Marirosa Dello Buono

Death ideation and its correlates: survey of an over-65-year-old population

The presence of dissatisfaction with life or thoughts of death or suicide has been variously surveyed in adolescent samples and in the general population, but there is a paucity of research on the elderly. The aim of this study was to assess, in an elderly community-dwelling population: a) the prevalence of death and/or suicidal feelings and thoughts and any attempted suicides; and b) factors associated with these experiences. A total of 611 over-65-year-old subjects were interviewed at home. Seventeen percent of the total (F:M = almost 2:1) responded affirmatively to at least one of the questions on suicidality. Elderly people reporting suicidal feelings presented markedly higher levels of physical and psychological distress, such as depression, anxiety, and hostility. Results indirectly confirm that depressive symptomatology is not adequately treated. Greater attention is warranted in psychological evaluation of the elderly to take into account those risk factors that, if identified and managed, could reduce the frequency of suicidal thoughts and, probably, associated actions.

Alternative medicine in a sample of 655 community-dwelling elderly

OBJECTIVE Use and satisfaction with herbal/homeopathic remedies, acupuncture and relaxation techniques were examined in an Italian elderly population. METHODS Data were collected as part of a survey on an elderly population, conducted in 1996--1997 in the urban centre of Padua, Italy. A total of 1362 elderly received a letter inviting them to participate and to accept the visit of an interviewer at home. Of these, 212 were unable to do so for insurmountable reasons and 666 gave consent to take part in the study with a response rate of 65%. Eleven participants were excluded from the study because cognitively impaired. RESULTS Among the 655 respondents, overall use of at least one alternative medicine was 29.5%. Herbs/phytotherapeutics (47%) and acupuncture (34%) were the most frequently cited therapies. The use of alternative medical practices seems rather widespread among the elderly population in Padua, especially among females with depressive symptoms, pain and discomfort, but not suffering from chronic somatic disease. A percentage of 3.7% of the sample used exclusively alternative medicines; those subjects seemed to be younger, less likely to be physically ill and to report functional disorders and chronic somatic disease. CONCLUSION Alternative medicines seem to have a complementary role for the elderly with self-perceived psychological symptomatology or disorders, particularly of depressive nature. They may constitute an attempt at self-treatment, probably concealing the difficulties encountered by the elderly subjects in seeking specialist advice for these problems.

Community care for patients with Alzheimer's disease and non-demented elderly people: use and satisfaction with services and unmet needs in family caregivers.

This study measures and compares use of and satisfaction with medical and social services in addition to subjectively perceived needs of family supporters of patients with probable or possible Alzheimers disease (AD) and family supporters of non‐demented elderly people. Differences in judgement of services within the subpopulation of families of AD patients are also assessed by gender and burden level.

Reality Orientation Therapy to delay outcomes of progression in patients with dementia. A retrospective study

Objective: To evaluate the impact of continued Reality Orientation Therapy (ROT) in delaying the outcomes of dementia progression. Design: Retrospective study. Data collection was based on review of clinical charts and on telephone interviews performed with patients or primary caregivers. Setting: Day hospital of the Alzheimers Disease Unit, Brescia (Italy). Subjects: Seventy-four patients enrolled in at least one cycle of ROT from 1994 to 1998 were studied. Interventions: Rehabilitative intervention based on formal ROT. Main outcome measures: This study analysed the time to the occurrence of any of the following: cognitive decline on Mini-Mental State Examination scores, urinary incontinence as an index of functional decline, institutionalization, and death. Results: Data on a 30-month period after the first ROT session were analysed. We compared 46 patients (treatment group) who completed from 2 to 10 ROT cycles (corresponding to 8–40 weeks of training; mean = 15.48) with 28 patients (control group) who completed only one ROT cycle (4 weeks). Treatment group showed higher estimated survival rates than control group on cognitive decline (p = 0.022) and institutionalization (p = 0.002). The relative risks for cognitive decline and institutionalization in the control group compared with treatment group were 0.60 (p = 0.014), and 0.42 (p = 0.021), respectively. Conclusions: Continued ROT classes during the early to middle stages of dementia may delay nursing home placement and slow down the progression of cognitive decline.

Hostility as a Feature of Elderly Suicidal Ideators

Literature suggests that suicidal feelings are relatively rare in mentally healthy older adults. This research investigated the presence of death or suicidal ideation in a group of home-dwelling elderly people (N = 611, M age = 75.7 yr., SD = 7.2), taking into account their psychopathological profiles assessed by means of the Brief Symptom Inventory. Suicidality was investigated by the Italian translation of the 1974 questions from Paykel, Myers, Lindenthal, and Tanner. Elderly with death or suicidal ideation manifested depressive and anxious symptoms on the Brief Symptom Inventory. This psychopathological profile, which has been reported for these subjects in various contributions to the literature, was also characterized by the presence of hostility. The correlation with higher scores on the hostility scale is difficult to interpret, although these feelings are often accompanied by failure to control impulses, which is an essential characteristic in suicidal behaviour.

Epidemiology of suicide in the elderly population in Italy: 1958-1988

Abstract In this study we analyzed suicide rates. based on official ISTAT data published in the Health Statistics Year Book, relating to the Italian population aged over sixty-five, divided up into groups of five years, from 1958 to 1988. We calculated the rates of death by suicide (per 100,000 subjects) for each year and then. standardizing by sex, the mortality rates relative to each method of suicide for the overall population over sixty-five. Analysis of the results obtained shows that there was an increase in the suicide phenomenon in the elderly population in Italy over the tested period. The rates are at least three times higher in men than in women. The highest rates are reported for elderly men, but it seems that there has been a greater proportional increase with regard to the number of suicides committed by elderly women. The increase was statistically significant in both sexes (men: 0.81. p < 0.001, women: 0.85. p < 0.001). Over the thirty year study period, substantial changes have come about...