scholarly journals Effects of Depression, Dementia and Delirium on Activities of Daily Living in Elderly Patients after Discharge

2019 ◽  
Author(s):  
Ching Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Short Form ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
The Impact

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients aged 65 years and older admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. There were significant lower BI scores in patients with dementia and delirium compared with those without up to 180 days after discharge, but no difference was seen in the depression group. In general, patients had delirium or dementia had worsening functional status, even though significant magnitude of improvements on BI scores after discharge. Conclusions Depression does not affect patients’ ADLs. On the other hand, dementia and delirium can persistently limit patients’ physical function. Future care should focus more on dementia and delirium to restore function.

scholarly journals Effects of Depression, Dementia and Delirium on Activities of Daily Living in Elderly Patients after Discharge

2019 ◽  
Author(s):  
Ching Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Short Form ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
The Impact

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients aged 65 years and older admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. There were significant lower BI scores in patients with dementia and delirium compared with those without up to 180 days after discharge, but no difference was seen in the depression group. In general, patients had delirium or dementia had worsening functional status, even though significant magnitude of improvements on BI scores after discharge. Conclusions Depression does not affect patients’ ADLs. On the other hand, dementia and delirium can persistently limit patients’ physical function. Future care should focus more on dementia and delirium to restore function.

scholarly journals Effects of Depression, Dementia and Delirium on Activities of Daily Living in Elderly Patients after Discharge

2019 ◽  
Author(s):  
Ching Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Short Form ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
The Impact

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients aged 65 years and older admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. There were significant lower BI scores in patients with dementia and delirium compared with those without up to 180 days after discharge, but no difference was seen in the depression group. In general, patients had delirium or dementia had worsening functional status, even though significant magnitude of improvements on BI scores after discharge. Conclusions Depression does not affect patients’ ADLs. On the other hand, dementia and delirium can persistently limit patients’ physical function. Future care should focus more on dementia and delirium to restore function.

scholarly journals Effects of Depression, Dementia and Delirium on Activities of Daily Living in Elderly Patients after Discharge

2019 ◽  
Author(s):  
Ching Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Short Form ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
The Impact

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients aged 65 years and older admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. There were significant lower BI scores in patients with dementia and delirium compared with those without up to 180 days after discharge, but no difference was seen in the depression group. In general, patients had delirium or dementia had worsening functional status, even though significant magnitude of improvements on BI scores after discharge. Conclusions Depression does not affect patients’ ADLs. On the other hand, dementia and delirium can persistently limit patients’ physical function. Future care should focus more on dementia and delirium to restore function.

scholarly journals Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ching-Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Short Form ◽  
Medical Center ◽  
Functional Decline ◽  
Depression Scale ◽  
Assessment Method ◽  
Functional Improvement ◽  
The Impact

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients who aged over 65 years and admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation (GEE) was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. The study demonstrated that all the geriatric patients with functional decline presented gradual improvements of physical function up to 180 days after discharge. Whether depression exists did not substantially affect functional recovery after discharge, whilst either dementia or delirium could impede elder people functional status. The recovery of functional improvement in delirium or dementia was relatively irreversible when comparing with depression. Once delirium or dementia was diagnosed, poorer functional restore was expected. In brief, intensive work and strategies on modifying delirium or dementia should be put more effort as early as possible. Conclusions Old hospitalized patients with depression can recover well after adequate intervention. We emphasize that early detection of dementia and delirium is imperative in subsequent functional outcome, even if at or before admission. Comprehensive plan must be implemented timely.

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.

Moving towards novel multidisciplinary approaches for improving elderly quality of life: The emerging role of telemedicine in Sicily

2018 ◽  
Vol 25 (5) ◽  
pp. 318-324 ◽  
Author(s):  
Giuseppa Maresca ◽  
Maria C De Cola ◽  
Santina Caliri ◽  
Rosaria De Luca ◽  
Alfredo Manuli ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Health Survey ◽  
Daily Living ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Short Form Health Survey ◽  
Form Health ◽  
Short Form Health

Introduction Elderly care is a worldwide social and economic challenge for the public health system, and it requires the development of new management strategies. Telemedicine provides an innovative approach towards elderly care, especially for those with chronic diseases. In this study, we aimed to evaluate the potential role of a multidisciplinary telemedicine approach for improving elderly quality of life. Methods Twenty-two participants received weekly vital parameter monitoring and nutritional counselling, biweekly psychological counselling and a monthly consultation with a neurologist. The neuropsychological assessment included the Mini Mental State Examination, the Activities of Daily Living, the Instrumental Activities of Daily Living, the Geriatric Depression Scale and the Short-Form Health Survey, and was administered at enrolment (T0) and at the end of the study (T3). The nutritional evaluation included haematochemical examinations of glycaemia, total cholesterol, and triglycerides at baseline (T0) and every four months (T1, T2, T3). Results Significant differences in Activities of Daily Living, Geriatric Depression Scale and all domains of the Short-Form Health Survey were observed between baseline and the end of the study. The haematochemical parameters showed obvious changes over time, especially in cholesterol values, and the patients with hypercholesterolaemia and hypertriglyceridaemia showed a reduction in body mass index. Moreover, we found that the haematochemical values were moderately correlated with the Activities of Daily Living, Geriatric Depression Scale and Short-Form Health Survey scores. Conclusion Telemedicine can be a suitable tool for caring for elderly people more efficiently by promoting the remission of depressive symptoms and improving social functioning, cognitive levels and nutritional habits to prevent vascular diseases and exacerbations of pre-existing chronic illness.

