therapy, brief psychoeducation, or usual care. The overall evidence quality was, however, characterised by bias, inconsistency, and imprecision in effect estimates. Positive participant feedback and low dropout rates (15%–31%) suggested treatment satisfaction, although these data were not routinely provided. Conclusions: PATH may be a viable treatment for older people living with mental and cognitive disorders, however there is a need for more rigorous research incorporating follow‐up assessments to consolidate the effectiveness of PATH relative to other treatments. Incorporating measures of treatment fidelity are also critical to interpreting and generalising these data. The protocol for this study was prospectively published on the Open Science Framework (https://osf.io/gx57a). [ABSTRACT FROM AUTHOR]
- Published
- 2024
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30. A systematic review of digital access to post‐diagnostic health and social care services for dementia.
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Watson, James, Hanna, Kerry, Talbot, Catherine, Hansen, Marcus, Cannon, Jacqueline, Caprioli, Thais, Gabbay, Mark, Komuravelli, Aravind, Eley, Ruth, Tetlow, Hilary, and Giebel, Clarissa
- Subjects
- *
TREATMENT of dementia , *HEALTH services accessibility , *MEDICAL technology , *RESEARCH funding , *HEALTH status indicators , *DIGITAL health , *SOCIAL services , *HUMANITY , *MEDICAL care , *SYSTEMATIC reviews , *INFORMATION literacy , *HEALTH equity , *QUALITY assurance , *INTERPERSONAL relations , *SOCIAL support , *DEMENTIA patients , *CAREGIVER attitudes , *WELL-being - Abstract
Objectives: For many people with dementia and unpaid carers, using technology for care and support has become essential. Rapid proliferation of technology highlights the need to understand digital access to health and social care services for dementia. This mixed‐methods systematic review aims to explore digital access to health and social care services for dementia, from the perspective of people with dementia and unpaid carers. Methods: Nine electronic databases were searched in May 2023 for qualitative, quantitative, or mixed‐method studies, published in English or German, focused on experiences of using technology‐delivered health and social care services for people with dementia and unpaid carers. After removal of duplicates and screening, 44 empirical papers were included. Results: From the 44 studies, findings were grouped into five categories, highlighting experiences for people with dementia and unpaid carers: (1) Adapting to technology, (2) Inequalities and variations in outcomes, (3) Impact on caring, (4) Impact on health, and (5) Impact on relationships. Proliferation of technology in care access emphasised the need for quick adaptation to technology and examination of its impact. The impact of such service delivery has evidenced mixed findings. There were improvements in the health and wellbeing of people with dementia and unpaid carers, and benefits for their dyadic relationship. However, using technology for health and social care access is not always possible and is often reliant on unpaid carers for support. Lower tech‐literacy, lack of equipment or money to buy equipment and poor internet connection can impact the potential for positive outcomes. Conclusions: Technology can bring great benefits: social inclusion, improved service access and care. However, using technology in service delivery in dementia needs careful thought. Professionals and service providers need to be cognizant of the complex nature of dementia, and the benefits and challenges of hybrid service delivery. Key points: Evidence emphasises benefits and challenges to the availability, implementation, use, of technology in health and social care access in dementia.Though there are issues, technology can help improve quality of life for people with dementia, can support carers to care, and facilitate positive relationships between unpaid carers and people with dementia.Proliferation of technology for care access was expedited during COVID‐19, but has not been equally rolled out, making remote and disadvantaged groups less well‐served.A hybrid delivery of services in which people are given choice of delivery method, and are supported in accessing and using technology, will better serve people with dementia and unpaid carers. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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31. CITATION PATTERNS IN THE INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY: CULTURAL ETHNOCENTRISM REVISITED?
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Barak, Yoram, Philpot, Michael, and Levy, Raymond
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GERIATRIC psychiatry ,ETHNOCENTRISM ,CULTURAL relativism ,CITATION indexes ,PSYCHIATRY - Abstract
The country/region of origin of all original papers appearing in the International Journal of Psychiatry (IJGP) during the first 9 years of its publication was recorded. A inure detailed analysis of citation patterns was carried out on the 105 original articles published during 1992. The results indicated that 50-60% of the articles emanated from the United Kingdom but that in general authors cited a broad range of specialities from journals published around the world. North American authors tended to cite North American sources more frequently titan did their counterparts from other countries. There was evidence that the impact of the IJGP is increasing despite its omission from same scientific reference databases. [ABSTRACT FROM AUTHOR]
- Published
- 1995
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32. A synthesis of the evidence on peer research with potentially vulnerable adults: how this relates to dementia.
