scholarly journals AN INTEGRATED TRANSITIONAL CARE MODEL FOR OLDER ADULTS WITH MULTIMORBIDITY AND DEPRESSIVE SYMPTOMS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S867-S867
Author(s):  
Maureen Markle-Reid ◽  
Carrie McAiney ◽  
Rebecca Ganann ◽  
Kathryn Fisher ◽  
Amy Bartholomew ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Physical Functioning ◽  
Chronic Conditions ◽  
Service Use ◽  
Transitional Care ◽  
Group Differences ◽  
Significant Group ◽  
Implementation Effectiveness

Abstract This pragmatic randomized controlled trial examined the implementation, effectiveness and costs of a nurse-led transitional care intervention to improve hospital-to-home transitions for 127 older adults (≥ 65 years) with depressive symptoms and multimorbidity in three Ontario communities. Participants were randomly allocated to receive the intervention plus usual care (n=63) or usual care alone (n=64). The intervention included an average of 5 in-home visits and 6 phone calls from a Registered Nurse (RN) over a 6-month period. The RN provided system navigation, patient education, medication review, and management of depressive symptoms and chronic conditions. Implementation outcomes included engagement rate, intervention dose, and feasibility of intervention implementation. Effectiveness outcomes included quality of life, depressive symptoms, anxiety, social support, and health and social service use and costs. Participants were an average of 76 years and had an average of 8 chronic conditions. Findings suggest that the intervention was feasible and acceptable to participants and providers. Intention-to-treat analyses using ANCOVA models showed no statistically significant group differences for the outcomes. However, the upper 95% confidence interval for the mean group difference showed greater clinically significant improvements in physical functioning in the intervention group. Quantile regression showed that the intervention may result in greater improvements in physical functioning for individuals with low to average physical functioning values compared to the control group. The intervention may also result in higher levels of perceived social support for individuals with a range of social support values. No statistically significant group differences were observed for service use or costs.

scholarly journals Effectiveness of a nurse-led hospital-to-home transitional care intervention for older adults with multimorbidity and depressive symptoms: A pragmatic randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254573
Author(s):  
Maureen Markle-Reid ◽  
Carrie McAiney ◽  
Kathryn Fisher ◽  
Rebecca Ganann ◽  
Alain P. Gauthier ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Usual Care ◽  
Patient Experience ◽  
Service Use ◽  
Transitional Care ◽  
Controlled Trial ◽  
Mental Functioning ◽  
Significant Group ◽  
Secondary Outcomes

Objective To evaluate the effectiveness of a nurse-led hospital-to-home transitional care intervention versus usual care on mental functioning (primary outcome), physical functioning, depressive symptoms, anxiety, perceived social support, patient experience, and health service use costs in older adults with multimorbidity (≥ 2 comorbidities) and depressive symptoms. Design and setting Pragmatic multi-site randomized controlled trial conducted in three communities in Ontario, Canada. Participants were allocated into two groups of intervention and usual care (control). Participants 127 older adults (≥ 65 years) discharged from hospital to the community with multimorbidity and depressive symptoms. Intervention This evidence-based, patient-centred intervention consisted of individually tailored care delivery by a Registered Nurse comprising in-home visits, telephone follow-up and system navigation support over 6-months. Outcome measures The primary outcome was the change in mental functioning, from baseline to 6-months. Secondary outcomes were the change in physical functioning, depressive symptoms, anxiety, perceived social support, patient experience, and health service use cost, from baseline to 6-months. Intention-to-treat analysis was performed using ANCOVA modeling. Results Of 127 enrolled participants (63-intervention, 64-control), 85% had six or more chronic conditions. 28 participants were lost to follow-up, leaving 99 (47 -intervention, 52-control) participants for the complete case analysis. No significant group differences were seen for the baseline to six-month change in mental functioning or other secondary outcomes. Older adults in the intervention group reported receiving more information about health and social services (p = 0.03) compared with the usual care group. Conclusions Although no significant group differences were seen for the primary or secondary outcomes, the intervention resulted in improvements in one aspect of patient experience (information about health and social services). The study sample fell below the target sample (enrolled 127, targeted 216), which can account for the non-significant findings. Further research on the impact of the intervention and factors that contribute to the results is recommended. Trial registration clinicaltrials.gov Identifier: NCT03157999.

