Factors associated with antidepressant use in depressed and non-depressed community-dwelling elderly: the three-city study

IntroductionThe proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.SettingThree hospitals in NSW, Australia.ParticipantsCommunity-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes complications or angina pectoris. Data were collected from patients, their general practitioners (GPs) and hospital records.Outcome measuresAssessments of the preventability of each admission by an Expert Panel.Results323 admissions were assessed for preventability: 46% (148/323) were assessed as preventable, 30% (98/323) as not preventable and 24% (77/323) as unclassifiable. Statistically significant differences in proportions preventable were found between the three study sites (29%; 47%; 58%; p≤0.001) and by primary discharge diagnosis (p≤0.001).Significant predictors of an admission being classified as preventable were: study site; final principal diagnosis of CHF; fewer diagnoses on discharge; shorter hospital stay; GP diagnosis of COPD; GP consultation in the last 12 months; not having had a doctor help make the decision to go to hospital; not arriving by ambulance; patient living alone; having someone help with medications and requiring help with daily tasks.ConclusionsThat less than half the chronic PPH were assessed as preventable, and the range of factors associated with preventability, including site and discharge diagnosis, are important considerations in the validity of PPH as an indicator. Opportunities for interventions to reduce chronic PPH include targeting patients with CHF and COPD, and the provision of social welfare and support services for patients living alone and those requiring help with daily tasks and medication management.

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Factors associated to functioning and health in relation to home rehabilitation in Sweden: a non-randomized pre-post intervention study

BMC Geriatrics ◽

10.1186/s12877-021-02360-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anette Johansson ◽

Marie Ernsth Bravell ◽

Eleonor I. Fransson ◽

Sofi Fristedt

Keyword(s):

Repeated Measures ◽

Linear Models ◽

Medical Condition ◽

Rehabilitation Program ◽

Community Dwelling ◽

Rehabilitation Service ◽

Post Intervention ◽

Factors Associated ◽

Rehabilitation Outcomes ◽

Self Rated Health

Abstract Background Home rehabilitation is a growing rehabilitation service in many countries, but scientific knowledge of its components and outcomes is still limited. The aim of this study was to investigate; 1) which changes in functioning and self-rated health could be identified in relation to a home rehabilitation program in a population of community-dwelling citizens, and 2) how socio-demographic factors, health conditions and home rehabilitation interventions were associated to change in functioning and self-rated health after the home rehabilitation program. Method The sample consisted of participants in a municipal home rehabilitation project in Sweden and consisted of 165 community-dwelling citizens. General Linear Models (ANOVA repeated measures) was used for identifying changes in rehabilitation outcomes. Logistic regressions analysis was used to investigate associations between rehabilitation outcomes and potential factors associated to outcome. Result Overall improvements in functioning and self-rated health were found after the home rehabilitation program. Higher frequencies of training sessions with occupational therapists, length of home rehabilitation, and orthopaedic conditions of upper extremities and spine as the main health condition, were associated with rehabilitation outcomes. Conclusion The result indicates that the duration of home rehabilitation interventions and intensity of occupational therapy, as well as the main medical condition may have an impact on the outcomes of home rehabilitation and needs to be considered when planning such programs. However, more research is needed to guide practice and policymaking.

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Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2380 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 683-683

Author(s):

Asa Inagaki ◽

Ayumi Igarashi ◽

Maiko Noguchi-Watanabe ◽

Mariko Sakka ◽

Chie Fukui ◽

...

Keyword(s):

Older Adults ◽

Online Survey ◽

Physical Restraint ◽

Community Dwelling ◽

Physical Restraints ◽

Care Nurse ◽

Factors Associated ◽

Home Care Nurse ◽

Community Dwelling Older Adults ◽

At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

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Abstract P32: Potential Underuse of Antidepressants in Post Stroke Depression: Data From the AVAIL Registry

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_1.ap32 ◽

2011 ◽

Vol 4 (suppl_1) ◽

Author(s):

Nada El Husseini ◽

Daniel T Laskowitz ◽

Amanda C Guidon ◽

DaiWai M Olson ◽

Xin Zhao ◽

...

Keyword(s):

Ischemic Stroke ◽

Cognitive Status ◽

Stroke Recurrence ◽

Stroke Patients ◽

Living Situation ◽

Factors Associated ◽

Post Stroke ◽

Depression Status ◽

Post Stroke Depression ◽

Antidepressant Use

Background: Post-stroke depression is common, yet little is known about factors associated with antidepressant use in this population Methods: Data from the multicenter, prospective Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) registry was used to identify patients with post-stroke depression and to describe factors associated with antidepressant use. The analysis was performed after 3 months in 1751 ischemic stroke patients who had been admitted to 97 hospitals nationwide; 12 month follow-up was available for 1637 patients. The Get with the Guidelines-Stroke database was used to collect baseline data. Patients were classified as depressed based on a self-report scale (the Patient Health Questionnaire-8; score range 0 to 24, score ≥10 indicating depression). Frequencies were compared with Pearson X 2 and unadjusted ORs were calculated. Results: The prevalence of post stroke depression was similar at 3 and 12 months (19% [331/1751] vs 17% [280/1637], respectively, p=0.17). Regardless of depression status, antidepressant use was higher at 12 months (16% [287/1751] vs 20% [334/1637], p=0.002). Antidepressant use was also higher at 12 months in depressed patients (25% [84/331] vs 35% [98/280], p=0.009). The odds of antidepressant use at 3 months was higher in women than men (OR 1.6, 95% CI 1.2-2.1), Whites vs. Blacks (OR 1.7, 95% CI 1.1-2.8), in patients with vs. without cognitive deficits (OR 1.6, 95% CI 1.2-2.1) and in those with more severe disabilities (mRS≥3 vs. mRS<3, OR 1.7, 95% CI 1.3-2.3). Use did not vary with educational level, marital status, living situation, medication insurance coverage, or stroke recurrence. Similar trends were present at 12 months, except with higher use in those with recurrent stroke or TIA (OR 2.1, 95% CI 1.4-3.1). Conclusion: Three-quarters of depressed stroke patients at 3-months and nearly two-thirds at 12 months were not receiving antidepressants. Regardless of depression status, utilization of antidepressants after 3 and 12 months varied based on gender, race/ethnicity, cognitive status, disability level, and after 12-months, stroke recurrence. The reasons for the apparent underuse of antidepressants in patients with prevalent post-stroke depression require further study.

