A neuropsychological group rehabilitation program with institutionalized elderly

2016 ◽  
Vol 33 (S1) ◽  
pp. s235-s235
Author(s):  
L. Lemos ◽  
H. Espírito-Santo ◽  
S. Simões ◽  
F. Silva ◽  
J. Galhardo ◽  
...  

IntroductionElderly institutionalization involves an emotional adaptation and the research shows that the risk of depression increases.ObjectivesEvaluate the impact of a neuropsychological group rehabilitation program (NGRP) on depressive symptomatology of institutionalized elderly.AimsNGRP influences the decrease of depressive symptoms.MethodsElderly were assessed pre- and post-intervention with the Geriatric Depression Scale (GDS) and divided into a Rehabilitated Group (RG), a Waiting List Group (WLG), and a Neutral Task Group (NTG).ResultsIn this randomized study, before rehabilitation, 60 elderly people (RG; 80.31 ± 8.98 years of age; 74.2% women) had a mean GDS score of 13.33 (SD = 9.21). Five elderly included in the NTG (80.13 ± 10.84 years; 75.0% women) had a mean GDS score of 10.60 (SD = 4.72). Finally, 29 elderly in the WLG (81.32 ± 6.68 years; 69.0% women) had a mean GDS score of 14.93 (SD = 6.02). The groups were not different in GDS baseline scores (F = 0.74; P = 0.478). ANCOVA has shown significant differences (P < 0.05) in GDS scores between the three groups after 10 weeks. Sidak adjustment for multiple comparisons revealed that elderly in the WLG got worse scores in GDS, comparing with elderly in RG (P < 0.01), and with elderly in NTG (P < 0.05).ConclusionsElderly that are not involved in a task get worse in depressive symptomatology. Being involved in a structured group task means lower depressive symptoms and being in a NGRP means even greater results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2012 ◽  
Vol 42 (12) ◽  
pp. 2619-2629 ◽  
Author(s):  
E. Scafato ◽  
L. Galluzzo ◽  
S. Ghirini ◽  
C. Gandin ◽  
A. Rossi ◽  
...  

BackgroundDepression is recognized as being associated with increased mortality. However, there has been little previous research on the impact of longitudinal changes in late-life depressive symptoms on mortality, and of their remission in particular.MethodAs part of a prospective, population-based study on a random sample of 5632 subjects aged 65–84 years, with a 10-year follow-up of vital status, depressive symptoms were assessed by the 30-item Italian version of the Geriatric Depression Scale (GDS). The number of participants in the GDS measurements was 3214 at baseline and 2070 at the second survey, 3 years later. Longitudinal changes in depressive symptoms (stable, remitted, worsened) were examined in participants in both evaluations (n=1941). Mortality hazard ratios (MHRs) according to severity of symptoms and their changes over time were obtained by means of Cox proportional hazards regression models, adjusting for age and other potentially confounding factors.ResultsSeverity is significantly associated with excess mortality in both genders. Compared to the stability of depressive symptoms, a worsened condition shows a higher 7-year mortality risk [MHR 1.46, 95% confidence interval (CI) 1.15–1.84], whereas remission reduces by about 40% the risk of mortality in both genders (women MHR 0.55, 95% CI 0.32–0.95; men MHR 0.59, 95% CI 0.37–0.93). Neither sociodemographic nor medical confounders significantly modified these associations.ConclusionsConsistent with previous reports, the severity and persistence of depression are associated with higher mortality risks. Our findings extend the magnitude of the association demonstrating that remission of symptoms is related to a significant reduction in mortality, highlighting the need to enhance case-finding and successful treatment of late-life depression.


2012 ◽  
Vol 25 (2) ◽  
pp. 292-302 ◽  
Author(s):  
Melanie Luppa ◽  
Hans-Helmut König ◽  
Dirk Heider ◽  
Hanna Leicht ◽  
Tom Motzek ◽  
...  

ABSTRACTBackground: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.Methods: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.Results: Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.Conclusions: Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.


2021 ◽  
Vol 20 (4) ◽  
pp. 170-216
Author(s):  
Edison Vitório de Souza Júnior ◽  
Sterline Therrier ◽  
Cristiane dos Santos Silva ◽  
Bianca de Moura Peloso-Carvalho ◽  
Lais Reis Siqueira ◽  
...  

