Comparison of Sleep Disturbances Between Older Nursing Home Residents in High- and Low-Altitude Areas

2019 ◽  
Vol 33 (6) ◽  
pp. 370-376
Author(s):  
Shou Liu ◽  
Ines H. I. Chow ◽  
Li Lu ◽  
Yan-Ming Ren ◽  
Hui-Lian Yang ◽  
...  
Keyword(s):  
Nursing Home ◽  
Sleep Disturbance ◽  
High Altitude ◽  
Sleep Disturbances ◽  
Nursing Home Residents ◽  
Male Gender ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
High Altitude Area ◽  
Low Altitude

Background and Objective: This study compared sleep disturbances between older adults living in nursing home located in high- and low-altitude areas and explored the association between sleep disturbances and quality of life (QoL). Method: In total, 207 participants living in a high-altitude area and 437 participants in a low-altitude area were included. Sleep disturbances (ie, difficulty in initiating sleep, difficulty in maintaining sleep, and early morning awakening) were measured using standardized questions. The independent demographic and clinical correlates of sleep disturbances in high-altitude area were examined using multiple logistic regression analyses. Each type of sleep disturbance was entered as the dependent variable separately, while those with significant group differences in the univariate analyses (ie, male gender, married status, age and depressive symptoms) were entered as independent variables. Results: The prevalence of any type of sleep disturbances in the whole sample was 26.09%, with 41.54% in the high-altitude area and 18.76% in the low-altitude area. Physical, psychological, social, and environmental QoL domains were negatively associated with sleep disturbances in high-altitude area. Multiple logistic regression analyses revealed that male gender and married status were less likely to have sleep disturbances, while those with more severe depressive symptoms were more likely to have sleep disturbances in high-altitude area. Conclusion: Sleep disturbance is common among older nursing home residents in high-altitude areas. Considering the negative impact of sleep disturbance on QoL, regular screening and treatment strategies need to be developed directly for this population.

scholarly journals Prevalence of Depression in Older Nursing Home Residents in High and Low Altitude Regions: A Comparative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Wang ◽  
Shou Liu ◽  
Qinge Zhang ◽  
Chee H. Ng ◽  
Xiling Cui ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
High Altitude ◽  
Negative Impact ◽  
Multiple Logistic Regression Analysis ◽  
Nursing Home Residents ◽  
Treatment Of Depression ◽  
Prevalence Of Depression ◽  
Low Altitude

Objective: Depressive symptoms (depression hereafter) is common in older adults, and closely associated with environmental factors. This study compared the prevalence of depression in older adults living in high-altitude and low-altitude regions, and their association with quality of life (QOL).Method: A total of 632 older nursing home residents were included, with 425 participants living in low-altitude and 207 participants living in high-altitude regions. Depression and QOL were assessed using standardized instruments.Results: The prevalence of depression was 26.9% (95% CI: 23.43–30.37%) in the whole sample of older nursing home residents, with 11.1% (95% CI: 8.01–14.05%) in those living in low-altitude and 59.4% (95% CI: 52.68–66.17%) in those living in high-altitude regions. Multiple logistic regression analysis revealed that living in low-altitude region (P < 0.001, OR = 0.07, 95% CI: 0.04–0.12) was associated with lower risk of depression, while perception of poor health status (P < 0.001, OR = 3.86, 95% CI: 1.98–7.54) and having insomnia (P < 0.001, OR = 4.76, 95% CI: 2.99–7.56) were associated with higher risk of depression. QOL was significantly lower in physical (F(1,632) = 35.421, P < 0.001), psychological (F(1,632) = 20.777, P < 0.001), social (F(1,632) = 8.169, P < 0.001) and environmental domains (F(1,632) = 11.861, P < 0.001) in those with depression.Conclusion: Depression was common in older nursing home residents especially those living in the high-altitude region. Considering the negative impact of depression on QOL and functional outcomes, routine screening and timely treatment of depression should be implemented in this population.

