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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The complexity of caring for the ageing heart failure (HF) population is further complicated by concomitant chronic conditions (i.e., polypharmacy, depression), age related impairments (i.e., hearing, visual and cognitive impairments, impairments in activities of daily living (ADL/IADL), and other issues (e.g., health illiteracy, lack of social support). This paper provides an overview of these risk factors, outlines how they individually and in interplay endanger favourable outcome by putting patients at risk for poor self-management. Moreover, suggestions are made on how these issues could be addressed and integrated in heart failure management by applying gerontological care principles in caring for the ageing heart failure population.
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PMID:Complexity in caring for an ageing heart failure population: concomitant chronic conditions and age related impairments. 1557 13

The effects of stressful life events which cause depression in the elderly and the role of the social support network--a longitudinal study in Hokkaido prefecture It has been reported that various stressful life events experienced by the elderly increase the risk of depression, and that a support network mitigates the effects. However, reports in our country are still lacking. This research was a longitudinal study in a former coal mining area, conducting a baseline survey on 1991. Every three to four years, we followed-up the elderly in the area. The questionnaire included :1) base attributes 2) stressful life events 3) networks, 4) instrumental/emotional support, support provided themselves, 4) Zung's Self Rating Depression Scale, 5) subjective health/number of illness/hospital admission/body aches/vision and hearing/urinary incontinence/signs of dementia, 6) hobbies and motivation in life/ADL/IADL. Whether male or female, SDS scores after three years were significantly high in cases of poor health, body aches, and signs of dementia. Females who did not participate in social activities scored significantly high after three years. In cross-sectional analysis, both males and females who were not working had significantly high scores. The effect of networks on SDS scores in females was significantly recognized for items regarding children living separately, neighborhood, close friends/relatives, and groups. However, it was not significant for males. Thus, a gender difference was found. In females, the level of depression was low when there were supports, though it was not significant in males. The subjective health condition was significantly different from SDS scores in both male and female groups. Admission to hospital, existence of body aches and vision disturbance were significantly different in females. Nevertheless, those were not significant in the male group. For social activity, whether the persons possessed hobbies and motivation in life or not created a significant difference in SDS scores. For stressful life events, both males and females had significantly high SDS scores caused by aggravation of health condition. In the female group, moving against the will, illness of spouse/family, and increased borrowing showed significance, and life events experienced within a year and SDS scores were significantly related. In multivariate analysis using parameters of males in 1995, only subjective health condition significantly increased the level of depression. In females, when the number of experienced life events was large, the level of depression was higher even when adjusted for the subjective health condition. Moreover, even then when "home visits by children separately living" were rare, the level of depression tended to be higher. As future issues, (1) adequate measures for evaluation of social support networks and (2) early preventive action in each community with validated scales for stressful life events are important.
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PMID:[Effects of stressful life events which cause depression in the elderly, and the role of the social support network--a longitudinal study in Hokkaido prefecture]. 1592 Sep 47

The present study was conducted in October 2003 to investigate the factors related to psychological stress and the heavy burden of caregivers taking care of frail elderly persons in the northern part of the Onga district, Fukuoka Prefecture, Kyushu, Japan. A total of 40 caregivers were assessed using a self-administered questionnaire involving the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI) and thus described their own caregiving situation. J-ZBI research had been done on a yearly basis for the previous 5 years and the results of each investigation regarding Center for Epidemiologic Studies Depression Scale (CES-D), and incidence of depression, ADL and dementia were compared prior to and after initiation of public long term care insurance for the elderly (LTCI). Compared to caregivers with a middle or light burden, heavily burdened caregivers were more likely to have a higher J-ZBI, and CES-D. Compared to caregivers with a light burden, heavily burdened caregivers were more likely to 1) be in poor condition, 2) complain of their economical situation, 3) spend a longer time with care talker. Compared to caregivers with a middle burden, heavily burdened caregivers more frequently used short-stay services (i.e., temporary nursing home assistance). J-ZBI and ADL were compared to before LTCI, and 4 years after LTCI had been started. Scores for both were lower after 4 years. Compared to before LTCI, day-care and day service were used less frequently 3 and 4 years after LTCI. After LTCI, caregivers showed a lower J-ZBI score, but the incidence of depression among caregivers was higher, compared to the general public. It is suggested that a government agency should be created to support not only the frail elderly but also their caregivers.
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PMID:[Burden among caregivers of the frail elderly and its correlation with the introduction of a long-term care insurance system for the elderly in fourth year]. 1611 82

