Functional analysis and treatment of problem behavior of elderly adults in long-term care

Functional analyses were conducted for the problem behavior of 3 older adults in a long-term care setting. Two of the problem behaviors were maintained by attention, and a third was maintained by escape from demands. Function-based interventions were implemented that resulted in decreases in problem behavior in each case. Implications for the use of functional analysis and function-based interventions in the field of gerontology are discussed.     

老年非小细胞肺癌治疗中存在的问题

肺癌已成为危害人类健康和导致死亡的最主要疾病,其中一半以上发生在老年人,且大部分为确诊时已为晚期,针对这些患者的诊断和治疗还存在很多误区,因多病并发所致的诊断延误、因恐惧所致的逃避、以及因对药物的过度依赖而对患者心理因素的忽视等,致使部分老年肺癌患者不能及时得到合理的治疗,值得引起临床医师的重视。     

Depression and Mortality in the Elderly

It is well known that depression can be a consequence of medical illness and disability, but a growing literature suggests also that depression can cause biological changes linked to morbidity and mortality. Depression is strongly implicated as a contributor to cardiovascular disease and mortality. Using the cascade-to-death model as a conceptual framework, we explore the complex relations among behavior, affect, motivation, and pathophysiology that might account for the association between depression and premature death. Our model suggests that some individuals become entrapped in a downward spiral in which behavior, medical illness, and depressive affect feed on each other to undermine the biological integrity of the organism. In addition to specifying behavioral and biological mechanisms linking depression to mortality, future research needs to more closely examine phenomenological aspects of depression in order to determine what aspects of depression and related constructs such ashopelessness, vital exhaustion, and motivational depletion account for the link between depression and mortality.     

老年高血压治疗决策的个体化和系统化

高血压是严重危害老年人健康的常见病,老年人高血压临床症状及特点与中青年高血压有显著不同,在诊断治疗中应注重老年人血压升高的病理生理特点及机制,在老年高血压的治疗决策中运用个体化和系统论的原则,选择个体最优化综合治疗决策,启思和引导老年高血压研究水平的纵深发展,积极有效地改善老年人的生活质量。     

西藏老年病房2型糖尿病患者的血糖管理

西藏老年2型糖尿病患者有着知晓率低、病程长、慢性并发症多、其他相关疾病多等特点。加强糖尿病教育、控制饮食、合理用药、注意相关疾病的处理和个体化治疗是血糖管理的有效方案。     

社会发展过程中城市老年人心理适应的柏林智慧范式研究

基于智慧显义理论,对社会发展过程中我国城市老年人的心理适应进行柏林智慧范式研究。在对上海市社区老年人(n=247)进行社会发展相关典型现实生活问题的随机抽样调查的基础上,遴选三种问题情境,通过结构性晤谈采集老年人(n=65)应对这些问题的认知-行为反应,对晤谈记录进行五个维度的评价,并且考察评价结果与生活满意度的关系。研究结果表明,受访老年人中多数表现出中度的心理适应水平,心理适应较好者具有较高的生活满意度。本研究采用的测评方式具有符合心理测量学要求的信度和效度。本研究对于生活在现代社会的城市老年人的成功老龄化心理适应辅导工作具有重要的指导意义,也有助于进一步开展成功老龄化的跨文化研究。     

Effects of lifestyles and the Mediterranean diet on elderly people’s quality of life according to gender / Efectos de los estilos de vida y la dieta mediterránea en la calidad de vida en personas mayores en función del género

Abstract

Health-related quality of life (HRQoL) has been associated with certain eating habits, such as the Mediterranean diet (MD) and lifestyles. However, the specific role of gender in this association is not yet known. The objective of this study was to analyse the relationship between the consumption of the MD essential foods and lifestyle (tobacco and alcohol consumption and exercise) with the HRQoL of 340 elderly people aged over 60 living in the Spanish Mediterranean area. The results show a better HRQoL in males. Compared to females, the lifestyles of males include a moderate consumption of alcohol and tobacco in addition to a greater frequency of physical activity. The predictive models of HRQoL were also different between males and females, as the influence of lifestyles and MD were greater in males. These results are clinically useful for the designing of programmes that promote successful ageing as they can be specified for sex.     

老年人抑郁情绪发展轨迹及社会参与的作用：空巢与非空巢老人的对比研究

应用多样本潜变量增长模型,探究空巢和非空巢老人抑郁情绪发展轨迹的差异以及社会参与对两者抑郁情绪发展轨迹的影响。结果表明：老年人抑郁情绪发展趋势遵循阶段化线性增长轨迹,空巢老人抑郁情绪初始水平及二阶段发展速度均高于非空巢老人;社会参与可以降低老年人抑郁情绪初始水平,对空巢老人而言,社会参与可降低抑郁情绪上升速度。结论：空巢老人是抑郁情绪高发人群,社会参与是降低和缓解老年人抑郁情绪的重要途径。     

Anxiety and Depression in Medically Ill Older Adults

Anxiety and depression are extremely common in the elderly with medical problems. They can manifest not only as symptoms of a primary psychiatric illness, but also as physiologic sequelae of medical illnesses and medical treatments. Recognition and treatment of depression and anxiety in the medically ill is especially difficult. If these states go untreated, they result in higher morbidity and mortality, higher health care costs and utilization, and poorer functional status and outcomes. Three of the most common medical illnesses that afflict geriatric patients, cardiovascular disease, pulmonary disease, and rheumatoid arthritis, will be presented to illustrate the difficulty in recognizing depression and anxiety and the impact of treating these symptoms in the medically ill elderly. Multidisciplinary approaches combining optimal medication regimens and psychosocial interventions can be effective for treatment of anxiety and depression in the medically ill elderly.