Assessment of mental disorder in older patients

2012 ◽  
pp. 1524-1530
Author(s):  
Robin Jacoby
Keyword(s):  
Older People ◽  
Mental Disorder ◽  
Mental State ◽  
Outpatient Clinic ◽  
Older Patients ◽  
Depressive Illness ◽  
Younger Patients ◽  
Dementing Illness ◽  
State Examination

The assessment of older people is not fundamentally different from that of younger patients. The principles of taking history and mental-state examination are the same at any age. But if the goals are common, the routes taken to reach them are not necessarily so. For example, an assessment adequate enough to begin treatment of a 30-year-old woman presenting to an outpatient clinic with a depressive illness might take about an hour and involve speaking only to the patient and perhaps briefly to her partner, whereas the equivalent assessment of an 81-year-old woman in whom uncertainty exists as to whether the diagnosis is that of a depressive or a dementing illness may require more than one interview and necessitate enquiry from several informants. This section will not repeat what can be found in Chapter 1.8.1, but cover only those points which are specific to or need to be emphasized for older patients.

Presentation of stroke in the older person

2020 ◽  
pp. 25-32
Author(s):  
Jagdish Sharma
Keyword(s):  
Older People ◽  
Ischaemic Stroke ◽  
Older Patients ◽  
Clinical Presentation ◽  
Cerebral Haemorrhage ◽  
Older Person ◽  
Younger Patients ◽  
Age Related ◽  
Atypical Presentations ◽  
Symptoms And Signs

‘Presentation of stroke in the older person’ outlines the varied patterns of clinical presentation of stroke in the older person, looking at common and the less common syndromes. Symptoms and signs in older people can be very subtle, often difficult to diagnose, and challenge even the most astute of clinicians. Most stroke presentations in older patients are similar to those in younger patients with respect to Oxford Community Stroke Project classification. However, atypical presentations can lead to diagnostic challenges in older patients due to the interaction between age-related cerebral and circulatory changes and comorbidities. The presentation of ischaemic stroke with its different vascular patterns, is discussed. Cerebral haemorrhage is explored in the context of its presentation patterns.

Psychiatric assessment of older people

2013 ◽  
Author(s):  
Alan Thomas
Keyword(s):  
Older People ◽  
Mental State ◽  
Cognitive Assessment ◽  
Social Care ◽  
Psychiatric History ◽  
Neurological Signs ◽  
Care Services ◽  
Health And Social Care ◽  
Holistic Assessment ◽  
State Examination

The venue for assessment varies but given the choice there are substantial advantages in the first assessment being conducted at home. The aims of the assessment are to do more than achieve a diagnosis, though this is crucial; the aim should also be to produce a holistic assessment of all needs leading to the involvement a range of appropriate professionals in health and social care services to address these needs and carry out their own specialist assessments. Information from informants will supplement that of the patient and enable completion of all the important domains in the psychiatric history. The mental state examination will include a special emphasis on cognitive assessment and a brief physical looking for neurological signs is important.

The Geriatric Mental State Examination As a Case-finding Instrument in the Community

1988 ◽  
Vol 152 (2) ◽  
pp. 205-208 ◽  
Author(s):  
C. Mcwilliam ◽  
J. R. M. Copeland ◽  
M. E. Dewey ◽  
N. Wood
Keyword(s):  
Mental State ◽  
Diagnostic System ◽  
Depressive Illness ◽  
Case Finding ◽  
Psychiatric Interview ◽  
Predictive Values ◽  
Low Prevalence ◽  
State Examination ◽  
Diagnostic Index ◽  
Effective Case

The Geriatric Mental State Examination (GMS), a standardised psychiatric interview, and its computerised diagnostic system, AGECAT, have been applied to a large (1070) sample of subjects aged over 65 in Liverpool. In a split-half study of this sample, diagnostic scales within the GMS and a diagnostic index derived from them were tested for efficacy in cases of organic and early organic illness (mostly various stages of dementia) and depressive illness. Results demonstrated high levels of sensitivity and specificity, and positive predictive values were within the expected range when applied to these disorders, given their low prevalence in the community. The GMS, when used in this way, is a flexible and effective case-finding instrument.