A rehabilitation care management oriented towards the severity of the disease, the individual competence and the patient's needs essentially improves the effectivity and the sustainability of inpatient rehabilitation. The Institute of Gerontology of the University of Heidelberg is developing an assessment for elderly stroke patients to optimize placement decision by an early rehabilitation prognosis. Data concerning functional, cognitive and psychological status were collected in 267 patients participating in a postacute rehabilitation program on admission, after two weeks and on discharge and six weeks later. In this article are presented the study design and patients' characteristics during the rehabilitation process. The first assessment at admission gives important information about the sustainability of the ADL-competence after discharge. Severe stroke, premorbid ADL-competence, cognitive impairment, communication problems, depression and higher age were found to be predictors for the outcome of the rehabilitation process.
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PMID:[Rehabilitation processes and sustainability: first results of a rehabilitation study of geriatric stroke patients]. 1703 92

In this study it has been estimated the prevalence of the disability in the over 65 population, resident in the sanitary district 50 of the ASL NA1. The aim is an appropriate nursing planning based on the needs of the population. The used geriatric questionnaire is provided by law (ex art. 70 comma 1 lettera a. del DPR 270/2000). The general practitioners of the district filled in 6014 questionnaires. The elders that resulted as self-reliant at the ADL and self-sufficient at the IADL are 86.9% and 80.2% respectively. 54.9% of the elders are free from slight or heavy depression. 81.7% are not going to have mental worst damage. Depression is statistically related to a low income and to a low level of self-reliance and self-sufficiency at the ADL and IADL questionnaire. The study evaluated important formative needs of the elders and pointed out some issues regarding the questionnaire structure and its filling in.
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PMID:[Geriatric questionnaire assessment in the sanitary district 50 of the ASL NA1]. 1708 58

Parkinson's disease (PD) is a neurodegenerative disorder that imposes an important burden upon the patient's caregiver. This study aims at assessing caregiver burden (CB) and analyzing its relationship with sociodemographic, emotional, and functional factors, as well as health-related quality of life (HRQoL). The following measures were applied to 80 patients with PD: the Hospital Anxiety and Depression Scale (HADS); the EuroQoL (for HRQoL); and PD-specific measures (Hoehn and Yahr staging and SCOPA-Motor ADL subscale). Patients' main caregivers completed the HADS, SF-36, EuroQoL, and Zarit CB Inventory (ZCBI). The ZCBI was found to be a valid and reliable measure in the context of PD. There was a significant association between CB and caregivers' HRQoL (r = -0.29 to -0.64). Mental aspects of caregivers' HRQoL and burden were affected by disability and disease severity. The presence of caregivers' depression had a significant negative effect on both CB and HRQoL. The main predictors of CB were caregivers' psychological well-being, patients' mood and clinical aspects of PD (disability and severity), and HRQoL of patients and caregivers. This study underscores the need to consider the impact of PD on caregivers' well-being.
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PMID:Caregiver burden in Parkinson's disease. 1723 93

