International psychogeriatrics
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There is no valid instrument currently in use at acute-care hospitals in Hong Kong to aid the detection of cognitive impairment. The objectives of this study were to (1) validate the Digit Span Test (DST) in the identification and differentiation of dementia and delirium; and (2) determine the prevalence of major cognitive impairment in elderly people in an acute medical unit. ⋯ Dementia and delirium were prevalent, yet under-recognized, in acute medical geriatric inpatients. The DSB is an effective tool in identifying patients with major cognitive impairment.
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Comparative Study
Patterns of psychotropic medication use in nursing homes: surveys in Sydney, allowing comparisons over time and between countries.
This study aimed to explore changes in patterns of use of psychotropic medication in Sydney nursing homes over recent years, and to compare current usage rates with those reported from other countries. ⋯ Compared to other countries, rates of use of hypnotic, anxiolytic and antidepressant medication in Sydney nursing homes are low. Benefits and disadvantages of these differences merit analysis. Antipsychotic medications were administered to similar percentages of survey residents in 1993 and 2009, but at lower mean dosages in 2009 compared to previous surveys, and with a change to using mainly atypical antipsychotic drugs. Compared to various other countries, cognition-enhancing and antidepressant medications are administered to proportionally fewer residents in Sydney nursing homes. Outcome analysis regarding the use and benefits of such drugs in nursing homes is desirable.
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Using a representative secondary care survey for the first time, we explored family carers' reasons for providing care. We hypothesized that carers with a positive rather than negative motivation for caring would be less abusive towards the care recipient and more likely to be caring for someone still living at home a year later. ⋯ We found preliminary evidence that carers' reasons for providing care predict the well-being of the care recipient. Future studies involving dementia family carers should consider asking why the main carer assumed this role.
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The purpose of this study was to investigate the impact of caregivers' appraisals of the effectiveness of their own communication strategies on caregiver burden when caring for family members with Alzheimer's disease (AD). ⋯ Findings provide preliminary support for understanding mechanisms by which the appraisals of communication strategies influence caregiver burden and justify testing empirically derived communication interventions.
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There is a high prevalence of subjective memory complaints (SMCs) amongst older adults, many of whom experience significant distress. It remains unclear why some older adults with SMCs experience more distress than others. The Common Sense Model of Illness Perceptions has been used to explain patients' differential response to illness based on the beliefs they hold about their illness and subsequent selection of coping strategies. The present study aimed to examine the role of perceptions and coping styles in predicting anxiety and depression in older adults with SMCs. ⋯ Illness perceptions predicted depression and anxiety in older adults with SMCs. Contrary to the Common-Sense Model coping style was not found to be an important determinant of psychological distress. The findings provide a basis for developing interventions to reduce psychological distress in older adults with subjective memory complaints. Targeting causal attributions and perceived consequences of SMCs may help to improve well-being.