Impacts associated with special care units in long-term care facilities.

This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status.

Some applications of latent trait analysis to the measurement of ADL.

The use of latent trait methods for detection of biased items used in scales is discussed and two examples given. In the first, items measuring functional impairment in elderly community residents are tested for possible sex bias, and items predicted on the basis of clinical judgment to be clearly sex-biased are correctly identified. In the second example, taken from a cross-national study of elderly residents in long-stay institutions in New York and London, scale items suspected of bias due to interviewer variability and to cross-national differences in institutional environments are identified.

The EASI: a self-administered screening test for cognitive impairment in the elderly.

The Early Assessment Self Inventory (EASI), a rapid self-administered screening test for cognitive impairment in the elderly, was constructed to permit individuals to be assessed in a group or singly without examiner intervention. This paper-and-pencil device requires a fourth-grade reading level and makes minimal demands on literacy while assessing orientation, recent and remote memory, language, visual-construction, calculation, and attention. In the present study, the EASI was group-administered to 146 elderly persons attending senior centers and completed individually without examiner intervention by 19 outpatients at a memory disorders clinic.

Factors relating to institutional risk among elderly members of Israeli kibbutzim.

Characteristics of 269 functionally impaired elderly persons and their primary caregivers were examined in relation to long-term care planning. Contrary to expectation, there were no differences in rates of institutional risk between those elderly residents of Israeli kibbutzim cared for primarily by formal caregivers and cared for by informal caregivers. Lack of informal caregivers emerged as an important risk factor for institutional risk, even in the service-rich environment of kibbutzim.

Informal versus formal supports for impaired elderly people: determinants of choice on Israeli kibbutzim.

Among 269 functionally impaired elderly people residing on 53 Israeli kibbutzim, those cared for principally by informal caregivers were compared with those cared for principally by formal caregivers. The major findings were that the variables differentiating between primary reliance on formal versus informal care are similar to those that have been found in other studies, and that the availability of formal resources was not accompanied by withdrawal of informal supports.

Effects of treatment for isolated systolic hypertension on cognitive status and depression in the elderly.

The Systolic Hypertension in the Elderly Program (SHEP) was designed as a feasibility study and in part dealt with the effects of the treatment of isolated systolic hypertension on cognitive status and depression. Subjects were 60 years of age or older with a systolic blood pressure of 160 mmHg or greater and diastolic of less than 90 mmHg; free of several specified illnesses or chronic conditions. These volunteers were randomly assigned to treatment (n = 443) and placebo (n = 108) groups.

Comparison of self-administered and rater-administered methods of assessing levels of severity of depression in elderly patients.

Eighty consecutive attenders (M age = 75 years) in a primary care group practice associated with a teaching hospital in New York were assessed for depression using a self-administered questionnaire, the Zung Self-Rating Depression Scale (SDS), and a rater-administered interview, the Short-CARE. The sample was 75% female and 85% black or Hispanic. The response rate of completed interviews was 65% for the Zung SDS and 100% for the Short-CARE.

The physical well-being of old homeless men.

This study addressed a variety of issues related to the etiology, prevalence, and treatment of physical disorders among aging homeless men. The sample consisted of 195 nonstreet dwellers (177 residing in flophouses, 18 in apartments) and 86 street dwellers on the Bowery in New York City. The sample comprised men aged 50 and older.

The mental health of old homeless men.

The recent focus on the young homeless mentally ill has diverted attention from other subgroups of the homeless, particularly the aging, who compose one fourth of the homeless population. A total of 86 street-dwelling and 195 non-street-dwelling (177 flophouse-, 18 apartment-dwelling) men aged 50 and older on the Bowery in New York City were studied. Although 23% evidenced psychosis or had prior psychiatric hospitalization (PPH group), depression was more prevalent with one third of all men categorized as clinically depressed.

Digoxin levels in prehospital sudden-death syndrome.

Digitalis toxicity is common and has been associated with ventricular dysrhythmias. Digoxin levels in patients who suffer prehospital sudden death have never been studied. This study measured digoxin levels in a population of sudden-death patients.

Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population.

Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year.

Social networks and mortality in an inner-city elderly population.

The authors address some of the methodological problems found in earlier investigations of the relationship between social networks and mortality. Of particular concern was the use of rudimentary measures of social interaction in previous work. Utilizing nineteen social network variables, the authors examined 155 elderly residents of midtown Manhattan single-room occupancy hotels.

Social networks, stress, and physical health: a longitudinal study of an inner-city elderly population.

Research examining the relationship between social networks, stress, and physical symptoms has been limited by rudimentary network measures and the lack of longitudinal data. Using 19 network variables, the authors followed 133 elderly residents of mid-Manhattan hotels for 1 year. The findings indicated that social networks exert a direct effect on reducing subsequent physical symptoms.

The SHORT-CARE: an efficient instrument for the assessment of depression, dementia and disability.

The Comprehensive Assessment and Referral Evaluation (CARE) covers a wide range of psychiatric, medical, and social problems. It has been, for certain purposes, reduced to a relatively brief instrument, the SHORT-CARE, that measures three major content areas: depression, dementia, and disability. The SHORT-CARE includes additional items for arriving at operational diagnoses that have public health relevance (pervasive depression, pervasive dementia, and personal time dependency).

Concurrent and predictive validity of indicator scales developed for the Comprehensive Assessment and Referral Evaluation interview schedule.

Evidence for the concurrent and predictive validity of indicator scales developed to assess psychiatric, social, and medical conditions of elderly adults is presented. These scales were developed from the Comprehensive Assessment and Referral Evaluation (CARE) on probability samples of 445 elderly community residents in New York City and 396 in London, England. Corroborative information was also collected from key collaterals of a random subsample of 162 of the New York elderly adults.

Construct validity of indicator-scales developed from the Comprehensive Assessment and Referral Evaluation interview schedule.

This paper is an assessment of the construct validity of the scales developed from the Comprehensive Assessment and Referral Evaluation (CARE). Data collected from 445 elderly adults residing in New York and 396 in London were used to develop scales to measure medical, psychiatric, and social problems. Diagnostic and global ratings made by psychiatrists and social scientists provided one source of corroborative information; scales developed from information obtained from a random subsample of 162 collateral sources were used as another method of determining validity.

Development of indicator scales for the Comprehensive Assessment and Referral Evaluation (CARE) interview schedule.

The objective of this research was to develop indicator scales for major health and social problems of individuals aged 65 or over who live in the community. A semistructured interview technique, the Comprehensive Assessment and Referral Evaluation (CARE), was used in two large surveys in London and New York City. Twenty-two indicator scales were developed by using items that met certain clinical and statistical criteria.

Differences among black, Hispanic, and white people in knowledge about long-term care services.

This article provides data obtained through telephone interviews with 1,608 white, black, Mexican American, or Puerto Rican respondents. The study was designed to measure differences among ethnic groups in knowledge and attitudes toward long-term care services and the extent to which knowledge and attitudes affect service use. Across all groups, there is less knowledge about long-term, community-based care than institutional services.

Detection of dementia and depression cases with the Comprehensive Assessment and Referral Evaluation interview schedule.

The objective of this research was to develop two indicator-scales for detection of dementia and detection of depression for individuals aged sixty-five or over who are living in the community. Data were collected in two large surveys in London and New York City using a semistructured interview technique, the Comprehensive Assessment and Referral Evaluation. Each of the two indicator-scales were developed so as to meet criteria regarding content and construct validity and internal consistency reliability such as is required in geriatric epidemiological research.

Studies of body image. IV. Figure drawings in normal and abnormal geriatric and nongeriatric groups.

Figure drawings were obtained from 72 normal adults, 48 adult psychiatric inpatients, 30 senior citizens, and 33 elderly inpatients in a mental hospital. Blind analyses were carried out for "emotional indicators" and other characteristics such as body image disturbance and intellectual impairment. Significant differences were found on almost all measures between the normal elderly and the normal adult.