We developed a telemedicine protocol for diagnosis of Alzheimer's Disease (AD). Assessments by video-conferencing (remote) were compared with face to face (direct) assessments. Eight physicians performed direct assessments and two physicians conducted remote assessments. There was alternate allocation of direct or remote initial assessment. The participants were 20 subjects over 65 years living in a rural area and referred by general practitioners (GPs) because of cognitive impairment. Each assessment included a Standardised Mini Mental State Examination, Geriatric Depression Scale, Katz assessment of Activities of Daily Living, Instrumental ADL assessment, and the Informant Questionnaire for Cognitive Decline in the Elderly. Laboratory results and radiological imaging were available from referring GPs. There was good agreement for diagnosing Alzheimer's disease between telemedicine and direct assessment, kappa = 0.8 (P<0.0001). However, because of the small sample size, the presence of systematic bias could not be completely excluded. We conclude that it is possible to diagnose AD at a distance using telemedicine, but this requires validation with a larger study.
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PMID:Development of a telemedicine protocol for the diagnosis of Alzheimer's disease. 1735 73

The purpose of the study was to investigate the over-time effects of physical, psychological and social resources on the incidence of depression in family caregivers of the disabled elderly. Data were collected twice at a one-year interval from 1,141 primary caregivers of a disabled older person in an urban area of Japan using a self-reported questionnaire survey. The questionnaire included physical health as an indicator of physical resources, caregiving satisfaction and intention to care as indicators of psychological resources, and instrumental and emotional support network and formal home care service utilization as indicators of social resources. The mental health outcome measure was the General Health Questionnaire 12-item version (GHQ-12). Complete data on 235 non-depressed female caregivers were separated into 3 groups according to the relationship type (wife, daughter and daughter-in-law) and analyzed separately. Multivariate logistic regression models controlling for duration of caregiving, care-recipient's gender, ADL dependency and behavioral problems demonstrated that significant predictors of depression were caregiving satisfaction and intention to care in wives, caregiving satisfaction in daughters, and physical health and emotional support network in daughters-in-law. Noteworthy, intention to care increased the risk of depression in wives, while decreasing the risk of depression in daughters-in-law. The findings indicate that the effects of caregivers' resources on mental health may differ by relationship type.
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PMID:The effects of caregiving resources on the incidence of depression over one year in family caregivers of disabled elderly. 1747 7

Bone pain and pathological fractures due to spinal metastases result in severe disorders of ADL (activities of daily living). Osteoclastic pathology by metastases is local bone metabolism disorders by an activation of osteoclast by oncocyte. Therefore, early detection and treatment are important, and radiation therapies and stabilization surgeries have been performed as local treatment. Bisphosphonate therapy to plan pain relief and prevention of enlargement of metastases came to be performed recently by depression of bone resorption. We should aggressively perform combination therapies against bony pain due to metastases.
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PMID:[Spinal metastases]. 1766 Jun 26

Although the role of inflammation has been studied in specific diseases or in community living elderly, data in hospitalized acute care elderly patients are scarce. The present study was designed to determine the predictive value of sociodemographic, clinical and biological factors for mortality in acute care geriatric wards. Retrospective study was conducted in two acute care wards in a university-based geriatric hospital with elderly patients (n=224) consecutively admitted to acute care wards with available medical files. Sociodemographic variables, primary medical diagnosis and number of associated conditions, dementia, depression, pressure sores, functional status (measure by the activities of daily living=ADL scale), weight, and plasma levels of albumin, transthyretin, C-reactive protein (CRP) and orosomucoid were recorded at admission. Patients who died in the acute care wards were compared to those who survived. The mean length of stay was 16+/-13 days; mortality was 12%. Univariate analysis revealed that disability, no anti-depressant drug, pressure ulcers, a higher number of associated conditions, living with another person, and biological markers of malnutrition (albumin <35g/l, transthyretin <200mg/l) and inflammation (CRP < or =30mg/l, orosomucoid > or =1.25g/l) were significantly associated with an increase in the risk of death. The logistic regression model retained CRP > or =30mg/l (odds ratio (OR)=3.72, 95% confidence interval (CI)=1.34-10.31; p=0.009) and disability for at least one ADL item (OR=2.16, 95% CI=1.55-2.99; p<0.001) as independent risk factors for death. We conclude that CRP and disability are strong independent risk factors for death in this population, and special attention should be paid to these patients in an integrated therapeutic approach to geriatric care.
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PMID:Inflammation and disability as risk factors for mortality in elderly acute care patients. 1845 52


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