scholarly journals How long should older people take antidepressants to prevent relapse?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 70-73 ◽  
Author(s):  
Jon Spear
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Clinical Practice ◽  
High Risk ◽  
Depressive Disorder ◽  
Older People ◽  
Future Research ◽  
Open Label ◽  
Psychotherapeutic Interventions ◽  
Risk Of Relapse

Patients with depressive disorder have a high risk of relapse after recovery from a depressive episode. Can the relapse of depressive disorder be prevented or delayed for older adults? This paper reviews the evidence from randomised clinical trials and open label trials of the effectiveness of maintenance antidepressant therapy for older adults with depressive disorder. It also examines the evidence for the effectiveness of psychosocial and psychotherapeutic interventions. The paper concludes with recommendations for clinical practice and future research.

The economic recession and subjective well-being in older adults in the Republic of Ireland

2016 ◽  
Vol 36 (2) ◽  
pp. 99-104 ◽  
Author(s):  
R. M. Duffy ◽  
K. Mullin ◽  
S. O’Dwyer ◽  
M. Wrigley ◽  
B. D. Kelly
Keyword(s):  
Older Adults ◽  
Older People ◽  
Urban Areas ◽  
Economic Recession ◽  
Well Being ◽  
Poor Health ◽  
Future Research ◽  
Subjective Well Being ◽  
Physical And Mental Health ◽  
Future Health

ObjectiveSubjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008.MethodsCross-sectional data from the biennial European Social Survey (2002–2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers.ResultsData were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00–1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas.ConclusionsSubjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.

scholarly journals Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 222-222
Author(s):  
Noriko Suzuki ◽  
Masahiko Hashizume ◽  
Hideyuki Shiotani
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Future Research ◽  
Baseline Body Mass Index ◽  
Term Care ◽  
Postprandial Hypotension ◽  
Before And After ◽  
Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p &lt;0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

Persistent Depressive Disorder

2015 ◽  
pp. 226-237
Author(s):  
Daniel N. Klein ◽  
Sarah R. Black
Keyword(s):  
Depressive Disorder ◽  
Future Research ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
The Past ◽  
Psychotherapeutic Interventions ◽  
Interpersonal Difficulties ◽  
Persistent Depression ◽  
Continuation Maintenance ◽  
Persistent Depressive Disorder

Over the past few decades, there has been increasing recognition of the problem of persistent, or chronic, depression. Chronic depressions account for up to a third of the cases of depression in the community and half the cases in clinical practice. Moreover, as reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), persistent depressive disorder differs in many significant respects from nonpersistent depression. This chapter provides an overview of the current literature on persistent depression, starting with classification, epidemiology, and course. Psychosocial and neurobiological risk factors, including early adversity, genetics, personality/temperament, cognitive style, interpersonal difficulties, neural abnormalities, and chronic stress, are then reviewed. Next, we discuss psychopharmacological and psychotherapeutic interventions for acute and continuation/maintenance treatment of persistent depression. We conclude with suggestions for future research.

Neuropsychological assessment in older people: old principles and new directions

2000 ◽  
Vol 6 (5) ◽  
pp. 362-370 ◽  
Author(s):  
Robin G. Morris ◽  
Claire Worsley ◽  
David Matthews
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Older People ◽  
Neuropsychological Assessment ◽  
Rating Scales ◽  
Clinical Psychologist ◽  
Narrow Sense ◽  
New Directions ◽  
Different Types ◽  
Common Clinical Practice

Neuropsychological assessment, in the broader sense, is common clinical practice with older adults because of the widespread use of mental status examinations and dementia rating scales. In the more narrow sense, a neuropsychological assessment conducted by a clinical psychologist or clinical neuropsychologist is used less frequently and for more specific purposes. This paper outlines these uses and provides a brief overview of the different types of test that might be used, with a clinical example to illustrate the type of information gained. This review is designed not to be comprehensive, but to provide a pointer towards the latest trends in test development.

