Assessment of Older Adults

2009 ◽  
pp. 21-40
Author(s):  
Dolores Gallagher-Thompson ◽  
Larry W. Thompson
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Substance Abuse ◽  
Functional Status ◽  
Medical History ◽  
Suicide Ideation ◽  
Depression And Anxiety ◽  
Suitable Candidate

Assessment of cognitive, emotional, and functional status is recommended prior to beginning CBT with an older client. This provides a clearer understanding of the client’s main problems and enables the therapist to determine whether or not the client is a suitable candidate for CBT. This chapter outlines preparation for assessment, the CBT model for older adults, assessment of alcohol or other substance abuse, depression and anxiety, suicide ideation, medical history, and social support.

scholarly journals Changes in Functional Status Among Clusters of Older Adults After Hospitalization for Pneumonia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 595-596
Author(s):  
Chan Mi Park ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Wonsock Kim ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Functional Recovery ◽  
Daily Living ◽  
Social Deprivation ◽  
Group A ◽  
Group B ◽  
Group D

Abstract Little is known about how social determinants, comorbidity, and disability status are associated with functional recovery after an acute illness. A prospective cohort study was conducted between 2019-2020 at a university hospital in Korea, to investigate functional recovery after hospitalization for pneumonia in older adults with different degrees of social deprivation, disabilities, and comorbidities. K-means cluster analysis was used to identify groups of patients based on social deprivation score, activities of daily living, instrumental activities of daily living, physical limitation score, and Gagne comorbidity index. Four groups were identified: Group A: non-disabled group with limited social support (n=61 [30.3%]); Group B: multimorbid but non-disabled group with social support (n=45 [22.4%]); Group C: multimorbid and disabled group with social support (n=38 [18.9%]); Group D: multimorbid and disabled group with limited social support (n=57 [28.4%]). Functional status, defined as ability to perform 21 activities and physical tasks independently, was measured via telephone interviews at 1, 3, and 6 months after discharge. Group-based trajectory model identified four functional status trajectories: excellent (n=29 [14.4%]), good (n=51 [25.4%]), fair (n=58 [28.9%]) and poor (n=63 [31.3%]). The most common functional trajectory by four groups was good trajectory (59%) in Group A, excellent trajectory (48.9%) in Group B, fair (50%) and poor trajectory (50%) in Group C, and poor trajectory (77.2%) in Group D. Our results suggest that most patients without disability recover functional status after pneumonia, despite multimorbidity or limited social support. Social support seems to be more important for those with multimorbidity and disability.

The relationship among age, anxiety, and depression in older adults with cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9123-9123 ◽  
Author(s):  
Talia Weiss ◽  
Christian J Nelson ◽  
William P. Tew ◽  
Molly Hardt ◽  
Supriya Gupta Mohile ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Psychological State ◽  
Anxiety And Depression ◽  
Tumor Type ◽  
Depression And Anxiety ◽  
Psychological Sequelae ◽  
Clinically Significant ◽  
Prospective Longitudinal ◽  
The Relationship

9123 Background: Depression and anxiety are common psychological sequelae of cancer, resulting in decreased adherence to treatment regimens and longer hospital stays. In men with prostate cancer, aging is associated with reduced anxiety and increased depression. The overall goal of this study was to examine the association among age, anxiety, and depression in a cohort of older adults receiving chemotherapy (chemo). Methods: This is a secondary analysis of a prospective longitudinal study investigating chemotherapy toxicity in older adults with cancer. Eligibility included: age > 65, diagnosis of cancer, and scheduled to receive a new chemo regimen. Baseline data (pre-chemotherapy) included: age, sociodemographics, tumor and treatment factors (including tumor type and stage), geriatric assessment parameters (functional status, comorbidities, psychological state, nutritional status, social support). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Univariate and multiple regression analyses were conducted to test the relationship between age, anxiety, and depression. Results: The average age of the 500 patients (56% females) was 73.1 (range 65-91, SD+6.18) with 5% Stage I, 12% Stage II, 22% Stage III and 61% stage IV. Mean depression and anxiety scores were: 3.6+3.17; 4.7+3.60. Clinically significant depression was reported in 12.6% (n=62). Clinically significant anxiety was reported in 20.9% (n=103). In univariate analyses, there was no association between anxiety and age, or depression and age. In multivariable analyses, older age (beta= -0.07, p = 0.05) was associated with decreased anxiety, as well as lack of social support (p < 0.01) and increased number of comorbidities (p < 0.01). In multivariable analysis, depression was associated with lack of social support (p < 0.01), increased number of comorbidities (p < 0.01), and advanced stage (p < 0.01). Conclusions: This study supports previous research that anxiety decreases with age in older adults with cancer. However, depression remained constant with increasing age. Greater resources and attention to identifying and treating the psychological sequelae of cancer in older adults are warranted.

