PENGARUH TERAPI LIFE REVIEW TERHADAP PENURUNAN DEPRESI DI SEKSI KESEJAHTERAAN SOSIAL PENYANTUNAN LANJUT USIA PADU WAU MAUMERE

Lansia merupakan tahap lanjut dari suatu proses kehidupan yang terjadi secara alamiah. Tingginya stresor dan peristiwa kehidupan yang tidak menyenangkan dapat menimbulkan masalah psikologis, salah satu diantaranya adalah depresi. Depresi pada lansia lebih tinggi terjadi pada lansia yang hidup di panti jompo dibandingkan dengan lansia yang hidup di komunitas dan masih rendahnya intervensi psikologis untuk mengatasi depresi. Penelitian ini bertujuan untuk mengetahui pengaruh terapi life review terhadap penurunan depresi pada lansia di Seksi Kesejahteraan Penyantunan Sosial Lanjut Usia Padu Wau Maumere. Jenis penelitian yang digunakan adalah Quasi experiment dengan rancangan penelitian one group pre post test. Jumlah sampel sebanyak 36 orang, dengan menggunakan consecutive sampling. Instrumen yang digunakan dalam penelitian ini adalah kuesioner pendek Geriatric Depression Scale (GDS) dengan 15 pertanyaan dalam versi Indonesia untuk mengukur depresi pada lansia. Intervensi terapi life review diberikan sebanyak 4 sesi yakni pengalaman masa anak-anak, masa remaja, masa dewasa dan masa lansia. Analisis data menggunakan uji wilcoxon. Hasil uji wilcoxon menunjukkan bahwa terdapat pengaruh terapi life review terhadap penurunan depresi lansia dibuktikan dengan nilai p value (0.000) < α (0.05). Terapi life review berhasil dalam menurunkan depresi pada lansia.

Relationship between Eating Alone and Poor Appetite Using the Simplified Nutritional Appetite Questionnaire

One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional Appetite Questionnaire (SNAQ). We surveyed 818 people aged 70 and over in Takashimadaira, Itabashi-ku, Tokyo, Japan, in 2016. Comparisons were made between two groups, a poor appetite group (n = 295) and a good appetite group (n = 523), and results indicate that the poor appetite group had a higher rate of eating alone than the good appetite group (38.0% vs. 20. 1%: p < 0.001). Multivariable logistic regression (OR; 95%CI) was performed and poor appetite was significantly associated with the Geriatric Depression Scale (GDS) score (1.707; 1.200–2.427), the number of medications (1.061; 1.007–1.118), JST score (0.894; 0.841–0.950), the indication of “very healthy” on a self-rated health scale (0.343; 0.152–0.774), and reports of eating alone (1.751; 1.130–2.712). Our results suggest that eating alone is associated with a poor appetite.

