Anxiety disorders in older people

2012 ◽  
Vol 22 (3) ◽  
pp. 204-217 ◽  
Author(s):  
James Lindesay ◽  
Robert Stewart ◽  
Jatinder Bisla
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Differential Diagnosis ◽  
Anxiety Disorders ◽  
Older People ◽  
Age Group ◽  
The Past ◽  
Treatment And Prevention ◽  
Co Morbidity ◽  
Assessment Scales

SummaryThis article reviews the research into anxiety disorders in adults aged 65 years and older that has been published over the past ten years. The topics covered include: the construct of anxiety and its disorders in this age group; epidemiology, including prevalence, incidence, course, outlook, and risk factors; assessment scales; co-morbidity and differential diagnosis (depression, dementia, physical illness); and management, both pharmacological and non-pharmacological. There has been a significant improvement in our understanding of these disorders in older adults over this period, but evidence to support their treatment and prevention is still quite sparse.

Depressive Symptoms in Older People in Greece and Cyprus

2016 ◽  
Vol 33 (S1) ◽  
pp. S468-S468
Author(s):  
K. Argyropoulos ◽  
G. Panteli ◽  
G. Charalambous ◽  
A. Argyropoulou ◽  
P. Gourzis ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Older People ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Major Public Health Problem ◽  
Age Group ◽  
Co Morbidity ◽  
High Prevalence ◽  
Prevalence Of Depression

IntroductionDepression is fast becoming a major public health problem with a very high prevalence rate in the 65 and over age group.ObjectivesThe aim of the present study was to estimate the prevalence of depression in Greeks and Cypriots older adults.MethodsA cross-sectional study was conducted among the 445 participants, 239 members of three day care centers for older people, in the municipality of Patras, West-Greece and 206 older adults (110 in the community, 65 in outpatient clinics, 31 in nursing homes) in Cyprus, aged > 60 years. A questionnaire was administered including socio-demographic characteristics. Depression was assessed using the Greek version of Geriatric Depression Scale (GDS-15).ResultsThe overall prevalence of depression according to GDS-15 was 33% (28% moderate, 5% severe type). Depressive symptoms were more frequent in women (41,6% vs. 28,3%, P < 0,001), in not married (43,0% vs. 29,3%, P < 0,001), in elderly with chronic diseases (36,8% vs. 25,0%, P = 0,007), in older people dwellers of urban areas compared to rural (36,3% vs. 26,4%, P = 0,028) and in ages between 70 to 80 years old (38,7% vs. 31,6%, P = 0,038). Moreover, higher prevalence of depression was measured in Greeks compared to Cypriots (44,3% vs. 20,6%, P < 0,001). In a univariate analysis, the following variables were significantly associated with depression: female gender (P < 0,001), co-morbidity (P = 0,004), higher age group (P = 0,018), place of living (P = 0,022) and Greek nationality (P < 0,001).ConclusionsHigh prevalence and several risk factors are strongly associated with depression, whereas Greeks are in higher danger of developing depressive symptoms in late life, than Cypriots.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 222-222
Author(s):  
Noriko Suzuki ◽  
Masahiko Hashizume ◽  
Hideyuki Shiotani
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Future Research ◽  
Baseline Body Mass Index ◽  
Term Care ◽  
Postprandial Hypotension ◽  
Before And After ◽  
Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p &lt;0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

scholarly journals Risk of falls and fear of falling in older adults residing in public housing in Ontario, Canada: findings from a multisite observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Melissa Pirrie ◽  
Guneet Saini ◽  
Ricardo Angeles ◽  
Francine Marzanek ◽  
Jenna Parascandalo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Public Housing ◽  
Fear Of Falling ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Medical Attention ◽  
Fruit And Vegetable ◽  
The Past ◽  
Risk Factors For Falls