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 Tracking personalized functional health in older adults using geriatric assessments

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anup K. Mishra ◽  
Marjorie Skubic ◽  
Mihail Popescu ◽  
Kari Lane ◽  
Marilyn Rantz ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Case Studies ◽  
Daily Living ◽  
Short Form ◽  
Depression Scale ◽  
Functional Health ◽  
Adverse Health ◽  
Health Trajectories ◽  
Model Predictions

Abstract Background Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even though several geriatric assessments capture several aspects of functional health, there is limited research in longitudinally tracking personalized functional health of older adults using a combination of these assessments. Methods We used geriatric assessment data collected from 150 older adults to develop and validate a functional health prediction model based on risks associated with falls, hospitalizations, emergency visits, and death. We used mixed effects logistic regression to construct the model. The geriatric assessments included were Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Short Form 12 (SF12). Construct validators such as fall risks associated with model predictions, and case studies with functional health trajectories were used to validate the model. Results The model is shown to separate samples with and without adverse health event outcomes with an area under the receiver operating characteristic curve (AUC) of > 0.85. The model could predict emergency visit or hospitalization with an AUC of 0.72 (95% CI 0.65–0.79), fall with an AUC of 0.86 (95% CI 0.83–0.89), fall with hospitalization with an AUC of 0.89 (95% CI 0.85–0.92), and mortality with an AUC of 0.93 (95% CI 0.88–0.97). Multiple comparisons of means using Turkey HSD test show that model prediction means for samples with no adverse health events versus samples with fall, hospitalization, and death were statistically significant (p < 0.001). Case studies for individual residents using predicted functional health trajectories show that changes in model predictions over time correspond to critical health changes in older adults. Conclusions The personalized functional health tracking may provide clinicians with a longitudinal view of overall functional health in older adults to help address the early detection of deterioration trends and decide appropriate interventions. It can also help older adults and family members take proactive steps to improve functional health.

scholarly journals P130: Feasibility of self-assessing functional status in older emergency department patients

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S111-S111
Author(s):  
V. Boucher ◽  
V. Boucher ◽  
M. Lamontagne ◽  
J. Lee ◽  
M. Émond
Keyword(s):  
Emergency Department ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Assessment Tool ◽  
Assessment Method ◽  
Assessment Tools ◽  
Self Assessment ◽  
Medical Reason ◽  
Significant Difference

Introduction: Geriatric Emergency Department (ED) guidelines recommend systematic screening of older patients for geriatric syndromes. However, compliance issues to this recommendation have already been observed. Self-assessment tools could be an interesting solution as self-assessed general, mental and physical health was shown to be predictive of functional decline and mortality. The Older Americans Resources and Services scale (OARS), is a simple geriatric functional assessment scale that is widely used by professionals to quantify patients’ ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL). However, its use as a self-assessment tool has never been tested. Objective: to evaluate the feasibility of the self-assessed OARS compared to its standard administration by a research assistant (RA) in older ED patients. Methods: A planned sub-analysis of a single center randomized crossover pilot study in 2018 was realized. Patients aged ≥65 who consulted to the ED for any medical reason were included. Patients were excluded if they: 1) required resuscitation (CTAS 1); 2) were unable to consent/to speak French; 3) had a physical condition preventing the use of an electronic tablet. Patients were randomized 1:1 to either 1) tablet-based functional status self-assessment or 2) the RAs questionnaire administration at first, after which they crossed-over to the other assessment method. Paired t-tests were used to assess the score differences. Results: 60 patients were included. Mean age was 74.4 ± 7.6 and 34 (56.7%) participants were women. Mean OARS score according to RA was 25.1 ± 3.3 and mean self-assessed OARS score was 26.4 ± 2.5 (p < 0.0001). There was also differences when looking at the AVQ and AIVQ separately. Mean AVQ scores were 12.5 ± 1.8 and 13.5 ± 0.9 (p < 0.0001) and mean AIVQ scores were 12.6 ± 1.8 and 12.9 ± 1.8 (p = 0.04) for RA assessment and self-assessment, respectively. Conclusion: Our results show a statistically significant difference between RA assessment and patient self-assessment of functional status, and this difference seems to be more pronounced regarding AVQ than AIVQ. The study confirms that self-assessment of functional status by older ED patients is feasible, but further testing is required in order to confirm the validity and psychometric values of this self-administered version of the OARS.

Number of Comorbidities Negatively Influence Psychological Outcomes of the Elderly Following Hip Fracture in Taiwan

2016 ◽  
Vol 28 (8) ◽  
pp. 1343-1361 ◽  
Author(s):  
Yueh-Fang Huang ◽  
Jersey Liang ◽  
Yea-Ing Lotus Shyu
Keyword(s):  
Hip Fracture ◽  
Short Form ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Estimating Equation ◽  
Psychological Outcomes ◽  
First Year ◽  
Medical Outcomes

Objective: Hip fracture usually affects psychological functions of the elderly, and comorbidities often interfere with their recovery. However, little is known about the influence of number of comorbidities on their psychological outcomes. Method: Data from a previous study of 461 hip-fractured elders treated at a medical center in northern Taiwan were analyzed by the generalized estimating equation approach. Outcomes were assessed at 1, 3, 6, 12 months following discharge by the Geriatric Depression Scale (GDS), Mini-Mental State Examination, and two subscales of the Medical Outcomes Study Short Form 36: role limitations due to emotional problems, and Mental Health (MH). Results: Hip-fractured elders with more comorbidities were more likely to have cognitive impairment (β = 0.224, p = .004), higher GDS scores (β = 0.328, p = .001), and worse MH (β = −1.784, p = .009) during the first year following discharge. Discussion: Having more comorbidities negatively influenced the psychological outcomes of elderly patients with hip fracture.

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