Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T20:09:24.233Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatry of old age and ethnic minority older people in the United Kingdom

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  17 September 2009

Ajit Shah
Ajit Shah*
Affiliation:
International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston and West London Mental Health NHS Trust, London, UK
*
Address for correspondence: Professor Ajit Shah, John Connolly Unit, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

This review examines the demographic changes, the epidemiology of mental disorders and suicides, the potential risk and protective factors, access to secondary care old age psychiatry services (OAPSs) and the policy context pertaining to older people from ethnic minority groups in the United Kingdom. The number of older people from ethnic minority groups is increasing. The prevalence of mental disorders in older people from ethnic minority groups is either similar to or higher than that in the indigenous population. Therefore, the number of older people from ethnic minority groups with psychiatric morbidity is also increasing. Ethnic minority older people also have inequity of access to secondary care OAPSs. There is an urgent need to develop and implement practical strategies to improve access by older people from ethnic minority groups to OAPSs.

Keywords

Old age psychiatrypsychogeriatricsdementiadepressionethnic minorityblack and ethnic minority
Type
Neuropsychiatry of old age
Information
Reviews in Clinical Gerontology , Volume 19 , Issue 2 , May 2009 , pp. 119 - 134
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Rajkumar, S, Kumar, S, Thara, R. Prevalence of dementia in a rural setting: a report from India. Int J Geriat Psychiat 1997; 12: 702–7.3.0.CO;2-H>CrossRefGoogle Scholar
2Barker, J. Research Perspectives on Ageing: Black and Asian Old People in Britain. London: Age Concern Research Unit, 1984.Google Scholar
3McCallum, JA. The Forgotten people: Carers in Three Minority Communities in Southwark. London: Kings Fund Centre, 1990.Google Scholar
4Manthorpe, J, Hettiaratchy, P. Ethnic minority elders in Britain. Int Rev Psychiat 1993; 5: 173–80.CrossRefGoogle Scholar
5Chandra, V, Ganguli, M, Ratcliff, G et al. Studies of the epidemiology of dementia: comparison between developed and developing countries. Aging Clin Exp Res 1994; 6: 307–21.CrossRefGoogle ScholarPubMed
6Rajkumar, S, Kumar, S. Prevalence of dementia in the community: a rural urban comparison from Madras, India. Aus J Ageing 1996; 15: 9–13.Google Scholar
7Rait, G, Morley, M, Lambat, I, Burns, A. Modification of brief cognitive assessments for use with elderly people from the South Asian sub-continent. Ageing Mental Health 1997; 1: 356–63.CrossRefGoogle Scholar
8Bhopal, R. Is research into ethnicity and health racist, unsound or unimportant science? Br Med J 1997; 314: 1751–56.CrossRefGoogle ScholarPubMed
9Lloyd, K. Ethnicity, primary care and non-psychotic disorders. Int Rev Psychiat 1992; 4: 257–62.CrossRefGoogle Scholar
10McKenzie, K, Crowcroft, NS. Describing race, ethnicity and culture in medical research: describing the groups is better than trying to find a catch all name. Br Med J 1996; 312: 1051.CrossRefGoogle Scholar
11Pringle, M, Rothera, I. Practicality of recording patient ethnicity in general practice: descriptive intervention study and attitude survey. Br Med J 1996; 312: 1080–82.CrossRefGoogle ScholarPubMed
12Rait, G, Burns, A. Appreciating background and culture: the south Asian elderly and Mental Health. Int J Geriat Psychiat 1997; 12: 973–77.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
