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Haldar P, Tripathi M, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Association of obstructive sleep apnea and sleep quality with cognitive function: a study of middle-aged and elderly persons in India. Sleep Breath 2024; 28:975-987. [PMID: 38055152 DOI: 10.1007/s11325-023-02953-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/28/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. METHODS We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. RESULTS A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score - 0.02, p-value 0.006), memory (- 0.03, 0.014), and G-factor (- 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50-60 years) (- 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (- 0.48, < 0.001), memory (- 0.08, 0.005), and executive domains (- 0.12, < 0.001), but not with information domain. CONCLUSION The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Formerly at: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - MArfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kavya P, Ilanchoorian D, Hari Krishnan R. Prevalence of psychiatric morbidity and cognitive impairment among non-communicable disease patients in Southern Chennai, Tamil Nadu. J Family Med Prim Care 2023; 12:3123-3128. [PMID: 38361849 PMCID: PMC10866241 DOI: 10.4103/jfmpc.jfmpc_342_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction According to the WHO, non-communicable diseases cause 71% of all deaths globally. Despite many studies showing a significant association between non-communicable diseases (NCDs) and cognitive decline, it is not researched in Tamil Nadu. Hence, this study was conducted to screen for psychiatric morbidity and cognitive impairment (CI) among NCD patients in Southern Chennai. Aims The aim of this study was to estimate the prevalence of psychiatric morbidity and CI and their associated factors among NCD patients attending NCD clinics of tertiary care hospitals. Methods and Material A cross-sectional study was carried out in NCD patients (n = 343) attending an NCD clinic in a tertiary care hospital. Basic sociodemographic and clinical details were obtained by a semi-structured questionnaire. Cognition function and psychiatric morbidity were assessed using mini-mental state examination, patient health questionnaire 9 and generalised anxiety disorder 7 tools, respectively. Results The mean age of the study participants was 58 years. Of 343 participants, 19.2% had severe CI, 26.8% had severe depression, and 29.7% had severe anxiety. Among 180 participants aged 59-86 years, 25.5% participants had osteoarthritis; of these, 41.3% had severe CI (P < 0.0001), 82.6% had severe depression (P < 0.0001) and 63% had severe anxiety (P < 0.027), and their association was statistically significant. Conclusions This study concludes that about one-fourth of the NCD patients suffered from CI and psychiatric morbidity, which are of rising concern. Musculoskeletal diseases are neglected to be assessed under NCDs, and in this study, osteoarthritis was found to be significantly associated with depression, anxiety and CI.
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Affiliation(s)
- P Kavya
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, OMR, Kelambakkam, Chennai, Tamil Nadu, India
| | - Divya Ilanchoorian
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, OMR, Kelambakkam, Chennai, Tamil Nadu, India
| | - R Hari Krishnan
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, OMR, Kelambakkam, Chennai, Tamil Nadu, India
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Chakravarty K, Ray S. Cognitive Screening Tools for Adults in Indian Setting: A Commentary. Ann Indian Acad Neurol 2023; 26:347-348. [PMID: 37970313 PMCID: PMC10645264 DOI: 10.4103/aian.aian_394_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/05/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Kamalesh Chakravarty
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sucharita Ray
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Pandey NM, Tripathi RK, Kar SK, Vidya KL, Singh N. Mental health promotion for elderly populations in World Health Organization South-East Asia Region: Needs and resource gaps. World J Psychiatry 2022; 12:117-127. [PMID: 35111583 PMCID: PMC8783159 DOI: 10.5498/wjp.v12.i1.117] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
The accelerated population growth of the elderly (individuals aged 60 years or more) across the globe has many indications, including changes in demography, health, the psycho-social milieu, and economic security. This transition has given rise to varied challenges; significant changes have been observed in regard to developing strategies for health care systems across the globe. The World Health Organization (WHO) is also engaging in initiatives and mediating processes. Furthermore, advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model. The concept behind this move was to shift from disablement to enablement and from illness to wellness, with the notion of mental health promotion (MHP) being promoted. This article attempts to discuss the MHP of elderly individuals, with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries. We have tried to present the current knowledge gap by exploring the existing infrastructure, human resources, and financial resources. There is much to do to promote the mental health of the elderly, but inadequate facilities are available. Based on available resources, a roadmap for MHP in elderly individuals is discussed.
