scholarly journals The ‘Wish to Die’ in later life: prevalence, longitudinal course and mortality. Data from TILDA

2021 ◽  
Author(s):  
Robert Briggs ◽  
Mark Ward ◽  
Rose Anne Kenny
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Later Life ◽  
Community Dwelling ◽  
Mortality Data ◽  
Individual Level ◽  
Longitudinal Course ◽  
Wish To Die ◽  
Community Dwelling Older People

Abstract Background ‘Wish to Die’ (WTD) involves thoughts of or wishes for one’s own death or that one would be better off dead. Objective To examine the prevalence, longitudinal course and mortality-risk of WTD in community-dwelling older people. Design Observational study with 6-year follow-up. Setting The Irish Longitudinal Study on Ageing, a nationally representative cohort of older adults. Subjects In total, 8,174 community-dwelling adults aged ≥50 years. Methods To define WTD, participants were asked: ‘In the last month, have you felt that you would rather be dead?’ Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. Results At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41–9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33–8.67)) were independently associated with WTD. Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (−44%) and loneliness (−19%) was more likely to decline in this group at follow-up. Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. Conclusions WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic.

scholarly journals Apathy is associated with incident dementia in community-dwelling older people

Neurology ◽  
2017 ◽  
Vol 90 (1) ◽  
pp. e82-e89 ◽  
Author(s):  
Jan Willem van Dalen ◽  
Lennard L. Van Wanrooij ◽  
Eric P. Moll van Charante ◽  
Edo Richard ◽  
Willem A. van Gool
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Cox Regression ◽  
Depression Scale ◽  
Community Dwelling ◽  
Memory Complaints ◽  
Incident Dementia ◽  
Increased Risk ◽  
Community Dwelling Older People

ObjectiveTo assess whether apathy and depressive symptoms are independently associated with incident dementia during 6-year follow-up in a prospective observational population-based cohort study.MethodsParticipants were community-dwelling older people in the Prevention of Dementia by Intensive Vascular Care trial, aged 70–78 years, without dementia at baseline. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). Dementia during follow-up was established by clinical diagnosis confirmed by an independent outcome adjudication committee. Hazard ratios (HRs) were calculated using Cox regression analyses. Given its potentially strong relation with incipient dementia, the GDS item referring to memory complaints was assessed separately.ResultsDementia occurred in 232/3,427 (6.8%) participants. Apathy symptoms were associated with dementia (HR 1.28, 95% confidence interval [CI] 1.12–1.45; p < 0.001), also after adjustment for age, sex, Mini-Mental State Examination score, disability, and history of stroke or cardiovascular disease (HR 1.21, 95% CI 1.06–1.40; p = 0.007), and in participants without depressive symptoms (HR 1.26, 95% CI 1.06–1.49; p = 0.01). Depressive symptoms were associated with dementia (HR 1.12, 95% CI 1.05–1.19), also without apathy symptoms (HR 1.16, 95% CI 1.03–1.31; p = 0.015), but not after full adjustment or after removing the GDS item on memory complaints.ConclusionsApathy and depressive symptoms are independently associated with incident dementia in community-dwelling older people. Subjective memory complaints may play an important role in the association between depressive symptoms and dementia. Our findings suggest apathy symptoms may be prodromal to dementia and might be used in general practice to identify individuals without cognitive impairment at increased risk of dementia.

scholarly journals Does the Meeting Centres Support Programme reduce unmet care needs of community-dwelling older people with dementia? A controlled, 6-month follow-up Polish study

2019 ◽  
Vol Volume 14 ◽  
pp. 113-122 ◽  
Author(s):  
Justyna Mazurek ◽  
Dorota Szcześniak ◽  
Katrzyna Urbańska ◽  
Rose-Marie Dröes ◽  
Maciej Karczewski ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Care Needs ◽  
Support Programme ◽  
People With Dementia ◽  
Polish Study ◽  
Community Dwelling Older People

scholarly journals ‘I’ve never drunk very much water and I still don’t, and I see no reason to do so’: a qualitative study of the views of community-dwelling older people and carers on hydration in later life

2019 ◽  
Vol 49 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Cini Bhanu ◽  
Christina Avgerinou ◽  
Kalpa Kharicha ◽  
Yehudit Bauernfreund ◽  
Helen Croker ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Later Life ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Drinking Patterns ◽  
Adequate Hydration ◽  
Perceived Importance ◽  
Community Dwelling Older People ◽  
Informal Carers