Implicações da depressão na qualidade de vida do idoso: estudo seccional

Objective: To analyze the association between depressive symptoms and quality of life in older adults. Method: Cross-sectional study carried out between July and October, in 2020, with 596 older adults who answered three instruments, namely: bio-sociodemographic, Geriatric Depression Scale and WHOQOL-Old. Data were analyzed using Chi-square, Kruskal-Wallis, Spearman correlation and linear regression tests, considering a 95% confidence interval (p<0.05). Results: Depressive symptoms were negatively and statistically significantly associated with all facets of quality of life: sensory abilities (β= -1.922 [CI95%= -2.328 – -1.517]); autonomy (β= -2.410 [CI95%= -2.755 - -2.064]); past, present and future activities (β= -3.534 [CI95%= -3.879 – -3.189]); social participation (β= -3.436 [CI95%= -3.816 – -3.056]); death and dying (β= -2.260 [CI95%= -2.792 – -1.728]) and intimacy (β= -3.547 [CI95%= -3,900 – -3.194]). Conclusion: The presence of depressive symptoms is negatively associated with the quality of life of older adults, thus requiring interventions in this area. Objetivo: Analizar la asociación entre sintomatología depresiva y calidad de vida de adultos mayores.Método: Estudio transversal realizado entre julio y octubre de 2020 con 596 personas mayores que respondieron a tres instrumentos: biosociodemográfico, Escala de Depresión Geriátrica y WHOQOL-Old. Los datos se analizaron mediante pruebas de Chi-cuadrado, Kruskal-Wallis, correlación de Spearman y regresión lineal, considerando un intervalo de confianza del 95% (p<0,05).Resultados: La sintomatología depresiva se asoció de forma negativa y estadísticamente significativa con todas las facetas de la calidad de vida: habilidades sensoriales (β= -1,922 [IC95%= -2,328 – -1,517]); autonomía (β= -2,410 [IC95%= -2,755 – -2,064]); actividades pasadas, presentes y futuras (β= -3,534 [IC95%= -3,879 – -3,189]); participación social (β= -3,436 [IC95%= -3,816 – -3,056]); muerte y morir (β= -2,260 [IC95%= -2,792 – -1,728]) e intimidad (β= -3,547 [IC95%= -3,900 – -3,194]).Conclusión: La presencia de sintomatologías depresivas se asocia negativamente con la calidad de vida de las personas mayores, por lo que requiere intervenciones en este ámbito. Objetivo: Analisar a associação entre ecesitando ía ecesitan e qualidade de vida de idosos. Método: Estudo seccional realizado entre julho e outubro de 2020 com 596 idosos que responderam três instrumentos: biosociodemográfico, Escala de Depressão Geriátrica e WHOQOL-Old. Os dados foram analisados com os testes de Qui-quadrado, Kruskal-Wallis, correlação de Spearman e regressão linear, considerando um intervalo de confiança de 95% (p<0,05). Resultados: A sintomatologia depressiva se associou de forma negativa e estatisticamente significante com todas as facetas da qualidade de vida: habilidades sensoriais (β= -1,922 [IC95%= -2,328 – -1,517]); autonomia (β= -2,410 [IC95%= -2,755 – -2,064]); atividades passadas, presentes e futuras (β= -3,534 [IC95%= -3,879 – -3,189]); participação social (β= -3,436 [IC95%= -3,816 – -3,056]); morte e morrer (β= -2,260 [IC95%= -2,792 – -1,728]) e intimidade (β= -3,547 [IC95%= -3,900 – -3,194]). Conclusão: : A presença de sintomatologias depressivas está associada negativamente à qualidade de vida dos idosos, necessitando, portanto, de intervenções nessa área.

Does the Global Postural Re-Education Affect the Psychological and Postural Aspects of Alzheimer Disease Patients? A Six Months Quasi-Experimental Study

Objective: To study the implementation of Global Postural Re-education as a rehabilitative alternative in residence facilities for seniors with Alzheimer, and to verify its effect on psychological and cognitive symptoms. Methods: A quasi-experimental design was employed using month-follow-up assessments at 1,3, and 6 months respectively. Ninety elderly people participated in the composition of the study sample: 69 women and 21 men aged from 67 to 89 years (80.2 ±5.5), grouped in two phases: mild and moderate, according to Alzheimer severity. Patients in both groups received the same treatment twice a week for consecutively 24 weeks. Three follow-up medium-long term assessments were performed at intervals of 1, 3, and 6 months. Outcome measures included Mini-Mental State Examination, Geriatric Depression Scale, Quality of Life in Alzheimer Disease, Barthel Index, and Tinetti Scale. Results: The severity of groups therapy interaction showed significant changes in four outcome measures as cognition [F(1,88)=60.26; p=.000; partial η2= 0.406], depression [F(1,88)=8.24; p=.005; partial η2= 0.086], life quality [F(1,88)= 10.45; p=.002; partial η2= 0.106] and equilibrium [F(1,88)= 6.96; p=.010; partial η2= 0.073]. No changes were found for autonomy [F(1,88)= 1.10; p=.297; partial η2= 0.012]. These changes between the two groups were observed at the sixth month follow-up assessment. Conclusion : Global postural reeducation could be useful as a complementary rehabilitation treatment in Alzheimer patients.

Depression and Dementia: The Role of Cortisol and Vascular Brain Lesions. AGES-Reykjavik Study

