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Adequacy of nutrient intake among elderly persons receiving home care.

https://arctichealth.org/en/permalink/ahliterature154657
Source
J Nutr Elder. 2008;27(1-2):65-82
Publication Type
Article
Date
2008
Author
C Shanthi Johnson
Monirun Nessa Begum
Author Affiliation
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada. shanthi.johnson@uregina.ca
Source
J Nutr Elder. 2008;27(1-2):65-82
Date
2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Diet - methods - statistics & numerical data
Eating
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health status
Home Care Services - statistics & numerical data
Humans
Male
Nutrition Assessment
Nutritional Status
Ontario
Questionnaires
Risk assessment
Risk factors
Sex Distribution
Abstract
This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.
PubMed ID
18928191 View in PubMed
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Changes in the Lethality of Frailty Over 30 Years: Evidence From Two Cohorts of 70-Year-Olds in Gothenburg Sweden.

https://arctichealth.org/en/permalink/ahliterature285261
Source
J Gerontol A Biol Sci Med Sci. 2017 Jul 01;72(7):945-950
Publication Type
Article
Date
Jul-01-2017
Author
Kristoffer Bäckman
Erik Joas
Hanna Falk
Arnold Mitnitski
Kenneth Rockwood
Ingmar Skoog
Source
J Gerontol A Biol Sci Med Sci. 2017 Jul 01;72(7):945-950
Date
Jul-01-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health Status Disparities
Health Status Indicators
Humans
Male
Mortality - trends
Sweden - epidemiology
Abstract
With aging, health deficits accumulate: people with few deficits for their age are fit, and those with more are frail. Despite recent reports of improved health in old age, how deficit accumulation is changing is not clear. Our objectives were to evaluate changes over 30 years in the degree of deficit accumulation and in the relationship between frailty and mortality in older adults.
We analyzed data from two population based, prospective longitudinal cohorts, assembled in 1971-1972 and 2000-2001, respectively. Residents of Gothenburg Sweden, systematically drawn from the Swedish population registry. The 1901-1902 cohort (N = 973) had a response rate of 84.8%; the 1930 cohort (N = 500) had a response rate of 65.1%. A frailty index using 36 deficits was calculated using data from physical examinations, assessments of physical activity, daily, sensory and social function, and laboratory tests. We evaluated mortality over 12.5 years in relation to the frailty index.
Mean frailty levels were the same (x¯ = 0.20, p = .37) in the 1901-1902 cohort as in the 1930 cohort. Although the frailty index was linked to the risk of death in both cohorts, the hazards ratio decreased from 1.67 per 0.1 increment in the frailty index for the first cohort to 1.32 for the second cohort (interaction term p = .005).
Although frailty was as common at age 70 as before, its lethality appears to be less. Just why this is so should be explored further.
Notes
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PubMed ID
27522060 View in PubMed
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Characteristics of older adults hospitalized in acute psychiatric units in ontario: a population-based study.

