Advances in the Conceptualization and Study of Schizophrenia in Later Life

Cohen, Carl I.; Freeman, Ksenia; Ghoneim, Dina; Vengassery, Aninditha; Ghezelaiagh, Brian; Reinhardt, Michael

doi:10.1016/j.psc.2017.10.004

Cited by 19 publications

(19 citation statements)

References 80 publications

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“…Similarly, while representing a small proportion of the LTC population, adults with IDD are, in fact, over-represented in the setting. A recent study found that rates of admission to LTC was up to nine times higher among those with IDD compared to the general population; this study also showed they were, on average, 25 years younger when admitted ( 19 , 20 ).…”

Section: Introductionsupporting

confidence: 57%

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Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

et al. 2021

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Person-centered care approaches continue to evolve in long-term care (LTC). At the same time, these settings have faced increased challenges due to a more diverse and complex population, including persons with intellectual and developmental disabilities (IDD) and serious mental illness (SMI). This study examined the mental, social, and physical wellbeing of residents with different diagnoses, within a person-centered care model. It was hypothesized that individual wellbeing would be comparable among all residents, regardless of primary diagnosis. The study cohort was drawn from all admissions to long-term care facilities in the USA from 2011 to 2013. Data are based on admission, 3 and 6 month follow-up Minimum Data Set (MDS) 3.0 assessments. The groups examined included: schizophrenia, other psychotic disorders, IDD, dementia, and all others (i.e., none of the above diagnoses). The wellbeing outcomes were depression (mental), pain (physical), and behaviors (social). All residents experienced improvements in pain and depression, though the group without the examined diagnoses experienced the greatest gains. Behaviors were most prevalent among those with psychotic disorders; though marked improvements were noted over time. Improvement also was noted among persons with dementia. Behavior worsened over time for the three other groups. In particular, those with IDD experienced the highest level of worsening at 3-month follow-up, and continued to worsen. The results suggest person-centered care in US nursing homes provides the necessary foundation to promote mental and physical wellbeing in persons with complex needs, but less so for social wellbeing.

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Section: Introductionsupporting

confidence: 57%

“…Individuals with a SMI diagnosis tend to enter nursing homes at a younger age despite having lower rates of cognitive impairment, and functional limitations (15)(16)(17)(18)(19). Similarly, while representing a small proportion of the LTC population, adults with IDD are, in fact, over-represented in the setting.…”

Section: Admission To Ltcmentioning

confidence: 99%

Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

et al. 2021

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“…Most mental health disorders decline in frequency in late life (Byers et al, 2010; Reynolds et al, 2015). Rates of depressive, anxiety, personality, schizophrenia spectrum, and bipolar disorders are lower among older adults compared to younger and middle-aged adults (Byers et al, 2010; Cohen et al, 2018; Depp & Jeste, 2004; Fiske et al, 2009; Reynolds et al, 2015). Alcohol and substance use disorders have been on the rise among older adults over the past decade as baby boomers have aged (Kuerbis, 2020).…”

Section: Psychopathology In Late Lifementioning

confidence: 90%

“…Nonetheless, older adults with schizophrenia tend to have fewer and less severe positive symptoms compared to younger adults, although negative symptoms persist (Cohen et al, 2018). Depressive symptoms occur in almost half to three-quarter of cases among the older population and have been linked to worse functioning, more severe medical disease, poorer quality of life, and less social support (Cohen et al, 2018).…”

Section: Serious Mental Illnessmentioning

confidence: 99%

Clinical practice: A foundational geropsychology knowledge competency.

Jacobs¹,

Bamonti²

2022

Clinical Psychology: Science and Practice

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Most psychologists who provide services to older adults have not received professional training and education in geropsychology. To meet the mental health needs of the growing population of older adults, psychologists without specialty training would benefit from developing foundational knowledge competencies for clinical practice with older adults. Clinical care of older adults offers unique challenges as mental disorders are often complicated by medical illnesses, functional impairments, and latelife stressors, which contribute to under-detection and under-treatment. Age-and disease-related cognitive, sensory, and functional changes necessitate treatment adaptations and a holistic approach to care to maximize older adults' adjustment to aging and overall well-being. This article reviews the foundations of clinical practice with older adults. Specific topics covered are psychopathology in late life, neuroscience of aging, functional changes in late life, common medical illnesses in older adults, and the concept of person-environment interaction as it relates to adaptation in the context of functional changes. Public Health Significance StatementGeneralist psychologists without specialty training in geropsychology will be tasked with providing care to a growing patient population of adults 65 years of age and older. To meet this demand, all providers should attain foundational knowledge competencies in clinical practice with older adults. Dissemination of foundational knowledge competencies in geropsychology is a vital step in enhancing the mental health workforce in preparation to meet the unprecedented growth in the number of older adult patients and their families.

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“…In light of worldwide demands to address the needs of the rapidly rising number of OAS (Cohen et al, 2018), self-rated health provides an attractive research and clinical tool for assessing this population. It has been conceptualized as the global result of the influences of physical health, psychological well-being, and perceived quality of life.…”

Section: Introductionmentioning

confidence: 99%

The utility of self-rated health in older adults with schizophrenia

Cohen

Vengassery

Reinhardt

2019

Int. Psychogeriatr.

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Objectives:Self-rated health is one of the most widely used measures in gerontology, but it has not been evaluated systematically in older adults with schizophrenia (OAS). Therefore, the aim of this study was to determine the utility of self-rated health in OAS by examining its influencing factors and contrasting these findings with a community comparison (CC) group.Method:We compared 249 community-dwelling persons aged 55 years and older having a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnosis of schizophrenia arising before age 45 years with a demographically similar group of 113 older adults in the general community. Using a modified version of Ocampo’s model of self-rated health, we identified 12 predictor variables within 5 dimensions.Results:There were no significant differences in self-health ratings between the OAS and the CC groups. Six of the 12 variables in the model significantly correlated with self-rated health in both groups. In linear regression analysis, three variables were significantly associated with self-rated health in both groups: Center for Epidemiological Studies−Depression score, number of physical disorders, and perception of self-health versus others. Self-rated health assessment was not associated with positive or negative symptoms or lack of awareness of mental illness.Conclusion:There was a striking similarity in the factors influencing self-rated health in the two groups. The findings were consistent with results of previous gerontological studies that self-rated health reflects elements of psychiatric and physical well-being, as well as perceptions of their age peers. Our results support the use of self-rated health as a legitimate clinical and research measure in OAS.

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Advances in the Conceptualization and Study of Schizophrenia in Later Life

Cited by 19 publications

References 80 publications

Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

Clinical practice: A foundational geropsychology knowledge competency.

The utility of self-rated health in older adults with schizophrenia

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