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Di Lorito, Claudio, Birt, Linda, Poland, Fiona, Csipke, Emese, Gove, Dianne, Diaz‐Ponce, Ana, Orrell, Martin, and Diaz-Ponce, Ana
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DEMENTIA research ,MILD cognitive impairment ,DEMENTIA patients ,DISEASES in adults ,DIAGNOSIS ,THERAPEUTICS - Abstract
Background: There is limited literature around peer research in dementia. This study aims to identify the benefits, the risks and the practical challenges and to develop a model of good practice in peer research with people with dementia.Methods: We searched on PsycInfo, PubMed and Google Scholar for empirical investigations or discussion papers on peer research. Given the limited literature in the field of dementia, we included studies with groups who share similar demographics (older people), experience of stigma (mental health service users) and exclusion from research (people with learning disabilities). We applied no restrictions on language and publication date.Analysis: We identified three themes: the potential benefits, the potential risks and the practical challenges of peer research. We developed a model of good practice. The European Working Group of People with Dementia reviewed our paper and added to our findings.Results: We included seven papers. Potential benefits of peer research included enriched data and empowering people with dementia. Potential risks included power differentials between researchers and issues of representativeness. The practical issues for good practice included the training of peer researchers, defining involvement and roles, working with cognitive impairment and considering resource implications. The European Working Group of People with Dementia emphasised the importance of equality issues.Conclusion: Involving people with dementia in peer research can generate several benefits, including empowerment and opportunities for inclusion for the peer researchers and the research participants living with dementia, challenging academics' traditional views on research processes and gathering enhanced research data. There remains a need for further research on the impact of peer research in dementia studies. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2017
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33. 'I can see what's going on without being nosey...': What matters to people living with dementia about home as revealed through visual home tours.
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Campbell, Sarah, Clark, Andrew, Keady, John, Manji, Kainde, Odzakovic, Elzana, Rummery, Kirstein, and Ward, Richard
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DEMENTIA ,HOME environment ,INTERVIEWING ,PATIENTS' attitudes ,EXPERIENCE ,CONGREGATE housing ,DEMENTIA patients ,RESEARCH funding ,THEMATIC analysis ,FAMILY relations ,NEIGHBORHOOD characteristics ,VIDEO recording ,SOCIAL integration ,PSYCHOLOGY - Abstract
Objectives: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities. Methods: Forty‐six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis. Results: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia. Discussion: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home. Key points: Neighbourhoods begin within homes and are interconnected. This relationship has important implications for the discourse of ageing in place.'Home' for people living with dementia holds the same meanings for those without dementia, but with some notable differences. It is important to recognise the shifting dynamics of home and to recognise the complexity of home in the context of dementia. There is not a fixed solution to the challenges of ageing at home with dementia, but support and understanding need to evolve alongside people with lived experience.Homes are a site of renegotiation where new meanings are created to reflect the changing nature of home and the lived experience of home for those with dementia.The study has provided findings through innovation in the research design. The employment of creative methods enabled people living with dementia to participate in sharing their own narratives of home.The work provides evidence where there is a current gap in understanding 'what matters' about home for people living with dementia. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. Gaining access to unspoken narratives of people living with dementia on a hospital ward—A new methodology.
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Collins, Pippa, Bridges, Jackie, and Bartlett, Ruth
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DEMENTIA patients ,HOSPITAL care ,COMMUNICATION ,BODY movement ,RESEARCH funding ,VIDEO recording - Abstract
Background: This is a methodological paper that aims to advance the conceptualisation of participatory research by focusing on the value of capturing and understanding movement as a vital means of communication for older people with dementia in a general hospital ward. Qualitative research involving people with dementia tends to be word‐based and reliant upon verbal fluency. This article considers a method for capturing and understanding movement as a vital means of communication. Method: This narrative enquiry is underpinned by the model of social citizenship that recognises people with dementia as citizens with narratives to share. The study focused on spontaneously produced conversations that were video recorded and analysed through a lens of mobility. This enabled each participant to share what was important to them in that moment of time without always using words. Findings: The study findings showed that people with dementia have narratives to share, but these narratives do not fit the bio‐medically constructed model that is generally expected from patients. Utilising a mobilities lens enabled the narratives to be understood as containing layers of language. The first layer is the words; the second layer is gestures and movements that support the words; and the third layer is micro movements. These movements do not only support the words but in some cases tell a different story altogether. Conclusion: This methodology brings attention to layers of communication that reveal narratives as a mobile process that require work from both the teller and the listener to share and receive. Movements are shown to be the physical manifestations of embodied language which when viewed through a lens of mobility enable a deeper understanding of the experience of living with dementia when an inpatient. Viewing narratives through a mobilities lens is important to the advancement of dementia and citizenship practices. Key points: Movement and micro‐movements are a vital form of communication for people living with dementia.Viewing narratives through a lens of mobility enables a more nuanced understanding of people's narratives than just words alone.Qualitative methods based on communication strategies other than words have the potential to promote inclusion.An acknowledgement of the juxta positioning of hypermobility and micro‐mobility may help in providing quality healthcare for people living with dementia. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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35. Improving older adults' autobiographical memory through video‐conferencing intervention during COVID‐19.
