Mental health promotion for elderly populations in World Health Organization South-East Asia Region: Needs and resource gaps

 Nisha Mani Pandey 1, Rakesh Kumar Tripathi 2, Sujita Kumar Kar 3, K L Vidya 2, Nitika Singh 3

Affiliations 

• PMID: 35111583
 
• PMCID: PMC8783159
 
• DOI: 10.5498/wjp.v12.i1.117

Abstract

The accelerated population growth of the elderly (individuals aged 60 years or more) across the globe has many indications, including changes in demography, health, the psycho-social milieu, and economic security. This transition has given rise to varied challenges; significant changes have been observed in regard to developing strategies for health care systems across the globe. The World Health Organization (WHO) is also engaging in initiatives and mediating processes. Furthermore, advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model. The concept behind this move was to shift from disablement to enablement and from illness to wellness, with the notion of mental health promotion (MHP) being promoted. This article attempts to discuss the MHP of elderly individuals, with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries. We have tried to present the current knowledge gap by exploring the existing infrastructure, human resources, and financial resources. There is much to do to promote the mental health of the elderly, but inadequate facilities are available. Based on available resources, a roadmap for MHP in elderly individuals is discussed.

Keywords: Elderly; Mental health promotion; Mental healthcare needs; Resource gaps; World health organization.

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

Cognitive impairment among Hindi mental state examination positive community-dwelling rural older adults

 Pandey, Nisha Mani; Tripathi, Rakesh Kumar; Tripathi, Shailendra Mohan; Singh, Bhupendra; Tiwari, Sarvada C.

Author Information

Journal of Geriatric Mental Health 7(1):p 45-50, Jan–Jun 2020. | DOI: 10.4103/jgmh.jgmh_40_19

Abstract

Background: 

Cognitive impairment is emerging as one of the greatest mental health challenges in older adults. Its proper screening is required primarily. This article aimed to determine the usefulness of cognitive screening and assessment tools for ascertaining cognitive impairments among community-dwelling rural older adults.

Methods: 

Lucknow rural elderly project was funded by the Indian Council of Medical Research, carried out in randomly selected rural areas of Lucknow district. The present article is based on the archived data of the same project. We have analyzed 1243 patients' data, who participated in the referred study. Data related to sociodemographic details, Hindi Mental State Examination (HMSE), were extracted. There were 81 patients who screened as HMSE positives (scored ≤23). These patients were then assessed using the Cambridge Examination for Mental Disorders of the Elderly-Revised to reach to a diagnostic category as per the International Classification of Diseases-10^th Revision DCR criteria. Further, a triad of Brief Cognitive Rating Scale (BCRS), Functional Assessment Staging (FAST), and Global Deterioration Scale (GDS) administered on the cognitively impaired patients. The data were analyzed by employing SPSS version 15.

Results: 

Among HMSE positives, 81.5% (66) had a diagnosable cognitive impairment and 18.5% (15) non-cases. FAST, BCRS, and GDS had concordant findings and were found to be effective instruments for the assessment of severity of cognitive decline.

Conclusion: 

HMSE is a useful cognitive screening tool for rural older adults. A triad of BCRS, and GDS is found to be useful in determining the severity of cognitive impairment.

Link for full paper  https://journals.lww.com/jgmh/fulltext/2020/07010/cognitive_impairment_among_hindi_mental_state.8.aspx

Problems and strain of caregivers of urban older adults An exploration

 Journal of Geriatric Mental Health 

Journal of Geriatric Mental Health 7(1):p 38-44, Jan–Jun 2020. | DOI: 10.4103/jgmh.jgmh_38_19

Abstract

Background: Due to the ever-changing psychosocial priorities and changes in family paradigms, care of older adults (aged 60 years and above) is often being experienced difficult. However, studies have hardly been done in this direction to elicit caregivers' experiences. The present article explores the problems and strain faced by the caregivers of urban older adults and discusses the basic differences faced during care of the healthy (elderly with no discernable illness) and unhealthy (elderly with single or multiple morbidity[ies]) older adults.

Methods: 

The data were extracted from an extramural ad hoc research project sponsored by the Indian Council of Medical Research. It was a cross-sectional study, in which 1163 caregivers, aged 18 years or more, were interviewed. They were asked to share experiences for caring their elderly. It was revealed that around 57% (n = 661) of caregivers were taking care of unhealthy (elderly with psychiatric disorders, physical diseases, organic disorders, or two or more morbidities) older adults, whereas 43% (n = 502) of caregivers were taking care of healthy older adults. The Problem Checklist and Strain Scale was administered and the obtained data were analyzed applying percentages, mean, standard deviation, and χ² test.

Results: 

The mean age of caregivers was 43.64 ± 13.8 years for males and 44.57 ± 12.42 for females; females outnumbered males (59.4%) as primary caregivers. Irrespective of health conditions, majority of the caregivers reported that they experienced problems (73.86%) and strain (70.59%) due to their caregiving responsibilities. The pertinent issues have been analyzed and discussed.