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Affiliation(s)
- Nisha Mani Pandey
- Department of Geriatric Mental Health, King George's Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Rakesh Kumar Tripathi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow 226003, Uttar Pradesh, India
| | - K L Vidya
- Department of Geriatric Mental Health, King George's Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Nitika Singh
- Department of Psychiatry, King George's Medical University, Lucknow 226003, Uttar Pradesh, India
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Ghosh S, Samanta A. A study on socioeconomic correlates of family caregiver burden: Comparison between geriatric patients with dementia and with schizophrenia in a tertiary care center in Kolkata. JOURNAL OF GERIATRIC MENTAL HEALTH 2022. [DOI: 10.4103/jgmh.jgmh_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Petrova NN, Khvostikova DA. Prevalence, Structure, and Risk Factors for Mental Disorders in Older People. ADVANCES IN GERONTOLOGY 2021. [PMCID: PMC8654500 DOI: 10.1134/s2079057021040093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.
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Affiliation(s)
- N. N. Petrova
- St. Petersburg State University, 199106 St. Petersburg, Russia
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Banerjee D, Mukhopadhyay S. Relevance of the Indian telemedicine guidelines 2020 in psychogeriatric care: A critical appraisal. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_24_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Effects of Clinical Experience on Early Career Psychiatrists' Beliefs and Attitudes Towards Older Psychiatric Patients. Community Ment Health J 2020; 56:1344-1353. [PMID: 32026217 DOI: 10.1007/s10597-020-00571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
Although literature has documented widespread negative and stereotypical attitudes held by healthcare professionals towards the older adults, there is a current paucity of research about the perspective of psychiatrists. We aimed to identify the attitudes of Tunisian early career psychiatrists towards the older adults. This was a cross-sectional study conducted among 71 early career psychiatrists. Data were collected through anonymous online surveys. A series of 4 point Likert-type questions ("strongly agree", "somewhat agree", "somewhat disagree", "strongly disagree") asked participants about their beliefs about older patients, the characteristics of the psychiatric care of an older person and emotions related to caring for older patients. Psychiatrists agreed that the older patient: is frail and vulnerable in 64.8% of cases, does not trust his psychiatrist in 28% of cases, has problems of communication in 36.6% of the cases and shows hostile or aggressive behavior in 5.6% of the cases. A multivariate binary logistic regression analysis found that clinical experience would play an independent role in predicting the following beliefs and attitudes of early career psychiatrists towards older patients: the belief that the older patient often has perceptual disorders that he is fragile and vulnerable, that he often requires polypharmacy, and that his management exposes the psychiatrist to painful emotional experiences. Given the population aging, early career psychiatrists need to be equipped with skills to fulfil significant roles in responding to future health and support needs. Integrating clinical training in psychogeriatrics into the psychiatric curriculum is strongly recommended.
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Sivakumar PT, Mukku SSR, Kar N, Manjunatha N, Phutane VH, Sinha P, Kumar CN, Math SB. Geriatric Telepsychiatry: Promoting Access to Geriatric Mental Health Care Beyond the Physical Barriers. Indian J Psychol Med 2020; 42:41S-46S. [PMID: 33354062 PMCID: PMC7736734 DOI: 10.1177/0253717620958380] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Psychiatric illnesses are an important contributor of morbidity and mortality in older adults. There is increase in older adults with psychiatric disorders paralleling their growth in absolute numbers. This leads to challenges in mental health care and service delivery. Several barriers that exists in our community hinder older adults from receiving mental health care. Additionally, lack of adequate human resources in geriatric mental health care compounds the problem. Telemedicine, though not new in other fields of medicine, is relatively new in the practice of psychiatry in India. This is probably due to lack of clear guidelines and regulations regarding the same in India. There is a recent increase in teleconsultations in India similar to other developed countries due to ongoing COVID-19 pandemic. The recent telepsychiatry operational guidelines have made telepsychiatry a legitimate and official practice in India. Challenges specific to older adults in the form of low digital literacy, sensory issues, and cognitive impairment can be overcome by adopting telepsychiatry services in coming years. Concerns related to security and safety of telepsychiatry require further evaluation.
