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

Caregiver burden and quality of life of key caregivers of patients with dementia

Caregiver burden and quality of life of key caregivers of patients with dementia Srivastava G, Tripathi RK, Tiwari SC, Singh B, Tripathi SM - Indian J Psychol Med

Abstract

Background: Dementia is the most devastating cognitive disorder of the elderly and needs extra attention to care. Therefore, this study was conducted to identify the caregiver burden of dementia key caregivers and their Quality of Life (QOL). Materials and Methods: Sample consisted of purposively selected 24 dementia key caregivers fulfilling the inclusion criteria from the in-patient of the Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India. Zarit Burden Interview and World Health Organization QOL-BREF were administered. Mean, standard deviation, t-test, Chi-square with Yate's correction were used to analyze the data. Results: All key caregivers felt mild to moderate level of burden. Gender-wise significant difference was found on burden area of "expectation" (P < 0.05). Mean scores on physical, psychological, social relationship, and environmental QOL were found to be on lower side. A negative correlation was found between burden and QOL. Conclusion: Professional help and supportive psychotherapy can be provided to the key caregivers of dementia patients to reduce their burden, strengthen the coping skill and thus improve their QOL.

A Case Of “Rapidly Progressive” Progressive Supranuclear Palsy

Shailendra Mohan Tripathi, Priti Singh , Ravi Soni, Rakesh Kumar Tripathi , S.C.Tiwari

Progressive supranuclear palsy (PSP) is an uncommon brain disorder that affects movement, control of walking (gait) and balance, speech, swallowing, vision, mood and behavior, and thinking. The disease results from damage to nerve cells in the brain. It is grouped under Parkinson-Plus syndrome as the parkisonian symptoms and cognitive impairment present at the same time........

Tripathi SM, Singh P, Soni R, A case of “rapidly progressive” progressive supranuclear Tripathi RK, Tiwari SC. palsy.  Indian Journal of Psychiatry, 2016; 58(supplement), S146-S147.
available at:
http://www.indianjpsychiatry.org/temp/IndianJPsychiatry585122-1626336_002706.pdf

Personality of Schizophrenics on Dimension Personality Inventory (DPI)

IJSAR, 2(8), 2015; 08-15

International Journal of Sciences & Applied Research
www.ijsar.in

Rupali Chandola1, Aradhna Shukla1, Rakesh Kumar Tripathi2*

1Department of Psychology, Kumaun University Campus, Almora, Uttrakhand, India. 2Department of Geriatric Mental Health, King George‟s Medical University UP, Lucknow, India.

Correspondence Address: *Dr. Rakesh Kumar Tripathi, Assistant Professor cum Clinical Psychologist, Department of Geriatric Mental Health, King George‟s Medical University UP, Lucknow, India. _________________________________________________________________________________Abstract: 

This study examined the personality characteristics of 40 schizophrenic inpatients of Psychiatry department, Susheela Tiwari Forest Medical Collage, Haldwani, Uttrakhand and 40 normal controls (General Health Questionnaire-12 negative) from Awas Vikas Colony, Rudrapur, Uttrakhand, India. Subjects fulfilling inclusion/exclusion criteria and giving written informed consent were included in the study. A comparison of their personality profile on Dimension Personality Inventory (DPI)-B revealed that there was significant difference (p<0.05) in the mean scores on different dimensions of personality between schizophrenic and normal group. Schizophrenics were found to be passive, non-enthusiastic, submissive, suspicious, depressive and emotionally instable however, normal individuals were on opposite dimension of these. Males were found to be assertive of both the groups. Study findings revealed that schizophrenics can be differentiated from normals on the basis of personality characteristics.
Keywords: Dimension Personality Inventory, Personality, Schizophrenia
Introduction
Studying personality of an individual was used to be a very interesting subject not only in ancient era but even today. The ancient Indian model of “personality”, described in the Upanishads consists of the five sheaths. These are ‘Annamaya’, ‘Pranamaya’, ‘Manomaya’ ‘Vijnanamaya’ and ‘Anandamaya’. (Das, 1987.) In Atharv Veda and Bhagwat Gita personality was discussed in the terms of Triguna i.- ‘Sattvik Guna’, ‘Rajasik Guna’ and ‘Tamsik Guna’ of an individual (Srivastava , 2012). There are seven types Sattvik, six kinds of Rajasik and three types of Tamasik, total 16 types of personalities under which persons can be classified (Mukherjee , 2007). A triguna scale has....
Full article pdf is available on www.ijsar.in 

Does Personality of Psychopaths differ from Normal?

http://ijsar.in/Admin/pdf/212.pdf


Rupali Chandola1 , Aradhna Shukla1 , Rakesh Kumar Tripathi2 *

1Department of Psychology, Kumaun University Campus, Almora, Uttrakhand, India 1Department of Psychology, Kumaun University Campus, Almora, Uttrakhand, India 2Assistant Professor cum Clinical Psychologist, Department of Geriatric Mental Health, King George‟s Medical University UP, Lucknow, India. Correspondence Address: *Dr. Rakesh Kumar Tripathi, Assistant Professor cum Clinical Psychologist, Department of Geriatric Mental Health, King George‟s Medical University UP, Lucknow, India-226003.