https://arctichealth.org/en/permalink/ahliterature119794
Source
Can J Psychiatry. 2012 Sep;57(9):554-63
Publication Type
Article
Date
Sep-2012
Author
Dallas P Seitz
Simone N Vigod
Elizabeth Lin
Andrea Gruneir
Alice Newman
Geoff Anderson
Mark J Rapoport
Paula Rochon
Daniel M Blumberger
Nathan Herrmann
Author Affiliation
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada. seitzd@providencecare.ca
Source
Can J Psychiatry. 2012 Sep;57(9):554-63
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Distribution
Age Factors
Aged
Canada - epidemiology
Comorbidity
Emergency Services, Psychiatric - statistics & numerical data
Female
Geriatric Assessment - methods - statistics & numerical data
Health Services for the Aged - statistics & numerical data
Health Status Disparities
Health Surveys
Hospitalization - statistics & numerical data
Humans
Male
Mental Competency
Mental Disorders - diagnosis - epidemiology - psychology - therapy
Mental Health Services - statistics & numerical data
Middle Aged
Population Dynamics
Psychiatric Status Rating Scales
Abstract
As the numbers of older adults in Canada increases, there will be a growing need for mental health services for this population. Acute psychiatric units (APUs) provide inpatient psychiatric services for the management of serious mental illness. Understanding the characteristics of older adults in APUs is necessary to determine the range of inpatient services required for this population.
We conducted a population-based study of all adults discharged from APUs in Ontario in a 2-year period, 2008-2010, using administrative databases. We compared the characteristics of older adults (aged 66 years and older) in APUs to those of younger adults (aged 18 to 65 years), including sociodemographics, psychiatric and medical diagnoses, and measures of cognition and functioning.
There were a total of 79 352 discharges from APUs, with older adults accounting for 8.8% of all discharges. Depressive disorder was the most common diagnosis, both in older and in younger populations (32.1% and 29.9%, respectively), while dementia accounted for 19.5% of discharges for older adults. Older adults, compared with younger adults, were more likely to have 2 or more chronic medical conditions (83.8% and 20.5%, respectively), significant cognitive impairment (47.0% and 14.5%, respectively), and moderate-to-severe functional impairment (21.8% and 3.3%, respectively).
Older adults in APUs are a complex group, with mental health and medical care needs that differ from younger adults. APUs must be able to provide adequate psychiatric, medical, and interprofessional services to achieve optimal outcomes. Future studies are required to understand the quality of care and outcomes for older adults in APUs.
PubMed ID
23073033 View in PubMed
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Cognitively impaired residents' risk of malnutrition is influenced by foodservice factors in long-term care.

https://arctichealth.org/en/permalink/ahliterature160191
Source
J Nutr Elder. 2006;25(3-4):73-87
Publication Type
Article
Date
2006
Author
Natalie Carrier
Gale E West
Denise Ouellet
Author Affiliation
Ecole des sciences des aliments, de nutrition et d'etudes familiales, Université de Moncton, New Brunswick, E1A 3E9, Canada. carrien@umoncton.ca
Source
J Nutr Elder. 2006;25(3-4):73-87
Date
2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition Disorders - epidemiology
Female
Food Services - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Humans
Long-Term Care - methods - statistics & numerical data
Male
Malnutrition - epidemiology
New Brunswick - epidemiology
Nursing Homes - statistics & numerical data
Questionnaires
Risk factors
Abstract
Several long-term care studies have shown that residents with dementia-related disorders are more prone to weight loss and malnutrition. Very few studies have investigated institutional characteristics, such as foodservice factors, and their possible link to malnutrition in this population. The objective of this study was to identify whether foodservice factors influence risk of malnutrition in cognitively impaired elderly nursing home residents.
Cognitively impaired residents meeting inclusion criteria and living within each of 38 participating nursing homes were randomly sampled. The final sample of 263 residents was screened for risk of malnutrition, and a questionnaire on participants' dining experiences was completed by primary caregivers. Additional data came from participants' medical charts, and a written questionnaire was completed by each institution's foodservice manager. Logistic regressions were used to examine relationships between risk of malnutrition and foodservice characteristics.
Close to 70% of participants were at risk of malnutrition. Foodservice factors, including tray food delivery systems, timing of menu selection, difficulty manipulating dishes, lids and food packages, as well as therapeutic diets were all significantly associated with risk of malnutrition.
Our findings suggest that many nursing homes could modify certain aspects of foodservices that may affect risk of malnutrition among cognitively impaired residents.
PubMed ID
18032217 View in PubMed
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The contribution of heart failure to sleep disturbances and depressive symptoms in older adults.

