Functional Assessment in Geriatric Mental Health

Kemp, Bryan J.; Mitchell, Judith M.

doi:10.1016/b978-0-12-101277-9.50028-0

Cited by 15 publications

(10 citation statements)

References 37 publications

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“…Stigma may help explain the fact that few older adults identified depression spontaneously as one of their problems (7,(33)(34)(35), although participants acknowledged that others had characterized their condition as depression, and the sample had relatively high rates of past and current depression treatment. Their infrequent identification of depression may also reflect their view of its close association with other problems, particularly those pertaining to physical health, social support, physical functioning, and pain-a view consistent with the biopsychosocial perspective (36)(37)(38) and social models of depression (39), in which depression is viewed as arising from adverse personal and social circumstances that accrue in old age (40). Finally, the low ranking of depression may reflect low self-efficacy and a sense that late-life depression is inevitable.…”

Section: Discussionmentioning

confidence: 96%

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Proctor¹,

Hasche²,

Morrow‐Howell³

et al. 2008

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Effective and durable improvements to mental health care must be shaped by an understanding of client perceptions and priorities. Motivational interviewing, health education, and assessment of treatment priorities may be necessary in helping older adults value and accept depression care. Nonspecialty settings of care may effectively link depression treatment to other services, thereby increasing receptivity to mental health services.

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Section: Discussionmentioning

confidence: 96%

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Proctor¹,

Hasche²,

Morrow‐Howell³

et al. 2008

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show abstract

“…Their infrequent identification of depression may also reflect their view of its close association with other problems, particularly those pertaining to physical health, social support, physical functioning, and pain-a view consistent with the biopsychosocial perspective (36)(37)(38) and social models of depression (39), in which depression is viewed as arising from adverse personal and social circumstances that accrue in old age (40). Finally, the low ranking of depression may reflect low self-efficacy and a sense that late-life depression is inevitable.…”

Section: Discussionmentioning

confidence: 99%

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Proctor

Hasche²,

Morrow‐Howell³

et al. 2008

Psychiatric Services

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Objective-Depression often co-occurs with other conditions that may pose competing demands to depression care, particularly in later life. This study examined older adults' perceptions of depression among cooccurring social, medical, and functional problems and compared the priority of depression with that of other problems.Methods-The study's purposeful sample comprised 49 adults age 60 or older with a history of depression and in publicly funded community long-term care. Fourpart, mixed-methods interviews sought to capture participants' perceptions of life problems as well as the priority they placed on depression. Methods included standardized depression screening, semistructured qualitative interviews, listing of problems, and qualitative and quantitative analysis of problem rankings.Results-Most participants identified health, functional, and psychosocial problems cooccurring with depressive symptoms. Depression was ranked low among the co-occurring conditions; 6% ranked depression as the most important of their problems, whereas 45% ranked it last. Relative rank scores for problems were remarkably similar, with the notable exception of depression, which was ranked lowest of all problems. Participants did not see depression as a high priority compared with co-occurring problems, particularly psychosocial ones.Conclusions-Effective and durable improvements to mental health care must be shaped by an understanding of client perceptions and priorities. Motivational interviewing, health education, and assessment of treatment priorities may be necessary in helping older adults value and accept depression care. Nonspecialty settings of care may effectively link depression treatment to other services, thereby increasing receptivity to mental health services.Depression is a major chronic illness that affects one-fourth to one-fifth of communitydwelling older adults (1,2). It diminishes quality of life, exacerbates physical and functional dependency (3-6), and increases medical costs (7,8). Although depression in later life can be effectively treated, most elderly people with depression remain untreated (9). Older adults are vulnerable to mental health service barriers (10), low detection and treatment rates in primary medical care (11,12), and pervasive stigma-their own as well as that from their family members and treatment providers. Depression treatment is further complicated by comorbidity with other problems. Although older adults with functional disability have higher rates of depression (13), they and their providers may demote depression treatment to a lower priority when medical, functional, and psychosocial comorbidities vie for attention (14). Competing demands may diminish depression as a priority concern, thereby contributing to inadequate rates of depression treatment (15).(e-mail: ekp@wustl.edu). The authors report no competing interests. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThis study explored depression as a treatment priority among a gr...

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“…Instrumental activities of daily living refer to capacities that are required for autonomous function within society. 9 Decline in IADL usually begins after age 80 in community samples, and the impairment of individual activities develops sequentially (i.e., housework Ͼ transportation Ͼ shopping Ͼ meal preparation Ͼ finances). Activities of daily living refer to capacities that are essential to autonomous function at home.…”

Section: Activities Of Daily Livingmentioning

confidence: 99%

“…General overviews to this literature, including sources for assessment scales, can be found in Kemp and Mitchell,9 McCue, 26 Park, 15 Gallo et al, 27 and Pearson. General overviews to this literature, including sources for assessment scales, can be found in Kemp and Mitchell,9 McCue, 26 Park, 15 Gallo et al, 27 and Pearson.…”

Section: Functional Assessmentmentioning

confidence: 99%

The Cognitive Correlates of Functional Status: A Review From the Committee on Research of the American Neuropsychiatric Association

Royall

Lauterbach

Kaufer³

et al. 2007

JNP

330

173

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This report reviews the state of the literature and opportunities for research related to the cognitive correlates of functional status. The prediction of functional capacity on the basis of cognitive test performance is an important aspect of neuropsychological assessment. Moreover, functional impairment or "disability" is an essential part of dementia case finding. Nevertheless, relatively little attention has been given to the empirical study of the specific cognitive correlates of functional outcomes. What literature is available suggests that 1) the variance in functional status that can be specifically attributed to cognition is surprisingly modest; 2) some cognitive domains may be more relevant to functional capacity than others; 3) some measures of executive control function are relatively strong correlates of functional capacities, particularly medical or financial decision-making; and 4) "general" cognitive screening tests are surprisingly strong correlates of functional status. These findings are of particular significance to dementia case finding, epidemiology, and treatment. The extensive literature on functional status has yet to be integrated with the equally extensive literature on cognitive assessment. Better integration of cognitive and functional assessments would offer greater clinical utility. However, psychometric batteries may have to be redesigned to maximize their capacity to capture the variance in functional outcomes.

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Functional Assessment in Geriatric Mental Health

Cited by 15 publications

References 37 publications

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

The Cognitive Correlates of Functional Status: A Review From the Committee on Research of the American Neuropsychiatric Association

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