Correlates of agitation and depression in nursing home residents with dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1779-1789 ◽  
Author(s):  
Tomislav Majić ◽  
Jan P. Pluta ◽  
Thomas Mell ◽  
Yvonne Treusch ◽  
Hans Gutzmann ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mini Mental State Examination ◽  
Nursing Home Residents ◽  
Regression Analyses ◽  
Dementia Severity ◽  
Advanced Stages ◽  
Severity Of Depression ◽  
And Gender ◽  
The Relationship ◽  
State Examination

ABSTRACTBackground:The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia.Methods:The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N= 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated usingχ2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender.Results:Increasing stages of dementia severity were associated with higher risk for physically aggressive (p< 0.001) and non-aggressive (p< 0.01) behaviors, verbally agitated behavior (p< 0.05), and depression (p< 0.001). Depressive symptoms were associated with physically aggressive (p< 0.001) and verbally agitated (p< 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding.Conclusions:Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.

Behavioral and Psychological Symptoms in Dementia in Nursing Home Residents: The Economic Implications

2000 ◽  
Vol 12 (S1) ◽  
pp. 51-57 ◽  
Author(s):  
Judith A. O'Brien ◽  
Lori A. Shomphe ◽  
J. Jaime Caro
Keyword(s):  
Nursing Home ◽  
Caregiver Burden ◽  
Behavioral Problems ◽  
Sleep Disturbances ◽  
Psychological Symptoms ◽  
Violent Behavior ◽  
Nursing Home Residents ◽  
Level Of Care ◽  
Economic Implications ◽  
Behavioral And Psychological Symptoms

A variety of behavioral and psychological symptoms are inherent to dementia, such as delusional thinking, hallucinations, agitation, violent behavior, verbal outbursts, wandering, sleep disturbances, and sexually inappropriate behavior (Jackson et al., 1989; Reisberg et al., 1987; Teri et al., 1992; Yeager et al., 1995). Although opinions in the literature differ concerning behavioral problems and how they relate to caregiver burden and institutionalization (Martinson et al., 1995; Mega et al., 1996; Reisberg et al., 1987), this analysis focuses on their role in increasing the level of care once the patient is placed in permanent residential care.

scholarly journals Depressive symptoms and chronotypes of elderly nursing home residentes: A case management study

2020 ◽  
Vol 14 (2) ◽  
pp. 165-170
Author(s):  
Evany Bettine de Almeida ◽  
Thais Bento Lima-Silva ◽  
Luiz Menna-Barreto
Keyword(s):  
Nursing Home ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Sleep Disturbances ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Sleep Diary ◽  
Low Educated

ABSTRACT. Institutionalization potentiates the tendency for specific sleep disturbances which occur with aging, besides negative health consequences such as increased rate of depressive symptoms. Objective: To compare sleep profile and depressive symptoms in elderly nursing home residents, highlighting gender differences. Methods: A quantitative descriptive study of 29 elderly from two different nursing homes was conducted. A sociodemographics questionnaire, Sleep Diary, Morningness-Eveningness Questionnaire and the 15-item Geriatric Depression Scale were applied. Data were analyzed using descriptive statistics, Student’s t-test and the Mann-Whitney U-test. Results: The sample comprised individuals that were predominantly female (72%), aged 80-90 years (48%), widowed (66%) and low-educated (83%). The women were found to sleep and awake later than the men. Regarding chronotypes, the women were classified as evening types and men as intermediate/indifferent types. Most of the elderly exhibited symptoms of major depression (48%). Compared to men, women had more depressive symptoms in both dysthymia and major depression categories. Conclusion: No significant differences were evident on comparisons of sleep profile and depressive symptoms, but elderly with the intermediate chronotype scored lower on the depressive symptoms scale.

Neurologic Concerns in Long-Term Care

1993 ◽  
Vol 6 (6) ◽  
pp. 290-296
Author(s):  
Susan K. Bowles
Keyword(s):  
Nursing Home ◽  
Behavioral Interventions ◽  
Sleep Disturbances ◽  
Nursing Home Residents ◽  
Antipsychotic Agents ◽  
Behavioral Symptoms ◽  
Pharmacological Intervention ◽  
Dramatic Improvement ◽  
Drug Induced ◽  
Term Care

Nursing home residents exhibit a number of different neurological disorders, including behavioral symptoms associated with dementia, sleep disturbances, and drug-induced disorders such as tardive dyskinesia. Behavioral symptoms are frequently treated with antipsychotic agents. However, there is growing evidence that these agents are frequently used inappropriately. While some patients may benefit from pharmacological intervention, it is doubtful that the majority will show dramatic improvement. Some sleep disturbances may be effectively treated with drugs, although they should be used in conjunction with environmental and behavioral interventions. The overuse of psychoactive drugs, particularly the neuroleptics, may result in neurological complications. Pharmacists have a role in ensuring that drugs are used for appropriate indications in elderly nursing home residents and in identifying drug-induced disease.

