Does diagnosis determine delivery? The Islington study of older people's needs and health care costs

Nelson, Tanya; Fernández, José-Luis; Livingston, Gill; Knapp, Martín

doi:10.1017/s0033291703008808

Cited by 22 publications

(12 citation statements)

References 12 publications

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“…Accordingly, a scale testing the affective status can be regarded as a surrogate measure of perceived health (Kennedy et al 2001). On the other hand, measures of cognitive ability and physical dependency were not correlated with the use of drugs, although they are well recognized indexes of health status impairment (Nelson et al 2004). This suggests an alternative explanation to the relationship between consumption of drugs and affective status: polypharmacy might negatively affect the perception of disease status (Fincke et al 1998) and, as a consequence, induce depression.…”

Section: Discussionmentioning

confidence: 99%

Depression and drug utilization in an elderly population

Incalzi¹,

Corsonello²,

Corica³

et al. 2005

tcrm

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Objective: To verify whether depression, defined as a 15-item Geriatric Depression Scale (GDS) > 6, is associated with greater drug utilization by elderly patients. Population: 2568 patients enrolled in the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Main outcome measure: Polypharmacy, ie, the daily use of at least 3 drugs, excluding antidepressant and anxiolytic agents, in the month prior to admission. Method: Home therapy data were collected according to a validated procedure. Correlates of polypharmacy were assessed by logistic regression analysis in the whole population and in subgroups for which indexes of disease severity were available. Results: GDS > 6 was found to be positively correlated with polypharmacy (odds ratio 1.22; 95% confidence interval 1.01-1.48) as were older age, comorbidity, hypertension, diabetes mellitus, congestive heart failure, and renal failure. Negative correlates of polypharmacy were smoking habit and alcohol consumption, and GDS > 6 was negatively associated with the use of analgesic (11.8% vs 15.6%, p = 0.012). In the subgroups with congestive heart failure and chronic renal failure, GDS > 6 was strictly associated with greater disease severity, but did not correlate with polypharmacy in multivariable models including indexes of disease severity. Conclusions: Depressed mood is associated with polypharmacy in the broad elderly population. However, when indexes of disease severity were considered, the association was lost, indicating that depression is a marker of the burden of disease and does not increase drug consumption per se.

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Section: Discussionmentioning

confidence: 99%

Depression and drug utilization in an elderly population

Incalzi¹,

Corsonello²,

Corica³

et al. 2005

tcrm

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“…For example, a person's living situation may affect the use of health care. Nelson et al 44 found that people who were 65 years of age or older and who were living alone were less likely to receive health care services. This finding may be attributable to an inability to access care outside the home.…”

Section: Outpatient Physical Therapy For Musculoskeletal Conditionsmentioning

confidence: 99%

Use of Outpatient Physical Therapy Services by People With Musculoskeletal Conditions

Carter

Rizzo

2007

Physical Therapy

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“…Older adults living alone with cognitive impairment are at high risk for poor health outcomes [3]. They are less likely to use health services [4], and they are more exposed to self-neglect [5, 6] and falls [6] than counterparts living with others. Older adults living alone with cognitive impairment also report a higher number of unmet needs in managing money, medications, and mobility [6], and they are less likely to seek a diagnosis for their cognitive impairment [3, 7].…”

Section: Introductionmentioning

confidence: 99%

The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer’s Disease When One Lives Alone

Portacolone

Johnson

Covinsky

et al. 2018

JAD

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Background One third of older adults with cognitive impairment live alone and are at high risk for poor health outcomes. Little is known about how older adults who live alone experience the process of receiving a diagnosis of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Objective The aim of this study was to understand the effects and meanings of receiving a diagnosis of MCI or AD on the lived experience of older adults living alone. Methods This is a qualitative study of adults age 65 and over living alone with cognitive impairment. Participants’ lived experiences were elicited through ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Results Twenty-nine older adults and 6 members of their social circles completed 114 ethnographic interviews. Core themes included: relief, distress, ambiguous recollections, and not knowing what to do. Participants sometimes felt uplifted and relieved by the diagnostic process. Some participants did not mention having received a diagnosis or had only partial recollections about it. Participants reported that, as time passed, they did not know what to do with regard to the treatment of their condition. Sometimes they also did not know how to prepare for a likely worsening of their condition, which they would experience while living alone. Conclusion Findings suggest the need for more tailored care and follow-up as soon as MCI or AD is diagnosed in persons living alone.

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Does diagnosis determine delivery? The Islington study of older people's needs and health care costs

Cited by 22 publications

References 12 publications

Depression and drug utilization in an elderly population

Depression and drug utilization in an elderly population

Use of Outpatient Physical Therapy Services by People With Musculoskeletal Conditions

The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer’s Disease When One Lives Alone

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