International Journal of Sciences & Applied Research ( IJSAR), 2(12), 2015; 20-26. _________________________________________________________________________________ Abstract

Background: Personality of an individual determines his behavior towards others. Psychopaths behave differently. Therefore, study was conducted to know that, which personality dimension of psychopaths differ from normal. Methods: Study examined personality dimension of 80 subjects selected purposively. Of them 40 were normal subjects (20 male & 20 female) and 40 psychopaths (20 male & 20 female). GHQ-12 negative subjects from the community formed the normal group. Dimension Personality Inventory (DPI-B) was administered on all the included subjects. Results: Mean scores on DPI-B reveal that normal and psychopath group were significantly (p<0.05) differ on all the six personality dimensions i.e. „activity-passivity‟, „enthusiastic-non enthusiastic‟, „assertive-submissive‟, „suspicious-trusting‟, „depressive-non depressive‟ and „emotional instability-emotional stability‟. Mean scores were found to be significantly higher of psychopaths compared with normal group. Conclusion: Personality of psychopath can be differentiated on „depressive-nondepressive‟ and „suspicious-trusting‟ dimensions on DPI-B. Psychopaths were found to be „depressive‟ and „suspicious‟ in present study. Keywords: GHQ-12, DPI, Personality, Psychopaths

Care Needs of Dementia Key Caregivers

Garima Srivastava, Rakesh Kumar Tripathi*, S.C. Tiwari*,  Bhupinder Singh#

*Department of Geriatric Mental Health, King George's Medical University, UP, Lucknow, India

 Abstract:

Background: Dementia is the most devastating mental health problem of elderly and needs extra attention to care. Therefore, this study was conducted to identify the care needs of dementia key caregivers and their quality of life (QOL).

Methods: Sample consisted of purposively selected 24 dementia key caregivers fulfilling the inclusion and exclusion criteria from the inpatient of the Department of Geriatric Mental Health, KGMU, UP, Lucknow. Semi-structured proforma for sociodemographic details, Zarit Burden Interview and WHOQOL-BREF were administered.

Statistical Analysis: Mean, SD, t test, Chi Square with Yate’s correction were used to analyze the data.

Results:  All key caregivers of dementia patients felt mild to moderate level of burden.  Significant difference was found on burden areas of ‘expectation’ (p<.01) and ‘incompetence’ (p<.05) between males and females key caregivers. Mean scores on physical, psychological, social relationship and environmental QOL were found to be on lower side of dementia key caregivers.

Key Words: Dementia, Key care giver, Burden and QOL
Note: Paper was presented in national Annual Conference of Indian Association for Geriatric Mental Health held at Mysore, 2012.

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

Author Affiliations

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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]

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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

Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India

SC Tiwari¹, Garima Srivastava², Rakesh Kumar Tripathi¹, NM Pandey¹, GG Agarwal³, Smita Pandey⁴, Samyak Tiwari^5
1 Department of Geriatric Mental Health, King George's Medical University, Lucknow, India
² Department of Geriatric Mental Health, King George's Medical University, Lucknow; Department of Psychology, Allahabad University, Allahabad (UP), India
³ Department of Statistics, Lucknow University, Lucknow, India
⁴ Department of Geriatric Mental Health, King George's Medical University, Lucknow; Institute of Behavioural Sciences, Gujarat Forensic Sciences University, Gandhinagar, Gujarat, India
⁵ Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India

Date of Submission	07-Jun-2011
Date of Web Publication	19-Nov-2013

Indian Journal of Medical Research Year : 2013  |  Volume : 138  |  Issue : 4  |  Page : 504-514 http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2013;volume=138;issue=4;spage=504;epage=514;aulast=Tiwari Correspondence Address: S C Tiwari Department of Geriatric Mental Health, King George's Medical University, Lucknow 226 003  India Abstract