Objetivo: Analizar la asociación entre sexualidad y variables biosociodemográficas y síntomas depresivos en adultos mayores. Método: Se trata de un estudio seccional diseñado con 292 personas mayores. La recolección de datos se realizó entre agosto y octubre de 2020. Se utilizó la Escala de Experiencias Sexuales y Afectivas de Ancianos y la Escala de Depresión Geriátrica. Se utilizaron pruebas de Mann-Whitney, correlación de Spearman y pruebas de Kruskal-Wallis, adoptando un intervalo de confianza del 95% para todos los análisis estadísticos.Resultados: Predominaron los varones (52,1%) y entre 60 y 64 años (46,6%). La prevalencia de síntomas depresivos fue del 30,1% para los casos leves y del 8,6% para los graves. Los ancianos con síntomas depresivos experimentaron peor el acto sexual, las relaciones afectivas y las adversidades físicas y sociales relacionadas con la sexualidad. La única dimensión de la sexualidad que se asoció con las variables biosociodemográficas fue el acto sexual, mostrando que es mejor vivido por los ancianos en unión estable (p = 0.023) y entre quienes conviven con la pareja por un período ≤ 5 años, en comparación con los mayores de 20 años (p = 0,001). Además, solo la dimensión acto sexual se correlacionó negativamente y con magnitud moderada entre los síntomas depresivos graves (ρ = -0,442; p = 0,027), lo que indica que estas dos variables exhiben comportamientos inversamente proporcionales. Conclusión: La sexualidad se asocia con algunas variables biosociodemográficas y se correlaciona con síntomas depresivos severos en ancianos. Objective: To analyze the association of sexuality with the bio-sociodemographic variables and depressive symptomatology in the elderly. Method: This is a sectional study designed with 292 elderly people. Data were collected between August and October 2020. The Elderly Affective and Sexual Experiences Scale and the Geriatric Depression Scale were used. Mann-Whitney, Spearman correlation, and Kruskal-Wallis tests were used, adopting a 95% confidence interval for all statistical analyses.Results: The participants were predominantly male (52.1%) and aged between 60 and 64 years (46.6%). The prevalence of depressive symptoms was 30.1% for mild cases and 8.6% for severe cases. The elderly with depressive symptomatology experienced worse the sexual act, affective relationships, and physical and social adversities related to sexuality. The only dimension of sexuality that was associated with the bio-sociodemographic variables was the "sexual act," proving to be better experienced by the elderly in stable unions (p = 0.023) and among those who live with their partner for a period ≤ 5 years, when compared to those with living together for more than 20 years (p = 0.001). In addition, only the Sexual act dimension correlated negatively and with moderate magnitude with severe depressive symptoms (ρ = -0.442; p = 0.027), indicating that these two variables present inversely proportional behaviors.Conclusion: Sexuality is associated with some bio-sociodemographic variables and correlated with severe depressive symptoms among the elderly. Objetivo: Analisar a associação entre a sexualidade com as variáveis biosociodemográficas e sintomatologia depressiva em idosos. Método: Trata-se de um estudo seccional delineado com 292 idosos. Realizou-se a coleta de dados entre agosto e outubro de 2020. Foi utilizada a Escala de Vivências Afetivas e Sexuais do Idoso e a Escala de Depressão Geriátrica. Utilizou-se os testes de Mann-Whitney, correlação de Spearman e Kruskal-Wallis, adotando intervalo de confiança de 95% para todas as análises estatísticas.Resultados: Predominaram-se os participantes do sexo masculino (52,1%) e com idade entre 60 e 64 anos (46,6%). A prevalência de sintomatologia depressiva foi de 30,1% para os casos leves e 8,6% para os severos. Os idosos com sintomatologias depressivas pior vivenciaram o ato sexual, as relações afetivas e as adversidades física e social relacionadas à sexualidade. A única dimensão da sexualidade que se associou com as variáveis biosociodemográficas foi o ato sexual, demonstrando ser melhor vivenciada pelos idosos em união estável (p=0,023) e entre aqueles que convivem com o parceiro por um período ≤ 5 anos, quando comparados a aqueles com convivência superior a 20 anos (p=0,001). Além disso, somente a dimensão ato sexual se correlacionou de maneira negativa e com moderada magnitude entre os sintomas depressivos severos (ρ= -0,442; p=0,027), indicando que essas duas variáveis apresentam comportamentos inversamente proporcionais.Conclusão: A sexualidade está associada à algumas variáveis biosociodemográficas e correlacionada às sintomatologias depressivas severas entre os idosos.