13Senior, PA, Bhopal, R. Ethnicity as a variable in epidemiological research. Br Med J 1994; 309: 327–30.CrossRefGoogle ScholarPubMed
14Department of Health. Delivering Race Equality in Mental Health Care. An Action Plan for Reform Inside and Outside Services and the Government's Response to the Independent Inquiry into the Death of David Bennett; www.dh.gov.UK/assetroot/04/10/07/75/04100775.pdf (viewed 11 July 2009).Google Scholar
15Livingston, G, Leavey, G, Kitchen, G et al. Mental health of migrant elders – the Islington study. Br J Psychiat 2001; 179: 361–66.CrossRefGoogle ScholarPubMed
16Shah, AK, Dennis, M, Lindesay, J. Comparison of elderly suicide rates amongst migrants in England and Wales with their country of origin. Int J Geriat Psychiat 2009; 24: 292–99.CrossRefGoogle Scholar
17Dennis, MS, Shah, AK, Lindesay, J. Methods of elderly suicides in England and Wales by country of birth groupings. Int J Geriat Psychiat (in press).Google Scholar
18Office of Population Censuses & Surveys. 1991 Census: Ethnic Group and Country of Birth Great Britain. London: Office of Population Censuses and Surveys, 1993.Google Scholar
19Wild, SH, Fischbacher, CM, Brock, A, Griffiths, C, Bhopal, R. Mortality from all causes and circulatory diseases by country of birth in England and Wales, 2001–2003. J Pub Health 2007; 29: 191–98.CrossRefGoogle ScholarPubMed
20Office of Population Censuses & Surveys. 1981 Census: country of birth. Great Britain. London: HMSO, 1983.Google Scholar
21Office of Population Censuses & Surveys. 1991 Census: County Reports. London: Office of Population Censuses and Surveys, 1993.Google Scholar
22Shah, AK, Oommen, G, Wuntakal, B. Cultural aspects of dementia. Psychiatry 2005; 4: 103–6.CrossRefGoogle Scholar
23Shah, AK. Demographic changes among ethnic minority elders in England and Wales. Im plications for development and delivery of old age psychiatry services. Int J Mig Health Soc Care 2007; 3: 22–32.CrossRefGoogle Scholar
24Markson, EW. Social Gerontology Today. An Introduction. Los Angeles: Roxbury Publishing, 2003.Google Scholar
25Mui, AC, Kang, S, Chen, LM, Domanski, MD. Reliability of the GDS for use among elderly Asian immigrants to the USA. Int Psychogeriat 2003; 15: 253–71.CrossRefGoogle ScholarPubMed
26Stevens, T, Leavey, G, Livingston, G. Dementia and hypertension in African/Caribbean elders. Age Ageing 2004; 33: 193–95.CrossRefGoogle ScholarPubMed
27Lindesay, J, Jagger, C, Mlynik-Szmid, A et al. The mini-mental state examination (MMSE) in an elderly immigrant Gujarati population in the United Kingdom. Int J Geriat Psychiat 1997; 12: 1155–67.3.0.CO;2-E>CrossRefGoogle Scholar
28Silveira, E, Ebrahim, S. Mental health and health status of elderly Bengalis and Somalis in London. Age Ageing 1995; 24: 474–80.CrossRefGoogle Scholar
29Silveria, E, Ebrahim, S. Social determinants of psychiatric morbidity and well-being in immigrant elders and whites in east London. Int J Geriat Psychiat 1998; 13: 801–12.3.0.CO;2-Z>CrossRefGoogle Scholar
30Silveria, E, Ebrahim, S. A comparison of mental health among minority ethnic elders and whites in east and north London. Age Ageing 1998; 27: 375–83.Google Scholar
31Ebrahim, S, Patel, N, Coats, M et al. Prevalence and severity of morbidity among Gujarati Asian elders: a controlled comparison. Family Practice 1991; 8: 57–62.CrossRefGoogle Scholar
32Bhatnagar, KS, Frank, J. Psychiatric disorders in elderly from the Indian subcontinent living in Bradford. Int J Geriat Psychiat 1997; 12: 907–12.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
33Reeves, SJ, Sauer, J, Stewart, R, Granger, A, Howard, R. Increased first contact rates for very late onset schizophrenia-like psychosis in African and Caribbean born elders. Br J Psychiat 2001; 179: 172–74.CrossRefGoogle ScholarPubMed