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Jung, Dawoon, Choi, Juhee, Park, Soohyun, and Choi, Kee‐Hong
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AUTOBIOGRAPHICAL memory ,COVID-19 ,VIDEOCONFERENCING ,COGNITION ,MENTAL health ,INDEPENDENT living ,MENTAL depression ,DESCRIPTIVE statistics ,RESEARCH funding ,EMOTIONS ,PSYCHOTHERAPY - Abstract
Background: Autobiographical memory (AM) is valuable not only as an indicator of mental health and cognitive function, but also as a target of therapeutic intervention for older adults. In the context of the COVID‐19 pandemic, the demand for online psychosocial interventions and assessment services has sharply increased. Thus, the present study examined the effectiveness of videoconferencing AM (vAM) intervention using the Ecological Momentary Assessment (EMA) method in addition to the traditional paper‐and‐pencil assessment among samples of community dwelling older adults. Methods: Twenty‐seven older adults (aged 66–86 years) participated in a vAM intervention composed of 4 weekly 90‐min sessions. The primary outcome was AM specificity, with secondary outcomes as depressive symptom and cognitive function, measured before and after the intervention. In addition, daily emotions were measured through EMA over 4 weeks of intervention. The EMA data were analyzed using a multilevel analysis. Results: The results showed low dropout rates (7%) and high EMA response rates (85%). Autobiographical memory specificity increased (Cohen's d = 0.678), and the level of depression declined significantly (Cohen's d = 0.375) after the program. Additionally, measures assessing cognitive function, such as Seoul Verbal Learning Test and DSC (Digit Symbol Coding), showed significant improvements. The EMA results indicated a decrease in the intensity and proportion of negative emotions experienced during the program. Conclusions: This study is the first to utilize videoconferencing and EMA to deliver an AM intervention targeting older adults. The intervention was effective in improving mental health and cognitive function, including AM in older adults. Additionally, EMA was found to be a feasible tool for use in older adults. Key points: Video‐conferencing intervention and Ecological Momentary Assessment (EMA) were feasible for older adults.After video‐autobiographical memory intervention, the older adults showed significant improvements in Autobiographical memory (AM), cognitive function, and depressive symptoms.During the intervention, participants experienced a reduction in negative affects in their daily lives. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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36. Glymphatic pathway: An emerging perspective in the pathophysiology of neurodegenerative diseases.
- Author
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Rehman, Muneeb U., Sehar, Nouroz, Rasool, Iyman, Aldossari, Rana M., Wani, Amir Bashir, Rashid, Shahzada Mudasir, Wali, Adil Farooq, Ali, Aarif, Arafah, Azher, and Khan, Andleeb
- Subjects
- *
LYMPHATIC physiology , *TREATMENT of neurodegeneration , *BRAIN anatomy , *LYMPHATICS , *NUTRITIONAL genomics , *METABOLIC disorders , *BEHAVIOR modification , *NEURODEGENERATION , *MICRONUTRIENTS , *NERVE tissue proteins , *AGING , *HEALTH behavior , *COGNITION disorders , *SLEEP disorders , *ACTIVE aging , *DIET , *INTERLEUKINS - Abstract
The central nervous system (CNS) is widely recognized as the only organ system without lymphatic capillaries to promote the removal of interstitial metabolic by‐products. Thus, the newly identified glymphatic system which provides a pseudolymphatic activity in the nervous system has been focus of latest research in neurosciences. Also, findings reported that, sleep stimulates the elimination actions of glymphatic system and is linked to normal brain homeostatis. The CNS is cleared of potentially hazardous compounds via the glymphatic system, particularly during sleep. Any age‐related alterations in brain functioning and pathophysiology of various neurodegenerative illnesses indicates the disturbance of the brain's glymphatic system. In this context, β‐amyloid as well as tau leaves the CNS through the glymphatic system, it's functioning and CSF discharge markedly altered in elderly brains as per many findings. Thus, glymphatic failure may have a potential mechanism which may be therapeutically targetable in several neurodegenerative and age‐associated cognitive diseases. Therefore, there is an urge to focus for more research into the connection among glymphatic system and several potential brain related diseases. Here, in our current review paper, we reviewed current research on the glymphatic system's involvement in a number of prevalent neurodegenerative and neuropsychiatric diseases and, we also discussed several therapeutic approaches, diet and life style modifications which might be used to acquire a more thorough performance and purpose of the glymphatic system to decipher novel prospects for clinical applicability for the management of these diseases. Key points: Age‐associated dementia is growing rapidly leading to various neurological diseases and is currently one of the prime reasons for diseases and related morbidity which impacts a wide range of populations.Recently discovered glymphatic system, through which CNS is cleared of potentially harmful substances and plays a significant role in modulating various neurodegenerative and neuropsychiatric illnesses.To avert these diseases various natural interventions like traditional herbal medicine, non‐invasive neurological stimulation, regular sleep cycle and dietary additives may ameliorate disease pathogenesis by improving glymphatic activity are recently identified.Furthermore, investigations are going on the role of nutrigenomics and micronutrients in boosting the activity of glymphatic clearance in various neurological diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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37. Loneliness and social isolation among informal carers of individuals with dementia: A systematic review and meta‐analysis.