Characteristics of multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents: a systematic review

2020 ◽  
pp. 1-29 ◽  
Author(s):  
Denise Wilfling ◽  
Jonas Hylla ◽  
Almuth Berg ◽  
Gabriele Meyer ◽  
Sascha Köpke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Sleep Disturbances ◽  
Light Exposure ◽  
Complex Interventions ◽  
Nursing Home Residents ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Positive Effects ◽  
Multicomponent Interventions

ABSTRACT Background: Dementia guidelines propose the use of nonpharmacological interventions for sleep disturbances for older people. Based on available reviews, it seems most likely that multicomponent interventions have the strongest potential to be effective in improving sleep. However, a detailed description of multicomponent interventions is missing. This systematic review aims to identify, describe, and summarize multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents. Methods: This review followed established methodological frameworks for systematic evidence syntheses. A computerized search was conducted in December 2018, using the databases PubMed, CINAHL, Scopus, and Cochrane Library. Two independent reviewers assessed all search results to identify eligible studies and assessed studies’ methodological quality following the Cochrane Risk of Bias methodology for randomized controlled trials and the CASP Appraisal Checklist for controlled trials. Evaluation studies of any design investigating multicomponent interventions were included, except case studies. Components of included intervention programs were analyzed applying the TIDieR and CReDECI 2 criteria. Results: A total of 2056 studies were identified through the database search; ten publications about nine interventions met the inclusion criteria and were included in the review. The identified interventions can be summarized assigned to the categories “daytime activities,” “nighttime activities,” “staff training,” and “light exposure.” The approaches showed similarities and differences in procedures, materials, modes of delivery, intervention provider, and intervention period. None of the studies described any intended interactions between components or considered context characteristics in intervention modeling as well as internal and external facilitators or barriers influencing delivery of intervention. We identified positive or mixed positive effects for sleep-related outcomes for the mentioned categories. Conclusions: The analysis of included interventions demonstrates somehow promising results, although findings are difficult to interpret as interventions were not well described, and the challenges of developing and evaluating complex interventions were not sufficiently acknowledged.

Sleep disturbances among nursing home residents

2002 ◽  
Vol 17 (7) ◽  
pp. 604-609 ◽  
Author(s):  
Arne Fetveit ◽  
Bj�rn Bjorvatn
Keyword(s):  
Nursing Home ◽  
Sleep Disturbances ◽  
Nursing Home Residents

scholarly journals Anesthesia of a high-altitude area inhabitant who underwent aortic dissection emergency surgery in a low-altitude area

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097987
Author(s):  
Huan Zheng ◽  
Xin-Chuan Wei ◽  
Tao Yu ◽  
Qian Lei
Keyword(s):  
Aortic Dissection ◽  
High Altitude ◽  
Emergency Surgery ◽  
Heart Surgery ◽  
Perioperative Management ◽  
Anesthetic Management ◽  
Cor Pulmonale ◽  
High Altitude Area ◽  
Low Altitude ◽  
Chronic Hypoxemia

Heart surgery in patients from high-altitude areas is more challenging than usual. Few studies have been published on this issue, and none of them have discussed the effect of an altitude change (from high to low altitude) on a patient’s physiology or its effects on a patient’s perioperative management. Here, we present the case of a 46-year-old man who was a long-time resident of Tibetan area in Sichuan (altitude >3000 m) who underwent Stanford type A aortic dissection emergency surgery on the plain. Anesthetic management occurred through monitoring of the bispectral index (BIS) and transesophageal echocardiography (TEE), and we used a relatively loose fluid hydration strategy. The surgery was performed using cardiopulmonary bypass (CPB), deep hypothermia (DH), and selective antegrade cerebral perfusion. The most prominent anesthesia challenges for these patients are physiological changes due to habitation in an high-altitude environment (chronic hypoxemia), which can cause hyperhemoglobinemia, polycythemia, hypercoagulable blood, and even pulmonary hypertension, cor pulmonale, or congestive heart failure. Optimized perioperative management and close cooperation among the entire cardiac medical team were the key factors in the successful management of this rare case.

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