34McCracken, CFM, Boneham, MA, Copeland, JRM et al. Prevalence of dementia and depression among elderly people in black and ethnic groups. Br J Psychiat 1997; 171: 269–73.CrossRefGoogle Scholar
35Shah, AK, Lindesay, J, Nnatu, I. Cross-cultural issues in the assessment of cognitive impairment. In: Burns, A, O’Brien, J, Ames, D (eds), Dementia. London: Arnold Hodder, 2005; pp. 147–64.Google ScholarPubMed
36Stewart, R, Richards, M, Brayne, C, Mann, A. Vascular risk and cognitive impairment in an older British, African-Caribbean population. J Am Geriat Soc 2001; 49: 263–69.CrossRefGoogle Scholar
37Stewart, R, Prince, M, Mann, A. Age, vascular risk, and cognitive decline in an older, British, African Caribbean population. J Am Geriat Soc 2003; 51: 1547–53.CrossRefGoogle Scholar
38Mak, Z, Kim, JM, Stewart, R. Leg length, cognitive impairment and cognitive decline in an African-Caribbean population. Int J Geriat Psychiat 2006; 21: 266–72.CrossRefGoogle Scholar
39Stewart, R, Russ, C, Richards, M, Brayne, C, Lovestone, S, Mann, A. Apolipoprotein E genotype, vascular risk and early cognitive impairment in an African Caribbean population. Dem Geriat Cog Dis 2001; 12: 251–56.CrossRefGoogle Scholar
40Stewart, R, Powell, J, Prince, M, Mann, A. ACE genotype and cognitive decline in an African Caribbean population. Neurobiol Ageing 2004; 25: 1369–75.CrossRefGoogle Scholar
41Jordanova, V, Stewart, R, Davies, E, Sherwood, R, Prince, M. Markers of inflammation and cognitive deline in an African Caribbean population. Int J Geriat Psychiat 2007; 22: 966–73.CrossRefGoogle Scholar
42Stewart R, Johnson J, Richards M, Brayne C, Mann A and Medical Research Council Cognitive Function and Ageing Study. The distribution of Mini-Mental State Examination scores in older UK African-Caribbean population compared to MRC CFA study norms. Int J Geriat Psychiat 2002; 17: 745–51.CrossRefGoogle Scholar
43Guglani, S, Coleman, PG, Sonuga-Barke, EJS. Mental health of elderly Asians in Britain: a comparison of Hindus from nuclear and extended families of differing cultural identities. Int J Geriat Psychiat 2000; 15: 1046–53.3.0.CO;2-C>CrossRefGoogle Scholar
44Stewart, R, Russ, C, Richards, M, Brayne, C, Lovestone, S, Mann, A. Depression, APOE genotype and subjective memory impairment: a cross-sectional study in an African Caribbean population. Psychol Med 2001; 31: 431–40.CrossRefGoogle Scholar
45Raleigh, VS, Bulusu, L, Balarajan, R. Suicides among immigrants from the Indian subcontinent. Br J Psychiat 1990; 156: 46–50.CrossRefGoogle Scholar
46Neeleman, J, Mak, V, Wessely, S. Suicide by age, ethnic group, coroner's verdict and country of birth. A three-year survey in inner London. Br J Psychiat 1997; 181: 463–67.CrossRefGoogle Scholar
47McKenzie, K, Bhui, K, Nanchahal, K, Blizard, B. Suicide rates in people of South Asian origin in England and Wales: 1993–2003. Br J Psychiat 2008; 193: 406–9.CrossRefGoogle ScholarPubMed
48Burvill, P. Suicide in the multiethnic population of Australia, 1979–1990. Int Psychogeriat 1995; 7: 319–33.CrossRefGoogle ScholarPubMed
49Burvill, P, Woodings, TL, Stenhouse, NS, McCall, NS. Suicide during 1961–1970 of migrants in Australia. Psychol Med 1982; 12: 295–308.CrossRefGoogle Scholar
50Kleiwer, EV, Ward, RH. Convergence of immigrant suicide rates to those in the destination country. Am J Epidemiol 1988; 127: 640–53.CrossRefGoogle Scholar
51Kleiwer, EV. Immigrant suicide in Australia, Canada, England and Wales, and the United States. J Aust Popul Assoc 1991; 8: 111–28.Google Scholar
52Raleigh, VS, Balarajan, R. Suicide and self burning among Indians and west Indians in England and Wales. Br J Psychiat 1992; 161: 365–68.CrossRefGoogle Scholar
