Depression, nutritional risk and eating behaviour in older caregivers

Objective
This study investigated the relationship between depression, nutritional risk and dietary intake in a population of older caregivers.

Design
Mailed questionnaire with sub group participating in a home-based interview.

Participants and setting
Seventy-six community dwelling caregivers aged 50 y or over from Victoria, Australia.

Measurements
Questionnaires provided information on weight, height, hours of care, depressive symptoms, nutritional risk and appetite. The home-based interview assessed dietary intake and shopping, cooking and meal consumption habits.

Results
The sample had a mean±SD age of 70.3±12.8 y, BMI of 27.2±4.8 kg/m2 and the time spent caring was 101.8±68.1 h/wk. Overall, 32% of caregivers had depressive symptoms, 21% were at risk of malnutrition and 21% reported their appetite was fair/bad/very bad. Caregivers with depressive symptoms (32%) compared to those with no depressive symptoms (53%) had a poorer appetite (p<0.05). Of the 20 caregivers who participated in the home interview, 25% reported they ate their meals alone.

Conclusion
A significant proportion of community dwelling older caregivers had depressive symptoms, were at risk of malnutrition and had poor appetites, although the majority were overweight or obese.

An evaluation of a wellness guide for older carers living in the community

Objective: To assess the usefulness and effectiveness of a wellness guide and to identify whether its use by a group of older ‘‘new’’ carers would make them healthier and knowledgeable of community resources. Design and Sample: Pretest, posttest measures of physical and mental health and a questionnaire with associated focus groups. A purposive sample of 21 older carers who were ‘‘new’’ carers was selected for the study. Measures: Locus of control (LOC), Short Form 12, depression anxiety stress scale, and questionnaire. Results: Participants embraced the wellness guide as an excellent resource. It
changed their behavior and improved their health on LOC measures, although changes in physical and mental health were not statistically significant. Conclusions: The wellness guide assisted carers’ preparedness for their role and enhanced their sense of personal control over demanding situations.

Older peoples' experience of accessing emergency care

Older ED users are more likely to be seriously ill, arrive by ambulance, spend more time in ED and require hospital admission. The aim of this study was to describe older people’s experiences of accessing Emergency Department (ED) care.

Habitual physical activity and the risk for depressive and anxiety disorders among older men and women

Background: Regular physical activity is generally associated with psychological well-being, although there are relatively few prospective studies in older adults. We investigated habitual physical activity as a risk factor for de novo depressive and anxiety disorders in older men and women from the general population.
Methods: In this nested case-control study, subjects aged 60 years or more were identified from randomly selected cohorts being followed prospectively in the Geelong Osteoporosis Study. Cases were individuals with incident depressive or anxiety disorders, diagnosed using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP); controls had no history of these disorders.Habitual physical activity,measured using a validated questionnaire, and other exposures were documented at baseline, approximately four years prior to psychiatric interviews. Those with depressive or anxiety disorders that pre-dated baseline were excluded.
Results: Of 547 eligible subjects, 14 developed de novo depressive or anxiety disorders and were classified as cases; 533 controls remained free of disease. Physical activity was protective against the likelihood of depressive and anxiety disorders; OR = 0.55 (95% CI 0.32–0.94), p = 0.03; each standard deviation increase in the transformed physical activity score was associated with an approximate halving in the likelihood of developing depressive or anxiety disorders. Leisure-time physical activity contributed substantially to the overall physical activity score. Age, gender, smoking, alcohol consumption, weight and socioeconomic status did not substantially confound the association.
Conclusion: This study provides evidence consistent with the notion that higher levels of habitual physical activity are protective against the subsequent risk of development of de novo depressive and anxiety disorders.

Perceived control and subjective wellbeing in older adults

Across age, the ability to accept what cannot be changed increases while feelings of control remain stable. The growth of acceptance preserves, rather than compensates for, older adults' sense of being in control. In later life, acceptance and control appear to operate together to maintain wellbeing. The professional portfolio uses four case studies to illustrate how Cognitive Behavioural Therapy (CBT) programs can be reinterpreted through and Acceptance and Committment Therapy (ACT) framework and elements of both employed within a single therapeutic program.

Training divided attention and memory skills of older adults

The study examined whether divided attention and memory skills of older adults could be improved through video game training. The findings show that limited training with the games cannot enhance these skills. However, greater amounts of training could improve these vital skills amongst older adults.

Promoting a team ball game (Lifeball) to older people : who does this game attract and who continues?

Issue addressed: To describe the demographic and health-related characteristics (physical activity, self-reported health status, quality of life and falls history) of older people who enroll in a team-based game, Lifeball, and examine associations between continuation and participant characteristics. Reasons for stopping, participants' perceptions of the game and changes in health-related characteristics over 12 months were examined.

Methods: Telephone surveys were conducted with a cohort of Lifeball players at: baseline, soon after commencing playing and 12 months later.

Results: At baseline, participants were aged 40 to 96 years (mean 67). Most were female (84%), in good to excellent health (86%) and reported being sufficiently (>150 minutes per week) physically active (69%). Almost half (43%) were still playing 12 months later (continuers). Continuers were more likely to perceive Lifeball had helped them to: feel fitter and healthier (91%); improve their social life (73%); and be more active (53%). No significant changes in continuers' physical activity, self-reported health status and quality of life measures were reported. The main reason for stopping playing was illness/injury unrelated to Lifeball.

Conclusions: Lifeball mainly appealed to healthy, active older people.

Volunteering and quality of life of the older age population

The contribution of volunteers to society and economy is substantial. The participation in voluntary work is on the increase, particularly by the over 55 age group. Given the aging of the Australian population, this growth has an important social consequence. The aim of this conceptual study is to review the influences of older age Australian volunteering practice, its growth pattern and the types of voluntary work undertaken. The study uses the expectancy theory of motivation to argue that volunteers participate for the perceived benefits they get from their interaction with others, by experiencing self-esteem from being useful, being connected, gaining self-satisfaction, and by focusing on giving. It reviews the issue of quality of life (QOL) in relation to voluntary social engagement and suggests that there is an association between the older age group voluntarism and improvement in their QOL. The role of policy makers in further motivating larger participation by the older age groups and the social benefits emerging from this strategy is briefly reviewed.

Managing constipation in older people

The study consists of two parts: a systematic review that critically analysed existing Chinese medicine clinical trials in managing constipation and, a cluster randomised controlled trial investigating the effects of education and acupressure on constipation in older people. Participants in the experimental group reported significant improvements in their constipation symptoms.