scholarly journals Mini-Mental State Examination as a Predictor of Mortality among Older People Referred to Secondary Mental Healthcare

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e105312 ◽  
Author(s):  
Yu-Ping Su ◽  
Chin-Kuo Chang ◽  
Richard D. Hayes ◽  
Gayan Perera ◽  
Matthew Broadbent ◽  
...  
Keyword(s):  
Older People ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Mental Healthcare ◽  
State Examination

Psychiatric morbidity in older prisoners: unrecognized and undertreated

2011 ◽  
Vol 23 (8) ◽  
pp. 1354-1360 ◽  
Author(s):  
Paul Kingston ◽  
Nick Le Mesurier ◽  
Graeme Yorston ◽  
Sue Wardle ◽  
Lucy Heath
Keyword(s):  
Mental Disorder ◽  
Mental State ◽  
Short Form ◽  
Prison Population ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
The United Kingdom ◽  
Older Prisoners ◽  
Physical Disorders ◽  
State Examination

ABSTRACTBackground: The aging population in prison is growing rapidly in the United Kingdom. This trend is also found in other countries worldwide. As this population increases prison authorities will need to adjust the custody process to accommodate increasing mental and physical frailty.Methods: This study examined the prevalence of psychiatric disorders and physical disorders, including dementia, in prisoners aged 50 years and over from four prisons in and around Staffordshire to see whether detection and treatment rates have improved over the past decade during which there has been a dramatic increase in the number of older prisoners. Subjects were assessed using the Geriatric Mental State Examination, the Mini-Mental State Examination and Short Form 12 and their prison records.Results: Sixty prisoners (50%) had a diagnosable mental disorder, with depression being most common, and 15 (12%) prisoners had signs of cognitive impairment. Only 18% of those with a psychiatric diagnosis were prescribed medication from the appropriate class. Physical problems were also common in this population with an average self-report of 2.26 problems per prisoner.Conclusions: Mental disorders in older prisoners are common, but despite recent training initiatives they often go undetected and untreated. Prisoners themselves accurately self-report mental disorder, but the best way of detecting dementia in the prison population remains unclear. The psychological and physical health of this prison population was poorer than that of their community-based peers.

scholarly journals Dementia among older patients attending National Institute of Mental Health (NIMH), Dhaka, Bangladesh

2017 ◽  
Vol 29 (1) ◽  
pp. 5-9
Author(s):  
Arman Ibne Haq ◽  
Mekhala Sarkar ◽  
Susmita Roy ◽  
Md Faruq Alam
Keyword(s):  
Mental Health ◽  
Elderly Patients ◽  
Mental State ◽  
Health Care Professionals ◽  
Older Patients ◽  
Mini Mental State Examination ◽  
Sampling Technique ◽  
Cross Sectional ◽  
Male Predominance ◽  
State Examination

Dementia has become the focus of attention of health care professionals’ worldwide. The objective of the study was to find out the proportion of dementia among older patients as well as to identify the socio-demographic characteristics of patients with dementia attending National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka, Bangladesh. This was a cross sectional study conducted in NIMH during the period from 1st November 2014 to 30th April 2015. For this purpose, 78 elderly patients aged e”60 years attending both in outpatient and inpatient departments of NIMH, satisfying inclusion and exclusion criteria were selected by convenient sampling technique. Data were collected by face-to-face interview using semi-structured questionnaire. Cognitive impairment was assessed by Bengali version of Mini Mental State Examination (MMSE) and dementia was diagnosed according to Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). The results showed that most of the patients (51.3%) were in between the ages of 60 to 64 years with male predominance (56.4%). The mean (± SD) age of the patients was 66.84 (±5.49) years. Among the patients 43.6 % came from urban area, 39.7% from the family with monthly income within 30001-45000 Bangladeshi taka (BDT) and 53.9% had family members in between 4 to 6. Among them 61.5% patients were married, 43.6% were retired from service, 32.1% studied up to primary level and 62.8% had caregivers. Most of them (88.5%) scored between 24-30 in Mini Mental State Examination (MMSE) and only 5.1% respondents had dementia. This study has provided baseline information about the proportion of dementia among elderly patients in Bangladesh that can be used in future studies.Bang J Psychiatry June 2015; 29(1): 5-9

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