Background & objectives: The population of elderly is growing globally and so are the physical illnesses and psychiatric morbidity. This study was planned to assess the prevalence and patterns of psychiatric morbidity amongst rural older adults in Lucknow, north India.
Methods: A survey was conducted in subjects aged 60 yr and above to identify the cases of psychiatric morbidity in rural population from randomly selected two revenue blocks of Lucknow district, Uttar Pradesh, India. All subjects were screened through Hindi Mental Status Examination (HMSE) and Survey Psychiatric Assessment Schedule (SPAS) to identify for the suspected cases of cognitive and the psychiatric disorders, respectively. The subjects screened positive on HMSE and SPAS were assessed in detail on Cambridge Mental Disorder of the Elderly Examination-Revised (CAMDEX-R) and Schedule for Clinical Assessment in Neuropsychiatry (SCAN), to diagnose cognitive disorders and psychiatric disorders (other than the cognitive), respectively on the basis of International Classification of Diseases-10 (ICD-10) diagnostic guidelines.
Results: The overall prevalence of psychiatric morbidity in rural older adults was found to be 23.7 per cent (95% CI=21.89-25.53). Mood (affective) disorders were the commonest (7.6%, 95% CI=6.51-8.80), followed by mild cognitive impairment (4.6%, 95% CI=3.72-5.53), mental and behavioural disorders due to substance use (4.0%, 95% CI=3.17-4.87) and dementia (2.8%) [Alzheimer's disease (2.4%, 95% CI=1.81-3.16) and vascular (0.4%, 95% CI=0.16-0.73)].
Interpretation & conclusions: Overall prevalence of psychiatric morbidity amongst rural elderly in this study was found to be less in comparison to those reported in earlier studies from India. However, prevalence pattern of different disorders was found to be similar. Therefore, it appears that a stringent methodology, refined case criteria for diagnosis and assessment by trained professionals restrict false diagnosis.

Keywords: Aged - CAMDEX-R - cognitive disorders - dementia - epidemiology - HMSE - mood disorders - northern India - prevalence

How to cite this article: Tiwari S C, Srivastava G, Tripathi RK, Pandey N M, Agarwal G G, Pandey S, Tiwari S. Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India. Indian J Med Res 2013;138:504-14

How to cite this URL: Tiwari S C, Srivastava G, Tripathi RK, Pandey N M, Agarwal G G, Pandey S, Tiwari S. Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India. Indian J Med Res [serial online] 2013 [cited 2013 Nov 21];138:504-14. Available from: http://www.ijmr.org.in/text.asp?2013/138/4/504/121491

Whether Delirium Acts as ECT?

Case Series	Open Access
Whether Delirium Acts as ECT? Department of Geriatric Mental Health, King George’s Medical University (KGMU), IndiaShailendra Mohan Tripathi, Department of Geriatric Mental Health, King George’s Medical University (KGMU), IndiaRakesh Kumar Tripathi*, Department of Geriatric Mental Health, King George’s Medical University (KGMU), IndiaIndrapal Singh, Department of Geriatric Mental Health, King George’s Medical University (KGMU), IndiaShrikant Srivastava and Department of Geriatric Mental Health, King George’s Medical University (KGMU), IndiaTiwari SC Corresponding Author : Rakesh Kumar Tripathi Department of Geriatric Mental Health King George’s Medical University (KGMU), India E-mail: rastripathi@yahoo.com Received March 18, 2013; Accepted July 15, 2013; Published July 24, 2013 Citation: Tripathi SM, Tripathi RK, Singh I, Srivastava S, Tiwari SC (2013) Whether Delirium Acts as ECT? Aging Sci 1:107. doi:10.4172/2329-8847.1000107 Copyright: © 2013 Tripathi SM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Related article at Pubmed Scholar Google Abstract   Full Text   PDF   References Abstract Delirium is defined by the acute onset of fluctuating cognitive impairment and a disturbance of consciousness with reduced ability to attend. It may occur at any age but is more common in older adults. By virtue of working in the psychogeriatric hospital (Department of Geriatric Mental Health, King George’s Medical University, Lucknow, India), authors experienced that many elderly patients with psychiatric illness develops delirium because of various reasons. Subsequently, we observed that psychiatric manifestations of the patients improved significantly following recovery from delirium. A series of such four cases (case 1- Depression with psychotic features, 2- Manic episode, 3- Bipolar affective disorder current episode mania and 4- Depressive episode) later developed delirium has been presented and discussed in this paper. ICD-10 criteria were used for the diagnosis of delirium and psychiatric illnesses. Average stay of these patients in the hospital was 10 days. We found that signs and symptoms of these psychiatric disorders disappeared almost completely following the recovery from delirium. Therefore, it can be assumed that delirium potentially acts similar to ECT. By reporting such case we open a new dimension of research for effective treatment of the psychiatric patients. Inducing delirium in a patient is unethical but understanding pathophysiology behind it will certainly open the door for better cure of the ailing psychiatric patients. This full paper is available on following link: http://www.esciencecentral.org/journals/whether-delirium-acts-as-ect-2329-8847.1000107.php?aid=17271 Best wishes on World Elder's Day- 1st October  Let us work for smile on their faces......

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