https://arctichealth.org/en/permalink/ahliterature119220
Source
J Geriatr Psychiatry Neurol. 2012 Sep;25(3):179-87
Publication Type
Article
Date
Sep-2012
Author
Peter Johansson
Barbara Riegel
Erland Svensson
Anders Broström
Urban Alehagen
Ulf Dahlström
Tiny Jaarsma
Author Affiliation
Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden. peter.johansson@aries.vokby.se
Source
J Geriatr Psychiatry Neurol. 2012 Sep;25(3):179-87
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Depression - epidemiology - psychology
Electrocardiography - methods - statistics & numerical data
Female
Geriatric Assessment - methods - statistics & numerical data
Heart Failure - epidemiology - psychology
Humans
Male
Questionnaires
Sleep Disorders - epidemiology - psychology
Sweden - epidemiology
Abstract
The aim of this study was to explore the associations between physical symptoms, sleep disturbances, and depressive symptoms in community-dwelling elderly individuals, comparing persons with and without heart failure (HF).
A total of 613 older adults (mean age 78 years) underwent clinical and echocardiographic examinations. Questionnaires were used to evaluate sleep disturbances and depressive symptoms. A model was developed in those with HF (n = 107) and compared with those without HF (n = 506).
Cardiopulmonary symptoms (ie, dyspnea and nighttime palpitations) and pain had significant direct associations with sleep disturbances, which indirectly affected depressive symptoms. The model was essentially the same in those with and without HF except that the effect of sleep disturbances on depressive symptoms was stronger in those with HF (ß = 0.64 vs ß = 0.45, P = .006).
In community-dwelling older adults, regardless of their diagnosis, physical symptoms had a direct effect on sleep disturbances and an indirect effect on depressive symptoms.
PubMed ID
23124012 View in PubMed
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C-reactive protein and fibrinogen of bedridden older patients in a six-month vitamin D supplementation trial.

https://arctichealth.org/en/permalink/ahliterature151349
Source
J Nutr Health Aging. 2009 May;13(5):435-9
Publication Type
Article
Date
May-2009
Author
M P Bjorkman
A J Sorva
R S Tilvis
Author Affiliation
Clinics of Internal Medicine and Geriatrics, Helsinki University Central Hospital, Helsinki, Finland. mikko.bjorkman@helsinki.fi
Source
J Nutr Health Aging. 2009 May;13(5):435-9
Date
May-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
C-Reactive Protein - drug effects - metabolism
Collagen Type I
Dietary Supplements
Double-Blind Method
Female
Fibrinogen - drug effects - metabolism
Finland
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Hospitalization
Humans
Male
Nutritional Status - drug effects
Parathyroid Hormone - blood
Peptide Fragments - blood
Peptides
Procollagen - blood
Vitamin D - administration & dosage - analogs & derivatives - blood
Vitamin D Deficiency - drug therapy
Vitamins - administration & dosage - blood
Abstract
To elucidate the association between vitamin D status, C-reactive protein (CRP) and fibrinogen.
Secondary analysis of a randomised double-blind placebo controlled trial.
Four longterm care hospitals (1215 beds) in Helsinki, Finland.
218 long-term inpatients aged over 65 years.
Eligible patients (n = 218) were randomized to receive 0 IU/d, 400 IU/d, or 1200 IU/d cholecalciferol for six months.
Plasma 25-hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), high sensitive CRP, fibrinogen, amino-terminal propeptide of type I procollagen (PINP), and carboxy-terminal telopeptide of type I collagen (ICTP) were measured.
The patients were aged (84.5 +/- 7.5 years), vitamin D deficient (25-OHD = 23 +/- 10 nmol/l), chronically bedridden and in stable general condition. The mean baseline CRP and fibrinogen were 10.86 mg/l (0.12 mg/l - 125.00 mg/l) and 4,7 g/l (2.3 g/l - 8.6 g/l), respectively. CRP correlated with ICTP (r = 0.217, p = 0.001), but not with vitamin D status. Supplementation significantly increased 25-OHD concentrations, but the changes in CRP and fibrinogen were insignificant and inconsistent. The post-trial CRP concentrations (0.23 mg/l -138.00 mg/l) correlated with ICTP (r = 0.156, p
PubMed ID
19390750 View in PubMed
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Data resource profile: The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).

