Some form of adversity is a common experience, although the severest abuses are less common in this population. Multiple adversities are common and only a minority experience single adversities. Physical abuse, sexual abuse and neglect rarely occur alone, but indicate a context of abuse.
Trauma is ubiquitous in the community and posttraumatic stress disorder is comparatively less common, persisting into the past year in 2.8% of those who have experienced lifetime trauma. The conventional models of female susceptibility to post-traumatic stress disorder are not supported in this sample. The type of trauma appears the most important determinant of progression to posttraumatic stress disorder. These com-munity prevalence statistics complement causal understanding that comes from studies of clinical and other special populations in which posttraumatic stress disorder and selection for treatment may be confounded.
This epidemiological study aimed at determining the prevalence of mild cognitive impairment (MCI) in 60- to 64-year-old individuals using different diagnostic criteria. Community dwelling individuals (n = 2,551) in the age range of 60–64 years were recruited randomly through the electoral roll. They were screened using the MMSE and a short cognitive battery, and those who screened positive underwent detailed medical and cognitive assessments. Extant MCI-related diagnoses were established by consensus. Predictive regression models on the sub-sample were used to determine population prevalence for the diagnoses. Of the 224 subjects who screened positive for MCI, 112 underwent a detailed assessment and 74% met the criteria for at least one recognised diagnosis of mild cognitive deficit (MCI and related diagnoses). By predictive regression modelling, the prevalence of any MCI diagnosis was 13.7% (95% CI 9.1–30.2) in the population of 60- to 64-year-olds. The estimated prevalence rates for specific diagnoses were: MCI 3.7%, ageing-associated cognitive decline 3.1%, Clinical Dementia Rating score (0.5) 2.8%, age-associated memory impairment 1%, other cognitive disorders 0.9%, and mild neurocognitive disorder 0.6%. Agreement on ‘caseness’ between various proposed diagnoses was at best fair and generally poor. Memory and other cognitive problems not meeting the threshold for dementia are relatively common in 60- to 64-year-old individuals living in the community. The prevalence rate varies up to six-fold according to the diagnostic criteria applied, with limited overlap between diagnoses. There is an urgent need for standardization of the criteria.
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