Abstract Background Falls in older adults is a widely researched topic. However, older adults residing in public housing are a vulnerable population that may have unique risk factors for falls. This study aims to describe the prevalence and risk factors for falls, fear of falling, and seeking medical attending for falls in this population. Methods Sociodemographic and health-related data was collected as part of a community-based health assessment program with older adults in public housing. Three pre-screening questions identified individuals at potential risk for falls; individuals who screened positive performed the objective Timed Up and Go (TUG) test. Logistic regression was used to evaluate risk factors for four outcome variables: falls in the past year, seeking medical attention for falls, fear of falling, and objectively measured fall risk via TUG test. Results A total of 595 participants were evaluated, of which the majority were female (81.3%), white (86.7%), did not have a high school diploma (50.0%), and reported problems in mobility (56.2%). The prevalence of falls in the past year was 34.5%, seeking medical attention for falls was 20.2% and fear of falling was 38.8%. The TUG test was completed by 257 participants. Notably, males had significantly reduced odds of seeking medical attention for a fall (OR = 0.50, 95%CI 0.25–0.98) and having a fear of falling (OR = 0.42, 95%CI 0.24–0.76); daily fruit and vegetable consumption was associated with decreased odds of having a fall in the past year (OR = 0.55, 95%CI 0.37–0.83), and alcohol consumption was associated with increased odds of fear of falling (OR = 1.72, 95%CI 1.03–2.88). Conclusion Older adults residing in public housing have unique risk factors associated with social determinants of health, such as low fruit and vegetable consumption, which may increase their risk for falls. The findings of this study can be used to inform falls interventions for this population and identify areas for further research.

scholarly journals Status Epilepticus among Older Adults in the United States

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 45 ◽  
Author(s):  
Priya Mendiratta ◽  
Neeraj Dayama ◽  
Jeanne Y Wei ◽  
Pallavi Prodhan ◽  
Parthak Prodhan
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Ischemic Stroke ◽  
Status Epilepticus ◽  
Age Group ◽  
Brain Hemorrhage ◽  
Factors Associated ◽  
Hospitalized Elderly ◽  
Risk Of Mortality ◽  
Overall Mortality

Objective: This study aimed to identify temporal time trends and risk factors associated with mortality for hospitalized older adults with status epilepticus (SE). Design: A retrospective study was performed. Setting: Hospitalized patients were identified utilizing an administrative database—The Nationwide Inpatient Sample database from 1998 through September 2015. Patients: Patients were older adults 65 years and older with SE. Interventions: No interventions were undertaken. Measurements and Main Results: Demographic, temporal trends, clinical characteristics, and outcome data were abstracted. The results indicated that hospitalized elderly Americans with SE increased over the 11-year study period. Univariate and multivariate analyses were performed to evaluate risk factors associated with mortality in the study cohort. From the weighted sample, 130,109 subjects were included. Overall mortality was 19%. For age subgroups, the mortality was highest for the >85 years age group (24.1%) compared to the 65–75 years (19%) and 75–85 years (23%) age groups. Among investigated etiologies, the three most common causes of SE were acute ischemic stroke (11.2% of total) followed by non-traumatic brain hemorrhage (5.4%) and malignant brain lesions (4.9%). The highest mortality by etiology was noted for acute traumatic brain injury (TBI) (31.5%), non-traumatic brain hemorrhage (31%), and acute ischemic stroke (AIS) (30.1%). Multivariate analysis indicated that non-survivors when compared to survivors were more like to have the following characteristics: older age group, acute TBI, brain neoplasms, non-traumatic brain hemorrhage, AIS and central nervous system (CNS) infections, and utilization of mechanical ventilation. Associated conditions significantly increasing risk of mortality were sodium imbalance, cardiac arrest, anoxic brain injury, pneumonia, and sepsis. Comorbidities associated with increased risk of mortality included valvular heart disease, renal failure, liver disease, and neoplasms. Conclusions: The number of hospitalized elderly Americans with SE increased over the 11-year study period. Overall mortality was 19%, with even higher mortality among various patient subsets. Several demographic and co-morbid factors are associated with increased mortality in this age group.

