scholarly journals Psychiatric and Physical Comorbidity in Elderly Attending the Geriatric Clinic of a Psychiatric Hospital

2021 ◽  
Vol 33 (1) ◽  
pp. 40-43
Author(s):  
Humayra Jesmin ◽  
Ahsan Aziz Sarkar ◽  
Helal Uddin Ahmed ◽  
Hasinatul Zannat
Keyword(s):  
Older Adults ◽  
Depressive Disorders ◽  
Psychiatric Patients ◽  
Symptom Burden ◽  
Physical Disorder ◽  
Medical Diagnoses ◽  
Geriatric Clinic ◽  
Physical Disorders ◽  
Costs Of Treatment

Background: Physical comorbidity is quite common in older adults. When psychiatric and medical conditions co-occur, the combination is associated with elevated symptom burden, functional impairment, decreased length and quality of life, and increased costs of treatment. To estimate the proportion and patterns of physical comorbidity in elderly psychiatric patients. Methods: A retrospective observational study was carried out in the Geriatric Clinic of National Institute of Mental Health and Hospital (NIMHH). Patient registry of the clinic was used to collect required information and 113 consecutive older adults with psychiatric disorders who attended the clinic in a three-month period, were enrolled for the study. Psychiatric diagnoses were made by psychiatrists, according to DSM-5 criteria. Medical diagnoses were made by specialist physicians by reviewing physicians’ prescriptions. Data analysis was done by using SPSS 23.0. Results: Most of the patients (58.4%) belonged to the 7th decade. Among 113 patients 90 (79.7%) had only psychiatric illness & 23 had (20.4%) comorbid physical disorders. Depressive disorders (30%) and dementia (22.1%) were the most common psychiatric reasons for consultation. Among the associated physical comorbidities hypertension (43.5%) and diabetes (34.8%) were the most commons. Conclusion: Co-occurrence of psychiatric and physical disorder conditions is very common in a clinical setting. Physical comorbidity may influence follow up consultation pattern. Bangladesh J Medicine July 2022; 33(1) : 40-43

scholarly journals Occupational groups and its physical and mental health correlates: results from the Singapore Mental Health Study 2016

2021 ◽  
Author(s):  
Rajeswari Sambasivam ◽  
Anitha Jeyagurunathan ◽  
Edimansyah Abdin ◽  
Saleha Shafie ◽  
Sherilyn Chang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Work Productivity ◽  
Demographic Characteristics ◽  
Self Report ◽  
World Health ◽  
Physical Disorder ◽  
Occupational Groups ◽  
Physical Disorders

Abstract Purpose The physical and mental wellbeing of an individual is impacted by the type occupation one does. This study aims to establish the prevalence of mental and physical disorders, the association of occupational groups and health-related quality of life, and the extent of work-loss and work-cut back in past 30 days among the employed in the Singapore resident population. Methods Data from a population-based, epidemiological survey of a representative sample of Singapore citizens and permanent residents aged 18 years and above were used. Lifetime diagnosis of select mental disorders was established using the World Health Organization’s Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). Data on nicotine dependence, work productivity, quality of life and socio-demographics were obtained via self-report. Ten major occupational groups based on the Singapore Standard Occupational Classification were included in the analysis. Results The sample comprised 4021 employed individuals who were predominantly males (54.7%) and aged 35–49 years (35.4%). ‘Service and sales workers’ (22.6%), ‘Professionals’ (17.3%) and ‘Legislators, senior officials and managers’ (16.4%) were the three largest occupational groups. Socio-demographic characteristics differed significantly (p < 0.001) across all occupational groups. Lifetime prevalence of mood disorders among the employed was 8.4% and the most prevalent physical disorder was chronic pain (18.9%). No significant differences were observed in work productivity loss across the occupational groups. Conclusions The disparities in the socio-demographic characteristics and prevalence of mental and physical disorders across occupational categories provide policymakers with vital information to pilot effective interventions that can improve the psychosocial and physical conditions at work.

scholarly journals Pilot Randomized Trial of a Transdisciplinary Geriatric and Palliative Care Intervention for Older Adults With Cancer

2020 ◽  
Vol 18 (5) ◽  
pp. 591-598
Author(s):  
Ryan D. Nipp ◽  
Brandon Temel ◽  
Charn-Xin Fuh ◽  
Paul Kay ◽  
Sophia Landay ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Usual Care ◽  
Pilot Trial ◽  
Symptom Burden ◽  
Medium Effect ◽  
Care Needs ◽  
Care Intervention ◽  
Cancer Types

