High prevalence rates of psychiatric illness and high levels of behavioral disturbance have been reported in studies of nursing home residents; however, the populations evaluated have been ...predominantly Caucasian. The aims of the present study were to identify prevalence rates of psychiatric disorders and behavioral disturbances in a sample of African American nursing home residents.
The authors evaluated 106 African American nursing home residents, aged 65 and over, from a representative sample of nursing homes. The evaluation included informant interview with nursing home staff, cognitive assessment, and a psychiatric interview that included a physical and neurological examination. Consensus diagnoses were reached by using DSM-III-R criteria.
Of the 106 subjects, 90% received at least one primary psychiatric diagnosis, and 71% had at least one behavioral problem; dementia was the most common psychiatric diagnosis (68%). Thirty -one percent of the patients were treated with neuroleptic medication; most of these patients received diagnoses of dementia or schizophrenia. Fifteen percent of the patients had been in physical restraints, which correlated with physical disability.
The prevalence of psychiatric illness in this sample of African American nursing home residents is similar to that reported in previous studies with predominantly Caucasian populations. Behavioral disturbances, while commonly reported, were somewhat less frequent than reported in previous studies.
Studying behavioral disturbances of dementia across cultures allows us to identify commonalities and differences that may be useful in determining the best approach to managing these problems. ...However, what we tend to find in cross-cultural studies is that the best approach may not be the same approach, given the different prevalence of and levels of tolerance for various behavioral problems. These differences are apparent in the authors' studies of four populations—Jamaicans in Kingston; Cree in Northern Manitoba, Canada; Yoruba in Ibadan, Nigeria; and African Americans in the United States. The Jamaicans in this study live in a poor suburb of Kingston, the Cree live in two fairly small, isolated communities in Northern Manitoba, and the Yoruba live in Ibadan, a city of more than 1 million people. The Yoruba community the authors are studying, although concentrated in the city center, functions much like a village. The African-American population resides in Indianapolis, Indiana, a moderately sized city of approximately 1 million people.
Cross-cultural data are drawn on to compare the prevalence & treatment of behavioral disturbances of dementia among four populations: 18 Jamaicans living in a poor suburb of Kingston; Cree in two ...small, isolated communities in northern Manitoba (N unspecified); 28 Yoruba in Ibadan, Nigeria; & 50 African Americans in Indianapolis, IN. US caregivers were more likely to report changes in personality than were Nigerian & Jamaican caregivers. It is suggested that differences in treatment approaches were due to psychosocial & demographic factors; eg, in Jamaica, decreased cognitive function was often misunderstood as difficult or attention-seeking behavior, while in Nigeria, symptoms were often not reported by caregivers for fear of the stigma of being diagnosed as mentally ill. Differences in the availability & use of treatment services are also discussed. 3 Tables, 5 References. C. Haywood
Life satisfaction Index Z was administered to 945 persons aged 60 years and over in a community survey in rural and urban locations in South-Western Nigeria. Life Satisfaction Index scores correlated ...significantly with items on self-assessed health, loneliness, sex (women having a higher mean score) and location. Items that measure social contact, such as marital status, proximity of nearest child, and frequency of seeing close friends, did not correlate at a significant level. Factor analysis produced two factors on varimax rotation and an internal consistency value of 0.72 was obtained. These values are similar to some of those reported in other studies outside Africa.
Out of 2494 subjects screened in a Nigerian community, 28 patients with dementia were identified. Alzheimer's disease was diagnosed in 18 patients (64.3%), 16 of whom had probable Alzheimer's ...disease. Eight patients (28.6%) had vascular dementia while one patient each had parkinsonism with dementia and depression with dementia. Patients with Alzheimer's disease were significantly older, predominantly females and illiterates. Cognitive deficit commonly took the form of memory and judgment impairment while financial mismanagement was the most frequent impaired activity of daily living. More than half of the cases had mild disease on severity rating and were comprised mainly of Alzheimer's disease subjects. These results confirm the higher frequency of Alzheimer's disease over the other types as reported in other communities.
Attitude to aging and the aged was surveyed in three groups of Nigerians, 1) caregivers living at home with the elderly, 2) various categories of hospital workers, and 3) the general public. Based on ...scores of an eleven-item questionnaire the best attitude was in caregivers, and the poorest in hospital workers. Years of education had an overall negative effect on attitudinal measurement. An inference from this study is that the elderly are still valued, but caregivers could be under some stress and would appreciate assistance. It is important for developing countries like Nigeria to begin to think seriously of what types of public assistance the elderly and their families would need.
The fourth apolipoprotein E haplotype found in the Yoruba of Ibadan Murrell, Jill R; Price, Brandon M; Baiyewu, Olusegun ...
American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics,
06/2006, Letnik:
141B, Številka:
4
Report