The Information, Advice and Guidance Needs of Older Workers

2006 ◽  
Vol 5 (4) ◽  
pp. 541-550 ◽  
Author(s):  
Lavinia Mitton ◽  
Cathy Hull
Keyword(s):  
Older Adults ◽  
Older People ◽  
Older Workers ◽  
Age Group ◽  
Working Lives ◽  
Guidance Needs

This article reviews the research on Information, Advice and Guidance (IAG) services for older workers in England. It sets out the arguments for targeting IAG services at older people in the context of extended working lives. It reviews the evidence on how to provide services which meet the specific needs of older workers, whilst recognising the diversity of the 50+ age group, and provides a case study of an age-sensitive IAG project. It concludes that demand for IAG from older workers needs to be stimulated and that the role of IAG in helping older adults to work and learn deserves greater recognition.

Gender and age group differences in suicide risk associated with co-morbid physical and psychiatric disorders in older adults

2016 ◽  
Vol 29 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Catherine Lamoureux-Lamarche ◽  
Samantha Gontijo Guerra
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Service ◽  
Suicide Risk ◽  
Service Use ◽  
The Elderly ◽  
Health Service Use ◽  
Age Group ◽  
Co Morbidity ◽  
Gender And Age

ABSTRACTBackground:It is unclear whether health service use influences the association between psychiatric and physical co-morbidity and suicide risk in older adults.Methods:Controls were older adults (n = 2,494) participating in a longitudinal study on the health of the elderly carried out between 2004 and 2007, in Quebec. The cases were all suicide decedents (n = 493) between 2004 and 2007, confirmed by the Quebec Coroner's office. Multivariate analyses were carried out to test the association between suicide and the presence of psychiatric and physical illnesses controlling for health service use and socio-demographic factors by gender and age group. Interaction terms were also tested between suicide and co-morbidity on outpatient service use.Results:The presence of physical illnesses only, was associated with a reduced risk of suicide across all sex and age groups. The presence of a mental disorder only was associated with an increased risk of suicide overall and specifically in females and those aged 70 to 84 years of age. Suicide risk was lower in those with a psychiatric and physical co-morbidity and consulting mental health services.Conclusions:Increased mental health follow-up in older adults with psychiatric illnesses is needed for the detection of suicidal behavior and reducing suicide risk in males. Further research should focus on the mitigating effect of the presence of physical illnesses on stigma and health service use and the presence of social support in the elderly.

scholarly journals Definitions and Risk Factors for Drug-Resistant Epilepsy in an Adult Cohort

2021 ◽  
Vol 12 ◽  
Author(s):  
Alyssa Denton ◽  
Lilian Thorpe ◽  
Alexandra Carter ◽  
Adriana Angarita-Fonseca ◽  
Karen Waterhouse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Drug Resistant ◽  
Age Group ◽  
Drug Resistant Epilepsy ◽  
New Diagnosis

Background: Less than one-third of people with epilepsy will develop drug-resistant epilepsy (DRE). Establishing the prognosis of each unique epilepsy case is an important part of evaluation and treatment.Most studies on DRE prognosis have been based on a pooled, heterogeneous group, including children, adults, and older adults, in the absence of clear recognition and control of important confounders, such as age group. Furthermore, previous studies were done before the 2010 definition of DRE by the International League Against Epilepsy (ILAE), so data based on the current definitions have not been entirely elucidated. This study aimed to explore the difference between 3 definitions of DRE and clinical predictors of DRE in adults and older adults.Methods: Patients with a new diagnosis of epilepsy ascertained at a Single Seizure Clinic (SSC) in Saskatchewan, Canada were included if they had at least 1 year of follow-up. The first study outcome was the diagnosis of DRE epilepsy at follow-up using the 2010 ILAE definition. This was compared with 2 alternative definitions of DRE by Kwan and Brodie and Camfield and Camfield. Finally, risk factors were analyzed using the ILAE definition.Results: In total, 95 patients with a new diagnosis of epilepsy and a median follow-up of 24 months were included. The median age of patients at the diagnosis of epilepsy was 33 years, and 51% were men. In the cohort, 32% of patients were diagnosed with DRE by the Kwan and Brodie definition, 10% by Camfield and Camfield definition, and 15% by the ILAE definition by the end of follow-up. The only statistically significant risk factor for DRE development was the failure to respond to the first anti-seizure medication (ASM).Conclusion: There were important differences in the percentage of patients diagnosed with DRE when using 3 concurrent definitions. However, the use of the ILAE definition appeared to be the most consistent through an extended follow-up. Finally, failure to respond to the first ASM was the sole significant risk factor for DRE in the cohort after considering the age group.