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Affiliation(s)
- Palanimuthu Thangaraju Sivakumar
- Dept. of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shiva Shanker Reddy Mukku
- Dept. of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Nilamadhab Kar
- Black Country Healthcare NHS Foundation Trust, Wolverhampton, England, United Kingdom
| | | | - Vivek Haridas Phutane
- Goulburn Valley Area Mental Health Services (GVAMHS), Goulburn Valley Health, Shepparton and Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Preeti Sinha
- Dept. of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Suresh Bada Math
- Tele Medicine Centre, Dept. of Psychiatry, NIMHANS, Bengaluru, India
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Pandey N, Tripathi R, Tripathi S, Singh B, Tiwari S. Problems and strain of caregivers of urban older adults: An exploration. JOURNAL OF GERIATRIC MENTAL HEALTH 2020. [DOI: 10.4103/jgmh.jgmh_38_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Joseph J, Kumari S. Comparison of depression among the elderly in a selected semiurban and rural community of Haryana, North India: A cross-sectional survey. JOURNAL OF GERIATRIC MENTAL HEALTH 2020. [DOI: 10.4103/jgmh.jgmh_5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Konda PR, Sharma PK, Gandhi AR, Ganguly E. Correlates of Cognitive Impairment among Indian Urban Elders. JOURNAL OF GERONTOLOGY & GERIATRIC RESEARCH 2018; 7:489. [PMID: 31406631 PMCID: PMC6690611 DOI: 10.4172/2167-7182.1000489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cognitive impairment among elderly is increasing owing to increases in life expectancy globally. The problem is multifactorial. The objective of the present paper was to study the correlates of cognitive impairment in an urban elderly population in India. METHODS A cross sectional study was conducted among 100 randomly selected urban elderly population. Data was collected upon household visits using a predesigned pretested questionnaire administered by a trained investigator. Measurements included cognitive function assessment using Mini Mental State Examination, depression assessment using Geriatric Depression Scale, blood pressure measurement and anthropometry. Cognitive impairment was defined at MMSE score <24. Logistic regression was done to identify independently associated factors with cognitive impairment. RESULTS Prevalence of cognitive impairment among elderly was 10%. Women had a higher prevalence than men. Higher age, no schooling, living single, lower weight, lower waist and hip ratios, difficulty in activities of daily living, poor self-reported health, bedridden and depression significantly associated with cognitive impairment. The independently associated factors upon logistic regression were increasing age, no schooling and bedridden status for past six months. CONCLUSION Although the current prevalence of cognitive impairment among Indian urban elderly is low, several associated factors exist in this population that may increase the burden in future. Geriatric health policy should address the modifiable risk factors to manage the problem of cognitive impairment and its consequent outcomes.
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Affiliation(s)
| | - Pawan Kumar Sharma
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and Share India, Fogarty International NIH, USA
| | - Atul R Gandhi
- Consultant Statistician & Chief Manager-Monitoring and Evaluation, EdelGive Foundation, Edelweiss House, Mumbai, India
| | - Enakshi Ganguly
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and Share India, Fogarty International NIH, USA
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Pandey NM, Tripathi SM, Singh B, Tiwari SC. Nonpharmacological methods in managing patients with dementia in a tertiary care hospital. Indian J Psychiatry 2018; 60:141-144. [PMID: 29736079 PMCID: PMC5914245 DOI: 10.4103/psychiatry.indianjpsychiatry_365_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Management of dementia is very crucial. Nonpharmacological methods (NPM) are well appreciated and encouraged to be used as first-line treatment for managing elderly patients with dementia (PwD). The present case reports aimed to share the strategies of NPM for managing PwD. NPM requires a structured blueprint to record, follow-up, and monitor the outcomes. A structured proforma has been developed in the department. After getting all the basic information from the patient, needed assessments are being done by the concerned team member to identify and rate the level of severity of the problem, and specific NPM strategies are being provided. Concerted efforts give positive results; knowledge and understanding about the illness help the caregiver in managing the patient. No negative impact has been reported; NPM is a cost-effective approach and therefore should be studied on a larger level to provide evidence from India and prove its efficacy.
