Aging & Mental Health

Sullivan, K.; O'Conor, F.

doi: 10.1080/13607860020020582pmid: 11513014

Improving carers' knowledge of Alzheimer's disease (AD) has been associated with benefits for carer well-being. This has led to recognition of the need to systematically evaluate dementia education tools. In this study dementia knowledge was measured before and after interventions designed to improve knowledge in a sample of 100 undergraduate students. Dementia education materials were selected from existing resources that are readily accessible and are recommended for use in clinical settings. Subjects were allocated to one of four conditions, including a control group. Subjects allocated to education conditions were asked to view a video on AD, read written information about the disease or do both. Results showed that education improved knowledge of AD, as measured by increased scores on a dementia knowledge questionnaire. This study has important implications for public education about dementia and resource allocation for service providers.

Netten, A.; Darton, R.; Bebbington, A.; Forder, J.; Brown, P.; Mummery, K.

doi: 10.1080/13607860020020591pmid: 11513008

Cognitive impairment among residents has considerable resource implications for both individuals and those responsible for publicly funded care. Two linked surveys were carried out in England: (1) a longitudinal study followed 2500 admissions to publicly funded care up to 42 months after admission; and (2) a cross-sectional survey of 618 homes collected information about 11,900 residents. Information was collected about cognitive impairment using the Minimum Data Set Cognitive Performance Scale. Cognitive impairment was associated with source of funding and type of home. Although level of cognitive impairment has some effect, fees and costs were most influenced by type of home. At the same level of impairment, self-funded residents were more likely to be located in relatively low-cost settings than publicly funded residents. In independent homes fees were lower for publicly funded than for self-funded residents. Overall median length of stay of publicly funded admissions was 18 months. For the most part length of stay was not associated with level of cognitive impairment on admission. It is concluded that more information is needed about the effect of quality of care on people with cognitive impairment in different settings. If the same quality of care can be achieved in residential and nursing homes, the evidence would suggest that changes in placement policies could result in potential savings to the public purse.

Chou, Kee-Lee; Chi, Iris

doi: 10.1080/13607860020020609pmid: 11513009

For many Hong Kong Chinese elderly, depression and financial strain are quite a common occurrence. This study examines the mediating and moderating effect of sense of control in the relationship between financial strain and depressive symptoms. The data came from a survey of a representative community sample of 411 elderly respondents in Hong Kong. Using multiple regression models, the authors found that generalized sense of control mediated and moderated the linkage between financial strain and depressive symptoms even after controlling socio-demographic variables but sense of control over finances did not. Findings suggest that generalized sense of control should be enhanced to protect older people under chronic financial strain from depression.

Jang, Y.; Small, B. J.; Haley, W. E.

doi: 10.1080/13607860020020618pmid: 11513010

It is becoming increasingly clear that, in order to better understand the implications of global aging, more cross-cultural research is needed. In the present study, the structure and validity of the Geriatric Depression Scale-Short Form (GDS-SF) was examined in Korean and US samples of older adults. The participants included 153 older adults living in Korea (mean age=65.9 years) and 459 older adults from Florida (mean age=72.4 years). All participants completed the original or translated versions of the GDS-SF, as well as additional demographic and health-related measures. The results indicated that the GDS-SF exhibited good reliability in both samples. However, the results of a principal components analysis indicated that the structure was not well replicated across the two samples. In general, the present study suggests that, despite great efforts to make the questionnaires equivalent in the two cultures, the concept of depression for older adults may vary greatly in Korea and the USA. Possible explanations for cross-cultural differences are discussed, as well as implications.

Hokoishi, K.; Ikeda, M.; Maki, N.; Nomura, M.; Torikawa, S.; Fujimoto, N.; Fukuhara, R.; Komori, K.; Tanabe, H.