Preparing students for intentional conversations with older adults

2020 ◽  
pp. 1-19
Author(s):  
Margaret McAllister ◽  
Leanne Dodd ◽  
Colleen Ryan ◽  
Donna Lee Brien
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Nursing Students ◽  
Older People ◽  
Educational Intervention ◽  
Narrative Theory ◽  
Life Stories ◽  
Human Beings ◽  
Study Approach ◽  
Story Theory

Abstract This paper presents the findings from a study introducing nursing students to narrative production. The aim was to use Story Theory to inspire students to intentionally collaborate with older people and produce a mini-biography of those individuals. Narrative theory was utilised in four ways: designing an educational intervention; collecting and developing older peoples’ life stories; framing an understanding of the meaning of the stories collected; analysing the significance of the storytelling approach. The paper explains the study approach and findings and outlines the benefits as well as challenges that occurred during the process. Most particularly, the anthology produced has become a tangible reminder about a clinical practice that allowed students to meet frail aged residents and come to know them as vibrant human beings.

scholarly journals First Trimester Biomarkers in the Prediction of Later Pregnancy Complications

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Stefan C. Kane ◽  
Fabricio da Silva Costa ◽  
Shaun Brennecke
Keyword(s):  
Risk Factors ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Preterm Birth ◽  
High Risk ◽  
Gestational Diabetes ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
High Risk Population ◽  
Maternal History

Adverse obstetric outcomes, such as preeclampsia, preterm birth, gestational diabetes, and fetal growth restriction, are poorly predicted by maternal history and risk factors alone, especially in nulliparae. The ability to predict these outcomes from the first trimester would allow for the early initiation of prophylactic therapies, institution of an appropriate model and location of care, and recruitment of a truly “high risk” population to clinical trials of interventions to prevent or ameliorate these conditions. To this end, development of adequately sensitive and specific predictive tests for these outcomes has become a significant focus of perinatal research. This paper reviews the biomarkers involved in these multiparametric tests and also outlines the performance of these tests and issues regarding their introduction into clinical practice.

scholarly journals Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Syed Ghulam Sarwar Shah ◽  
David Nogueras ◽  
Hugo Cornelis van Woerden ◽  
Vasiliki Kiparoglou
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Trials ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Future Research ◽  
Before And After ◽  
Quasi Experimental

Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

scholarly journals A New Normal? Continued Impact of COVID19 on Alzheimer’s Clinical Trials Research

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 137-137
Author(s):  
Elizabeth Rhodus ◽  
Allison Gibson ◽  
Shoshana Bardach ◽  
Erin Abner ◽  
Gregory Jicha
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Race And Ethnicity ◽  
Future Research ◽  
Research Engagement ◽  
Disease Research ◽  
Study Planning ◽  
Psychosocial Implications

Abstract The COVID-19 pandemic has led to unprecedented challenges in Alzheimer’s disease and related dementias (ADRD) clinical trials research. Scientists continue to grapple with the potential and multifaceted consequences of COVID-19. This presentation will discuss strategies used at a U.S. Alzheimer’s Disease Research Center to implement virtual methods to counter COVID-19’s impact on safety for continued research engagement; address the disparate impact by age, race, and ethnicity for online accessibility; and plans for virtual engagement in future research. As scientists navigate lasting implications of COVID-19, future study planning, design, and management will likely be altered. Specifically, increased awareness of participant-centered approaches, inclusion of psychosocial implications, and focus on ways to meet older adults’ unique needs of virtual accessibility will be needed. We must be intentional to counter COVID-19’s lasting impact on ADRD clinical trials research while maintaining rigor and reproducibility to uphold and progress advances toward treatment and cures for ADRD.

scholarly journals Ageing, Vision Impairment and Digital Inclusion in Ireland

2012 ◽  
Vol 8 (1) ◽  
Author(s):  
Blaithin Anna Mary Gallagher ◽  
Emma Murphy ◽  
Antoinette Fennell
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Older People ◽  
Digital Divide ◽  
Economic Life ◽  
Vision Impairment ◽  
Digital Inclusion ◽  
Digital Revolution ◽  
Ict Competence ◽  
Highly Correlated

Our population is ageing. Vision impairment is highly correlated with ageing and the population of older people with vision impairment is increasing. ICT competence is essential to fully partake in society. Older people, in particular those with vision impairment, are at a high risk of being excluded from the digital revolution and must be ecnourage to use ICT's. This paper outlines four projects in which NCBI has been involved in relation to older adults and digital inclusion. Improving access to ICT for older people with vision impairment will enhance their participation in social, cultural and economic life and bridge the digital divide.

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