Kristin A. Reynolds

Prevalence of psychiatric disorders in U.S. older adults: findings from a nationally representative survey.

Data on the prevalence of psychiatric disorders in late life are lacking. The present study addresses this gap in the literature by examining the prevalence of the broadest range of psychiatric disorders in late life to date; comparing prevalences across older adult age groups using the largest sample of adults aged 85+; and exploring gender differences in the prevalence of psychiatric disorders in late life. Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, we examined the prevalence of past‐year mood, anxiety, and substance use disorders, and lifetime personality disorders in a nationally representative sample of 12,312 U.S. older adults. We stratified our analyses by gender and by older age groups: young‐old (ages 55‐64), middle‐old (ages 65‐74), old‐old (ages 75‐84), and oldest‐old (ages 85+). The proportion of older adults who experienced any past‐year anxiety disorder was 11.4%, while the prevalence of any past‐year mood disorder was 6.8%. A total of 3.8% of older adults met criteria for any past‐year substance use disorder, and 14.5% of older adults had one or more personality disorder. We observed a general pattern of decreasing rates of psychiatric disorders with increasing age. Women experienced higher rates of mood and anxiety disorders, while men had higher rates of substance use disorders and any personality disorder. Gender differences in rates of most psychiatric disorders decreased with increasing age. These data indicate that psychiatric disorders are prevalent among U.S. older adults, and support the importance of prevention, diagnosis, and treatment of psychiatric disorders in this population.

Prevalence and correlates of generalized anxiety disorder in a national sample of older adults.

OBJECTIVES The objectives of this study are to provide current estimates of the prevalence and correlates of generalized anxiety disorder (GAD). METHODS The authors used Wave 2 data from the National Epidemiologic Survey on Alcohol and Related Conditions, which included 12,312 adults 55+ and older. In addition to examining the prevalence of GAD in the past year, this study explored psychiatric and medical comorbidity, health-related quality of life, and rates of help-seeking and self-medication. RESULTS The past-year prevalence of GAD in this sample was 2.80%, although only 0.53% had GAD without Axis I or II comorbidity. The majority of individuals with GAD had mood or other anxiety disorders, and approximately one quarter had a personality disorder. Individuals with GAD were also more likely to have various chronic health problems although these associations disappeared after controlling for psychiatric comorbidity. Health-related quality of life was reduced among older adults with GAD, even after controlling for health conditions and comorbid major depression. Finally, only 18% of those without and 28.3% with comorbid Axis I disorders sought professional help for GAD in the past year. Self-medication for symptom relief was rare (7.2%). CONCLUSIONS GAD is a common and disabling disorder in later life that is highly comorbid with mood, anxiety, and personality disorders; psychiatric comorbidity is associated with an increased risk of medical conditions in this population. Considering that late-life GAD is associated with impaired quality of life but low levels of professional help-seeking increased effort is needed to help individuals with this disorder to access effective treatments.

French Immersion Experience and Reading Skill Development in At-Risk Readers.

We tracked the developmental influences of exposure to French on developing English phonological awareness, decoding and reading comprehension of English-speaking at-risk readers from Grade 1 to Grade 3. Teacher-nominated at-risk readers were matched with not-at-risk readers in French immersion and English language programs. Exposure to spoken French phonetic and syllabic forms and to written French orthographic and morphological forms by children attending French immersion programs was expected to promote phonological, decoding and reading comprehension achievement. Growth in all outcomes was found, with children in immersion experiencing higher final status in phonological awareness and more rapid growth and higher final status in decoding, using multilevel modeling. At-risk readers in French immersion experienced faster growth and higher final status in reading comprehension. Benefits to reading of exposure to an additional language are discussed in relation to cross-language transfer, phonological grain size and enhanced executive control processes.

How well do websites concerning children’s anxiety answer parents’ questions about treatment choices?