Background: Oncologists often struggle with managing the unique care needs of older adults with cancer. This study sought to determine the feasibility of delivering a transdisciplinary intervention targeting the geriatric-specific (physical function and comorbidity) and palliative care (symptoms and prognostic understanding) needs of older adults with advanced cancer. Methods: Patients aged ≥65 years with incurable gastrointestinal or lung cancer were randomly assigned to a transdisciplinary intervention or usual care. Those in the intervention arm received 2 visits with a geriatrician, who addressed patients’ palliative care needs and conducted a geriatric assessment. We predefined the intervention as feasible if >70% of eligible patients enrolled in the study and >75% of eligible patients completed study visits and surveys. At baseline and week 12, we assessed patients’ quality of life (QoL), symptoms, and communication confidence. We calculated mean change scores in outcomes and estimated intervention effect sizes (ES; Cohen’s d) for changes from baseline to week 12, with 0.2 indicating a small effect, 0.5 a medium effect, and 0.8 a large effect. Results: From February 2017 through June 2018, we randomized 62 patients (55.9% enrollment rate [most common reason for refusal was feeling too ill]; median age, 72.3 years; cancer types: 56.5% gastrointestinal, 43.5% lung). Among intervention patients, 82.1% attended the first visit and 79.6% attended both. Overall, 89.7% completed all study surveys. Compared with usual care, intervention patients had less QoL decrement (–0.77 vs –3.84; ES = 0.21), reduced number of moderate/severe symptoms (–0.69 vs +1.04; ES = 0.58), and improved communication confidence (+1.06 vs –0.80; ES = 0.38). Conclusions: In this pilot trial, enrollment exceeded 55%, and >75% of enrollees completed all study visits and surveys. The transdisciplinary intervention targeting older patients’ unique care needs showed encouraging ES estimates for enhancing patients’ QoL, symptom burden, and communication confidence.

scholarly journals Screening Tool Identifies Older Adults With Cancer at Risk for Poor Outcomes

2020 ◽  
Vol 18 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Ryan D. Nipp ◽  
Leah L. Thompson ◽  
Brandon Temel ◽  
Charn-Xin Fuh ◽  
Christine Server ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
At Risk ◽  
Overall Survival ◽  
Symptom Burden ◽  
Hazard Ratio ◽  
Screening Tools ◽  
Vulnerable Patients ◽  
Poor Outcomes

Background: Oncologists often struggle with managing the complex issues unique to older adults with cancer, and research is needed to identify patients at risk for poor outcomes. Methods: This study enrolled patients aged ≥70 years within 8 weeks of a diagnosis of incurable gastrointestinal cancer. Patient-reported surveys were used to assess vulnerability (Vulnerable Elders Survey [scores ≥3 indicate a positive screen for vulnerability]), quality of life (QoL; EORTC Quality of Life of Cancer Patients questionnaire [higher scores indicate better QoL]), and symptoms (Edmonton Symptom Assessment System [ESAS; higher scores indicate greater symptom burden] and Geriatric Depression Scale [higher scores indicate greater depression symptoms]). Unplanned hospital visits within 90 days of enrollment and overall survival were evaluated. We used regression models to examine associations among vulnerability, QoL, symptom burden, hospitalizations, and overall survival. Results: Of 132 patients approached, 102 (77.3%) were enrolled (mean [M] ± SD age, 77.25 ± 5.75 years). Nearly half (45.1%) screened positive for vulnerability, and these patients were older (M, 79.45 vs 75.44 years; P=.001) and had more comorbid conditions (M, 2.13 vs 1.34; P=.017) compared with nonvulnerable patients. Vulnerable patients reported worse QoL across all domains (global QoL: M, 53.26 vs 66.82; P=.041; physical QoL: M, 58.95 vs 88.24; P<.001; role QoL: M, 53.99 vs 82.12; P=.001; emotional QoL: M, 73.19 vs 85.76; P=.007; cognitive QoL: M, 79.35 vs 92.73; P=.011; social QoL: M, 59.42 vs 82.42; P<.001), higher symptom burden (ESAS total: M, 31.05 vs 15.00; P<.001), and worse depression score (M, 4.74 vs 2.25; P<.001). Vulnerable patients had a higher risk of unplanned hospitalizations (hazard ratio, 2.38; 95% CI, 1.08–5.27; P=.032) and worse overall survival (hazard ratio, 2.26; 95% CI, 1.14–4.48; P=.020). Conclusions: Older adults with cancer who screen positive as vulnerable experience a higher symptom burden, greater healthcare use, and worse survival. Screening tools to identify vulnerable patients should be integrated into practice to guide clinical care.

scholarly journals Evidence-Based Integrative Health Care to Promote Quality of Life in Older Adults With Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 609-610
Author(s):  
Robin Majeski ◽  
Delia Chiaramonte
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Care ◽  
Cancer Care ◽  
Symptom Burden ◽  
Integrative Approach ◽  
Evidence Based ◽  
Cancer Symptoms ◽  
Integrative Health