- Author
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Liao, Xinqi, Wang, Zhong, Zeng, Qinglin, and Zeng, Yanli
- Subjects
- *
MEDICAL information storage & retrieval systems , *RESEARCH funding , *CINAHL database , *LONELINESS , *META-analysis , *DISEASE prevalence , *SYSTEMATIC reviews , *MEDLINE , *MEDICAL databases , *DEMENTIA , *PSYCHOLOGY of caregivers , *ONLINE information services , *CONFIDENCE intervals , *SOCIAL isolation , *PSYCHOLOGY information storage & retrieval systems , *OLD age - Abstract
Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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38. Effects of exergaming on cognitive functions and loneliness of older adults with cognitive frailty.
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Zhu, Yu‐Zhen, Lin, Chiou‐Fen, Yang, Hui‐Ling, Jin, Grace, and Chiu, Huei‐Ling
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COGNITION disorders ,FRAIL elderly ,ANALYSIS of variance ,RESEARCH methodology ,PSYCHOLOGICAL tests ,LONELINESS ,INDEPENDENT living ,COGNITIVE testing ,EXERCISE video games ,OLD age - Abstract
Objectives: Cognitive frailty combines physical frailty and cognitive impairment in the absence of dementia. The prompt detection of cognitive frailty and early implementation of preventive interventions may reduce the incidence of dementia. However, intervention studies of exergaming in older adults with cognitive frailty are scant. Therefore, we aim to investigate the effectiveness of exergaming on cognitive functions and loneliness among older adults with cognitive frailty. Design: Quasi‐experimental design. Methods: Participants were recruited from four community settings. The experimental group participated in two 40‐min group exergaming sessions weekly for eight weeks; the control group received usual care. The outcome measures were the Montreal Cognitive Assessment (MoCA) and the Chinese Version of the Loneliness Scale. Analyses of covariance were conducted to analyze whether exergaming influenced participants' cognitive functions and loneliness. In addition, the effect size of the posttest of the experimental group relative to its baseline value was calculated to determine the effectiveness of the intervention. Result: 69 older adults with cognitive frailty were included, and 35 and 34 were assigned to the experimental and control groups, respectively. The exergaming effectively improved the cognitive function of older adults with cognitive frailty. Conclusions: Exergaming interventions can effectively improve the cognitive functions of older adults with cognitive frailty but do not positively affect loneliness. We provide evidence to healthcare workers to apply exergaming interventions for older adults with cognitive frailty to improve cognitive function. Key points: This paper highlights that an exergaming intervention can effectively improve the cognitive functions of older adults with cognitive frailty.Older adults with cognitive frailty are a crucial group in the gerontology field, and this study emphasizes that healthcare workers can apply exergaming to achieve improvements in cognitive function based on our research results. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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39. Impact of social isolation and leisure activities on cognition and depression: A study on middle‐aged and older adults in India.