doi: 10.1080/13607860020020627pmid: 11513011

This study was performed to assess interrater reliability of the Japanese version of the Physical Self-Maintenance Scale (PSMS) and the Instrumental Activities of Daily Living Scale (IADL), which are simple and efficient assessment instruments of functional abilities in elderly patients. The subjects were 25 consecutive patients with Alzheimer's disease who were outpatients of the Department of Neuropsychiatry in Ehime University School of Medicine and their principal caregivers. One neuropsychiatrist administered the PSMS and IADL, and all sessions were videotaped. Then one clinical psychologist, one public health nurse and one neurologist, and one occupational therapist from another institution, viewed the videotape and performed reassessments. All interrater reliabilities between the neuropsychiatrist and the neurologist, the public health nurse, the clinical psychologist and the occupational therapist were extremely good. Interrater reliability between the public health nurse and the clinical psychologist, between the clinical psychologist and the neurologist and between the public health nurse and the neurologist was also extremely good. The PSMS and IADL showed good interrater reliability between personnel from different disciplines. They are likely to be useful tests for everyday medical consultations and for field research.

Hewitt, P. L.; Coren, S.; Steel, G. D.

doi: 10.1080/13607860020020636pmid: 11513012

The purpose of this study was to assess characteristics of individuals who died from anorexia nervosa by assessing the frequency with which anorexia nervosa is listed as a causal factor related to the death of individuals in the USA. Data from over 10 million death records (all National Center for Health Statistic registered deaths in the USA for 1986-90) were examined for mention of anorexia nervosa as a primary or contributing cause of death. Only 724 were found, which equals an average of 145 annual deaths, and a rate of 6.73 per 100,000 deaths. The age and sex distribution suggests two fatal forms of anorexia nervosa, an early-onset form comprising 89% women and a later form comprising 24% men. The findings suggest that the mortality risk from current anorexia nervosa may be lower than formerly supposed and that it is not confined to young adults and adolescents.

Schmitt, M.; Jüchtern, J.-C.

doi: 10.1080/13607860020020645pmid: 11513013

Subjective well-being (SWB) is at the centre of much ageing research due to its relationship to such important outcomes as health, morbidity and successful ageing. This paper discusses essential problems associated with its definition, measurement and dimensionality. Exploratory and confirmatory factor analyses were computed for data from the Interdisciplinary Longitudinal Study of Adult Development in order to assess whether SWB is a unidimensional or a multidimensional construct. The results suggest that SWB is unidimensional.

Reay, A. M. Campbell; Browne, K. D.

doi: 10.1080/13607860020020654pmid: 11513015

This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer.

Pritchard, E. J.; Dewing, J.

doi: 10.1080/13607860020020663pmid: 11513016

Changes to approaches in dementia care and subsequent services over the last decade have meant that quality of care for people with dementia and their carers has undoubtedly improved. However, few in-depth dementia service evaluation studies are documented. Those that are tend to focus on traditional evaluation measures such as length of stay or functional improvement, or they concentrate on the perspectives of carers. This study used multiple methods within Fourth Generation Methodology to evaluate (SPECAL) Specialized Early Care of Alzheimer's, a dementia care service and approach. The findings demonstrated that, within its approach, there was high quality of care offered by SPECAL to people with dementia and their carers. The evaluation also highlighted some of the difficulties facing SPECAL in its relationships with existing professional providers of mental health care for older people that have implications for other service providers. Recommendations from the evaluation were adopted as an agenda for future developmental work. This study has provoked broader questions for multi-disciplinary and multi-agency teams about quality of services for older people with dementia, and about relationships between the voluntary and statutory sectors.

Satre, D. D.; Knight, B. G.

doi: 10.1080/13607860020020672pmid: 11513017

Previous studies have demonstrated a correlation between expectancies that adolescents and young adults hold about the effects of alcohol and the amount of alcohol they consume. This study examined age and sex differences in expectancies and alcohol consumption in a sample of 92 older and 83 younger adults. The two groups were administered self-report questionnaires for quantity and frequency of alcohol consumption, and for positive and negative expectancies regarding the effects of alcohol. Results found lower quantities of alcohol consumption per occasion in older adults, but higher frequency of drinking occasions. Older adults reported significantly lower levels of both positive and negative expectancies when compared with the younger sample. Among older women, regression analyses found a significant relationship between negative expectancies and lower alcohol consumption. For older men, positive expectancies showed a positive relationship to consumption, while negative expectancies showed a negative relationship to consumption. For younger women, positive expectancies were related to increased consumption. These findings suggest different strategies based on age and sex in treatment models, which identify expectancies as important components of drinking behavior.