Background: Late-life depression (LLD) is related to an increased risk of developing dementia; however, the biological mechanisms explaining this relationship remain unclear. Objective: To determine whether the relationship between LLD and dementia can be best explained by the glucocorticoid cascade or vascular hypothesis. Methods: Data are from 4,354 persons (mean age 76±5 years) without dementia at baseline from the AGES-Reykjavik Study. LLD was assessed with the MINI diagnostic interview (current and remitted major depressive disorder [MDD]) and the Geriatric Depression Scale-15. Morning and evening salivary cortisol were collected (glucocorticoid cascade hypothesis). White matter hyperintensities (WMH; vascular hypothesis) volume was assessed using 1.5T brain MRI. Using Cox proportional hazard models, we estimated the associations of LLD, cortisol levels, and WMH volume with incident all-cause dementia, AD, and non-AD dementia. Results: During 8.8±3.2 years of follow-up, 843 persons developed dementia, including 397 with AD. Current MDD was associated with an increased risk of developing all-cause dementia (HR = 2.17; 95% CI 1.66–2.67), with risks similar for AD and non-AD, while remitted MDD was not (HR = 1.02; 95% CI 0.55–1.49). Depressive symptoms were also associated with increased risk of dementia, in particular non-AD dementias. Higher levels of evening cortisol increased risk of dementia, but this was independent of MDD. WMH partially explained the relation between current MDD and dementia risk but remained increased (HR = 1.71; 95% CI 1.34–2.08). Conclusion: The current study highlights the importance of LLD in developing dementia. However, neither the glucocorticoid cascade nor the vascular hypotheses fully explained the relation between depression and dementia.

A Szelekció–Optimalizáció–Kompenzáció Rövid Kérdőív magyar adaptációja

Elméleti háttér: A szelekció–optimalizáció–kompenzáció modell rugalmas alkalmazkodási folyamatokat feltételez, amelyekkel az idősek képesek pozitív egyensúlyt elérni életkoruk nyereségei és veszteségei között. Ezen stratégiák mérésére alkották meg a Szelekció– Optimalizáció–Kompenzáció Kérdőívet, majd annak rövid változatát (SOC-12). Cél: Kutatásunk egyik célja a SOC-12 kérdőív magyar nyelvre történő adaptálása és pszichometriai jellemzőinek vizsgálata volt. Módszerek: Keresztmetszeti kérdőíves kutatásunkat 155 fős, 60 éves és afeletti, kognitív zavarban nem szenvedő mintán végeztük el (átlagéletkor: 74,6 év, SD = 7,9 év, terjedelem: 60–98 év; nemi megoszlás: 125 [81%] nő és 30 [19%] férfi). Mérőeszközök: SOC-12 kérdőív, Connor–Davidson Reziliencia Skála, Rövid Geriátriai Depresszió Skála. Eredmények: A teljes SOC-12 kérdőív illeszkedési mutatói a megerősítő faktorelemzésben messze elmaradnak az elfogadhatótól. Feltáró faktorelemzéssel kétfaktoros szerkezet rajzolódott ki. A SOC-12 skála egészét reprezentáló (mind a négy alskála tételeiből tartalmazó) 1. faktor tételei jó megbízhatóságú skálát képeznek (McDonald-ω [95% CI]: 0,83 [0,79–0,87]. A 2. faktoron töltődő tételekből létrehozott alskála esetén az ω [95% CI]: 0,57 [0,43–0,69], így megbízhatósága elmarad a kívánatostól. Az általunk módosított, 7-tételes SOC-kérdőív konvergens és diszkriminatív validitása egyaránt optimális, alátámasztja a skála által mért erőforrás-felhasználási stratégiák érvényességét. Következtetések: Kutatásunk alapján a módosított SOC-12 kérdőív a magyar idős populációban jó pszichometriai mutatókkal rendelkezik. Eredményeink alátámasztják, hogy segítségével az időskori alkalmazkodási folyamatok összességében jól mérhetők. A szelekciós stratégiák önálló mérése azonban az alacsony megbízhatóságú tételek miatt nem lehetséges. A kérdőív használhatóságát elősegíti, hogy a kitöltés és az értékelés egyaránt rövid időt vesz igénybe.Background: The selection-optimization-compensation model assumes flexible adaptation processes by which the elderly are able to achieve a positive balance between gains and losses of their lives. The Selection-Optimization-Compensation (SOC-12) questionnaire was developed to measure these strategies. Aim: The aim of our research was to adapt the SOC-12 questionnaire to Hungarian language and to establish its psychometric properties. Methods: Our cross-sectional research was conducted on a sample of 155 people aged 60 and over (mean age: 74.6 years, SD = 7.9 years, range: 60–98 years; gender distribution: 125 (81%) women and 30 (19%) male). Measures: SOC-12 Questionnaire, Connor-Davidson Resilience Scale, Geriatric Depression Scale Short Form. Results: Based on our results, the fit of the original 4 factor structure of the SOC-12 questionnaire very weak. Exploratory factor analysis revealed a two-factor structure. The items of factor 1, which represent the whole of the SOC-12 scale (containing items from all subscales), form a scale with good reliability (McDonald’s ω [95% CI]: 0,83 [0,79–0,87]. In the case of the subscale created from the items loading on the factor 2, the ω-value [95% CI] is 0.56 [0.43–0.69], so its reliability is less than acceptable. Both convergent and divergent validity of the modified SOC questionnaire is optimal, supporting the validity of the resource use strategies measured by the scale. Conclusions: Based on the current study, the original SOC-12 questionnaire had to be modified. Our results support that the modified questionnaire makes measurable adaptation processes in old age. Independent measurement of selection strategies is not possible due to low reliability items. The scale provides a short, easy response to measure these strategies, and both completion and evaluation take a short time.