scholarly journals Clinical profile and outcome of children with congenital heart diseases admitted with acute events in a paediatric tertiary care unit in North Karnataka

2021 ◽  
Author(s):  
Ramaning Loni ◽  
Pruthvi Ranganath ◽  
Manisha Juvekar ◽  
Nitin Tikare ◽  
L. H. Bidari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Protein Energy Malnutrition ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Congenital Heart Diseases ◽  
Age Group ◽  
Presenting Symptoms ◽  
Co Morbidity

Background: Congenital heart diseases are the predominant causes of paediatric morbidity and mortality. This study was done to know the clinical profile, various acute presentations, and risk factors for repeated hospitalizations and their outcome in children with congenital heart diseases.Methods: This prospective observational study of children in the age group of 0 hour-12 years, who were previously diagnosed and or newly diagnosed with congenital heart diseases.Results: A total of 102 children were present during the study period. The most common age group for congenital heart disease was infancy with 46.1% (47 cases) of children. Acyanotic heart diseases were observed in 73.5% (75 cases) of the total, followed by cyanotic CHD with 14.7% (15 cases), complex CHD with 9.8% (10 cases), and the least, valvular diseases with 2% (2 cases). The most usual presenting symptoms in children with CHDs were breathlessness with 66.7% (67 cases), followed by fever with 54.9% (56 cases) and cough with 48% (49 cases. In this study, 23.5% (24 cases) of the children were completely immunized. The protein-energy malnutrition was present in 51% of cases (52 cases). The 16.7% of them (17 cases) have got the motor developmental delay predominantly. The dysmorphic features were present in 19 cases (18.6%) of total cases. The chest X-ray findings were abnormal in 58.8% (60 cases). The most common risk factor(co-morbidity) in children with CHD was noticed to be anaemia in 43 cases (42.2%).Conclusions: The infancy and early childhood are the most common age group for the presentation of CHDs. Most of them had the associated risk factors (co-morbid) like nutritional anaemia, pneumonia, and failure to thrive.

scholarly journals Relation Between Volunteering and Suicidal Ideation Among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 526-526
Author(s):  
Montgomery Owsiany ◽  
Amy Fiske ◽  
Kim Van Orden ◽  
Erika Fenstermacher
Keyword(s):  
Older Adults ◽  
Suicidal Ideation ◽  
Well Being ◽  
Age Group ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
The Past ◽  
Care Practices ◽  
Clinically Significant ◽  
Primary Care Practices

Abstract Suicide disproportionally affects older adults, necessitating further investigation into potential protective factors for suicide in late life. Volunteering is associated with psychological well-being in older adults. However, there is scant literature examining the association between volunteering and suicidal ideation or behavior in this age group. The present study involved a cross-sectional examination of volunteering and suicidal ideation using baseline data from the Helping Older People Engage study. This sample (N = 245, 88% White, 68% female, 60-92 years old) was recruited from primary care practices. Inclusion criteria included clinically significant loneliness (UCLA loneliness scale M = 49.5; SD = 5.7). Forty-three percent of the sample reported engaging in recent volunteer activity. Passive and active suicidal ideation in the past month were endorsed, respectively, by 20% and 9% of the sample. Results of hierarchical linear regression analyses examining the association between volunteering and suicidal ideation, controlling for covariates, will be discussed.

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