Investigating Moderator Hypotheses in Aging Research: Statistical, Methodological, and Conceptual Difficulties with Comparing Separate Regressions

2003 ◽  
Vol 57 (2) ◽  
pp. 119-150 ◽  
Author(s):  
Jason T. Newsom ◽  
Holly G. Prigerson ◽  
Richard Schulz ◽  
Charles F. Reynolds
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Age Differences ◽  
Group Differences ◽  
Aging Research ◽  
Beneficial Effects ◽  
Product Term ◽  
Regression Approach ◽  
Analysis Strategy

Many topics in aging research address questions about group differences in prediction. Such questions can be viewed in terms of interaction or moderator effects, and use of appropriate methods to test these hypotheses are necessary to arrive at accurate conclusions about age differences. This article discusses the conceptual, methodological, and statistical problems in one approach to investigating moderator hypotheses. The subgroup regression approach, in which separate regression analyses are conducted in two or more groups, is widely used in aging research to examine group differences in prediction, but the approach can lead to erroneous conclusions. The moderated regression approach, involving the test of a product term, is described and recommended as an a alternative approach. The question of whether social support has greater beneficial effects for younger or older adults is investigated in a study of 287 recently-bereaved adults ranging in age from 20 to 91. Using the subgroup approach, findings indicated that social support significantly predicted depressive symptoms among younger adults and did not significantly predict depressive symptoms among older adults. The moderated regression analysis, however, indicated no significant age differences in the effect of social support. These results clearly illustrate that the analysis strategy researchers choose may have important bearing on theory in aging research such as conclusions regarding the role of social support across the life span.

scholarly journals Psychosocial and physical factors associated with depression in older adults living in studio apartments: A cross-sectional study of a multi-ethnic Asian population

2019 ◽  
Vol 28 (4) ◽  
pp. 243-251
Author(s):  
Grace Sum ◽  
Yun Ru Tan ◽  
Song-Iee Hong ◽  
Gerald Choon-Huat Koh
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Exercise Behaviour

Background: There is a rapidly ageing population globally, leading to a rise in subsidised public housing in many countries for older adults. According to the World Health Organisation, depression is the most prevalent mental disorder in older adults. There is a gap in literature on the factors associated with depression in those residing in studio apartments for older adults, characterised by small living spaces and isolated community settings. Objective: The aim of this study was to examine the associations between socio-demographic variables, social support, self-perceived health and mental status, life satisfaction, exercise, physical functioning, chronic conditions, and the use of eldercare services, with depressive symptoms. Methods: We utilised a cross-sectional study of older adults aged ⩾55 years residing in Singapore’s studio apartments. Multivariable logistic regression was applied. Results: Widowhood was associated with depressive symptoms, compared to being married or having a domestic partner (adjusted odds ratio (AOR) = 1.70, 95% confidence interval (CI) = 1.01 to 2.86). Odds of depressive symptoms were associated with difficulty bathing and showering (AOR = 3.74, 95% CI = 1.06 to 13.21). Depressive symptoms were associated with cataract (AOR = 1.67, 95% CI = 1.01 to 2.77) and urinary tract disorder (AOR = 4.70, 95% CI = 1.21 to 18.26). There were dose-response relationships between higher odds of depressive symptoms and poorer social support, self-perceived mental health, life satisfaction, and exercise behaviour ( p for trend < 0.001). Conclusion: Factors including widowhood, physical functioning difficulty, chronic conditions, low social support, low self-perceived mental health, poor life satisfaction, and lack of exercise behaviour, were associated with depressive symptoms in older adults residing in studio apartments. More attention is needed to care for the psychosocial and physical needs of older adults in studio apartments.

