The Office Assessment of Depression and Cognitive Impairment

2017 ◽  
Author(s):  
Martin Steinberg ◽  
Paul B. Rosenberg
Keyword(s):  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Clock Drawing Test ◽  
Atypical Symptoms ◽  
Cognitive Difficulties ◽  
Patient Health

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

The Role of Neuropsychological Examination

2017 ◽  
Author(s):  
Martin Steinberg ◽  
Antonio N. Puente ◽  
Cynthia A. Munro
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Cognitive Domains ◽  
Clock Drawing Test ◽  
Atypical Symptoms ◽  
Cognitive Difficulties ◽  
Patient Health

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

scholarly journals Cognition, functionality and depression indicative among elderly

Rev Rene ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 103
Author(s):  
Winnie Andaki Nunes ◽  
Flavia Aparecida Dias ◽  
Janaína Santos Nascimento ◽  
Nayara Cândida Gomes ◽  
Darlene Mara dos Santos Tavares
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Functional Disability ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Cognitive Status ◽  
Chi Square ◽  
Chi Square Test

to describe the socioeconomic characteristics of the elderly according to cognitive status, and, to associate the cognitive decline with functional disability and depression indicative among the elderly. Methods: this is a quantitative, retrospective and observational study with 92 elderly. The used instruments were: Mini Examination of Mental State; Katz Index; Lawton and Brody Scale and Abbreviated Geriatric Depression Scale. Statistical analysis and chi-square test (p<0.05) were used. Results: elderly with a cognitive decline for females were predominant, 80 years and older, widowed and living with children, with one to three years of study, individual income up to a minimum wage. The proportion of elderly with a dependent cognitive decline in basic activities of daily living (p=0.043) and instrumental activities of daily living (p=0.008) was higher than independent. There were no significant differences in the depression indicative (p=0.437). Conclusion: the proportion of dependent elderly was higher in those with cognitive decline.

scholarly journals Mild cognitive impairment in the elderly Relationship between communication and functional capacity

2018 ◽  
Vol 12 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Ana Iza Gomes da Penha Sobral ◽  
Cláudia Marina Tavares de Araújo ◽  
Marcos Felipe Falcão Sobral
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Communication Skills ◽  
Social Communication ◽  
Daily Living ◽  
The Elderly ◽  
Intermediate Form ◽  
Instrumental Activities

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.

scholarly journals Depressive symptoms and disability in acute patients with comorbidities in departments of internal medicine

2012 ◽  
pp. 261-268
Author(s):  
Salvatore La Carrubba ◽  
Loredana Manna ◽  
Carmelina Rinollo ◽  
Antonino Mazzone ◽  
Gualberto Gussoni ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Female Gender ◽  
Instrumental Activities ◽  
Comorbidity Index ◽  
Acute Patients

Introduction: There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. Materials and methods: All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS), Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Charlson’s Comorbidity Index. Results: 1,947 subjects were included in the analyses. Of the patients, 509 (26.1%) showed depressive symptoms (indicated by GDS score > 15). Depression was significantly associated (univariate analyses) with hypertension (OR 1.45; CI 95% 1.18-1.79), diabetes (OR 1.48, CI 95% 1.17-1.87), cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07), cirrhosis (OR 1.49, CI 95% 1.01- 2.19), ADL score (OR 0.72: CI 95% 0.63-0.82), and IADL score (OR 0.83; CI 95% 0.78-0.87), but not with Charlson’s Comorbidity Index (OR 1.04; CI 95% 0.98-1.10). Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02), female gender (OR 2.29, CI 95% 1.83 - 2.87), and IADL score (OR 0.86, CI 95% 0.81 - 0.93). Conclusions: The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.

scholarly journals Variation in Functional Independence among Stroke Survivors Having Fatigue and Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Umaru Muhammad Badaru ◽  
Omoyemi Olubunmi Ogwumike ◽  
Ade Fatai Adeniyi ◽  
Olajide Olubanji Olowe
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence ◽  
Cross Sectional Survey ◽  
College Hospital ◽  
Cross Sectional ◽  
Significance Level

Objective. This study evaluated variation in functional independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) among individuals with poststroke fatigue (PSF) and poststroke depression (PSD).Methods. A cross-sectional survey involved 65 consenting poststroke survivors who were purposively recruited from physiotherapy clinics of the University College Hospital, Ibadan, Adeoyo Maternity Teaching Hospital, Ibadan, and Federal Medical Center, Gusau. Participants were assessed for symptoms of PSD with short geriatric depression scale-15, PSF with fatigue severity scale, ADL with Barthel Index and IADL with Nottingham extended ADL scale. Data analysis was done using Chi-square and unpairedt-test with significance level being 0.05.Results. Participants’ age ranged from 58 to 80 years. PSD alone (P=0.002) and both PSF and PSD (P=0.02) were significantly associated with ADL, while PSF alone was not (P=0.233). PSD alone (P=0.001) and both PSF and PSD (P=0.001) significantly negatively affected IADL, while PSF alone had no significant effect (P=0.2).Conclusions. Participants with PSD alone and those with both PSF and PSD had lower functional independence in ADL and IADL.