53Burvill, P. Migrant suicide rates in Australia and in the country of birth. Psychol Med 1998; 28: 201–8.CrossRefGoogle ScholarPubMed
54Prosser, D. Suicide by burning in England and Wales. Br J Psychiat 1996; 168: 175–82.CrossRefGoogle ScholarPubMed
55Hunt, IM, Robinson, J, Bickley, H et al. Suicides in ethnic minority within 12 months of contact with mental health services. Br J Psychiat 2003; 183: 155–60.CrossRefGoogle ScholarPubMed
56Adityanjee, DR. Suicide attempts and suicide in India: cross-cultural aspects. Int J Soc Psychiat 1986; 32: 64–73.CrossRefGoogle ScholarPubMed
57Bhatia, SC, Kahn, MH, Medirrata, RP. High risk suicide factors across cultures. Int J Soc Psychiat 1987; 33: 226–36.CrossRefGoogle ScholarPubMed
58Modan, B, Nissenkorn, I, Lewkowski, SR. Comparative epidemiological apsects of suicide and attempted suicide in Israel. Am J Epidemiol 1970; 91: 393–99.CrossRefGoogle Scholar
59Kings College London and London School of Economics. Dementia UK. The Full Report. www.alzheimers.org.uk/News_and_Campaigns/Campaigning/PDF/Dementia_UK_Full_Report.pdf (viewed 11 July 2009).Google Scholar
60Shah, A. Estimating the absolute number of cases of dementia and depression in the black and minority ethnic elderly population in the UK. Int J Mig Health Soc Care 2008; 4: 4–15.CrossRefGoogle Scholar
61Bhalia, A, Blakemore, K. Elders of the Minority Ethnic Groups. Birmingham: AFFOR, 1981.Google Scholar
62Donaldson, LJ. Health and social status of elderly Asians. A community survey. Br Med J 1986; 293: 1079–82.CrossRefGoogle ScholarPubMed
63Balarajan, R, Yuen, P, Raleigh, VS. Ethnic differences in general practice consultation rates. Br Med J 1989; 299: 958–60.CrossRefGoogle Scholar
64Gillam, S, Jarman, B, White, P et al. Ethnic differences in consultation rates in urban general practice. Br Med J 1989; 299: 953–58.CrossRefGoogle ScholarPubMed
65Lindesay, J, Jagger, C, Hibbert, MJ et al. Knowledge, uptake and availability of health and social services among Asian Gujarati and white elders. Ethnicity Health 1997; 2: 59–69.CrossRefGoogle Scholar
66Livingston, G, Leavey, G, Kitchen, G et al. Accessibility of health and social services to immigrant elders: the Islington study. Br J Psychiat 2002; 180: 369–74.CrossRefGoogle ScholarPubMed
67Blakemore, K, Boneham, M. Age, race, and ethnicity: a comparative approach. Buckingham: Open University Press, 1994.Google Scholar
68Shah, AK, Dighe-Deo, D. Elderly Gujaratis and psychogeriatrics in a London psychogeriatric service. Bull Int Psychogeriat Ass 1998; 14: 12–13.Google Scholar
69Jagger, C. Asian elders. An under studied and growing population. Old Age Psychiat 1998; 10: 8.Google Scholar
70Hassett, A, George, K. Access to a community old age psychiatry service by elderly from non-English speaking background. Int J Geriatr Psychiat 2002; 17: 623–28.CrossRefGoogle Scholar
71Adamson, J. Awareness and understanding of dementia in African/Caribbean and south Asian families. Health Soc Care Com 2001; 9: 391–96.CrossRefGoogle ScholarPubMed
72Marwaha, S, Livingston, G. Stigma, racism or choice. Why do depressed ethnic elders avoid psychiatrists? J Affect Dis 2002; 72: 257–65.CrossRefGoogle ScholarPubMed
73Bowes, A, Wilkinson, H. ‘We didn't know it would get so bad’: South Asian experiences of dementia and service response. Health Soc Care Com 2003; 11: 387–96.CrossRefGoogle ScholarPubMed
74Purandare, N, Luthra, V, Swarbrick, C, Burns, A. Knowledge of dementia among South Asian (Indian) older people in Manchester, UK. Int J Geriat Psychiat 2007; 22: 777–81.CrossRefGoogle ScholarPubMed
75Shah, AK. The burden of psychiatric disorders in primary care. Int Rev Psychiat 1992; 4: 243–50.CrossRefGoogle Scholar
