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4 results

  • 18 - Mental health of older people

    • By
  • Edited by Nicholas Procter, University of South Australia, Rhonda L. Wilson, University of Newcastle, New South Wales, Helen P. Hamer, Denise McGarry, University of Tasmania, Mark Loughhead, University of South Australia
  • Book:
    Mental Health
    Published online:
    07 April 2022
    Print publication:
    07 April 2022, pp 399-420

  • Summary

    This chapter will discuss the process of positive ageing, the life course, and the changing cultural norms of older people within contemporary society. The chapter will assist nurses to consider and understand how ageism and subsequent stigma and discrimination can impact on the well-being of the older person and their family/loved ones. The multiple losses and associated mental health problems will also be presented. The specific approaches to nursing care required to support human connectedness with older people will also be discussed. Common mental health problems, associated risk factors and considerations for treatment embedded within a recovery approach are explained. The chapter concludes with future issues for this area of specialty nursing practice.

  • 18 - Mental health of older people

  • Edited by Nicholas Procter, University of South Australia, Rhonda L. Wilson, University of Newcastle, New South Wales, Helen P. Hamer, Denise McGarry, University of Tasmania, Mark Loughhead, University of South Australia
  • Book:
    Mental Health
    Published online:
    07 April 2022
    Print publication:
    07 April 2022, pp 399-420

  • Summary

    This chapter will discuss the process of positive ageing, the life course, and the changing cultural norms of older people within contemporary society. The chapter will assist nurses to consider and understand how ageism and subsequent stigma and discrimination can impact on the well-being of the older person and their family/loved ones. The multiple losses and associated mental health problems will also be presented. The specific approaches to nursing care required to support human connectedness with older people will also be discussed. Common mental health problems, associated risk factors and considerations for treatment embedded within a recovery approach are explained. The chapter concludes with future issues for this area of specialty nursing practice.

  • Managing depressive symptoms in people with mild cognitive impairment and mild dementia with a multicomponent psychotherapy intervention: a randomized controlled trial

  • Johanne B. Tonga, Jūratė Šaltytė Benth, Espen A. Arnevik, Katja Werheid, Maria S. Korsnes, Ingun D. Ulstein
  • Journal:
    International Psychogeriatrics / Volume 33 / Issue 3 / March 2021
    Published online by Cambridge University Press:
    05 March 2020, pp. 217-231
    • Article
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  • Objective:

    To evaluate the feasibility and effectiveness of the CORDIAL program, a psychosocial intervention consisting of cognitive behavioral therapy (CBT), cognitive rehabilitation, and reminiscence to manage depressive symptoms for people with mild cognitive impairment (MCI) or dementia.

    Design:

    We conducted a randomized controlled trial, based on a two-group (intervention and control), pre-/post-intervention design.

    Setting:

    Participants were recruited from five different old age psychiatry and memory clinics at outpatients’ hospitals.

    Participants:

    Hundred and ninety-eight people with MCI or early-stage dementia were included.

    Intervention:

    The intervention group (n = 100) received 11 individual weekly sessions of the CORDIAL program. This intervention includes elements from CBT, cognitive rehabilitation, and reminiscence therapy. The control group (n = 98) received treatment-as-usual.

    Measurements:

    We assessed Montgomery–Åsberg Depression Rating Scale (MADRS) (main outcome), Neuropsychiatric Inventory Questionnaire, and Quality of Life in Alzheimer’s disease (secondary outcomes) over the course of 4 months and at a 10-month follow-up visit.

    Results:

    A linear mixed model demonstrated that the depressive symptoms assessed by MADRS were significantly more reduced in the intervention groups as compared to the control group (p < 0.001). The effect persisted for 6 months after the intervention. No significant differences between groups were found in neuropsychiatric symptoms or quality of life.

    Conclusion:

    Our multicomponent intervention, which comprised 11 individual sessions of CBT, cognitive rehabilitation, and reminiscence therapy, reduced depressive symptoms in people with MCI and dementia.

  • The impact of life review on depression in older adults: a randomized controlled trial

  • Anne Margriet Pot, Ernst T. Bohlmeijer, Simone Onrust, Anne-Sophie Melenhorst, Marjolein Veerbeek, Wilma De Vries
  • Journal:
    International Psychogeriatrics / Volume 22 / Issue 4 / June 2010
    Published online by Cambridge University Press:
    04 February 2010, pp. 572-581

  • Background: We developed an indicated preventive life-review course, “Looking for Meaning”, based on the assumption that reminiscence styles influence coping with depressive symptoms. This study describes the impact of this course in a pragmatic randomized controlled trial.

    Methods: Inclusion criteria were >50 years, a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D), and no depressive disorder or psychotropic or psychological treatment. Participants were randomized and stratified by gender: the experimental group (N = 83) was offered the course and the comparison group (N = 88) a movie. There were three measurements: pre-treatment, post-treatment and 6 months after post-treatment. Depressive symptoms constituted the primary outcome. Secondary outcomes were anxiety symptoms, satisfaction with life, mastery and reminiscence styles. All analyses were conducted according to the intention-to-treat principle. Missing values were replaced by regression imputation.

    Results: The course reduced depressive symptoms, a decrease that was retained during follow-up. A significant between-group effect size was found (d = 0.58). There was also a reduction in symptoms of anxiety; however, the comparison group showed the same reduction, resulting in a small between-group effect size. Gender and level of depressive symptoms were found to be prognostic factors for the change in depressive symptoms; age was not. Post hoc analyses showed significant between-group effect sizes for females and those with a score above the cut-off of the CES-D.

    Conclusion: The course “Looking for Meaning” can be recommended for people aged over 50 years, females and older adults with a clinically relevant level of depressive symptoms (above cut-off) in particular.