Vietnamese Version of the Geriatric Depression Scale (30 Items): Translation, Cross-Cultural Adaptation, and Validation

The proportion of geriatric depression recorded in Vietnam was 66.9%. Depression in older people is a risk factor for problems related to dementia, poor quality of life, and suicide. To have a good Vietnamese questionnaire for assessing geriatric depression, we conducted the study to translate and cross-culturally adapt the Geriatric Depression Scale—long-form with 30 items (GDS-30). The study has two steps. Step 1 is a translation of the GDS-30 scale. We followed the guideline by Beaton et al. (2000 & 2007). Firstly, two translators (informed and uninformed) translated the questionnaires. Secondly, the translations were synthesized. Thirdly, back translation was performed by two translators fluent in both Vietnamese and English but completely unknown of the original version of the scale and did not have medical expertise. Finally, seven experts reached a consensus on the pre-final Vietnamese version (GDS-30). Step 2 is a field test of the questionnaires on people 60 years or older. Then, we determined the internal consistency and test-retest reliability of the questionnaire in 55 Vietnamese inpatients in a geriatric department. Construct validity was determined by examining the relationship between depressive scores and patient characteristics. The Vietnamese version of GDS-30 was built with the agreement of all experts on the semantic, idiomatic, experiential, and conceptual equivalences between the original and pre-final Vietnamese versions of the GDS-30. The Cronbach’s alpha coefficient value was 0.928, indicating the items’ adequate internal consistency. Spearman’s correlation coefficient value of total scores between the first and second interviews showed medium correlation (0.479, p < 0.001), and the stability is acceptable. The GDS-30 scale reached the construct validity because the proportion of geriatric depression according to GDS-30 was significantly different between characteristics groups, such as gender, employment, level of education, economic status, and sleep disturbance. The Vietnamese version of the GDS-30 scale had high consistency, satisfactory reliability, and understanding and can be used as a screening tool for depression in elderly patients in primary healthcare centers. This is the first depression rating scale for the elderly in Vietnam to be translated and validated. Non-psychiatric health professionals or patients can quickly self-assess and screen for the illness.

Cross-Cultural Adaptation and Validation of The Geriatric Depression Scale Into Igbo Language: A Validation Study

Background: Late-life experiences such as protracted and indisposing medical disorders can negatively impact older adults’ psychological and mental health, making them vulnerable to depression. Majority of the assessment tools for depression were developed for use in western countries. There is therefore need for availability of culture- and environment- specific tools for assessment of depression in low and middle income countries. This study was designed to cross-culturally adapt and validate the Geriatric Depression Scale-15 (GDS-15) into Igbo Language and culture. Methods: The English version of the GDS-15 was translated into Igbo language; synthesized, back-translated, and underwent expert panel review, pretesting and cognitive debriefing interview, according to Beaton’s guideline. The Igbo version of the GDS-15 was tested for concurrent and structural validities and internal consistency among consecutively recruited 140 consenting older adults (62.9% females) in Enugu North Senatorial District, at 0.05 level of significance.Results: The English version of the GDS-15 was successfully cross-culturally adapted to Igbo with all the 15 items still retained on the Igbo version of the GDS-15. The Igbo version of the GDS-15 exhibited the same structure as the English version. The Igbo version of the GDS-15 has Cronbach’s alpha value of 0.53. The correlation between the participants’ total scores on the Igbo and the English versions of the GDS-15 (rho = 0.86) was excellent. There was no significant difference between corresponding scores in the English and Igbo versions of the GDS-15 (p = 0.89).Conclusions: The Igbo version of the GDS-15 is a valid and culturally specific instrument, and can be used for assessing depression among Igbo older adults in Nigeria.