76Shah, AK. Interviewing mentally ill ethnic minority elders with interpreters. Aus J Ageing 1997; 16: 220–21.CrossRefGoogle Scholar
77Shah, AK. Straight talk. Overcoming language barriers in diagnosis. Geriat Med 1997; 27: 45–46.Google Scholar
78Thornton, T, Shah, AK, Thomas, P. Understanding, testimony and interpretation in psychiatric diagnosis. Med Healthcare Philosophy 2009; 12: 49–55.CrossRefGoogle ScholarPubMed
79Thomas, P, Thornton, T, Shah, AK. Language, games and interpretation in psychiatric diagnosis: a Wittgensteinian thought experiment. J Med Hum 2009; 35: 13–18.CrossRefGoogle ScholarPubMed
80Age Concern/Help the Aged Housing Trust. Housing for Ethnic Elders. London: Age Concern, 1984.Google Scholar
81Hopkins, A, Bahl, V. Access to Care for People from Black and Ethnic Minorities. London: Royal College of Physicians, 1993.Google Scholar
82Lawrence, V, Banerjee, S, Bhugra, D, Sangha, K, Turner, S, Murray, J. Coping with depression in later life: a qualitative study of help-seeking in three ethnic groups. Psychol Med 2006; 36: 1375–83.CrossRefGoogle ScholarPubMed
83Bhatnagar, KS. Depression in South Asian elders. Geriat Med 1997; 27: 55–56.Google Scholar
84Lawrence, V, Murray, J, Samsi, K, Banerjee, S. Attitudes and support needs of Black Caribbean, south Asian and White Britsh carers of people with dementia in the UK. Br J Psychiat 2008; 193: 240–46.CrossRefGoogle Scholar
85Secretaries of State for Health, Northern Ireland and Scotland. Working for Patients. London: HMSO, 1989.Google Scholar
86Department of Health. National Service Framework for Older people. National Service Frameworks. London: Department of Health, 2001.Google Scholar
87Shah, AK. Can the recognition of clinical features of mental illness at clinical presentation in ethnic elders be improved? Int J Geriat Psychiat 2007; 22: 277–82.CrossRefGoogle ScholarPubMed
88Haider, I, Shah, A. A pilot study of behavioural and psychological signs of dementia in patients of Indian sub-continent origin admitted to a dementia day hospital in the United Kingdom. Int J Geriat Psychiat 2004; 19: 1195–204.CrossRefGoogle ScholarPubMed
89Patel, N, Mirza, NR, Lindblad, P, Amstrup, K, Samaoli, O. Dementia and minority ethnic older people. Managing care in the UK, Denmark and France. Lyme Regis: Russel House Publishing Limited, 1998.Google Scholar
90Patel, N. Care for ethnic minorities: the professionals’ views. J Dem Care 2000; Jan/Feb: 26–27.Google Scholar
91Lindesay, J. The diagnosis of mental illness in elderly people from ethnic minorities. Adv Psychiat Treat 1998; 4: 219–26.CrossRefGoogle Scholar
92Shah, AK. Difficulties experienced by a Gujarati psychiatrist in interviewing elderly Gujaratis in Gujarati. Int J Geriat Psychiat 1999; 14: 1072–74.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
93Shah, AK, MacKenzie, S. Disorders of ageing across cultures. In: Bhugra, D, Bhui, K (eds), Textbook of Cultural Psychiatry. Cambridge, Cambridge University Press, 2007; pp. 323–44.CrossRefGoogle Scholar
94Solomon, A. Clinical diagnosis among diverse populations: a multicultural perspective. Family in Society: J Contemp Human Ser 1992; June, 371–77.CrossRefGoogle Scholar
95Johnson, MRD, Cross, M, Cardew, S. Inner city residents, ethnic minorities and primary health care. Postgrad Med J 1983; 59: 664–67.CrossRefGoogle ScholarPubMed
96Redelinghuys, J, Shah, AK. The characteristics of ethnic elders from the Indian subcontinent using a geriatric psychiatry service in west London. Ageing Mental Health 1997; 1: 243–47.CrossRefGoogle Scholar
97Odutoye, K, Shah, AK. The clinical and demographic characteristics of ethnic elders from the Indian sub-continent newly referred to a psychogeriatric service. Int J Geriat Psychiat 1999; 14: 446–53.3.0.CO;2-L>CrossRefGoogle Scholar