Conclusion: 

Majority of the caregivers of older adults experience problems and strain, which is an alarming situation. This may further negatively affect the well-being and quality of life of the elderly. Therefore, there is a need to thoroughly study the caregivers' aspects and introduce remedial strategies so that the elderly and caregivers both can lead a better life.

https://journals.lww.com/jgmh/fulltext/2020/07010/problems_and_strain_of_caregivers_of_urban_older.7.aspx

Google Scholar profile गूगल स्कॉलर प्रोफाइल

 https://scholar.google.com/citations?user=sr04RHkAAAAJ&hl=en

Usefulness of clock-drawing test in Indian older adults with diabetes mellitus

Rakesh Kumar Tripathi, Yashi Verma, [...], and Sarvada Chandra Tiwari

Tripathi RK, Verma Y, Srivastava A, et al. Usefulness of clock-drawing test in Indian older adults with diabetes mellitus. Indian J Psychiatry. 2020;62(1):59–65. doi:10.4103/psychiatry.IndianJPsychiatry_62_18

Please see the full paper on the following link
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964444/

Prevalence of Psychiatric Illness among Residents of Old Age Homes in Northern India

http://www.ruralneuropractice.com/article.asp?issn=0976-3147;year=2018;volume=9;issue=2;spage=193;epage=196;aulast=Akbar

Abstract

Context: There are many factors which compelled older adults to live in old age homes (OAHs) and vulnerable to psychological problems. Studies reported high prevalence of mental health problems (20%–60%) among elderlies of OAHs. Therefore, the study was conducted to explore prevalence of psychiatric illness (PI) among residents of OAHs of Northern India. Settings and Design: The present study was conducted in OAHs of Districts Bareilly, Lucknow, Varanasi, Dehradun, and Haridwar, using cross-sectional descriptive study method. Sample Size were 306 (male – 98 [32.5%] and female n = 208 [68%]) residing in OAHs selected by means of purposive sampling. Subjects and Methods: Inclusion criteria: (a) older adults aged 60 years and above residing in OAHs and able to communicate. (b) Staying in OAHs for 6 months or more. (c) Able to understand comprehends and reply to questions and (d) Giving written informed consent. Exclusion criteria: (a) Residents who declined/not interested to participate in the study. (b) Residents having any sensory impairment/physical health problem which can impede the interview. Research tools were (i) a semi-structured pro forma, (ii) Hindi Mental Status Examination, (iii) Survey psychiatric assessment schedule, and (iv) Schedules for clinical assessment in neuropsychiatry-based clinical interview for diagnosis of PIs according to International Classification of Disease 10. Statistical Analysis Used: The quantitative data obtained was analyzed by means of frequency tables. Results: The results show overall prevalence of PI is 43% among residents of OAHs. The prevalence of PI was found to be higher among females compared to males. Depression was the most common among the residents of OAHs. Conclusions: There is an urgent need of trained professionals to provide professional help for highly prevalent psychiatric disorders among residents of OAHs.

Keywords: Depression, old age homes, prevalence, psychiatry, psychological problems

How to cite this article: Akbar S, Tiwari S C, Tripathi RK, Pandey NM, Kumar A. Prevalence of psychiatric illness among residents of old age homes in Northern India. J Neurosci Rural Pract 2018;9:193-6

How to cite this URL: Akbar S, Tiwari S C, Tripathi RK, Pandey NM, Kumar A. Prevalence of psychiatric illness among residents of old age homes in Northern India. J Neurosci Rural Pract [serial online] 2018 [cited 2018 Apr 12];9:193-6. Available from: http://www.ruralneuropractice.com/text.asp?2018/9/2/193/229532

P300 latency as an indicator of severity in major depressive disorder

P300 latency as an indicator of severity in major depressive disorder Tripathi SM, Mishra N, Tripathi RK, Gurnani K C - Ind Psychiatry J

Background: Depression is the most common mental health problem across all the age groups. Still diagnostic techniques and laboratory tests are awaited to confirm it. Some studies focus on P300 latency to aid in the diagnosis of depression. Hence, this study was conducted to know whether P300 latency is an indicator of major depressive disorder (MDD). Methods: This study was conducted both on patients admitted in the hospital and those attending outdoor clinic giving written informed consent and fulfilling inclusion/exclusion criteria from the Department of Psychiatry, S.N. Medical College and Hospital, Agra. The sample consisted of 30 consecutive patients suffering from MDD as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and 30 subjects as normal control. Sociodemographic and clinical history proforma, Hamilton Rating Scale for Depression (Ham-D), and P300 were administered on all 60 subjects. Data were analyzed using mean, standard deviation, and t-test. Results: Significant difference (P < 0.0001) has been found in HAM-D mean scores of depressed and nondepressed control group subjects. The mean score of depressed group was significantly high (18.066) compared to nondepressed control group (4.833). Significant difference (P < 0.0001) between the mean of P300 latency in depressed and nondepressed control subjects was also found. Mean score of P300 latency in depressed group was significantly high (346.918 ± 19.515) compared to the nondepressed control subjects (303.741 ± 6.378). There was a significant difference in the mean of P300 latency between mild and severe (P < 0.0001), mild and very severe (P < 0.0003), as well as moderate and severe (P < 0.0001) level of depression. Conclusions: P300 latency may be used as an indicator of MDD and it is directly proportional to the severity of MDD.

Keywords: Hamilton depression rating scale, major depression, P300 latency, severity

How to cite this article: Tripathi SM, Mishra N, Tripathi RK, Gurnani K C. P300 latency as an indicator of severity in major depressive disorder. Ind Psychiatry J 2015;24:163-7

How to cite this URL: Tripathi SM, Mishra N, Tripathi RK, Gurnani K C. P300 latency as an indicator of severity in major depressive disorder. Ind Psychiatry J [serial online] 2015 [cited 2016 May 5];24:163-7. Available from: http://www.industrialpsychiatry.org/text.asp?2015/24/2/163/181726