Abstract Background dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable. Little research has focused on the views of community-dwelling older people on hydration, healthy drinking and the perceived importance of drinking well in later life. Objectives to understand community-dwelling older people and informal carers’ views on hydration in later life and how older people can be supported to drink well. Methods qualitative study using interviews and a focus group exploring hydration and nutrition in later life (24 older people at risk of malnutrition and dehydration, 9 informal carers) and thematic analysis. Results this article presents the findings on hydration alone. Four themes are presented: perceptions of healthy drinking, barriers to and facilitators of drinking in later life and supporting older people to drink well. The perceived importance of adequate hydration in later life was polarised. Concerns about urinary incontinence and knowledge gaps were significant barriers. Consideration of individual taste preference and functional capacity acted as facilitators. Distinct habitual drinking patterns with medications and meals exist within individuals. Many relied on thirst at other times or when fluid demands are greater (such as hot weather), a known unreliable prompt in later life. Conclusions older people could be supported to drink well by building upon existing habitual drinking patterns. Primary care and public health should consider individual barriers, facilitators and tailored education. A multidisciplinary approach to promote hydration should be incorporated into care for older people with more complex needs.

scholarly journals Psychosocial resources related to survival among non-robust community-dwelling older people: an 18-year follow-up study

2020 ◽  
Vol 11 (3) ◽  
pp. 475-481
Author(s):  
Sirkku Lavonius ◽  
Marika Salminen ◽  
Tero Vahlberg ◽  
Raimo Isoaho ◽  
Sirkka-Liisa Kivelä ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Psychosocial Resources ◽  
Follow Up Study ◽  
Community Dwelling Older People

scholarly journals Fall-related efficacy is a useful and independent index to detect fall risk in Japanese community-dwelling older people: a 1-year longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Miki Sakamoto ◽  
Haruhiko Sato ◽  
Akie Kawamura
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Potential Risk Factors ◽  
Community Dwelling Older People ◽  
Walking Time

Abstract Background Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people. Methods The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors. Results The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls. Conclusions The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

scholarly journals Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People

2015 ◽  
Vol 29 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Claire McDonald ◽  
Mark S. Pearce ◽  
Joanna Wincenciak ◽  
Simon R.J. Kerr ◽  
Julia L. Newton
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Variability ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

2020 ◽  
Vol 14 (4) ◽  
pp. 394-402
Author(s):  
Anne Caroline Soares da Silva ◽  
Juliana Hotta Ansai ◽  
Natália Oiring de Castro Cezar ◽  
Francisco Assis Carvalho Vale ◽  
Julimara Gomes dos Santos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Home Visit ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Dwelling ◽  
Community Dwelling Older People

ABSTRACT. Background: Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. Objective: To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. Methods: One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. Results: Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show “other diagnoses” (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. Conclusions: Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.

scholarly journals Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study

2020 ◽  
Vol 32 (10) ◽  
pp. 1538-1551 ◽  
Author(s):  
Heidi Skantz ◽  
Taina Rantanen ◽  
Timo Rantalainen ◽  
Kirsi E. Keskinen ◽  
Lotta Palmberg ◽  
...  
Keyword(s):  
Older People ◽  
Physical Capacity ◽  
Community Dwelling ◽  
Outdoor Environment ◽  
Follow Up Study ◽  
Mobility Barriers ◽  
Community Dwelling Older People ◽  
Facilitators And Barriers

Objectives: To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Methods: Community-dwelling 75–90 -year-old persons ( N = 848) reported environmental outdoor mobility facilitators and barriers at baseline. Modifications in walking 2 km (adaptive, maladaptive, or no) were assessed at baseline and one and two years later. Results: Outdoor mobility facilitators were more often reported by those not using modifications or using adaptive versus maladaptive walking modifications. Differences in health and physical capacity explained most of the associations between outdoor mobility barriers and walking modifications. Perceived outdoor environment did not systematically predict future adaptive or maladaptive walking modifications. Discussion: Facilitators may compensate the declined physical capacity and alleviate the strain of walking longer distances by enabling the use of adaptive walking modifications, while lack of such facilitators fuels avoidance of walking longer distances.

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