scholarly journals Relationship Between Activities of Daily Living and Depression in Older Adults

Salmand ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 200-211 ◽  
Author(s):  
Marzieh Mohamadzadeh ◽  
◽  
Vahid Rashedi ◽  
Mitra Hashemi ◽  
Vahidreza Borhaninejad ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Daily Living ◽  
Pearson Correlation ◽  
Depression Scale ◽  
The Elderly ◽  
Cluster Sampling ◽  
Early Assessment ◽  
Cross Sectional

Objectives: Physical disability to perform daily living activities is one of the major causes of depression in the elderly people. On the other hand, depression is associated with loss of interest in daily activities and lack of independence. The present study aimed to assess the relationship of depression with the ability to perform Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in older adults in Iran. Methods & Materials: This cross-sectional study was performed on 148 elderly people aged ≥60 years who were selected by multi-stage cluster sampling method. Data were collected by using ADL, IADL, and 15-item Geriatric Depression Scale (GDS-15) questionnaires and were then presented by using descriptive statistics and analyzed by Chi-square test, Pearson correlation coefficient, and regression analysis. Results: Participants were 86 female (58.1%) and 62 male (41.9%); 109 (73.6%) aged 60-75 years, and the rest were older than 75 years; 71 (48%) had moderate or severe depression; 4(2.7%) and 61(41.2%) were dependent or in need of help performing ADL and IADL, respectively. Statistical analysis showed that depression has a significant negative correlation with ADL (r= -0.304, P<0.001) and IADL (r=-0.193, P>0.01); i.e. by increasing one of them, the depression decreases. Conclusion: The ability of the elderly people to perform ADL and IADL can be a good predictor of depression in them. With early assessment of their health and ability by health teams and family members, it is possible to prevent the development of their disability and depression.

scholarly journals Incapacidade funcional e fatores associados em idosos de área urbana: um estudo de base populacional

2016 ◽  
Vol 18 (5) ◽  
pp. 499 ◽  
Author(s):  
Darlene Mara dos Santos Tavares ◽  
Paula Berteli Pelizaro ◽  
Maycon Sousa Pegorari ◽  
Mariana Mapelli de Paiva ◽  
Gianna Fiori Marchiori
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Depression Scale ◽  
Action Planning ◽  
The Elderly ◽  
Bivariate Analysis ◽  
Urban Elderly ◽  
Cross Sectional ◽  
Instrumental Activities

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n5p499 Population aging may cause impaired functional abilities in the elderly population, with increased rates of functional disability. Early detection of functional disability makes it possible to postpone possible complications and helps with health action planning. The objective of this study was to investigate the factors associated with functional disability in urban elderly. We conducted an analytical and cross-sectional household survey with 1,691 urban elderly individuals in Uberaba (MG), Brazil, in 2012. The questionnaire included socioeconomic and clinical information. We used the following instruments to assessed the participants: Abbreviated Geriatric Depression Scale, Katz Index, and Lawton and Brody Scale. We performed a descriptive bivariate analysis and used a logistic regression model (p<0.05). The prevalence of functional disability in basic activities of daily living was 21.2%; whereas the prevalence of functional disability in instrumental activities of daily living was 65.9%. The following factors were associated with functional disability in basic and instrumental activities of daily living, respectively: age of 80 years old and older [(OR= 2.18; p<0.001), (OR=3.30, p<0.001)]; larger number of self-reported diseases [(OR=1.24, p<0.001), (OR=1.12; p<0.001)]; and symptoms of depression [(OR=1.49; p<0.003), (OR = 1.75, p<0.001)]; whereas no schooling (OR=1.88; p<0.001) was related to functional disability in instrumental activities of daily living. We found significant impairment of functional status, especially in instrumental activities of daily living and in association with socioeconomic and health variables; those aspects support the implementation of actions aimed at monitoring and controlling the factors that interfere with the functional ability of the elderly.