The goals of this study were to evaluate the quality of information concerning anxiety disorders in children that is available on the Internet and to evaluate changes in the quality of website information over time. The authors identified websites addressing child anxiety disorders (N = 26) using a Google search and recommendations from an expert in child anxiety. Each website was evaluated on the extent to which it addressed questions that parents consider important, the quality of information, and the reading level. All websites provided adequate information describing treatment options; however, fewer websites had information addressing many questions that are important to parents, including the duration of treatment, what happens when treatment stops, and the benefits and risks of various treatments. Many websites provided inadequate information on pharmacological treatment. Most websites were of moderate quality and had more difficult reading levels than is recommended. Five years after the initial assessment, authors re-analyzed the websites in order to investigate changes in content over time. The content of only six websites had been updated since the original analysis, the majority of which improved on the three aforementioned areas of evaluation. Websites could be strengthened by providing important information that would support parent decision-making.

The experiences of older male adults throughout their involvement in a community programme for men

ABSTRACT Community programmes have been shown to provide social and emotional benefits for older adults. The vast majority of community programmes for older adults are either mixed-sex or female-oriented in their activities and composition. As such, there is a scarcity of both opportunities for, and research focusing on older male adults’ participation in community programmes geared towards men. The present study describes the experiences of older male adults throughout their involvement in a male-oriented community programme. Participants described their involvement in the community programme on the basis of their characteristics and experiences that preceded their involvement, the characteristics of their current involvement, and aspects of the programme and their participation that promoted their continued involvement. The findings of this study have potential utility for community organisations aiming to increase the involvement of older men in their programmes. Furthermore, the findings indicate that community programme participation has the potential to promote social engagement and healthy, active ageing among older men.

Older men's perceptions of the need for and access to male-focused community programmes such as Men's Sheds

ABSTRACT Although participating in community social programming is associated with positive physical and mental health outcomes for older adults, older men participate less often than women. Mens Sheds is a community programme used primarily by older men that originated in Australia and is well established there. The goal of the current study was to explore mens perceptions of the need for Mens Sheds and issues concerning access to them in Canada, a country with a small but growing Mens Sheds movement. We conducted focus groups with 64 men aged 55 years and older, including Mens Sheds members and men from the community who were unfamiliar with this programme, and analysed the data using the framework analytic approach. The data revealed two primary themes concerning: (a) the need for male-focused community programmes, including the sub-themes reducing isolation, forming friendships and engaging in continued learning; and (b) access to programmes, including the sub-themes points of contact, sustaining attendance and barriers. Findings suggest that in order to reduce the likelihood of isolation and increase opportunities for social engagement, exposure to the concept of male-focused programming should begin before retirement age. In addition, such programmes should be mindful of how they are branded and marketed in order to create spaces that are welcoming to new and diverse members.

Searching for answers: How well do depression websites answer the public’s questions about treatment choices?

OBJECTIVE The purpose of this study was to evaluate websites providing information on treatment for depression to the public, and to evaluate changes in the quality of website information over time. METHODS Websites (N = 25) addressing depression treatment were identified through the use of the Google search engine and by suggestions from healthcare professionals. Each website was evaluated based on the extent to which it addressed content areas deemed important by the public identified in previous research, overall quality as determined by the DISCERN, and reading level. RESULTS Overall, the quality of depression websites varied greatly. The majority of websites did not adequately answer the publics questions about treatment options, and presented higher quality information in the area of pharmacological treatments as compared to other treatment options. An average reading level of 10.0 was found across websites. Upon re-evaluation, only 14 of 25 websites added new content, and the majority of websites did not improve in their overall website quality (as measured by the DISCERN). CONCLUSION AND PRACTICE IMPLICATIONS Websites could be improved by addressing important questions that consumers have concerning depression, as well as by creating higher quality content in the areas of psychological, neurotherapeutic, and alternative treatments.

Evaluating the quality of perinatal anxiety information available online

The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.