98Bhatkal, S, Shah, AK. Clinical and demographic characteristics of elderly Poles referred to a psychogeriatric service. Int Psychogeriat 2004; 16: 351–60.CrossRefGoogle Scholar
99LoGiudice, D, Hassett, A, Cook, R, Flicker, L, Ames, D. Equity of access to a memory clinic in Melbourne? Non-English speaking background attenders are more severely demented and have increased rates of dementia. Int J Geriat Psychiat 2001; 16: 327–34.CrossRefGoogle Scholar
100Hoxey, K, Mukherjee, S, Shah, AK. Psychiatric services for ethnic elders. Old Age Psychiat 1999; 1: 44–46.Google Scholar
101Purandare, N, Swarbrick, C, Fischer, A, Burns, A. Cholinesterase inhibitors for Alzheimer's disease: variations in clinical practice in the north-west of England. Int J Geriat Psychiat 2006; 21: 961–64.CrossRefGoogle ScholarPubMed
102Commission for Healthcare Audit and Inspection. Count Me In 2008. Results of the 2008 national census of inpatients in mental health and learning disability services in England and Wales. London: Commission for Healthcare Audit and Inspection, 2008.Google Scholar
103Shah, AK. The ‘Count Me In’ psychiatric inpatient census for 2007 and the elderly: evidence of improvement or cause for concern? Psychiat Bull 2009; 33: 201–3.CrossRefGoogle Scholar
104Richards, M, Abas, M, Carter, J et al. Social support and activities of daily living in older Afro-Caribbean and white UK residents. Age Ageing 1998; 27: 252–53.Google ScholarPubMed
105Shah, AK, Doe, P, Deverill, K. Ethnic minority elders: are they neglected in published geriatric psychiatry literature? Int Psychogeriat 2008; 20: 1041–45.CrossRefGoogle ScholarPubMed
106Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini-Mental State’: A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12: 189–98.CrossRefGoogle Scholar
107Rait, G, Burns, A, Baldwin, R et al. Validating screening instruments for cognitive impairment in older south Asians in the United Kingdom. Int J Ger Psychiat 2000; 15: 54–62.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
108Rait, G, Morley, M, Burns, A et al. . Screening for cognitive impairment in older African-Caribbeans. Psychol Med 2000; 30: 957–63.CrossRefGoogle ScholarPubMed
109Quereshi, KN, Hodkinson, HM. Evaluation of a ten-question mental test in institutionalised elderly. Age Ageing 1984; 3: 152–57.CrossRefGoogle Scholar
110Morris, J, Heyman, A, Mohs, R et al. The consortium to establish a registry for Alzheimer's disease (CERAD). Part 1. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 1989; 39: 1159–65.Google Scholar
111Roth, M, Tym, E, Mountjoy, CQ et al. CAMDEX: A standardised instrument for diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiat 1986; 149: 698–709.CrossRefGoogle Scholar
112Richards, M, Brayne, C. Cross-cultural research into cognitive impairment and dementia: some practical experiences. Int J Geriatr Psychiat 1996; 11: 383–87.3.0.CO;2-6>CrossRefGoogle Scholar
113Richards, M, Brayne, C, Dening, T et al. Cognitive function in UK community dwelling African Caribbean and white elders: a pilot study. Int J Geriat Psychiat 2000; 15: 621–30.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
114Stewart, R, Richards, M, Brayne, C et al. Cognitive function in UK community-dwelling African Caribbean elders: normative data for a test battery. Int J Geriat Psychiat 2001; 16: 518–27.CrossRefGoogle ScholarPubMed
115Sheikh, JA, Yesavage, J. Geriatric Depression Scale (GDS). Recent findings and development of a shorter version. Clin Gerontol 1986; 5: 165–73.Google Scholar
116Adshead, G, Cody, D, Pitt, B. BASDEC: a novel screening instrument for depression in elderly medical inpatients. Br Med J 1992; 305: 397.CrossRefGoogle ScholarPubMed
