scholarly journals Implementing the Rating Scale for Aggressive Behaviours in the Elderly: Can it Make a Difference to Nursing Management of Aggressive Behaviours in Elderly Patients with Dementia?

2021 ◽  
Author(s):  
◽  
Bernadette Lidiard
Keyword(s):  
Elderly Patients ◽  
Aggressive Behaviour ◽  
Quantitative Methods ◽  
Rating Scales ◽  
Rating Scale ◽  
The Elderly ◽  
Inpatient Setting ◽  
Management Problem ◽  
Nursing Management ◽  
Aggressive Behaviours

<p><b>Aggressive behaviour is the most common clinical and nursing management problem for patients with dementia. Many elderly patients with dementia show sexual, physical, and verbal aggressive behaviours that complicate their management and make day-to-day nursing care difficult. These behaviours include yelling, hitting, swearing and verbal abuse. Despite this there is no consistent use of rating scales for assessing aggressive behaviour in this population. Nurses in the inpatient setting are often the main target for this aggression and without a rating scale the assessment of the behaviour is open to interpretation of the individual. While aggressive behaviours can be the most difficult behaviours for nursing staff to manage, these behaviours can also disrupt the milieu on inpatient psychogeriatric settings and frequently distress other patients, visiting families/whanau and friends.</b></p> <p>The Rating Scale for Aggressive Behaviours in the Elderly (RAGE) is a twenty-one item rating scale, designed specifically to measure aggressive behaviours in the elderly in the psychogeriatric inpatient setting. The purpose of the scale is to qualify the aggressive behaviour, note any changes in the behaviour, and record intervention and/or treatments. This study combines both qualitative and quantitative methods with exploratory and descriptive designs to explore nurses’ experiences of using a consistent tool for monitoring, measuring and managing aggressive behaviours.</p> <p>Data gathered over a three month period of implementing RAGE will provide a ‘snapshot’ of the prevalence, extent and type of aggressive behaviours within the inpatient setting, providing evidence to nurses in developing strategies for the management of aggression. Focus group interviews were used to enable nurses to discuss their experiences of utilising a clinically validated tool in their practice and how this made a difference to their practice.</p> <p>Findings from this research indicate that nurses within the setting found that RAGE is a consistent tool with which nurses can record, measure and monitor aggressive behaviours. Responses from nurses’ experiences of utilising RAGE in their practice were varied, with some being unable to articulate how RAGE had made a difference to their practice. Despite this there was an overwhelming positive response for the continued use of RAGE within the setting as a clinically validated tool by which to measure, record and manage aggressive behaviours.</p>

scholarly journals Implementing the Rating Scale for Aggressive Behaviours in the Elderly: Can it Make a Difference to Nursing Management of Aggressive Behaviours in Elderly Patients with Dementia?

2021 ◽  
Author(s):  
◽  
Bernadette Lidiard
Keyword(s):  
Elderly Patients ◽  
Aggressive Behaviour ◽  
Quantitative Methods ◽  
Rating Scales ◽  
Rating Scale ◽  
The Elderly ◽  
Inpatient Setting ◽  
Management Problem ◽  
Nursing Management ◽  
Aggressive Behaviours

<p><b>Aggressive behaviour is the most common clinical and nursing management problem for patients with dementia. Many elderly patients with dementia show sexual, physical, and verbal aggressive behaviours that complicate their management and make day-to-day nursing care difficult. These behaviours include yelling, hitting, swearing and verbal abuse. Despite this there is no consistent use of rating scales for assessing aggressive behaviour in this population. Nurses in the inpatient setting are often the main target for this aggression and without a rating scale the assessment of the behaviour is open to interpretation of the individual. While aggressive behaviours can be the most difficult behaviours for nursing staff to manage, these behaviours can also disrupt the milieu on inpatient psychogeriatric settings and frequently distress other patients, visiting families/whanau and friends.</b></p> <p>The Rating Scale for Aggressive Behaviours in the Elderly (RAGE) is a twenty-one item rating scale, designed specifically to measure aggressive behaviours in the elderly in the psychogeriatric inpatient setting. The purpose of the scale is to qualify the aggressive behaviour, note any changes in the behaviour, and record intervention and/or treatments. This study combines both qualitative and quantitative methods with exploratory and descriptive designs to explore nurses’ experiences of using a consistent tool for monitoring, measuring and managing aggressive behaviours.</p> <p>Data gathered over a three month period of implementing RAGE will provide a ‘snapshot’ of the prevalence, extent and type of aggressive behaviours within the inpatient setting, providing evidence to nurses in developing strategies for the management of aggression. Focus group interviews were used to enable nurses to discuss their experiences of utilising a clinically validated tool in their practice and how this made a difference to their practice.</p> <p>Findings from this research indicate that nurses within the setting found that RAGE is a consistent tool with which nurses can record, measure and monitor aggressive behaviours. Responses from nurses’ experiences of utilising RAGE in their practice were varied, with some being unable to articulate how RAGE had made a difference to their practice. Despite this there was an overwhelming positive response for the continued use of RAGE within the setting as a clinically validated tool by which to measure, record and manage aggressive behaviours.</p>