Abstract Cancer disproportionately affects older adults and presents significant challenges to patients’ quality of life. Use of complementary medicine is increasing among older adults with cancer and these modalities have the potential for both benefit and harm. Thus, it is important that health care professionals are knowledgeable about the evidence-supported benefits and risks of complementary and integrative health approaches in the care of older adults with cancer. Integrative cancer care provides a comprehensive approach to reducing symptom burden in patients suffering with cancer symptoms and side effects of cancer treatment. Symptoms such as pain, fatigue, nausea, sleep disturbance, mood disorder, perceived stress, and reduced quality of life are common in this population.This session will discuss an evidence-based integrative approach to cancer care which incorporates both pharmacologic and non-pharmacologic modalities to decrease symptom burden, enhance patient well-being, and improve quality of life. Non-pharmacologic modalities used in the integrative approach to care will be described and relevant evidence for risks, benefits and indications will be presented. Case studies will be discussed to demonstrate the integration of these techniques into conventional western medical treatment plans for older adults with cancer. Diversity and inclusion issues relevant to integrative medicine for underserved cancer patients will be addressed, as well as recommendations for future research to expand access of underserved populations to evidence-supported integrative cancer care. A resource list will be provided to participants.

Issues in Differential Diagnosis of Sesxual Dysfunction: Mental and Physical Dysorders

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
Z. Zemishlany
Keyword(s):  
Psychosocial Factors ◽  
Interpersonal Relationships ◽  
Sexual Functioning ◽  
Psychiatric Patients ◽  
Interpersonal Relationship ◽  
Borderline Personality ◽  
Physical Disorder ◽  
Hypoactive Sexual Desire Disorder ◽  
Mind And Body ◽  
Physical Disorders

Sexuality is the ultimate union of mind and body; sexual functioning or dysfunction depends on complex bio-psycho-social conditions.Sexual dysfunction (SD) may be primarily due to physical disorders, including endocrinologic (diabetes, androgen deficiency, hyperprolactinemia, hypothyroidism and hyperthyroidism), cardiovascular and pelvic illnesses. SD can be secondary or indirectly related to impairments of the physical disorder such as fatigue, weakness and bladder incontinence, or to the psychosocial stress of the illness. Not only the disease itself, but the treatment prescribed, may also cause sexual impairment.SD is prevalent among psychiatric patients and maybe related to both the psychopathology and the psychopharmacology. SD has been reported in as many as 30%-60% of patients with schizophrenia treated with antipsychotic medication, up to 78% of individuals with depression treated with antidepressants and up to 80% in patients suffering from anxiety disorder. Eating disorders and personality disorders, mainly borderline personality disorder, are also associated with SD.Psychosocial factors, like interpersonal relationships, length of relationship, lifestyle, socioeconomic class and cultural background have been shown to correlate with SD, especially in hypoactive sexual desire disorder in women.An evaluation of SD should take into consideration the primary sexual functioning, the physical and mental disorders, the various medications and the psychosocial factors.It is recommended to identify the specific cause of the SD and to treat the patient according to the individual's mental disorder, physical disorder and interpersonal relationship.

Predictors for quality of life among older adults with depressive disorders: A prospective 3‐month follow‐up cohort study

2021 ◽  
Author(s):  
Darawan Wongprommate ◽  
Tinakon Wongpakaran ◽  
Manee Pinyopornpanish ◽  
Peerasak Lerttrakarnnon ◽  
Surin Jiraniramai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Cohort Study ◽  
Depressive Disorders

Factors Associated with Higher Symptom Burden and Lower Quality of Life Among Older Adults with Advanced Cancer (RP507)

2020 ◽  
Vol 60 (1) ◽  
pp. 232-233
Author(s):  
Yael Schenker ◽  
Andrew Althouse ◽  
Margaret Rosenzweig ◽  
Douglas White ◽  
Edward Chu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Factors Associated

scholarly journals The silent geriatric giant- anxiety disorders in late life

2014 ◽  
Vol 29 (1-2) ◽  
pp. 29-31
Author(s):  
Iffat Nowshin ◽  
Farhana Kabir
Keyword(s):  
Older Adults ◽  
Anxiety Disorders ◽  
Elderly Population ◽  
Depressive Disorders ◽  
Late Life ◽  
Public Health Issue ◽  
Major Depressive Disorders ◽  
Epidemiological Transitions ◽  
Population Demographic

Late-life anxiety can often be silent, missed or difficult to diagnose as older adults tend to somatize psychiatric problems. Yet late-life anxiety disorders are a "geriatric giant," being twice as prevalent as dementia among older adults and four to eight times more prevalent than major depressive disorders, causing significant impact on the quality of life, morbidity, and mortality of older adults. Bangladesh is one of the twenty countries in the world with the largest elderly population and by 2025, along with four other Asian countries, will account for 44% of world's total elderly population. Demographic and epidemiological transitions reveal geriatric problems as burning public health issue. So more emphasis should be given on geriatric health problems in order to ensure physical, mental and socially sound health. http://dx.doi.org/10.3329/bjpp.v29i1-2.20065 Bangladesh J Physiol Pharmacol 2013; 29(1&2) : 29-31

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