117Abas, M, Phillips, C, Carter, J, Walker, S, Banerjee, S, Levy, R. Culturally sensitive validation of instruments in older African-Caribbean people living in South London. Br J Psychiat 1998; 17: 249–54.CrossRefGoogle Scholar
118Rait, G, Burns, A, Baldwin, R et al. Screening for depression in African-Caribbean elders. Family Practice 1999; 16: 591–95.CrossRefGoogle ScholarPubMed
119Abas, M, Phillips, C, Richards, M, Carter, J, Levy, R. Initial development of a new culture-specific screen for emotional distress in older Caribbean people. Int J Geriat Psychiat 1996; 11: 1097–103.3.0.CO;2-8>CrossRefGoogle Scholar
120Abas, M. Depression and anxiety among older Caribbean people in the UK: screening, unmet need and the provision of appropriate services. Int J Geriat Psychiat 1996; 11: 377–82.3.0.CO;2-0>CrossRefGoogle Scholar
121Bedford, A, Foulds, GA, Sheffield, BF. A new personal disturbance scale. Br J Soc Clin Psychol 1976; 15: 387–94.CrossRefGoogle ScholarPubMed
122Gurland, B, Golden, R, Teresi, JA et al. The Short-Care. An efficient instrument for the assessment of depression and dementia. J Gerontol 1984; 39: 166–69.CrossRefGoogle Scholar
123Copeland, JRM, Kelleher, MJ, Kellett, JM et al. A semi-structured interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule. 1. Development and reliability. Psychol Med 1976; 6: 439–49.CrossRefGoogle Scholar
124Stewart, R, Richards, M, Brayne, C, Mann, A. Cognitive function in the UK community-dwelling African Caribbean elders: normative data for a test battery. Int J Geriat Psychiat 2001; 16: 518–27.CrossRefGoogle ScholarPubMed
125Shah, AK. Do socio-economic factors, elderly population size and service development factors influence development of specialist mental health programme for older people. Int Psychogeriat 2008; 20: 1238–44.CrossRefGoogle ScholarPubMed
126Department of Health. National Service Framework for Mental Health. National Service Frameworks. London: Department of Health, 1999.Google Scholar
127Audit Commission. Forget-Me-Not, Mental Health Services for Older People. London: Audit Commission, 2002.Google Scholar
128Audit Commission. Forget-Me-Not. London: Audit Commission, 2002Google Scholar
129Department of Health. Everybody's Business Integrated mental health services for older adults: a service development guide. London: Department of Health, 2005.Google Scholar
130National Institute of Mental Health England. Inside Outside – Improving Mental Health Services for Black and Minority Ethnic Communities in England. London: National Institute of Mental Health England, 2003.Google Scholar
131National Institute of Clinical Excellence. Dementia. NICE guidelines. London: National Institute of Clinical Excellence, 2006.Google Scholar
132National Institute of Clinical Excellence. Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease. NICE technological appraisal guidance 2 (amended). London: National Institute of Clinical Excellence, 2007.Google Scholar
133Department of Health. Living Well With Dementia: A National Dementia strategy. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058 (viewed 11 July 2009).Google Scholar
134Shah, AK, Lindesay, J, Jagger, C. Is the diagnosis of dementia stable over time among elderly immigrant Gujaratis in the United Kingdom (Leicester)? Int J Geriat Psychiat 1998; 13: 440–44.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
135Shah, AK. The Prevalence and Burden of Psychiatric Disorders. A Report to the Department of Health. London: Institute of Psychiatry, 1992.Google Scholar
136Goldberg, D, Huxley, P. Common Mental Disorders: A Biosocial Model. London & New York: Tavistock & Routledge, 1991.Google Scholar