A rating scale for aggressive behaviour in the elderly – the RAGE

1992 ◽  
Vol 22 (1) ◽  
pp. 211-221 ◽  
Author(s):  
Vikram Patel ◽  
R. A. Hope
Keyword(s):  
Aggressive Behaviour ◽  
Rating Scale ◽  
High Reliability ◽  
Reliability And Validity ◽  
The Elderly ◽  
Check List ◽  
Ward Staff

SYNOPSISA 21-item rating scale for measuring aggressive behaviour in psychogeriatric in-patients is described. This scale is designed to be completed by ward staff. It should prove valuable in treatment studies and in studies which aim to investigate the correlates of aggressive behaviour. Studies using the scale demonstrate that when used in conjunction with a ward check list the scale has high reliability and validity.

scholarly journals French version of the Rating Scale for Aggressive Behaviour in the Elderly (F-RAGE): Psychometric properties and diagnostic accuracy

2013 ◽  
Vol 7 (3) ◽  
pp. 278-285 ◽  
Author(s):  
Barry Adama ◽  
Calvet Benjamin ◽  
Clément Jean-Pierre ◽  
Druet-Cabanac Michel ◽  
Prado-Jean Annie
Keyword(s):  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Aggressive Behaviour ◽  
Rating Scale ◽  
Internal Consistency Reliability ◽  
The Elderly ◽  
Clinical Impression ◽  
Validity And Reliability ◽  
French Version ◽  
Clinical Diagnoses

ABSTRACT Aggressive behaviour is the most disturbing and distressing behaviour displayed by elderly people. The prevalence of aggressive behaviour is around 50% among psychogeriatric patients. Objective: This study sought to analyze the psychometric properties and diagnostic accuracy of the French version of the Rating Scale for Aggressive Behaviour in the Elderly (F-RAGE). Methods: The F-RAGE was administered to 79 patients hospitalized in a geriatric psychiatry department. A psychiatrist, who was blind to the subjects' RAGE scores, performed the diagnosis for aggressivity based on global clinical impression. The F-RAGE and MMSE were applied by a trained researcher blind to subjects' clinical diagnoses while the Cohen-Mansfield Agitation Inventory and Neuropsychiatric Inventory were administered by medical and nursing staff. Internal consistency, reliability, cut-off points, sensitivity and specificity for F-RAGE were estimated. Results: F-RAGE showed satisfactory validity and reliability measurements. Regarding reliability, Cronbach's a coefficient was satisfactory with a value of 0.758. For diagnostic accuracy, a cut-off point of 8 points (sensitivity=74.19%; specificity=97.98%) and area under curve of 0.960 were estimated to distinguish between aggressive patients and control subjects. Discussion: F-RAGE showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the diagnosis of aggressive behaviour in elderly.

scholarly journals Efficacy of Citalopram in the prevention of recurrent depression in elderly patients: Placebo-controlled study of maintenance therapy

2002 ◽  
Vol 181 (1) ◽  
pp. 29-35 ◽  
Author(s):  
René Klysner ◽  
Jesper Bent-Hansen ◽  
Hanne L. Hansen ◽  
Marianne Lunde ◽  
Elisabeth Pleidrup ◽  
...  
Keyword(s):  
Major Depression ◽  
Elderly Patients ◽  
Rating Scale ◽  
The Elderly ◽  
Term Treatment ◽  
Fixed Dose ◽  
Controlled Study ◽  
Recurrence Time ◽  
Long Term Treatment

