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Biomedical subjects

Betsy Kristjansson

Publications and source records attributed to Betsy Kristjansson.

6 recordsLinked to original sources
PubMed2005

Prevalence and predictors of depression in elderly Canadians: The Canadian Study of Health and Aging.

Depression in elderly Canadians is an important but often unrecognized public health problem. Numerous studies have examined depression in the general community, but studies of depression in the elderly have generally been small and limited. The Canadian Study of Health and Aging (CSHA) includes a large and national representation of both the cognitively intact and the cognitively impaired elderly. The current analyses of 2,341 participants from the CSHA who completed a clinical rating scale for depression have two objectives: 1) to determine the prevalence of minor and major depression and 2) to examine the importance of several risk factors. The prevalences of major and minor depression were 2.6 percent and 4.0 percent, respectively, and were higher for females, specifically those in institutions, those who reported that their health problems limited activities, and those with chronic health conditions. Women were more likely to exhibit depression (OR = 3.5; 95% CI: 1.4-8.8) than men, and those with dementia more likely to exhibit depression than those without (OR = 2.4; 95% CI: 0.9-3.1). Depression is a significant mental health problem among elderly Canadians, particularly among women and those with physical limitations. More attention should be paid to the detection and treatment of depression in the elderly, particularly among those most at risk.

Age Distribution↗
PubMed2004

On the classification of population health measurements.

Summary measures of population health, such as health-adjusted life expectancy, are increasingly being used to monitor the health status of regions and to evaluate public health interventions. Such measures are based on aggregated indicators of individual health and summarize health in a population. They describe population health status but have limitations in analytic studies of population health. We propose a broader framework for population health measurement. This classifies indicators according to their application (descriptive, prognostic, or explanatory), according to the conception of population (as an aggregate or a dynamic entity), and according to the underlying model of health. This approach extends the measurement repertoire to include indicators of the health of a population.

Chronic Disease↗
PubMed2004

Understanding the influence of the complex relationships among informal and formal supports on the well-being of caregivers of persons with dementia.

This study examined the direct and indirect relationships between caring for a person with dementia and caregiver health. A conceptual model of the caregiver stress process considered informal caregiver characteristics, sources of caregiver stress, and the influence of informal and formal support on the well-being of the caregivers of persons with dementia. Structural equation modeling was used to test specific hypotheses in a sample of 327 caregivers of people with dementia who were living in the community, as part of the first wave of the Canadian Study of Health and Aging. Our findings show that the negative impact of the increasing disability of the care recipient on the psychological well-being of the caregiver was mediated mostly by the use of informal support systems and marginally by the use of formal support systems. The use of informal support by caregivers was associated with a decreased use of formal supports. The relationship between caregiver characteristics and their psychological health was mediated by the use of formal support but not by the use of informal support systems.

Aged↗
PubMed2003

Five-year follow-up of cognitive impairment with no dementia.

CONTEXT: The importance of early identification of dementia has prompted numerous investigations of mild cognitive impairment and the preclinical stages of progressive degenerative disorders. To date, there is limited information from large-scale studies regarding outcomes of persons specifically identified with cognitive impairment but no dementia (CIND). OBJECTIVES: To investigate outcomes for persons with no cognitive impairment (NCI) or CIND, focusing on its etiologic subcategories, from the Canadian Study of Health and Aging (CSHA) and to examine the predictive validity of a set of core features thought to be early manifestations of subsequent dementia. DESIGN: Five-year, longitudinal follow-up of all persons without dementia examined during the first phase of the CSHA in 1991. SETTING: Community and institutional settings. PARTICIPANTS: Population-based sample of 883 persons with NCI and 801 persons with CIND at the first phase of the CSHA. At follow-up, 517 persons with NCI (59%) and 327 persons with CIND (41%) were alive and received clinical diagnoses. MAIN OUTCOME MEASURES: Mortality, institutionalization, and clinical diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria for dementia. RESULTS: Persons with CIND were more likely than those with NCI to die (49% vs 30%), to be admitted to facility care (29% vs 14%), or to receive diagnoses of dementia (47% vs 15%) at follow-up. Those subsequently diagnosed as having dementia were more likely to have had impaired memory, informant-reported change in memory, and functional impairment at baseline. CONCLUSIONS: Persons with CIND were more likely to have a negative outcome than persons with NCI during a 5-year interval. This was true across etiologic subcategories and suggests that the use of specific diagnostic criteria sets does not improve our identification of those who develop dementia compared with a broader, more inclusive approach. More factors contributed to the prediction of all forms of dementia than to AD, but the most accurate prediction was for those who remained dementia free.

Aged↗
PubMed2002

Cognitive scores, even within the normal range, predict death and institutionalization.

BACKGROUND: Dementia is a predictor of death and institutionalization. It is less clear if variations in cognition within the normal range predict adverse outcomes. OBJECTIVE: To determine if variation at the high end of cognitive test scores predicts mortality or institutionalization, independent of the effect of potential confounders. DESIGN: Secondary analysis of the Canadian Study of Health and Aging, a population-based longitudinal study with an initial data collection in 1991 and follow-up five years later. SETTING: Community-dwelling seniors living in Canada. PARTICIPANTS: 9008 consenting seniors were sampled from representative population registries in Canada. MEASURES: Age, gender, marital status, the Mini-Mental State Examination, self-rated health, and activities of daily living. OUTCOMES: Death or institutionalization over the five years of follow-up. RESULTS: Mini-Mental State Examination scores predicted mortality and institutionalization. The unadjusted odds ratio of mortality was 0.85 (95% confidence interval 0.84, 0.86) per point on the Mini-Mental State Examination, and the adjusted odds ratio was 0.95 (95% confidence interval 0.93, 0.97). The unadjusted odds ratio for institutionalization was 0.83 (95% confidence interval 0.82, 0.85), and the adjusted odds ratio was 0.91 (95% confidence interval 0.90, 0.94). This effect was present even in analyses restricted to those within the normal range of Time 1 Mini-Mental State Examination scores. CONCLUSIONS: Low normal cognitive test scores predict adverse outcomes. Clinicians should consider close clinical follow-up of those with low normal cognitive test scores. Further research is needed to target seniors for follow-up and possible intervention to decrease mortality and institutionalization risk.

Aged↗