2021 ◽  
pp. 222-228
Author(s):  
Paulina Morga ◽  
Błażej Cieślik ◽  
Małgorzata Sekułowicz ◽  
Maria Bujnowska-Fedak ◽  
Iris Drower ◽  
...  

The study aims to determine the impact of low-intensity exercise and psychoeducation on depressive symptoms and self-perceived stress in women with metabolic syndrome (MetS). Seventy-four women (mean age 69.35 ± 7.20) were included in the study. Participants were divided into two groups: those with MetS (n = 33) and those without MetS (n = 41). Subjects participated in low-intensity general-fitness exercise sessions combined with psychoeducation distributed regularly over a 12-week period. Participants completed the Geriatric Depression Scale-15 (GDS) and the Stress Level Questionnaire (SLQ) before and after the intervention. All investigated parameters significantly decreased for the participants with metabolic syndrome after the intervention. The level of GDS in this group decreased by approximately 37% (p < 0.01), and SLQ by around 23% (p < 0.01). Our results suggest, that low-intensity exercise combined with psychoeducation could lower depressive symptoms and stress level in women with MetS. However, the intervention does not lower anthropometric parameter scores.


2018 ◽  
Vol 128 (4) ◽  
pp. 148-151
Author(s):  
Magdalena Czarkowska ◽  
Tomasz Saran ◽  
Anna Mazur ◽  
Andrzej Horoch ◽  
Lech Panasiuk

Abstract Introduction. As a result of involution processes and diseases, changes occur in the human body, as a result of which, psychophysical fitness declines with age. Comprehensive rehabilitation is the way of improving and maintaining health condition, including, among others, the appropriate level of physical activity and the quality of affective functioning. This type of program was carried out as part of the Outpatient Healthcare Home (DDOM) at the Witold Chodźko Institute of Rural Health in Lublin. Aim. The objective of the present study was to assess the impact of comprehensive ambulatory rehabilitation, including tailored endurance training preceded by an ergospirometry test, on indicators demonstrating the level of involvement in daily physical activities and the severity of depressive symptoms of patients over 60 years of age receiving health services at DDOM. Material and methods. The study involved 60 seniors participating in the rehabilitation cycle implemented as part of the services provided to patients at DDOM of the Witold Chodźko Institute of Rural Health in Lublin. The tests were carried out in the test-retest model on the first and last day of the kinesiotherapy cycle. The tests were performed with use of International Physical Activity Questionnaire IPAQ and Geriatric Depression Scale GDS. The patient rehabilitation program included adapted systemic kinesiotherapy (endurance training with a load determined according to individual exercise capacity, as determined on the basis of the ergospirometry test) and local kinesiotherapy and physical therapy adapted to the needs resulting from the condition of the musculoskeletal system. Results. After the completion of the rehabilitation cycle we compared the tests carried out before it, and the patients received higher scores in the scales of IPAQ questionnaire for measuring weekly, intensive and mode-rate physical activity and time required for walking and were less likely to spend their time sitting or lying down. There were also lower scores of the respondents in GDS scale used to assess the severity of depressive symptoms. Conclusions. As a result of the rehabilitation program applied, DDOM patients simultaneously obtained the desired changes in the level of involvement in physical activity and minimization of the intensity of depressive symptoms.


2014 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Simone Camargo de Oliveira ◽  
Ariene Angelini dos Santos ◽  
Sofia Cristina Iost Pavarini

The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms) and the Family APGAR (to assess family functioning). The correlation coefficient of Pearson’s, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %). Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.


2008 ◽  
Vol 2 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Bryan A. Weber ◽  
Beverly L. Roberts ◽  
Terry L. Mills ◽  
Neale R. Chumbler ◽  
Chester B. Algood

Radical prostatectomy commonly results in urinary, sexual, and bowel dysfunction that bothers men and may lead to depressive symptomatology (hereafter depression) that occurs at a rate 4 times greater for men with prostate cancer than healthy counterparts. The purpose of this study was to assess depressive symptoms in men shortly after radical prostatectomy and to identify associated risk factors. Seventy-two men were interviewed 6 weeks after surgery. Measured were depression (Geriatric Depression Scale), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), physical and emotional factors (UCLA Prostate Cancer Index), and social function (SF-36 subscale). Results indicate that men with high self-efficacy and less sexual bother were 45% and 55% less likely to have depressive symptoms, respectively. Findings from this study add to the limited amount of information on the complex relationship between prostate cancer treatment and depression in men.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 284-284
Author(s):  
Milan Chang ◽  
Chiharu Nishizuka ◽  
Hrafnhildur Eymundsdottir ◽  
Sigurveig Sigurdardottir ◽  
Alfons Ramel ◽  
...  