BackgroundThe highly recurrent nature of major depression in the young and the elderly warrants long-term antidepressant treatment.AimsTo compare the prophylactic efficacy of citalopram and placebo in elderly patients; to evaluate long-term tolerability of citalopram.MethodOut-patients, ⩾65 years, with unipolar major depression (DSM – IV: 296.2 x or 296.3 x) and Montgomery – Åsberg Depression Rating Scale score ⩾22 were treated with citalopram 20–40 mg for 8 weeks. Responders continued on their final fixed dose of citalopram for 16 weeks before randomisation to double-blind treatment with citalopram or placebo for at least 48 weeks.ResultsNineteen of the 60 patients using citalopram v. 41 of the 61 patients using placebo had recurrence. Time to recurrence was significantly different between citalopram— and placebo-patients, in favour of citalopram (log-rank test, P < 0.0001). Long-term treatment was well tolerated.ConclusionsLong-term treatment with citalopram is effective in preventing recurrence of depression in the elderly and is well tolerated.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly With Major Depression. Study Protocol of the VESPA Study: A Pragmatic, Multicentre, Open-Label, Parallel-Group, Superiority, Randomized Trial

2020 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label ◽  
Parallel Group

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco ). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19 th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30 th 2021.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly with Major Depression. Study Protocol of the Vespa Study: A Pragmatic, Multicentre, Open-Label, Parrallel-Group, Superiority, Randomized Trial

2019 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
Good Clinical Practice ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30th 2021.

scholarly journals Tryptophan Intake and Metabolism in Older Adults with Mood Disorders

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3183 ◽  
Author(s):  
Cezary Chojnacki ◽  
Tomasz Popławski ◽  
Jan Chojnacki ◽  
Michał Fila ◽  
Paulina Konrad ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Mood Disorders ◽  
Rating Scale ◽  
Daily Intake ◽  
The Elderly ◽  
Xanthurenic Acid ◽  
Group Iii ◽  
Moderate Depression ◽  
Group I ◽  
Urinary Levels

The role of serotonin in the pathogenesis of depression is well-documented, while the involvement of other tryptophan (TRP) metabolites generated in the kynurenine pathway is less known. The aim of this study was to assess the intake and metabolism of TRP in elderly patients with mood disorders. Ninety subjects in three groups, 30 subjects each, were enrolled in this study: controls (healthy young adults, group I) and elderly individuals without (group II) or with (group III) symptoms of mild and moderate depression, as assessed by the Hamilton Depression Rating Scale (HAM-D) and further referred to as mood disorders. The average TRP intake was evaluated with the nutrition calculator. Urinary levels of TRP, 5-hydroxyindoleacetic acid (5-HIAA), L-kynurenine (KYN), kynurenic acid (KynA), xanthurenic acid (XA), and quinolinic acid (QA) were determined by liquid chromatography with tandem mass spectrometry and related to creatinine level. The average daily intake of TRP was significantly lower in group III than the remaining two groups, but group III was also characterized by higher urinary levels of KYN, KynA, XA, and QA as compared with younger adult individuals and elderly patients without mood disorders. Therefore, mild and moderate depression in the elderly may be associated with a lower intake of TRP and changes in its kynurenine metabolic pathway, which suggests a potential dietary TRP-based intervention in this group of patients.

scholarly journals Outcomes and Risks With Age in Spondylolisthesis: A Comparison of the Elderly From the Quality Outcomes Database

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Michael Karsy ◽  
Andrew Kai-Hong Chan ◽  
Michael S Virk ◽  
Praveen V Mummaneni ◽  
Mohamad Bydon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Rating Scale ◽  
Age Groups ◽  
The Elderly ◽  
Quality Outcomes ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Patient Reported ◽  
Lumbar Spondylolisthesis ◽  
The Impact