PELATIHAN DAN PEMBERDAYAAN KADER KESEHATAN TENTANG SCREENING KEJADIAN DEPRESI SEBAGAI SALAH SATU UPAYA IDENTIFIKASI KONDISI KESEHATAN LANSIA

ABSTRAKKegiatan Program Kemitraan Masyarakat “Pelatihan dan Pemberdayaan Kader Kesehatan Tentang Screening Kejadian Depresi Sebagai Salah Satu Upaya Identifikasi Kondisi Kesehatan Lansia, khususnya pada masa pandemi COVID-19 merupakan kegiatan yang bertujuan untuk meningkatkan pengetahuan dan keterampilan kader kesehatan tentang resiko depresi yang rentan muncul pada lansia dan bagaimana cara mengidentifikasi kejadian depresi yang mungkin muncul pada lansia. Pelatihan dan pemberdayaan kader kesehatan tentang resiko depresi pada lansia dilakukan menggunakan metode penyuluhan atau ceramah dengan media power point berikut diskusi dan tanya jawab. Untuk mempraktikkan bagaimana cara melakukan screening atau mengidentifikasi kejadian depresi pada lansia digunakan metode demonstrasi dengan mempraktikkan penggunakan instrument Geriatric Depression Scale. Hasil yang diperoleh dari kegiatan pengabdian masyarakat ini adalah peningkatan pengetahuan kader kesehatan tentang resiko depresi pada lansia serta dimilikinya keterampilan kader kesehatan dalam menggunakan instrument Geriatric Depression Scale dalam mengkaji resiko depresi pada lansia di Desa Tambakasri Kelurahan Tajinan Kabupaten Malang. Adanya peningkatan pengetahuan dan keterampilan kader kesehatan tersebut sangat bermanfaat bagi Desa Tambaksri untuk dapat secara mandiri mengenali dan mengidentifiaksi permasalahan kesehatan yang mungkin muncul di Desa Tambakasri sebagai upaya preventif dalam mencegah terjadinya permasalahan kesehatan dan untuk mewujudkan desa siaga kesehatan. Kata kunci: pelatihan; kader kesehatan; screening; depresi; lansia ABSTRACTCommunity Partnership Program Activities “Training and Empowerment of Health Cadres About Screening for Depression Events as One of the Efforts to Identify Elderly Health Conditions, especially during the COVID-19 pandemic, aims to provide understanding and skills for health cadres regarding depression that is prone to appear in the lives of the elderly. This risk is magnified by the COVID-19 pandemic situation which has consequences for limiting activities outside the home, so that the elderly's social activities are limited and monotonous and in the end can increase the risk of depression in the elderly. Training and empowerment of health cadres using counseling methods and demonstrations of the implementation of screening for depression in the elderly. The abilities and skills of health cadres possessed as an outcome of community service activities are very useful for efforts to identify the health conditions of the elderly, especially related to the incidence of depression and are useful for fulfilling elderly health data, especially for mental health posyandu owned in the local Tambakasri Village Keywords: health cadres; screening; depression; elderly.

Developing Multimodal IoMT Monitoring System of Geriatric Depression: A Feasibility Study

The Internet of Medical Things (IoMT) is a promising tool to monitor depression and relevant symptoms. However, the multimodal IoMT monitoring system has been rarely developed considering the characteristics of older adults, particularly living in the community. Therefore, it is necessary to know how to develop multimodal IoMT monitoring systems tailored for older adults and evaluate the feasibility for research and practice. We developed a multimodal IoMT monitoring system that included a smartphone for facial and verbal expressions, smartwatch for activity and heart rates, and ecological momentary assessment (EMA) application. A convenience sample of 21 older Korean adults aged over 65 years was recruited from a community center, and 19 participants completed it. The data were collected in four weeks using self-report questionnaires, IoMT devices, and semi-structured interviews between July and December 2020 and were analyzed in mixed methods. Based on the Geriatric Depression Scale-Short Form scores, eight participants were classified in the depressive group (38.1%) and 13 in the non-depressive group (61.9%). A total of 1,505 (70.72%) EMA data were collected, and 1,277 (60.00%) were analyzed. Furthermore, 1,421 (66.78%) facial expression data were collected and labeled, including anger, happiness, neutral, sadness, surprise, and exception. Voice dialogues were transformed into 5,264 scripts. The depressive group showed lower user acceptance relative to the non-depressive group. However, both groups experienced positive emotions, had regular life patterns, and increased their self-interest. Thus, our multimodal IoMT monitoring system is a feasible and useful measure for acquiring mental health information in older adults’ depression.