https://arctichealth.org/en/permalink/ahliterature260510
Source
Int J Epidemiol. 2014 Jun;43(3):731-8
Publication Type
Article
Date
Jun-2014
Author
Carin Lennartsson
Neda Agahi
Linda Hols-Salén
Susanne Kelfve
Ingemar Kåreholt
Olle Lundberg
Marti G Parker
Mats Thorslund
Source
Int J Epidemiol. 2014 Jun;43(3):731-8
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Cross-Sectional Studies
Female
Geriatric Assessment - methods - statistics & numerical data
Health Behavior
Health status
Humans
Leisure Activities
Longitudinal Studies
Male
Mental health
Mobility Limitation
Oral Health
Sex Factors
Socioeconomic Factors
Sweden - epidemiology
Abstract
As the number and proportion of very old people in the population increase, there is a need for improved knowledge about their health and living conditions. The SWEOLD interview surveys are based on random samples of the population aged 77+years. The low non-response rates, the inclusion of institutionalized persons and the use of proxy informants for people unable to be interviewed directly ensure a representative portrayal of this age group in Sweden. SWEOLD began in 1992 and has been repeated in 2002, 2004 and 2011. The survey is based on another national survey, the Swedish Level of Living Survey (LNU), started in 1968 with 10-year follow-up waves. This longitudinal design provides additional data collected when SWEOLD participants were in middle age and early old age. The SWEOLD interviews cover a wide range of areas including health and health behaviour, work history, family, leisure activities and use of health and social care services. Socio-economic factors include education, previous occupation and available cash margin. Health indicators include symptoms, diseases, mobility and activities of daily living (ADL). In addition to self-reported data, the interview includes objective tests of lung function, physical function, grip strength and cognition. The data have been linked to register data, for example for income and mortality follow-ups. Data are available to the scientific community on request. More information about the study, data access rules and how to apply for data are available at the website (www.sweold.se).
PubMed ID
24651397 View in PubMed
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Defining Health Trajectories in Older Adults With Five Clinical Indicators.

https://arctichealth.org/en/permalink/ahliterature285885
Source
J Gerontol A Biol Sci Med Sci. 2017 Aug 01;72(8):1123-1129
Publication Type
Article
Date
Aug-01-2017
Author
Giola Santoni
Alessandra Marengoni
Amaia Calderón-Larrañaga
Sara Angleman
Debora Rizzuto
Anna-Karin Welmer
Francesca Mangialasche
Nicola Orsini
Laura Fratiglioni
Source
J Gerontol A Biol Sci Med Sci. 2017 Aug 01;72(8):1123-1129
Date
Aug-01-2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging - physiology - psychology
Cognition
Disability Evaluation
Female
Gait
Geriatric Assessment - methods - statistics & numerical data
Health Status Disparities
Health Status Indicators
Humans
Male
Middle Aged
Mobility Limitation
Multiple Chronic Conditions - epidemiology
Sex Factors
Sweden - epidemiology
Abstract
People age differently, challenging the identification of those more at risk of rapid health deterioration. This study aimed to explore the heterogeneity in the health of older adults by using five clinical indicators to detect age-related variation and individual health trajectories over time.
Health of 3,363 people aged 60+ from the Swedish National study on Aging and Care-Kungsholmen (SNAC-K) assessed at baseline and at 3- and 6-year follow-ups. Number of chronic diseases, physical and cognitive performance, personal and instrumental activities of daily living were integrated in a health assessment tool (HAT). Interindividual health differences at baseline and follow-ups were assessed with logistic quantile regression. Intraindividual health trajectories were traced with quantile mixed-effect models.
The HAT score ranges from 0 (poor health) to 10 (good health); each score corresponds to a specific clinical profile. HAT was reliable over time and accurately predicted adverse health outcomes (receiver-operating characteristic areas: hospitalization = 0.78; 95% confidence interval = 0.74-0.81; mortality = 0.85; 95% confidence interval = 0.83-0.87; similar areas obtained for gait speed). Before age 85, at least 90% of participants were free of severe disability, and at least 50% were functionally independent despite chronic disorders. Age- and sex-related variation and high heterogeneity in health were detected at baseline and confirmed by intraindividual health trajectories.
This study provides a positive picture of the health status of people 60+. Despite the complexity and heterogeneity of health in this age group, we could identify age- and sex-specific health trajectories using an integrated HAT. HAT is potentially useful in clinical practice and public health interventions.
PubMed ID
28329788 View in PubMed
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[Development of indicators to promote measures for the prevention and rehabilitation of functional decline in older people].

