摘要:

The relationship between personality traits and late‐life depression is not well established. The Personality Disorder Examination (PDE), a recently developed structured interview for diagnosing DSM‐III‐R* personality disorders, has provided a methodological advance for studies in this area. The PDE was administered to 36 cognitively intact elderly individuals. The sample consisted of 21 patients who had recovered from depression and 15 normal volunteers. Two of the patients met DSM‐III‐R criteria for personality disorder according to the PDE. The patient group received higher scores on PDE items related to each personality diagnosis (P<.01) except antisocial personality disorder. These preliminary data suggest that elderly patients with a history of major depression have more lifetime personality dysfunction than normal elderly individuals, although no specific pattern could be i

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04658.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Forty‐nine matched triads of geriatric patients were compared after three months in their respective placement settings: nursing homes, geriatric foster homes, and own homes with supportive services. Compared to similarly disabled patients in nursing homes, patients in the two community settings made greater improvements in selfcare skills and mobility, expressed greater well‐being, had similar types and amounts of morbidity, and entailed lower costs. The results support the expansion of home and community‐based services as alternatives to institutional care for a substantial number of geriatric pat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04659.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Little is known about how the care received in emergency departments (ED) by the elderly population differs from that received by younger people. We prospectively abstracted ED records of 1620 consecutive patients visiting a large community hospital ED over a 22‐day period in 1984 for demographic and medical variables. Charts of patients presenting with five specific complaints (dyspnea, chest pain, abdominal pain, syncope, and motor vehicle accidents) were also analyzed for process of care variables and, for patients hospitalized, the accuracy of the ED diagnosis.Older people (ie, those ≥65 years of age) do not seem to be overutilizers of the ED for minor complaints, in fact, they tend to be more acutely ill on presentation than younger people. Older people were more likely to be hospitalized (46% v 10%, P<.001), to arrive by ambulance (35% v 10%, P<.001), and to have an identified source of primary care (95% v 64%, P<.01). Older people stayed longer in the ED than younger people if they were eventually released home but shorter if admitted to the hospital. Test ordering patterns for specific complaints varied by patient age (eg, older patients had more electrocardiograms performed for chest pain and fewer urinalyses for abdominal pain than younger patients). Therapy for specific complaints showed less age effect. Although generally more diagnostic tests were performed on older patients, the ED diagnosis tended to be more accurate for younger patients. Our data indicate that the process of ED care may be substantially different for the elderly population and have implications for future planning and financing of medical c

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04660.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

While providing home care for a family member with senile dementia is clearly extremely stressful, there has been little controlled research assessing the specific effects of this stress on caregiver psychological, social, and health functioning. To address this question, 44 primary caregivers of senile dementia patients and 44 matched controls completed a series of questionnaires and interview assessments. Caregivers reported significantly higher levels of depression and negative affect toward their relatives, and lower overall life satisfaction than controls. Caregivers also had significant impairment of their social activities, including visits with friends, vacations, and church attendance when compared with controls. Caregivers expressed less satisfaction with their social networks than did controls, but the groups did not differ in objective size of social network or number of network contacts. Caregivers reported poorer health, more prescription medication use, and higher utilization of health care than controls. Results clearly indicate the serious and wide‐ranging effects of the stress of caregiving, and reinforce the importance of providing comprehensive services for caregiving familie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04661.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) is a brief screening test for organic brain syndromes. The validity of the SPMSQ was evaluated in a random sample of 119 community residents and 282 consecutively admitted medical inpatients. The SPMSQ proved to be a sensitive and specific screening test for moderate to severe dementia both in the community and hospital. Using the cut‐off point (number of errors accepted) of three errors, the sensitivity of the test was 86.2% and the specificity 99.0% among medical inpatients. The percentages in the community sample were 66.7% and 100%, respectively. The validity of the SPMSQ was not as good for delirium because of its variable clinical picture. For screening purposes lower cut‐off points than previously recommended should be used: three errors for dementia and two errors for delirium. Among Finnish elderly people it was not necessary to use correction for education in the SP

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04662.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

In this study we have attempted to evaluate the role of dietary carbohydrate (CHO) in the decreased glucose tolerance of aging. Eighteen healthy young (mean age, 27 ± 1 standard error of the mean) (SEM) and 18 old (71 ± 1 SEM) subjects matched for relative weight and socioeconomic group were studied. Oral glucose tolerance tests were performed while eating ad lib diet and after being given high (85%), medium (45%), and low (20% to 30%) CHO formula diets for at least three days. A three‐ to seven‐day food record was used to determine the major nutrients including CHO and fiber intake in the ad lib diet at home. Our older subjects consumed significantly less total calories and slightly less carbohydrate but there was no difference in dietary fiber, protein, and fat intake. When studies were performed on matched CHO diets, decreased glucose tolerance was present in the older group. However, the mechanism(s) involved may vary with dietary CHO and with age. During the low CHO formula diet and the medium CHO ad lib diet, impaired insulin secretion was prominent in the elderly but was not present in the young. During the high CHO formula diet, insulin response was adequate in both old and young, but decreased glucose tolerance persisted in the older group, suggesting that insulin resistance may be the major contributing factor. We conclude that decreased glucose tolerance in the elderly is modified by CHO intake, but is present even when dietary CHO variability is acutely controlled. The mechanism of this age‐related, decreased glucose tolerance may vary with diet

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04663.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

In a double‐blind clinical trial, vinpocetine, a synthetic ethyl ester of apovincamine, was shown to effect significant improvement in elderly patients with chronic cerebral dysfunction. Forty‐two patients received 10 mg vinpocetine three times a day (tid) for 30 days, then 5 mg lid for 60 days. Matching placebo tablets were given to another 42 patients for the 90 day trial period. Patients on vinpocetine scored consistently better in all evaluations of the effectiveness of treatment including measurements on the Clinical Global Impression (CGI) scale, the Sandoz Clinical Assessment‐Geriatric (SCAG) scale, and the Mini‐Mental Status Questionnaire (MMSQ). There were no serious side effects related to the treatme

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04664.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

To examine the quality of mental health research in nursing homes, 130 articles published in six geriatric specialty and health care delivery journals were reviewed. Thirty‐nine (30%) articles used a mental health measure. Measures of cognitive function were most common, being used in 32 (25%) of the articles reviewed. Twenty‐three (18%) studies measured abnormal mental experiences and 17 (13%) articles measured behavioral disorder. Many articles used measures or determinations with no established reliability. Twenty‐six of the articles which used a mental health measure also used a measure of activities of daily living or physical function. Retrospective and prospective studies were similar in number. A minority of articles used control groups, random samples, or prepost measures while a majority (64%) identified an outcome measure. We conclude that nursing home research can be improved by the increased use of reliable measures of cognition and abnormal mental experiences and by the development of reliable measures of behavioral disorder. Study design can be improved by identifying a priori hypotheses and by the increased use of random sampling and control/comparison g

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04665.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04666.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb04667.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY