C. Forlani

Pet therapy in elderly patients with mental illness

Background:  To evaluate the effects of pet therapy on cognitive function, mood and perceived quality of life on elderly inpatients (mean age 84.7 years; 95.2% women) affected by dementia, depression and psychosis.

Prevalence and Gender Differences in Late-Life Depression: A Population-Based Study

OBJECTIVE The worldwide phenomenon of an aging population combined with the increasing prevalence of depression in late life are issues that need to be addressed. This study aims to estimate the frequency of depression and subthreshold depression occurring in a sample of cognitively well-functioning, community-dwelling, older Italian adults and to investigate sociodemographic and clinical correlates of depression, exploring gender differences. METHODS We used a cross-sectional analyses of survivors in a population-based study (the Faenza Project) that included 359 subjects aged 74 years and older (49.3% women). A modified version of Cambridge Examination for Mental Disorders of Elderly Persons-Revised was administered to all participants. Prevalence rates of depression and 95% confidence intervals (CIs) were estimated according to International Classification of Diseases, Tenth Revision criteria. Statistical analyses were implemented to describe sociodemographic and clinical features associated with depression. Odds ratios were estimated by multivariate logistic regression, and the dependant variable was any type of depression. RESULTS Overall prevalence of depression was 25.1% (95% CI: 20.6-29.6), with no evidence of gender difference. Prevalence of mild, moderate, and severe depression was 16.4% (95% CI: 12.6-20.2), 7.5% (95% CI: 4.8-10.2), and 1.1 (95% CI: -0.4-2.6), respectively. A rate of 5.6% of the population complained of subthreshold depressive symptoms. After age 81, depression occurrence decreased as age increased. The association between depression and functional measures, such as primary activity, mobility, and disability in performing household chores, were stronger in men than in women. Similarly, severely disabling conditions like stroke were more strongly associated with depression in men than in women. CONCLUSION Our data suggest a disparity between men and women regarding the impact of depression on everyday life. Specific gender differences need to be taken into account for the evaluation of the depression-related burden in late life.

Prevalence and characteristics of mild cognitive impairment in the general population. Data from an Italian population-based study: The Faenza Project.

The aim of this cross-sectional study is to investigate mild cognitive impairment (MCI) using the Mini-Mental State Examination in an Italian cohort (N = 6921; mean age 71.6 ± 7.5; 59.2% women). First, we applied psychometrically derived criteria for MCI regardless of presence/absence of subjective cognitive complaints (SCC); second, we implemented the analyses only on the SCC subsample. The estimated MCI prevalence was 6.0%. Amnestic- and non-amnestic MCI single domains accounted for 4.3% and 13.5% of the cases, respectively. Amnestic- and non-amnestic MCI multiple domains occurred in 2.0% and 4.5% of the cases, respectively. The 33.8% of the SCC subsample (6.0% of the cohort) had MCI. Stroke, diabetes and depressive symptoms were commonly associated to MCI suggesting that this common condition is associated with many correlates in Italian older persons. It deserves attention since it is early detectable and potentially preventable.

P02-163 The use of MMSE to identify mild cognitive impairment (MCI). A population-based study

Aims To evaluate the prevalence of MCI and its subtypes in the Faenza Project, using the Mini-Mental State Examination (MMSE). Methods Subjects living in the municipality of Faenza were clinically assessed. The diagnosis of MCI was achieved according to international criteria using a double-step procedure: first, we excluded subjects with dementia, functional impairment and MMSE Results 2,720 (40.3%) participants met MCI criteria. Prevalence were 4% (amnestic MCI), 26.5% (single non-memory MCI), 4.4% (multidomains amnestic MCI), and 5.4% (multidomains non-amnestic MCI). Conclusions MCI is common among Italian elderly. In our study prevalence are higher than reported in other population-based studies. The use of MMSE with different operational criteria, diverse sampling and assessment procedure might explain such discrepancy. The role of MMSE to identify persons with mild cognitive deficits deserves concerns. However, MMSE is largely used in both clinical practice and research and has been suggested as a useful screening tool for assessing the degree of cognitive impairment in the guidelines for the Report of the Quality Standards Subcommittee of the American Academy of Neurology.

PW01-77 - Cognitive status in 75 years and older subjects. A population-based study

Objectives To evaluate the cognitive status in an elderly population including both community-dwellers and institutionalised subjects. Methods 462 subjects (mean age 85.1±6.9 years, 53.2% females) living in the Faenza district (Ravenna, Northern Italy) were interviewed and clinically evaluated. The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) was administered to all participants to collect socio-demographic and clinical information. The cognitive status was evaluated using the cognitive assessment included in the CAMDEX (CAMCOG) and the Mini-Mental State Examination (MMSE) (adjusted by sex and age). Cut-offs were as follow: CAMCOG scores Results The CAMCOG identified 245 subjects (53.0%) as cognitively impaired; 132 persons (28.6%) had a MMSE score Cognitive domains: mean score and standard deviation (p Non-demented vs Demented All subjects: 78.4(±15.9) vs 28.7(±21.7) Males: 81.1(±13.0) vs 35.0(±19.9) ≤85: 83.3(±12.3) vs 38.0(±20.5) >85: 75.7(±13.2) vs 34.0(±20.2) Females all: 75.7(±18.0) vs 24.3(±21.9) ≤85: 82.5(±12.4) vs 58.5(±10.8) >85: 67.0(±20.2) vs 18.4(±17.5) Among demented subjects, only 4.5% were treated with acetylcholinesterase inhibitors (p=0.046); 10.2% used other anti-dementia medications (p=0.067). Conclusions Despite of the high prevalence of dementia, only few subjects affected by dementia were properly treated.

P01-364 - A Pet therapy intervention on elderly inpatients: an epidemiological study

Objectives The aim of the present study is to evaluate the effects of Pet Therapy intervention on cognitive function, mood and perceived quality of life on elderly subjects (mean age 84.7 years; 95.2% women) living in a nursing home. Methods Participants were 21 subjects affected by mental illness including dementia, depression and psychosis (diagnosis based on the International Statistical Classification of Disease - ICD-10). The Mini-Mental State Examination (MMSE) and the 15-items Geriatric Depression Scale (GDS) were administered to ten persons (pet-group) and eleven subjects (control-group) together with a self-perceived quality of life questionnaire. The pet-group underwent a dog-assisted educational intervention lasting 90 minutes, once a week for six weeks. MMSE and GDS mean scores were compared between and within groups by Students t-test. Results The mean age ± standard deviation of the overall sample was 84.7±9.9 years. Mean schooling level was 4.0±3.4 years. Dementia was the most frequent diagnosis (47.6%), followed by psychosis (33.3%) and depression (19.0%). Both pet-group and control-group improved on GDS and MMSE. Within the pet-group, GDS symptoms decreased by 50% (from 5.9 to 2.7, p=0.013), whereas mean MMSE score increased by 4.5 (p=0.060). The between group comparison showed positive effect of Pet intervention on GDS (p=0.070). Furthermore, most of the participants reported an improvement of their perceived quality of life. Conclusions According to the most recent literature, our findings suggest that Pet Therapy program can be efficient in improving depressive symptoms and cognitive function in residents of long-term care facilities with mental illness.

P-1019 - Mental health in late-life. Data from an Italian population-based study

Background Technological and medical progresses stimulated a worldwide demographic transition with a high socio-economic impact. The Mental Health in Older People Consensus suggests that elderly mental health deserve attention from a research and a public health perspective. Aims To investigate mental disorders in a population-based sample of persons aged 75+ living in Faenza (Northern Italy). Methods The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) (Roth, 1986) was administered to 462 elderly (or/and their proxies/informants). Cognitive functions were tested using CAMDEX-Cognitive section (CAMCOG) and dementia diagnoses were achieved according to DSM-IV criteria. Among cognitively intact individuals, depression was diagnosed based on DSM-IV and ICD-10 criteria. Presence of general anxiety disorder was evaluated using the Geriatric Anxiety Inventory Short Form (GAI-sf) (Byrne, 2011). Results Dementia prevalence was 19.1% (95% Confidence Intervals: 16–23%). Even if only eight (2.2%) participants were affected by a major depressive episode (DSM-IV criteria), one out of four participants was clinically diagnosed as being depressed when ICD-10 criteria were applied: mildmoderate- and severe-depression prevalence was 16.4% (95%CI: 12.6–20.2%); 7.5% (95%CI: 4.8–10.2%); 1.1 (95%CI: 0.04–2.2%) respectively. Furthermore 20 (5.4%) participants complained sub-threshold depressive symptoms. Three persons had psychotics’ symptoms (two were depressed). Fifty-one participants (11.0%) felt that living was not worthy (95%CI: 8.0–14.0%) and 29 (7.0%) had suicidal thoughts (95%CI: 4.0–8.0%). Anxiety affected the 18.6% of the sample (95%CI: 14.0–22.0%). Depression and anxiety co-occurred in 36 persons (10.2% of the total population). Conclusions At least one mental disorder is diagnosable in one out of two community-dwelling elderly.

P02-90 Depression, cognitive impairment, somatic complaints and disability. Data from the “Faenza community aging study”

Aim To evaluate the relationship between depression, somatic symptoms, cognitive impairment and disability in an elderly population. Methods 216 subjects (65-84 years) were clinically examined for somatic symptoms, and underwent a mental health examination. Depression was defined by Geriatric Depression Scale scores >11/30; cognitive impairment by Mini-Mental State Examination scores Results Disability was common among depressed individuals (OR(95%CI)=3.60(1.63-7.96)) and among cognitively impaired subjects (OR(95%CI)=7.35(3.07-17.60)). An increasing number of somatic complaints increased the probability of functional impairment: compared with presence of 1-2 somatic symptoms, complaint of 3-6 and 7-12 symptoms were related to disability with OR(95%CI)=3.30(1.11-9.80) and OR (95%CI)=4.20 (1.17-15.09) respectively. Distinguishing pain, gastrointestinal, pseudo-neurological and general symptoms, only general somatic symptoms (palpitations, fatigue, sleep disturbances) were associated with disability (OR(95%CI)=1.81(1.25-2.62), independently by medical conditions (OR(95%CI)=1.57(0.98-2.52)). An additive effect toward disability was observed when general somatic complaints and cognitive impairment were co-existing (OR(95%CI)=23.68(5.50-101.86)). Including simultaneously cognitive impairment, somatic complaints and depression in the model, only cognitive impairment was still significantly related (OR(95%CI)=5.87(2.66-12.96)). Conclusions Among many possible causes of disability in the elderly, an important role could be attributed to cognitive deficits.