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Affiliation(s)
- Nisha Mani Pandey
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shailendra Mohan Tripathi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Bhupendra Singh
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sarvada Chandra Tiwari
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
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Giri M, Chen T, Yu W, Lü Y. Prevalence and correlates of cognitive impairment and depression among elderly people in the world's fastest growing city, Chongqing, People's Republic of China. Clin Interv Aging 2016; 11:1091-8. [PMID: 27574409 PMCID: PMC4990376 DOI: 10.2147/cia.s113668] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Cognitive impairment and depression are major mental health problems affecting older people. The current study was designed to explore the prevalence of cognitive impairment and depression in representative sample of elderly people aged ≥60 years and to examine the correlates of cognitive impairment and depression with other sociodemographic variables. Methods A cross-sectional study based on comprehensive geriatric assessment of 538 elderly Chinese people was conducted from September 2011 to August 2012. Cognitive impairment was assessed using the Chinese version of Mini-Mental State Examination, and depressive symptoms were assessed by 30-item geriatric depression scale. Results The prevalence of cognitive impairment was 12.6%. Multiple logistic regression analysis revealed that the following were significant independent predictors of cognitive impairment: female, having a low level of education, increasing age, and depression. The overall prevalence of depression was 24.3%, and in adjusted model, cognitive impairment was only associated with increased risk of depression. Conclusion Cognitive impairment and depression are prevalent in elderly Chinese people. Among a number of factors identified in our study, cognitive impairment and depression were highly correlated in elderly people aged ≥60 years.
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Affiliation(s)
- Mohan Giri
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District
| | - Tian Chen
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District
| | - Weihua Yu
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District
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Srivastava G, Tripathi RK, Tiwari SC, Singh B, Tripathi SM. Caregiver Burden and Quality of Life of Key Caregivers of Patients with Dementia. Indian J Psychol Med 2016; 38:133-6. [PMID: 27114625 PMCID: PMC4820552 DOI: 10.4103/0253-7176.178779] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Dementia is the most devastating cognitive disorder of the elderly and needs extra attention to care. Therefore, this study was conducted to identify the caregiver burden of dementia key caregivers and their Quality of Life (QOL). MATERIALS AND METHODS Sample consisted of purposively selected 24 dementia key caregivers fulfilling the inclusion criteria from the in-patient of the Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India. Zarit Burden Interview and World Health Organization QOL-BREF were administered. Mean, standard deviation, t-test, Chi-square with Yate's correction were used to analyze the data. RESULTS All key caregivers felt mild to moderate level of burden. Gender-wise significant difference was found on burden area of expectation (P < 0.05). Mean scores on physical, psychological, social relationship, and environmental QOL were found to be on lower side. A negative correlation was found between burden and QOL. CONCLUSION Professional help and supportive psychotherapy can be provided to the key caregivers of dementia patients to reduce their burden, strengthen the coping skill and thus improve their QOL.
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Affiliation(s)
| | - Rakesh Kumar Tripathi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sarvada Chandra Tiwari
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Bhupinder Singh
- Department of Psychology, Barkatullah University, Bhopal, Madhya Pradesh, India
| | - Shailendra Mohan Tripathi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
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Abstract
Acceptance and Commitment Therapy (ACT) is gaining traction as an effective therapy for a wide range of presenting concerns. Limited research and discussion has been published focused on utilizing ACT with older adults. The ACT model is proposed to be a good fit for this population because many older adults may already be values orientated due to awareness that their lifetime is limited. A trans-diagnostic approach that normalizes experiences common to older age may be advantageous given older adults often present with heterogeneous issues and life experiences. A case study of an 89-year-old woman experiencing late-life clinical depression and generalized anxiety disorder is presented. A significant factor contributing to her distress was her struggle with the cognitive and physical changes associated with aging. Results suggest that a brief ACT course implemented by a relative novice ACT therapist was effective in reducing psychological inflexibility as well as reducing distress to non-clinical levels at 6 weeks post therapy. Potential implications for adapting ACT with older adults are discussed, as well as reflections on some of the potential challenges for clinicians who are ACT beginners.
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Affiliation(s)
| | - Ben Sedley
- Victoria University of Wellington, New Zealand
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