scholarly journals Personality disorders in later life: epidemiology, presentation and management

2020 ◽  
Vol 26 (4) ◽  
pp. 208-218
Author(s):  
Ayesha Bangash
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Older People ◽  
Medical Care ◽  
Personality Disorders ◽  
Late Life ◽  
Later Life ◽  
Enormous Amount ◽  
Expected Increase ◽  
Growing Population

SUMMARYDespite the enormous amount of literature on medical care of older people, personality disorders in late life have been given little attention. Clinicians tend not to assign this diagnosis to older adults in view of limited research into, and therefore limited awareness of, this topic. This article aims to promote better understanding of this subject in view of the growing population of older people and hence an expected increase in the number of personality disorder cases.

scholarly journals Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies

2019 ◽  
Vol 69 (680) ◽  
pp. e171-e181 ◽  
Author(s):  
Rachael Frost ◽  
Angela Beattie ◽  
Cini Bhanu ◽  
Kate Walters ◽  
Yoav Ben-Shlomo
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Older People ◽  
Functional Decline ◽  
Late Life ◽  
Later Life ◽  
Healthcare Services ◽  
Qualitative Studies ◽  
Late Life Depression ◽  
Psychological Therapies

BackgroundDepressive symptoms are common in later life and increase both the risk of functional and cognitive decline and the use of healthcare services. Despite older people expressing preferences for talking therapies, they are less likely to be referred than younger adults, particularly when aged ≥80 years.AimTo explore how healthcare professionals (HCPs) manage older people in relation to depression and referrals to psychological therapies.Design and settingSystematic review and thematic synthesis of qualitative studies.MethodMEDLINE, Embase, PsycINFO, CINAHL, and the Social Sciences Citation Index (inception–March 2018) were searched for studies exploring HCPs’ views regarding management of late-life depression across all settings. Studies of older people’s views or depression management across all ages were excluded.ResultsIn total, 27 studies, were included; these predominantly focused on the views of GPs and primary and community care nurses. Many HCPs felt that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited. Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate. Limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty. Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach.ConclusionMental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life. This may facilitate future identification and management of depression.

scholarly journals Gestandaardiseerd meten van persoonlijkheids­stoornissen bij ouderen

2020 ◽  
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Later Life ◽  
The Elderly ◽  
Classification Systems ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Co Morbidity ◽  
Personalized Approach

The double ageing evolution in Europe is a tremendous challenge for health care. Older adults with a personality disorder place an additional burden: they have more somatic and psychiatric co-morbidity than those without a personality disorder. Moreover, they experience less quality of life than individuals without personality disorders. This is in sharp contrast to the dearth of empirical research concerning the construct of personality disorders in later life, the very limited amount of available diagnostic tools, criteria of classification systems like DSM not being attuned to the elderly context and the lack of age-neutrality of popular instruments to measure personality disorders. Therefore, in the Netherlands and Belgium a start was made to develop and validate age-specific instruments and to examine the applicability of the alternative dimensional-hybrid DSM-5 classification of personality disorders in older adults. These recent developments and how to apply them for a personalized assessment in older adults will be discussed. Finally, we advise a phased test-based diagnostic approach in which the above-mentioned instruments, combined with measures of adaptive features or more specific tests, can contribute to an assessment optimizing the balance between restricting the load for the older patient and still being sufficiently comprehensive to result in a personalized approach of the diagnostic process.

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

ADA Standards of Medical Care in Diabetes: implications for Older Adults

2020 ◽  
Vol 35 (6) ◽  
pp. 258-265
Author(s):  
Catherine E. Travis ◽  
Caren McHenry Martin
Keyword(s):  
Older Adults ◽  
Older People ◽  
Medical Care ◽  
Microvascular Complications ◽  
Cost Of Care ◽  
Individualized Treatment ◽  
Treatment Goals ◽  
Long Term Outcomes ◽  
New Literature

Each year, new literature and recommendations are incorporated into updates in the American Diabetes Association's Standards of Medical Care in Diabetes. The 2020 update increased the focus on the rising cost of care for diabetes, long-term outcomes of newer antihyperglycemics in reducing macrovascular and microvascular complications of diabetes, and the importance of individualized treatment goals. These principles are of particular significance when managing older people with diabetes. This article focuses on updates pertinent to care of the older people.