Abstract INTRODUCTION Degenerative lumbar spondylolisthesis affects 3% to 20% of the population with an increasing incidence of up to 30% in the elderly. The impact of age on surgical complication and patient reported outcomes (PRO) have yet to be evaluated in a modern, multicenter study. METHODS The Quality Outcomes Database (QOD) multicenter, prospective registry was used to evaluate patients from 12 US centers, including academic and private institutions, between July 2014 and June 2016 who underwent surgical treatment for grade 1 lumbar spondylolisthesis. All patients received at least 12 mo of follow-up RESULTS A total of 608 patients were divided into < 60 (n = 239), 60 to 70 (n = 209), 71 to 80 (n = 128), and > 80 (n = 32) categories. Older patients showed lower body mass index (BMI) (P = .00001), increased diabetes (P = .007), coronary artery disease (P = .0001), and osteoporosis (P = .005). A lower likelihood for home disposition was seen with the elderly (89.1% in < 60 yr olds vs 75% in > 80 yr olds), with more elderly patients discharged to skilled nursing facilities or rehabilitation (P = .002). No baseline differences in PROs (Oswestry Disability Index [ODI], EQ-5D [EuroQol healthy survey], Numeric Rating Scale for leg pain [NRS-LP] and back pain [NRS-BP]) were seen among age categories. A significant improvement for all QOLs was seen regardless of age (P < .05). Minimal clinically important differences (MCID) in QOLs were seen after surgery for all age groups. No differences in hospital readmissions (30-d, 3-mo) or reoperations (30-d, 1-yr, 2-yr, and 3-yr) were seen among age groups (P < .05). CONCLUSION Despite increased presurgical comorbidities and risk, well-selected elderly patients undergoing surgical treatment of grade 1 spondylolisthesis can achieve meaningful outcomes without increases in complications or readmission. However, PRO do not improve to the same degree in the elderly as in younger adults. This modern, multicenter US study reflects the current use and limitation of spondylolisthesis treatment in the elderly, which may be informative to patients and providers.

Depression, Dementia and Disability in the Elderly

1987 ◽  
Vol 150 (4) ◽  
pp. 482-493 ◽  
Author(s):  
R. A. Griffiths ◽  
W. R. Good ◽  
N. P. Watson ◽  
H. F. O'Donnell ◽  
P. J. Fell ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Rural Community ◽  
Test Score ◽  
Rating Scales ◽  
The Elderly ◽  
Community Practice ◽  
Mental Test ◽  
Mental Test Score ◽  
Age Related ◽  
Prevalence Of Depression

A structured sample of mobile elderly patients in a rural community practice was assessed on validated rating scales for depression, dementia and disability. A total of 62% of the sample was abnormal on at least one variable. The overall prevalence of depression was 13%; the overall prevalence of dementia was either 10 or 18% depending on the criterion of Mental Test Score (MTS). Depression and dementia were related, depression being more common in females. In depressed and demented patients, MTS was age-related in those over 60 years; in depression alone, MTS was not age-related. Dementia was age-related, particularly over the age of 75. Disability increased with age and was more common in females. Disability was associated with both depression and dementia.

scholarly journals The Effectiveness of Hip and Knee Strengthening on Reducing Pain Intensity among Elderly with Osteoarthritis

2019 ◽  
Author(s):  
Theresia Titin Marlina ◽  
Sr Lucilla ◽  
Havids Aima
Keyword(s):  
Life Expectancy ◽  
Elderly Patients ◽  
Elderly People ◽  
Rating Scale ◽  
Severe Disease ◽  
The Elderly ◽  
Strengthening Exercise ◽  
Post Test ◽  
Pain Rating Scale ◽  
Test Control

Background: The population of elderly people increases from year to year along with increasing life expectancy. In 2000 the life expectancy in Indonesia was 64.5 years (with the percentage of the elderly population being 7.18%). It is estimated that the number of elderly people in 2020 reaches 9.9% of the total population in Indonesia. Osteoarthritis (OA) is a degenerative disease that occurs in the elderly due to thinning of joint cartilage, more common in the knee joint (89.91%) with pain manifestations. If the pain cannot be overcome, it can cause limitations in movement and disturb the daily activities, then it is suggested to do physical exercise, especially strengthening exercise. Objectives: the aimed of this study was to examine the effect of hip and knee strengthening to reducing pain in elderly patients with OA. Methods: A quasiexperimental study with randomized pre-post-test control design conducted in May untilJuly2014inYogyakarta.Seventyrespondentswithgrade1-2OAandnothavingan increasingly severe disease by exercising recruited.OApainassessedusingnumerical pain rating scale. The ordinal regression used to analyse the data. Results: hip and kneestrengtheninginterventionstatisticallysignificantreducedpainintensity(p=0.00). Conclusions:The result demonstrated the effectiveness of hip and knee strengthening to reduce pain in elderly patients with OA. Hip and knee strengthening intervention throughvideocanbeoneofasuggestedinterventiontoreducepaininpatientswithOA. Conclusions:The result demonstrated the effectiveness of hip and knee strengthening to reduce pain in elderly patients with OA. Hip and knee strengthening intervention through video can be one of the suggested intervention to reduc pain in patients with OA.

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