Bahasa Indonesia PENGARUH TINGKAT DEPRESI TERHADAP KEMANDIRIAN ACTIVITIES OF DAILY LIVING (ADL) PADA LANSIA

2018 ◽  
Vol 3 (1) ◽  
pp. 31-38
Author(s):  
W Ibowo
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Cross Sectional ◽  
Katz Index ◽  
Level 2 ◽  
Bahasa Indonesia

Proses penuaan yang dialami lansia tidak hanya berhubungan pada segi kehidupan tetapi juga akan diikuti dengan kemunduran fisik dan mental. Gangguan mental yang sering dijumpai pada lansia adalah kecemasan dan depresi serta gangguan faal tubuh. Tingkat depresi itu sendiri berbeda-beda pada setiap lansia. Saat memasuki usia tua, para lansia memiliki perubahan struktur otak yang menyebabkan kemunduran kualitas hidup yang berimplikasi pada kemandirian dalam melakukan aktivitas sehari-hari atau ADL (Activities of Daily Living). Metode penelitian menggunakan penelitian deskriptif korelasi dengan desain penelitian cross sectional yang bertujuan untuk melihat  hubungantingkat depresi  lansia terhadap tingkat kemandirian lansia dalam pemenuhan kebutuhan Activity Daily Living (ADL). Populasi dalam penelitian ini adalah para lansia yang datang ke posyandu,tehnik sampling yang digunakan adalah total sampling dengan jumlah sampel sebanyak 76 responden  dengan menggunakan alat ukur Geriatric Depression Scale (GDS) dan KATZ Index. Uji statistik yang digunakan adalah uji statistik non parametrik, yaitu uji Korelasi Rank Spearmen menggunakan aplikasi SPSS 20 for nilai signifikansi atau Sig. (2-tailed) sebesar 0,413. Karena nilai Sig. (2-tailed) 0,413 > 0,05 level (2-tailed) maka artinya tidak ada hubungan yang signifikan antara tingkat depresi dengan tingkat kemandirian pada lansia.   Kata Kunci: Depresi, Activities of Daily Living, Lansia

A proposal for an abbreviated onco-geriatric assessment in daily practice

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18565-18565
Author(s):  
V. Girre
Keyword(s):  
Social Environment ◽  
Geriatric Assessment ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Daily Practice ◽  
The Elderly ◽  
Activity Of Daily Living ◽  
Loss Of Autonomy ◽  
A Prospective Study

18565 Background: In order to describe the elderly population in Institut Curie and to determine if a brief multidimensional assessment may influence our decision to treat elderly patients with cancers we decided to realize a short assessment for each patient, 70 years and older. In a prospective study we evaluated such diverse areas as functional status, comorbidity, nutrition, polypharmacy and the presence or absence of geriatric syndromes. Methods: We studied 105 elderly cancer patients, median age 80 years with solid tumors. In addition to PS, their physical function was assessed by the activity of daily living (ADL) and instrumental activity of daily living (IADL) scales. During consultation comorbidities, Geriatric depression scale (GDS), the number of falls in the past year, concomitant medications, weight measurements and social environment were collected in a questionnaire. Cognitive functions were assesed if troubles were suspected. Blood tests were performed secondary. Results: To date 105 patients were evaluated : 10 % live in institution, 16% have no social environment, 35 % have a loss of autonomy in ADL and 7% were dependant. In the IADL: 30% presented a loss of autonomy and 24% were dependant. The median Body Mass Index (BMI) was 23.8 kg/m2, but the BMI was in 14% < 19kg/m2; 20% of the patients fall more than 2 times in the year and 53% have a suspicion of depression in the GDS in 4 items. 74% take more than 3 drugs per day. The median of comorbidities was 1.3. According to the results the decision of treatment was modified in 28% of patients. Conclusion: This questionnaire is not a replacement for the entire Comprehensive Geriatric assessment but is a reasonable prescreening instrument that may be performed in less than 15 minutes and be helpful to the clinician in his decision. No significant financial relationships to disclose.

scholarly journals Prevalence of Dementia Among Older Patients: A Hospital-Based Study in Iran

2019 ◽  
Vol 34 (7-8) ◽  
pp. 500-506
Author(s):  
Leila Kamalzadeh ◽  
Moein Moghaddamnia ◽  
Seyed Kazem Malakouti ◽  
Vahid Rashedi ◽  
Sara Bahrampour ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Health Hazard ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Prevalence Of Dementia

Background: Dementia constitutes a public health hazard in developing countries. The aim of this study was to evaluate the prevalence of dementia and its associated factors in older hospitalized patients. Methods: The participants of this cross-sectional study consisted of older patients admitted to medical wards in Rasoul-e Akram hospital in Tehran, Iran. Mini-Mental State Examination, Mini-Cog test, Geriatric Depression Scale, Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, and socioeconomic questionnaires were used. Results: A total of 205 elderly inpatients were included. The mean age was 71.33 ± 7.35 years; 63.4% of the participants had normal cognitive function, while 36.6% had some degree of cognitive impairment. There was a statistically significant relationship between gender, age, number of children, and occupation and the prevalence of dementia. Conclusion: Appropriate cognitive screening of older patients upon admission to hospitals could help identify potential adverse events and enhance the quality of care for patients with comorbid dementia.

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