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Mishra, Bijeta and Pradhan, Jalandhar
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COGNITION disorder risk factors ,MENTAL depression risk factors ,LEISURE ,EXECUTIVE function ,ANALYSIS of variance ,MULTIVARIATE analysis ,AGE distribution ,CROSS-sectional method ,MENTAL health ,SOCIAL isolation ,RISK assessment ,PSYCHOLOGICAL tests ,PEARSON correlation (Statistics) ,DESCRIPTIVE statistics ,DISEASE prevalence ,CENTER for Epidemiologic Studies Depression Scale ,DATA analysis software ,SENILE dementia ,DISEASE risk factors ,MIDDLE age ,OLD age - Abstract
Introduction: Recent studies highlight the negative impact of social isolation and involvement in leisure activities on enhanced well‐being of individuals. However, there is dearth of evidence on relationship between social isolation and leisure activities on cognitive abilities and depression of older adults in the Indian context. The paper reports the impact of social isolation and leisure activities on cognitive functioning and depression of older adults. Methods: Data were collected from the Longitudinal Ageing Study of India (LASI), and 63,806 participants aged 45 years or above were considered for the study with adherence to the exclusion criteria. Multivariate analysis was carried out to analyse the group‐based differences. Results: Social isolation (F = 102.09, p < 0.01; η2 = 0.09) and leisure (F = 224.54, p < 0.01; η2 = 0.07) had a statistically significant impact on the cognition and depressive symptoms of participants. Socially isolated older adults with little involvement in leisure activities had the worst cognitive functioning (M = 32.76, SD = 4.41), whereas middle‐aged adults who were actively involved in leisure activities and experienced the least social isolation exhibited the best cognitive functioning (M = 32.76, SD = 4.41). However, leisure and age as independent factors did not have a significant impact on depression. Conclusion: Socially isolated participants, irrespective of age, and involvement in leisure activities exhibit poor cognitive functioning and are more likely to suffer from depression as compared to their counterparts. The findings of the study can be used to design intervention strategies aimed at reducing social isolation by incorporating leisure activities to ensure the optimal functioning of middle‐aged and older adults. Key points: Socially isolated older adults with least involvement in leisure activities reported the worst cognitive functioning.Socially isolated participants reported a positive association with depressive symptomatology.Both middle‐aged and older adults who engaged in leisure activities reported better cognitive functioning as compared to their counterparts who did not engage in any form of leisure activities.Leisure as an independent factor is not significantly associated with depressive symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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40. Individual and group psychotherapy with people diagnosed with dementia: a systematic review of the literature.
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Cheston, Richard and Ivanecka, Ada
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TREATMENT of dementia ,DIAGNOSIS of dementia ,ALZHEIMER'S disease treatment ,ALZHEIMER'S disease diagnosis ,GROUP psychotherapy - Abstract
Objectives: Psychotherapy provides a means of helping participants to resolve emotional threats and play an active role in their lives. Consequently, psychotherapy is increasingly used within dementia care. This paper reviews the existing evidence base for individual and group psychotherapy with people affected by dementia.Design: The protocol was registered. We searched electronic databases, relevant websites and reference lists for records of psychotherapy with people affected by Alzheimer's Disease, Vascular dementia, Lewy-body dementia or a mixed condition between 1997 and 2015. We included studies of therapies which met British Association of Counselling and Psychotherapy definitions (e.g. occurs regularly, focuses on talking about life events and facilitates understand of the illness). Art therapy, Cognitive Stimulation and Rehabilitation, Life Review, Reminiscence Therapy and family therapy were excluded. Studies which included people with frontal-temporal dementia and mild cognitive impairment were excluded. Data was extracted using a bespoke form, and risk of bias assessments were carried out independently by both authors. Meta-analysis was not possible because of the heterogeneity of data.Results: A total of 1397 papers were screened with 26 papers using randomised, non-randomised controlled trials or repeated measured designs being included. A broad mix of therapeutic modalities, types, lengths and settings were described, focussing largely on people with mild levels of cognitive impairment living in the community.Conclusions: This study was limited to only those studies published in English. The strongest evidence supported the use of short-term group therapy after diagnosis and an intensive, multi-faceted intervention for Nursing Home residents. Many areas of psychotherapy need further research. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2017
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41. Aspects of Ageism, a discussion paper (Book).
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Pitt, Brice
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- *
AGING , *NONFICTION - Abstract
Reviews the book "Aspects of Ageism, a Discussion Paper," by Alison Norman.
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- 1988
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42. Publications on dementia in Medline 1974-2009: a quantitative bibliometric study.
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Theander, Sten S. and Gustafson, Lars
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DEMENTIA research ,BIBLIOMETRICS ,MEDLINE ,GERIATRIC psychiatry ,PERIODICALS - Abstract
Object The aim is to describe the development of the scientific literature on dementia. Methods We present a quantitative, bibliometric study of the literature on dementia, based on Medline, covering 36 years (1974-2009). Two samples of references to dementia papers were retrieved: The main sample based on the MeSH term Dementia holds more than 88 500 references. We have compared the annual additions of references on dementia with the addition to total Medline. Changes of 'the Dementia to Medline ratio' (%) give the best information on the development. Results Publications on dementia increased 5.6 times faster than Medline. Most of this relative acceleration took place during 1980-1997, when the references on dementia increased from 0.17 to 0.78%. During the recent 12 years, the publications on dementia have been keeping pace with Medline and have stabilized around 0.8%. Conclusions We have shown a large increase of the literature on dementia, relative both to the development of all medical research and to all psychiatric research. The bibliometric approach may be questioned as quantitative methods treat articles as being of equal value, what is not true. If, for example, during a certain period, the research output is 'inflated' by a great number of repetitive papers, the quantitative method will give an unfair picture of the development. Our relative method, however, will give relevant results as, at each point of time, the proportion of 'valuable research' ought to be about the same in the dementia group as in total Medline. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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43. Biweekly fluctuations of neuropsychiatric symptoms according to the Neuropsychiatric Inventory: Erratic symptoms or scores?