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Factors Associated with the Caregivers’ Desire to Institutionalize Persons with Dementia: A Cross-Sectional Study

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000494023 ◽

2018 ◽

Vol 46 (5-6) ◽

pp. 298-309 ◽

Cited By ~ 6

Author(s):

Sophie Vandepitte ◽

Koen Putman ◽

Nele Van Den Noortgate ◽

Sofie Verhaeghe ◽

Eric Mormont ◽

...

Keyword(s):

Behavioral Problems ◽

The Elderly ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Respite Care ◽

Community Dwelling ◽

Cross Sectional ◽

Factors Associated ◽

Care Services ◽

Modifiable Factors

Background/Aims: Dementia is one of the main reasons for institutionalization among the elderly. Few studies have explored factors associated with the caregivers’ (CG) desire to institutionalize (DTI) a person with dementia (PWD). The objective of this study is to identify modifiable and non-modifiable psychosocial and sociodemographic factors associated with a caregiver’s DTI. Methods: Cross-sectional data of 355 informal CG of community-dwelling PWD were analyzed. Several characteristics were identified in CG and PWD to be included in a multivariable regression model based on the purposeful selection method. Results: Positively modifiable associated factors were: higher CG burden, being affected by behavioral problems, and respite care use. Positively associated non-modifiable factors were: CG older age, being professionally active, and CG higher educational level. Cohabitation and change of professional situation were negatively associated. Conclusion: Although no causality can be assumed, several practical recommendations can be suggested. First of all, these results reconfirm the importance of multicomponent strategies, especially support aimed at decreasing burden and in learning coping strategies. Also, CG might benefit from information about support options, such as respite care services. Finally, special attention should be given to older and working CG. In the latter, flexible and adaptive working conditions might alleviate burden and therefore reduce the DTI of the PWD.

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Factors associated with potentially inappropriate drug utilization in a sample of rural community-dwelling older adults

The American Journal of Geriatric Pharmacotherapy ◽

10.1016/s1543-5946(05)80023-6 ◽

2005 ◽

Vol 3 (3) ◽

pp. 168-179 ◽

Cited By ~ 33

Author(s):

Susan J. Blalock ◽

John E. Byrd ◽

Richard A. Hansen ◽

Thespina J. Yamanis ◽

Katherine McMullin ◽

...

Keyword(s):

Older Adults ◽

Drug Utilization ◽

Rural Community ◽

Community Dwelling ◽

Inappropriate Drug ◽

Factors Associated ◽

Community Dwelling Older Adults

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Associations Between Potentially Modifiable and Nonmodifiable Risk Factors and Gait Speed in Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging

The Journals of Gerontology Series A ◽

10.1093/gerona/glab008 ◽

2021 ◽

Author(s):

Erica Figgins ◽

Yun-Hee Choi ◽

Mark Speechley ◽

Manuel Montero-Odasso

Keyword(s):

Risk Factors ◽

Longitudinal Study ◽

Gait Speed ◽

Chronic Conditions ◽

Serum Vitamin ◽

Lifestyle Factors ◽

Community Dwelling ◽

Life Course Perspective ◽

Factors Associated ◽

Modifiable Factors

Abstract Background Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and nonmodifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults. Methods We examined cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort. The study sample included 20 201 community-dwelling adults aged 45–85 years. The associations between sociodemographic and anthropometric factors, chronic conditions, and cognitive, clinical, and lifestyle factors and 4-m usual gait speed (m/s) were estimated using hierarchical multivariable linear regression. Results The coefficient of determination, R 2, of the final regression model was 19.7%, with 12.9% of gait speed variability explained by sociodemographic and anthropometric factors, and nonmodifiable chronic conditions and 6.8% explained by potentially modifiable chronic conditions, cognitive, clinical, and lifestyle factors. Potentially modifiable factors significantly associated with gait speed include cardiovascular conditions (unstandardized regression coefficient, B = −0.018; p < .001), stroke (B = −0.025; p = .003), hypertension (B = −0.007; p = .026), serum Vitamin D (B = 0.004; p < .001), C-reactive protein (B = −0.005; p = .005), depressive symptoms (B = −0.003; p < .001), physical activity (B = 0.0001; p < .001), grip strength (B = 0.003; p < .001), current smoking (B = −0.026; p < .001), severe obesity (B = −0.086; p < .001), and chronic pain (B = −0.008; p = .018). Conclusions The correlates of gait speed in adulthood are multifactorial, with many being potentially modifiable through interventions and education. Our results provide a life-course-perspective framework for future longitudinal assessments risk factors affecting gait speed.

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