https://arctichealth.org/en/permalink/ahliterature118835
Source
Rev Epidemiol Sante Publique. 2012 Dec;60(6):463-72
Publication Type
Article
Date
Dec-2012
Author
R. Hébert
M. Raîche
M-F Dubois
N R Gueye
M. Tousignant
Author Affiliation
Faculté de médecine et des sciences de la santé, université de Sherbrooke, Sherbrooke, Québec, Canada. Rejean.Hebert@Usherbrooke.ca
Source
Rev Epidemiol Sante Publique. 2012 Dec;60(6):463-72
Date
Dec-2012
Language
French
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Canada
Disabled Persons - rehabilitation
Female
Geriatric Assessment - methods - statistics & numerical data
Home Care Services - statistics & numerical data
Humans
Long-Term Care - statistics & numerical data
Male
Nursing Homes - statistics & numerical data
Abstract
In Europe and Asia, long-term care funding is disability-based. This introduces a perverse effect by inappropriately adding value to functional decline among beneficiaries. To support the efforts in prevention and rehabilitation made by personnel in long-term care services, indicators have to be developed to promote functional improvement of beneficiaries. As people receiving those services are already experiencing a functional decline process, it is essential to know the natural magnitude of functional decline in order to assess deviation from this expected decline. The objective of the study was to estimate the natural decrease of autonomy in beneficiaries of home care services and nursing homes.
Two databases were used: for home-dwelling people, 1235 subjects over 75 years old who participated in the PRISMA study; for institutions, 1330 residents over 65 years old of a nursing home in Sherbrooke (QC, Canada). These subjects were assessed several times over many years with the Functional Autonomy Measurement System (SMAF). Growth analyses were used to estimate the annual decrease in the SMAF score according to age, gender and the initial autonomy status.
At home, only age was significantly associated with the slope of functional decline. The average annual decrease of subjects 75-84 years old was 2.4 points on the SMAF score (out of 87); for those aged over 85, the annual loss was 3.8 points. In institutions, gender and the initial autonomy profile were associated with the annual decrease. For men, the annual decrease varied between 0.7 for the most disabled subjects to 5.2 for the most autonomous. For women, those values varied from 0.2 to 6.6, respectively.
A decrease in the SMAF score less than these expected values should be associated with a bonus to support personnel training, prevention activities, rehabilitation and activities aimed at supporting the autonomy of the beneficiaries. Such a strategy requires the implementation of a precise and reliable assessment instrument like the SMAF and also the availability of a longitudinal database where data for each beneficiary could be linked over time.
PubMed ID
23165198 View in PubMed
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Do depressive symptoms predict mortality in older people?

https://arctichealth.org/en/permalink/ahliterature147617
Source
Aging Ment Health. 2009 Sep;13(5):674-81
Publication Type
Article
Date
Sep-2009
Author
Philip D St John
Patrick R Montgomery
Author Affiliation
Section of Geriatrics, Health Sciences Centre, University of Manitoba, Winnipeg, MB R3A 1R9, Canada. pstjohn@hsc.mb.ca
Source
Aging Ment Health. 2009 Sep;13(5):674-81
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Affect
Aged
Aging - psychology
Cognition Disorders - epidemiology - psychology
Depressive Disorder - mortality - psychology
Female
Geriatric Assessment - methods - statistics & numerical data
Humans
Interpersonal Relations
Kaplan-Meier Estimate
Male
Manitoba - epidemiology
Predictive value of tests
Proportional Hazards Models
Psychiatric Status Rating Scales - statistics & numerical data
Risk factors
Survival Rate
Abstract
Depressive symptoms are common in older persons, and may predict mortality.
To determine: (1) If depressive symptoms predict mortality; (2) If there is a gradient in this effect; and (3) Which depressive factors predict mortality.
In 1991-1992, 1751 community-dwelling older persons, sampled from a population-based registry, were interviewed.
The Center for Epidemiologic Studies - Depression (CES-D), age, gender, the Modified Mini-Mental State Examination, self-rated health, and functional status.
Time to death.
Those scoring 16+ on the CES-D were considered depressed. To determine if a gradient was present, the CES-D was treated as a continuous variable. Four depressive factors from the CES-D (depressed affect, positive affect, somatic, and interpersonal) were analyzed. Cox regression models were constructed.
The mortality in those with depressive symptoms was higher in those without depressive symptoms (Hazard Ratio of 1.71, p
PubMed ID
19882405 View in PubMed
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31 records – page 1 of 4.