- Author
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Eikelboom, Willem S., den Teuling, Amy, Pol, Daphne E., Coesmans, Michiel, Franzen, Sanne, Jiskoot, Lize C., van Hemmen, Judy, Singleton, Ellen H., Ossenkoppele, Rik, de Jong, Frank Jan, van den Berg, Esther, and Papma, Janne M.
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DIAGNOSIS of dementia ,ALZHEIMER'S disease ,NEUROPSYCHOLOGICAL tests ,DEMENTIA ,PSYCHOLOGY of caregivers ,RESEARCH funding - Abstract
Objectives: This study investigates the stability of neuropsychiatric symptoms (NPS) assessed biweekly using the Neuropsychiatric Inventory (NPI) in a memory clinic population during a 6 week period.Methods: Twenty-three spousal caregivers (mean [SD] age = 69.7 [8.8], 82.6% female) of 23 patients (43.5% had dementia) completed all assessments. The NPI was assessed four times during 6 weeks. We examined whether NPI domains were present during all four assessments, studied within-person variation for each NPI domain, and calculated Spearman's correlations between subsequent time-points. Furthermore, we associated repeated NPI assessments with repeated measures of caregiver burden to examine the clinical impact of changes in NPI scores over time.Results: The course of NPS was highly irregular according to the NPI, with only 35.8% of the NPI domains that were present at baseline persisted during all 6 weeks. We observed large within-person variation in the presence of individual NPI domains (61.3%, range 37.5%-83.9%) and inconsistent correlations between NPI assessments (e.g., range rs = 0.20-0.57 for agitation, range rs = 0.29-0.59 for anxiety). Higher NPI total scores were related to higher caregiver burden (rs = 0.60, p < 0.001), but changes in NPI total scores were unrelated to changes in caregiver burden (rs = 0.16, p = 0.20).Conclusions: We observed strong fluctuations in NPI scores within very short time windows raising the question whether this represents erratic symptoms and/or scores. Further studies are needed to investigate the origins of these fluctuations. [ABSTRACT FROM AUTHOR]- Published
- 2022
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44. Key Papers in Geriatric Psychiatry: Natural History of Mental Disorder in Old Age.
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Roth, Martin
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LETTERS to the editor ,MENTAL health of older people - Abstract
Presents a letter to the editor about mental disorder in old age.
- Published
- 1996
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45. Observations on the brains of demented old people. B.E. Tomlinson, G. Blessed and M. Roth, Journal of the Neurological Sciences (1970) 11 , 205–242; (1968) 7 , 331–356.
- Author
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Burns, Alistair, Tomlinson, Bernard, and Mann, D. M. A.
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DEMENTIA ,BRAIN diseases ,GENDER differences (Psychology) ,GERIATRIC psychiatry ,NEUROBEHAVIORAL disorders - Abstract
This is a series in which key papers in old age psychiatry are presented with an introduction, commentary by the original author and current update by someone working in the field. A full introduction is given in volume 10, no 10. These papers are a milestone in the psychiatry of old age and in the link between pathological brain changes and clinical features of dementia during life. These two companion papers represent the pathological descriptions of the patients concerned. The summaries of the two papers, together with the associated commentaries by Professor Tomlinson and Dr Mann, underscore the immortality of the work. [ABSTRACT FROM AUTHOR]
- Published
- 1997
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46. The geriatric mental state schedule administered with the aid of a microcomputer: A pilot study.
- Author
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Jones, Jeffrey Royle and McWilliam, Christopher
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COMPUTERS ,PSYCHIATRY ,GERIATRICS ,BEHAVIORAL medicine ,CYBERNETICS - Abstract
A version of the Geriatric Mental State Schedule developed for the microcomputer is described and compared to the usual paper version of the questionnaire. The advantages and disadvantages of the two techniques are discussed. A feasibility study of the microcomputer-administered questionnaire is described. A shortened version of the Geriatric Mental State Schedule (version A) is administered to a number of geriatric patients attending psychogeriatric day hospitals. The study compares the microcomputer-administered with the pencil-and-paper questionnaire. Two raters administer the questionnaire using the two techniques to a group of patients and the reliability is evaluated by comparing the correlation coefficients for the scores obtained on the questionnaire, as well as by evaluating Cohen's kappa statistic. The correlation results show that there is significant positive correlation between the paper and the microcomputer-administered questionnaire. However, the kappa values comparing diagnoses obtained with the AGECAT program are not high and reasons for this are discussed. Further developments of the system, including an authoring program (QUESTLAN) for such questionnaires and the use of portable microcomputers in the community, are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 1989
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47. Predictors of long-term care placement in persons with dementia: a systematic review and meta-analysis.