scholarly journals What's it worth? Value and valuation of late-life creativity

2020 ◽  
pp. 1-16
Author(s):  
Vera Gallistl
Keyword(s):  
Older Adults ◽  
Positive Impact ◽  
Economic Value ◽  
Late Life ◽  
Later Life ◽  
Policy And Practice ◽  
The Arts ◽  
Narrow View ◽  
Long Time ◽  
Sociology Of Valuation

Abstract New interest in late-life creativity has arisen in gerontology. To date, such research has mainly focused on the positive impact creativity has on older adults, but has scarcely contextualised older adults’ creative engagement. Drawing on the sociology of valuation, this article aims to contextualise late-life creativity by critically exploring how creativity gains, stabilises and loses its value and how these processes are related to perceptions, images and discourses addressing old age. Data from 13 interviews with older (60+) adults involved in creative practices in Austria are used to explore these topics. Interviews examined perceptions of creative production, everyday routines and personal attitudes towards ageing. Interviews transcripts were analysed using the documentary method. The analysis revealed three registers of valuation in late-life creativity: economic value, in which valuable creativity was given away at a high revenue; field value, where valuable creativity was appreciated by institutions or other artists in the field; and lifecourse value, in which doing a creative activity for a long time meant being able to produce a creative product that was high in value. This article emphasises late-life creativity as a process of value production that is structured by the making and evaluating of creative products and adds to the current critique that the narrow view of late-life creativity in its associations with wellbeing present a reductionist picture of the capacities that the arts and creativity have for older adults. The results demonstrate the potential for valuation studies in gerontology as they highlight the circumstances and practices by which the activities of older adults are (de)valued. For policy and practice, this article suggests imagining arts-based interventions for older adults beyond the realm of health and wellbeing, and encourages thinking about how valuable artistic experiences can be supported in later life.

scholarly journals DON’T WORRY, BE HAPPY NOW, PET OWNERS: THE RELATION BETWEEN PET OWNERSHIP AND ANXIETY AND DEPRESSION IN LATE LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S165-S165
Author(s):  
Courtney J Bolstad ◽  
Carolyn E Adams-Price ◽  
Michael R Nadorff
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Late Life ◽  
Later Life ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Future Research ◽  
Pet Ownership ◽  
Pet Owners ◽  
Reported Health

Abstract Pets can provide older adults a means of social support, which can combat problems faced in later life including loneliness, anxiety, and depression. However, current research findings in this area are mixed. The current study explored the differences in anxiety and depression between pet owners and non-pet owners and how pet ownership was associated with these symptoms after accounting for other established correlates. We hypothesized pet owners would endorse fewer symptoms of anxiety and depression than non-pet owners and owning a pet would be associated with these symptoms even after accounting for other common correlates. Participants included 608 older adults aged 70 to 95 that were included in the University of Alabama at Birmingham Study of Aging. As hypothesized, results indicated that pet owners endorsed significantly fewer symptoms of anxiety and depression than non-pet owners. Hierarchical regressions indicated that owning a pet explained a significant amount of variance in anxiety symptoms even after controlling for depression, self-reported health, and demographics. However, owning a pet did not have a significant association with depressive symptoms after accounting for anxiety, self-reported health, and demographics. These results suggest that lower rates of anxiety and depression are related to owning a pet and that pet ownership is associated with fewer anxiety symptoms, but not depressive symptoms, independent of several established correlates of anxiety. Future research is needed to determine the specific mechanisms of pet ownership that comprise this relationship as well as whether pet ownership may longitudinally reduce or buffer against anxiety in late life.

Origins of depression in later life

2005 ◽  
Vol 35 (9) ◽  
pp. 1241-1252 ◽  
Author(s):  
DAN G. BLAZER ◽  
CELIA F. HYBELS
Keyword(s):  
Older Adults ◽  
Stressful Life Events ◽  
Cognitive Distortions ◽  
Late Life ◽  
Later Life ◽  
Late Life Depression ◽  
Younger Adults ◽  
Social Risks ◽  
Clinically Significant ◽  
The Many