scholarly journals Intergenerational Relationships, Social Support, and Psychological Well-Being Among Korean Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 498-498
Author(s):  
Yooumi Lee ◽  
Janet Wilmoth
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Living Arrangements ◽  
Linear Models ◽  
Depression Scale ◽  
Adult Child ◽  
Intergenerational Relationships ◽  
Well Being ◽  
Psychological Well Being

Abstract This study investigates whether intergenerational relationships and social support improve the psychological well-being of Korean older adults. We examine whether intergenerational relationships and social support directly influence psychological well-being and the extent to which they mediate the distressing consequences of life events such as declining health and recent widowhood. Using longitudinal data from the 2006 to 2016 Korean Longitudinal Study of Aging, we explore depression trajectories among individuals who are 60 or older with at least one living adult child at baseline. Specifically, we converted data from 5,383 older adults into a person-period file with 24,726 observations over a ten-year period. Then we estimated linear growth curve models of depression trajectories separately for men and women using the Center for Epidemiologic Studies Depression Scale (CES-D). Results from the hierarchical linear models indicate that declining health and recent widowhood are positively related to depressive symptoms. Satisfactory intergenerational relationships and social support in the form of personal interactions and proximate living arrangements with adult children decrease depressive symptoms of older parents, especially among women. We conclude that the psychological benefits of intergenerational relationships and social support are contingent upon the vulnerability of older adults and discuss the implications for public policy.

scholarly journals Effects of aging on emotion recognition from dynamic multimodal expressions and vocalizations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Diana S. Cortes ◽  
Christina Tornberg ◽  
Tanja Bänziger ◽  
Hillary Anger Elfenbein ◽  
Håkan Fischer ◽  
...  
Keyword(s):  
Older Adults ◽  
Emotion Recognition ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Group Differences ◽  
Significant Group ◽  
Positivity Effect ◽  
Video Recordings ◽  
Age Related ◽  
Effects Of Aging

AbstractAge-related differences in emotion recognition have predominantly been investigated using static pictures of facial expressions, and positive emotions beyond happiness have rarely been included. The current study instead used dynamic facial and vocal stimuli, and included a wider than usual range of positive emotions. In Task 1, younger and older adults were tested for their abilities to recognize 12 emotions from brief video recordings presented in visual, auditory, and multimodal blocks. Task 2 assessed recognition of 18 emotions conveyed by non-linguistic vocalizations (e.g., laughter, sobs, and sighs). Results from both tasks showed that younger adults had significantly higher overall recognition rates than older adults. In Task 1, significant group differences (younger > older) were only observed for the auditory block (across all emotions), and for expressions of anger, irritation, and relief (across all presentation blocks). In Task 2, significant group differences were observed for 6 out of 9 positive, and 8 out of 9 negative emotions. Overall, results indicate that recognition of both positive and negative emotions show age-related differences. This suggests that the age-related positivity effect in emotion recognition may become less evident when dynamic emotional stimuli are used and happiness is not the only positive emotion under study.

scholarly journals The Importance of Studying Health Behavior in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Behavior Change ◽  
Chronic Conditions ◽  
Population Level ◽  
Multiple Chronic Conditions ◽  
Prior Work ◽  
Time Changes ◽  
The Impact ◽  
Over Time

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.

The mediating role of disability and social support in the association between low vision and depressive symptoms in older adults

2013 ◽  
Vol 23 (3) ◽  
pp. 1039-1043 ◽  
Author(s):  
Gertrudis I. J. M. Kempen ◽  
Adelita V. Ranchor ◽  
Ton Ambergen ◽  
G. A. Rixt Zijlstra
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Low Vision ◽  
Mediating Role
Sign in / Sign up

Export Citation Format

Share Document