- Author
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Cepoiu‐Martin, Monica, Tam‐Tham, Helen, Patten, Scott, Maxwell, Colleen J., and Hogan, David B.
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HEALTH status indicators ,LONG-term care facilities ,TREATMENT of dementia ,SYSTEMATIC reviews ,META-analysis - Abstract
Objective: The main objective of this study was to summarize the effects of various individual, caregiver, and system-related factors on the risk of long-term care (LTC) placement for persons with dementia.Methods: We searched electronic databases for longitudinal studies reporting on predictors of LTC placement for persons with dementia residing in the community or supportive care settings. We performed meta-analyses with hazard ratios (HRs) of various predictors using random effects models and stratified the HRs with several study variables. Data on predictors not included in the meta-analyses were summarized descriptively.Results: Full-text reviews of 360 papers were performed with data from 37 papers used to calculate pooled HRs for LTC placement of select person with dementia (age, sex, race, marital status, type of dementia, living arrangement, and relationship to caregiver) and caregiver (age, sex, and depressive symptoms) characteristics. White race [HR = 1.67, 95% confidence intervals (CI): 1.41-1.99], greater dementia severity (HR = 1.05, 95% CI: 1.03-1.06), and older age (HR = 1.02, 95% CI: 1.01-1.03) increased the risk of LTC placement. Married persons with dementia (HR = 0.38, 95% CI: 0.16-0.86) and living with their caregiver (HR = 0.72, 95% CI: 0.56-0.92) had a lower risk. Behavioral and psychological symptoms of dementia, the degree of functional impairment, and caregiver burden had a consistent effect on the risk of LTC placement in our descriptive review.Conclusion: We quantified the predictive effect of several risk factors for LTC placement. These estimates could be used to more precisely categorize the risk of institutionalization and potentially link those at higher risk to appropriate services. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2016
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48. Trust and inclusion during the Covid‐19 pandemic: Perspectives from Black and South Asian people living with dementia and their carers in the UK.
- Author
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Armstrong, Megan, Aker, Narin, Nair, Pushpa, Walters, Kate, Barrado‐Martin, Yolanda, Kupeli, Nuriye, Sampson, Elizabeth L., Manthorpe, Jill, West, Emily, and Davies, Nathan
- Subjects
SOUTH Asians ,COVID-19 pandemic ,DEMENTIA ,MEDICAL personnel ,POLITICAL trust (in government) - Abstract
Introduction: People from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their White counterparts in the United Kingdom (UK). Covid‐19 has exacerbated health inequalities and diminished trust from underserved communities in the government and health services. The wider aim of the study was to explore the impact of covid‐19 on Black and South‐Asian people living with dementia and their carers as well as exploring the experiences of dementia care. The present paper specifically explores their views on trust and mistrust using an ecological model. Method: Semi‐structured interviews were conducted with 11 family carers and four people living with dementia from South Asian or Black communities living in the community. Thematic analysis was used to analyse data. Design: An exploratory qualiative design was used. Results: Four main themes were developed exploring trust at the structural, organisational, community and individual level. At the structural level, participants discussed the inequity of Covid‐19, some lack of trust in the UK Government and confusion in its messaging, and the anxiety sometimes leading to curtailment of media usage. At the organisational level, there was some evidence of a perceived lack of person‐centred and culturally sensitive care from healthcare professionals, as well as concerns around care homes as places of safety. At the neighbourhood community level, participants discussed both a distrust as well as a strengthening of relationships and, at the individual level, factors such as knowledge of services, identity, and faith influenced their experience of the pandemic. Conclusions: People living with dementia need support at all levels and this study highlights how the pandemic impacted each level. Ways to improve trust in the Government and health professionals alongside culturally adapted health messaging should be explored. Alongside this, an examination of how cultural values and norms may influence help‐seeking responses to dementia and increase trust in services may be helpful post‐pandemic. Key points: The pandemic impacted people from ethnic minority backgrounds living with dementia and their carers at each level of the socioecological modelA lack of trust in the Government and an increase in anxiety due to the media was reportedThere was a perceived lack of person‐centred and culturally sensitive care from healthcare professionals and concerns around care homes as places of safetyParticipants relationships with their community, knowledge of services, identity, and faith influenced their experience of the pandemic [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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49. What are the current and projected future cost and health‐related quality of life implications of scaling up cognitive stimulation therapy?