Association between baseline geriatric domains and survival in older adults with chronic lymphocytic leukemia (CLL).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12041-12041
Author(s):  
Julia Rice ◽  
Ryan David Nipp ◽  
Daniel E Lage ◽  
Ashley M. Nelson ◽  
Richard Newcomb ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Social Activity ◽  
Psychological Status ◽  
Timed Up And Go

12041 Background: CLL is a disease that commonly affects older adults. Although the value of geriatric assessment is increasingly being recognized in older adults with cancer, few studies have examined the relationship between baseline geriatric domains and clinical outcomes in older adults with CLL. Methods: We conducted a secondary data analysis of 369 adults diagnosed with CLL and treated in a phase 3 randomized trial of patients age ≥65 with bendamustine plus rituximab versus ibrutinib plus rituximab versus ibrutinib alone. We evaluated geriatric domains of functional status (activities of daily living [ADL], instrumental activities of daily living [IADL], Timed “Up and Go,” and number of falls in last 6 months), psychological status (Mental Health Inventory), social activity (Medical Outcomes Study [MOS] Social Activity Survey), cognition (Blessed Orientation Memory Concentration Test), social support (MOS Social Support Tangible and Emotional/Informational subscales), and nutritional status ( > 5% weight loss in the preceding 6 months). We examined associations among baseline geriatric domains with overall survival (OS) and progression-free survival (PFS) using multivariable Cox regression models. Results: The median age of patients was 71 years (range: 65-89). Most were male (67.1%) and had an ECOG performance status of 0 or 1 (96.9%). In multivariable models, the following geriatric domains were significantly associated with OS: better functional status (ADL score: HR 0.67, p = 0.012; IADL score: HR 0.98, p = 0.007); social activity score (HR 0.97, p = 0.004); and nutritional status (HR 2.58, p = 0.008). Similarly, functional status (ADL score: HR 0.77, p = 0.028; IADL score: HR 0.99, p = 0.007); social activity score (HR 0.97, p < 0.001); and nutritional status (HR 2.87, p < 0.001) were all associated with PFS. Additionally, the number of impaired geriatric domains was also associated with OS (HR 1.50, p = 0.004) and PFS (HR 1.45, p < 0.001). Timed “Up and Go”, number of falls in last 6 months, psychological status, cognition, and social support were not significantly associated with clinical outcomes. Conclusions: Geriatric domains of functional status, social activity, and nutritional status were associated with OS and PFS in this cohort of older adults with CLL. These findings highlight the importance of assessing geriatric domains to identify high-risk patients with CLL who may benefit from additional support during their treatment.

Suicide Attempters, Suicide Ideators, and Non-Ideators

Crisis ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 294-297 ◽  
Author(s):  
Tobias Teismann ◽  
Laura Paashaus ◽  
Paula Siegmann ◽  
Peter Nyhuis ◽  
Marcus Wolter ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Protective Factors ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Self Esteem ◽  
Positive Mental Health ◽  
Cross Sectional ◽  
Reasons For Living ◽  
Suicide Attempters

Abstract. Background: Suicide ideation is a prerequisite for suicide attempts. However, the majority of ideators will never act on their thoughts. It is therefore crucial to understand factors that differentiate those who consider suicide from those who make suicide attempts. Aim: Our aim was to investigate the role of protective factors in differentiating non-ideators, suicide ideators, and suicide attempters. Method: Inpatients without suicide ideation ( n = 32) were compared with inpatients with current suicide ideation ( n = 37) and with inpatients with current suicide ideation and a lifetime history of suicide attempts ( n = 26) regarding positive mental health, self-esteem, trust in higher guidance, social support, and reasons for living. Results: Non-ideators reported more positive mental health, social support, reasons for living, and self-esteem than suicide ideators and suicide attempters did. No group differences were found regarding trust in higher guidance. Suicide ideators and suicide attempters did not differ regarding any of the study variables. Limitations: Results stem from a cross-sectional study of suicide attempts; thus, neither directionality nor generalizability to fatal suicide attempts can be determined. Conclusion: Various protective factors are best characterized to distinguish ideators from nonsuicidal inpatients. However, the same variables seem to offer no information about the difference between ideators and attempters.

Influence of Social Support on Abused African American Women's Substance Abuse

2009 ◽  
Author(s):  
Shaquita Tillman ◽  
Thema Bryant-Davis ◽  
Kimberly Smith
Keyword(s):  
Social Support ◽  
Substance Abuse ◽  
African American
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