available on following link: http://www.intarchmed.com/content/7/1/26/abstract

Novel occupational therapy interventions may improve quality of life in older adults with dementia

Prakash Kumar, Sarvada Chandra Tiwari, Ashish Goel, Vishnubathla Sreenivas, Nand Kumar, Rakesh Kumar Tripathi, Vineet Gupta and Aparajit Ballave Dey

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International Archives of Medicine 2014, 7:26  doi:10.1186/1755-7682-7-26

Published: 20 May 2014

Abstract (provisional)

Background

Dementia is a major health problem in advancing age with no definitive treatment. Occupational therapy interventions are recognized strategies in treatment of dementia. Quality of life (QOL) assessment has been reliably used as an objective index of an individual's well being pertaining to interventions in dementia. A randomized controlled trial was conducted to study the effects of a novel occupational therapy program in improving QOL of subjects having mild to moderate dementia.

Methodology: 273 subjects older than 60 years were screened. 196 were excluded having cognitive impairment with no dementia (CIND). Remaining 77 subjects after satisfying DSM IV criteria for diagnosis of dementia were included in the study and were randomly assigned to experimental and control groups. Experimental group received a novel occupational therapy regimen along with medical treatment, while control group received only medical treatment for 5 weeks. Outcome measures included standard occupational therapy assessment and WHOQOL-BREF. Subjects were assessed at baseline and post intervention.

Result: The mean age of participants was 69.39 years with male preponderance (80.5 % male, 19.5%female). The quality of life (QOL) scores of physical and psychological domain in experimental groups significantly increased from 37.30 +/- 5.42 and 45.13 +/- 3.52 to 45.43 +/- 7.32 and 51.50 +/- 6.46 respectively. The QOL scores in social and environmental domains did not change significantly. The QOL scores in control groups declined in all domains with statistical significance found in social and environmental domain. (29.67 +/- 4.58 and 38.49 +/- 1.77 to 28.45 +/- 5.26 and 38.18 +/- 2.15 respectively)

Conclusion

This novel occupational therapy program improved the short term physical performance and psychological well being domain of quality of life in older adults with dementia. An improved physical performance is achieved by physical exercise of novel program and it creates sense of independency, increased motivation, positive outlook and reduced behavioral and psychological symptoms. The long term effects of the intervention can be ascertained in a study with longer period of intervention and follow-up.

Trial registration: [CTRI/2014/01/004290]

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Abstract of Prevalence of psychiatric morbidity among urban elderlies.........

Link of the paper http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2014;volume=56;issue=2;spage=154;epage=160;aulast=Tiwari

ORIGINAL ARTICLE

Indian Journal of Psychiatry, Year : 2014  |  Volume : 56  |  Issue : 2  |  Page : 154-160

Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study

SC Tiwari1, Rakesh Kumar Tripathi1, Aditya Kumar1, AM Kar2, Ragini Singh3, VK Kohli4, GG Agarwal5 1 Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India 2 Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India 3 Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India 4 Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India 5 Department of Statistics, Lucknow University, Lucknow, Uttar Pradesh, India Click here for correspondence address and email Date of Web Publication 11-Apr-2014

Abstract   Background: Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health. Aim: The present study aims to investigate the distribution of physical, neuropsychiatric, and cognitive disorders of a community sample of elderlies with certain socioeconomic data. Materials and Methods: A door-to-door household survey was conducted to identify houses with elderlies (≥55 years) in two urban localities of Lucknow. Mini mental state examination (MMSE), Survey Psychiatric Assessment Schedule (SPAS)/Mood Disorder Questionnaire (MDQ) and physical and neurological examination were used for screening all consenting elderlies. MMSE positive participants were assessed on Cambridge Mental Disorders of the Elderly Examination-Revised for diagnosis of cognitive disorders; SPAS/MDQ positives were assessed on Schedule for Clinical Assessment in Neuropsychiatry based clinical interview for diagnosis of neuropsychiatric disorders other than cognitive disorders (using ICD-10 criteria). Routine and indicated laboratory/radiological investigations on all and on MMSE/SPAS (organic section) positive/physically ill participants respectively were done to confirm organic and/or physical illness. Only percentages were calculated to find the distribution of morbidity. Results: The sample had proportionate age structure as that of the surveyed population and had balanced gender representation in each age deciles. Prevalence of neuropsychiatric disorders (with/without comorbidities) was 11.8% in the elderlies (60 years and above) highest being in the 60-69 years age group. Being women and of lower socioeconomic status was more commonly associated with a neuropsychiatric diagnosis. 7.6% of the elderlies had cognitive impairment. Overall findings suggest a prevalence rate of 17.34% of total psychiatric morbidity among elderlies. A significant number had comorbid physical illness diagnoses. Conclusion: More than half the elderlies had some diagnosable physical or mental ailment. The study familiarizes us to the significant amount of physical and psychiatric comorbidity in the particular age group. About one-fifth was found to suffer from psychiatric morbidity, which any health services for the elderly should be oriented towards. Keywords: Cambridge mental disorders of the elderly examination-revised, cognitive impairment, comorbid physical illness, elderly, prevalence, psychiatric morbidity How to cite this article: Tiwari S C, Tripathi RK, Kumar A, Kar A M, Singh R, Kohli V K, Agarwal G G. Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study. Indian J Psychiatry 2014;56:154-60 How to cite this URL: Tiwari S C, Tripathi RK, Kumar A, Kar A M, Singh R, Kohli V K, Agarwal G G. Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study. Indian J Psychiatry [serial online] 2014 [cited 2014 Apr 17];56:154-60. Available from: http://www.indianjpsychiatry.org/text.asp?2014/56/2/154/130496

S. C. Gupta Young Scientist Award- 2013

Cognitive functioning of community dwelling urban older adults with reference to socio-demographic variables 

Rakesh Kumar Tripathi^1*and S. C. Tiwari²

¹Assistant Professor cum Clinical Psychologist, ² Professor & Head, Department of Geriatric Mental Health, King George’s Medical University) Lucknow

Email: rastripathi@gmail.com, *Presenting and Communicating Author

Published in Indian Journal of Clinical Psychology, 40(2), 92-102, 2013.

Abstract

Study was conducted to identify socio-demographic variables associated with cognitive functioning of community dwelling urban older adults.  The study is based on a PhD work of the first author carried out alongwith the data collection of ICMR, New Delhi funded research project on same subjects. All houses in randomly selected 2 municipal wards of urban Lucknow were visited. Houses where at least one family member aged 60 years and above was residing were identified and listed. Subjects were included in the study after obtaining written informed consent by the subjects/family members according to inclusion/exclusion criteria.  Hindi Cognitive Screening Test (HCST), Semi-structured socio-demographic proforma and SES scale were administered. A cut off score of 24 was applied to differentiate cognitively impaired subjects from normal.  Thus, an equal number of cognitively impaired (150) and Normal (150) subjects on HCST were finally recruited in a consecutive series. Brief Cognitive Rating Scale was administered on all 300 subjects to assess level of cognitive functioning. As and when required, the family members were cross checked about the information given by the elderly subjects.  The information which was difficult to elicit from the subjects with cognitive impairment were obtained from their family members. Data was analyzed using statistical software SPSS version 12.0. and GraphPad InStat demo version 3.05 Inc year 2000. 

            Results showed age, education, living arrangements and occupation were found to be significantly associated with cognitive functioning of the older adults aged 60 years and above living in an urban community.   

Key Words: BCRS, Cognitive function, HCST, Older adults, Socio-demographic variables