- Author
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Knapp, Martin, Bauer, Annette, Wittenberg, Raphael, Comas‐Herrera, Adelina, Cyhlarova, Eva, Hu, Bo, Jagger, Carol, Kingston, Andrew, Patel, Anita, Spector, Aimee, Wessel, Audrey, and Wong, Gloria
- Subjects
QUALITY of life ,COGNITIVE therapy ,SERVICES for caregivers ,QUALITY-adjusted life years ,MEDICAL care costs ,MEDICAL care ,HEALTH services accessibility - Abstract
Objectives: Cognitive stimulation therapy (CST) is one of the few non‐pharmacological interventions for people living with dementia shown to be effective and cost‐effective. What are the current and future cost and health‐related quality of life implications of scaling‐up CST to eligible new cases of dementia in England? Methods/design: Data from trials were combined with microsimulation and macrosimulation modelling to project future prevalence, needs and costs. Health and social costs, unpaid care costs and quality‐adjusted life years (QALYs) were compared with and without scaling‐up of CST and follow‐on maintenance CST (MCST). Results: Scaling‐up group CST requires year‐on‐year increases in expenditure (mainly on staff), but these would be partially offset by reductions in health and care costs. Unpaid care costs would increase. Scaling‐up MCST would also require additional expenditure, but without generating savings elsewhere. There would be improvements in general cognitive functioning and health‐related quality of life, summarised in terms of QALY gains. Cost per QALY for CST alone would increase from £12,596 in 2015 to £19,573 by 2040, which is below the threshold for cost‐effectiveness used by the National Institute for Health and Care Excellence (NICE). Cost per QALY for CST and MCST combined would grow from £19,883 in 2015 to £30,906 by 2040, making it less likely to be recommended by NICE on cost‐effectiveness grounds. Conclusions: Scaling‐up CST England for people with incident dementia can improve lives in an affordable, cost‐effective manner. Adding MCST also improves health‐related quality of life, but the economic evidence is less compelling. Key points: There are few evidence‐based non‐pharmacological interventions for people living with dementia. Cognitive stimulation therapy (CST) is both effective and cost‐effective, but current availability is constrainedThis paper reports the cost and health‐related quality of life implications of scaling‐up cognitive stimulation therapy to eligible people with dementia in England over a 25 year periodScaling‐up CST would improve general cognitive functioning and health‐related quality of life, but also increase costs for health and social care services, and for family and other unpaid carers. Adding maintenance CST would also improve health‐related quality of life, with even greater cost increasesThe higher costs of scaling‐up CST to the full eligible population over a 25 year period would be considered worth paying by reference to criteria used by the National Institute for Health and Care Excellence (NICE) in England. The economic evidence for adding maintenance CST is less compelling [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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50. Cognitive screening instruments to identify vascular cognitive impairment: A systematic review.
- Author
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Ghafar, Mohd Zaquan Arif Abd, Miptah, Hayatul Nawwar, and O'Caoimh, Rónán
- Subjects
VASCULAR dementia ,COGNITION disorders diagnosis ,COGNITIVE testing ,NEUROPSYCHOLOGICAL tests ,MILD cognitive impairment ,MEMORY testing ,DISEASE complications - Abstract
Introduction: Vascular cognitive impairment (VCI) is common and important to detect as controlling risk factors, particularly hypertension, may slow onset and progression. There is no consensus as to which cognitive screening instrument (CSI) is most suitable for VCI. We systematically reviewed the psychometric properties of brief CSIs for vascular mild cognitive impairment (VMCI) and vascular dementia (VaD).Methods: Literature searches were performed using scholarly databases from inception until 31 May 2018. Studies were eligible if participants were aged 18 or older, interviewed face-to-face, and standard diagnostic criteria for VCI were applied, excluding those specifically identifying post-stroke dementia. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool.Results: Fifteen studies were identified including eight types of CSIs (27 subtests/variants) and 4575 participants (1015 with VCI), mean age range: 51.6 to 75.5 years. Most studies compared more than one instrument. Five papers examined clock-drawing; four, the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE); and three used the Brief Memory and Executive Test (BMET). The MoCA (AUC > 0.90) and MMSE (AUC: 0.86-0.99) had excellent accuracy in differentiating VaD from controls; the MoCA had good internal consistency (Cronbach's α: .83-.88). The MoCA (AUC: 0.87-0.93) and BMET (AUC: 0.94) had the greatest accuracy in separating VMCI from controls. Most studies had low to moderate risk of bias in all domains of the QUIPS. Data were heterogeneous, precluding a meta-analysis.Conclusions: Although few studies were available and further research is required, data suggests that the MoCA is accurate and reliable for differentiating VaD and VMCI from controls. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
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