Abstract Background Disability and depression are associated with cumulative health adversities such as socioeconomic status (SES), nutrition, medical care, and education among older adults. However, there is little evidence on the longitudinal association between mid-life education level with a disability and depressive symptoms in older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of activity of daily living (ADL) dependency and high depressive symptoms in late-life. Methods A large community-based population residing in Reykjavik, Iceland (n=4991, 57.3% women, 76.9±5.8 yrs) participated in a longitudinal study with an average of 25 years of follow-up. Mid-life education was categorized into 4 groups (primary, secondary, college, and university). ADL dependency and high depressive symptoms were assessed on average 25 (±4) years later. The 5-item ADL dependency score ranged between 0 (no difficulty) and 18. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS). Results After controlling for demographic and health-related risk factors, those with higher education at mid-life were significantly less likely to have high depressive symptomatology (6 or higher GDS scores, Odds Ratio (OR) = 0.65, 95% Confidence Interval (CI): 0.52 ~ 0.82, P &lt; 0.0001). However, mid-life education was not associated with ADL dependency in later life. Conclusion Our study shows that mid-life education is associated with depressive symptoms 25 years later, while no association found with ADL dependency among Icelandic older adults.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rico Krämer ◽  
Stephan Köhler

Abstract Background Patients with mild to moderate depressive symptoms can have limited access to regular treatment; to ensure appropriate care, low-threshold treatment is needed. Effective online interventions could increase the supply of low-threshold treatment. Further research is needed to evaluate the effectiveness of online interventions. This study aims to evaluate the online-based self-help programme “Selfapy” on a sample of depressive subjects and compares the impact of the programme’s unaccompanied version with its therapeutic accompanied version. Methods A sample of 400 subjects that have a mild to severe depressive episode (Becks Depression Inventory - II and Hamilton Depression Scale) will be used. Subjects are randomly assigned to immediate access to an unaccompanied course (no support from psychologist via weekly phone calls), immediate access to an accompanied course (support from a psychologist via weekly phone calls) or a waiting list control group (access to the intervention after 24 weeks). The intervention will last for a period of 12 weeks. Depressive symptoms as a primary parameter, as well as various secondary parameters, such as life satisfaction, therapeutic relationships, social activation, self-esteem, attitudes towards Internet interventions and drop-out rates, are recorded at four different points in time: at baseline (T1), 6 weeks after the start of the intervention (T2), 12 weeks after the start of the intervention (T3) and 3 months after completion of the treatment follow-up (T4). Conclusion This randomized and controlled, blinded study will make use of a “dismantled” approach to adequately compare the accompanied and unaccompanied versions of the intervention. Positive and meaningful results are expected that could influence the acceptance and implementation of online interventions. Trial registration German Clinical Trials Register DRKS00017191. Registered on 14 June 2019


Author(s):  
Juyeong Kim ◽  
Eun-Cheol Park

Background: Given the documented importance of employment for middle-aged and older adults’ mental health, studies of the association between their number of work hours and depressive symptoms are needed. Objectives: To examine the association between the number of work hours and depressive symptoms in Korean aged 45 and over. Methods: We used data from the first wave to fourth wave of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 9845 individuals. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale. We performed a longitudinal analysis to estimate the prevalence of depressive symptoms by work hours. Results: Both unemployed males and females aged 45–65 years were associated with higher depressive symptoms (β = 0.59, p < 0.001; β = 0.32, p < 0.001). Females working ≥ 69 h were associated with higher depressive symptoms compared to those working 41–68 h (β = 0.25, p = 0.013). Among those both middle-aged and older adults, both males and females unemployed were associated with higher depressive symptoms. Those middle-aged female working ≥69 h were associated with higher depressive symptoms. Conclusions: An increase in depressive symptoms was associated with unemployed males and females working ≥69 h compared to those working 41–68 h. Although this association was found among middle-aged individuals, a decrease in depressive symptoms in both sexes was associated with working 1–40 h. Depressive symptoms should decrease by implementing employment policies and social services to encourage employers to support middle-aged and older adults in the workforce considering their sex and age differences.


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