Background. Despite the burden of depression in late life, its origins present a paradox to investigators and clinicians alike.Method. We review biological (genetics and heredity factors, neurotransmitter dysfunction, endocrine changes, vascular disorders, and medical co-morbidities), psychological (personality attributes, neuroticism, cognitive distortions, and the lack of emotional control and self-efficacy) and social (stressful life events, bereavement, chronic stress or strain, socio-economic disadvantage and impaired social support) origins of late-life depression based upon an extensive though not exhaustive review of the extant literature. In addition, modifying psychological and social factors are discussed.Results. Older adults appear to be at greater risk for major depression biologically, such as depression resulting from vascular changes, yet the frequency of depression is lower compared to younger adults. Older adults may be protected psychologically due to factors such as socio-emotional selectivity and wisdom, compared to younger adults, and perhaps relatively protected from social risks.Conclusions. A biopsychosocial approach to evaluating the origins of late-life depression is heuristically valuable, a continual reminder of the many factors that contribute to the onset and persistence of clinically significant symptoms in late life.

scholarly journals Personality disorder in older people: how common is it and what can be done?

2008 ◽  
Vol 14 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Aparna Mordekar ◽  
Sean A. Spence
Keyword(s):  
Personality Disorder ◽  
Older People ◽  
Personality Disorders ◽  
Old Age ◽  
Systematic Study ◽  
Recent Literature ◽  
Ageing Population ◽  
Axis Ii ◽  
Qualitative Review ◽  
Personality Changes

There has been little systematic study of personality disorders in older people (65 years of age and above). However, with an ageing population worldwide we should expect to find increased numbers of people with Axis II disorders surviving into old age. We undertook a qualitative review of the recent literature concerning personality changes and disorders in older people, their prevalence and possible amelioration.

scholarly journals Transitions, generations andinformal learning in later life

2012 ◽  
Vol 18 (4) ◽  
pp. 29
Author(s):  
John Field
Keyword(s):  
Older Adults ◽  
Older People ◽  
Life Course ◽  
Demographic Change ◽  
Life Histories ◽  
Later Life ◽  
Identity Change ◽  
Social Scientists ◽  
Life Chances ◽  
The Life Course

The nature of transitions across the lifecourse is changing, as are the ways in which these transitions are understoodand investigated by social scientists. Much earlier debate on older adults’ transitions has tended to be rooted in acco-unts of relatively fixed social roles and age-based social stages. However, while we can detect some tendencies towardsdestandardization and restandardization of the lifecourse in later life, we can also see significant continuities in theinfluences of socio-economic position, gender, and ethnicity, as well as of generational position, that continue to affectpeople’s life chances, as well as the expectations and experiences of transition of older people. The paper examines theinterplay of these complex and contradictory structural positions and cultural locations on transitions, and considersthe ways in which older people use and understand learning, formally and informally, as a way of exercising agencyand recreating meaning. It will draw on recent research into the life histories of adults in Scotland, a relatively smallcountry with a typically European pattern of demographic change. The study was concerned with agency, identity,change and learning across the life course, and this paper will concentrate on the evidence relating to experiences oftransition in later life. It will particularly focus on the idea of ‘educational generations’ as a key concept that helps usunderstand how adults use and interpret learning in later life.

Ageing

2021 ◽  
pp. 240-254
Author(s):  
Wadad Kathy Tannous ◽  
Kathleen Quilty
Keyword(s):  
Older Adults ◽  
Older People ◽  
Older Persons ◽  
Later Life ◽  
Technological Evolution ◽  
Technological Advancement ◽  
Emergent Technologies ◽  
The World ◽  
First Time

In 2019, the number of people in the world aged over 65 was 703 million. By 2050, this number is projected to be 1.5 billion. However, it is not only the number of older persons but the proportion that is changing. Italy was the first country to experience a demographic milestone known as the ‘Historic Reversal', reporting in 1995 that the population of people aged 65 years and older outnumbered children under the age of 15 for the first time ever. By 2050, this number is expected to reach 90 countries. This social ‘megatrend' collides with another shifting paradigm: technological advancement, accelerating every year at an extraordinary pace. While this trend of continuous technological evolution is not developing uniformly around the world, the scope of potential support that new and emergent technologies can bring to older adults is enormous. This chapter explores key areas of consideration to ensure that the promise of the digital future is realised for older people and that it is an enabling force, rather than a barrier to enjoying a longer, more supported later life.

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