Biomedical subjects

Carolien H M Smits

Publications and source records attributed to Carolien H M Smits.

4 recordsLinked to original sources

PubMed2005

The CIDI as an instrument for diagnosing depression in older Turkish and Moroccan labour migrants: an exploratory study into equivalence.

OBJECTIVE: The number of elderly migrants from Turkey and Morocco in Western Europe will increase sharply in the coming decades. Many of these migrants seem to have mental health problems. As mental health care programs are based on DSM criteria, there is a need for diagnostic instruments with good psychometric properties. This exploratory study examines the presence of construct bias, method bias and item bias in the Composite International Diagnostic Interview (CIDI) Basis Life time version 2.1 in elderly Turkish and Moroccan men and women. METHOD: From a community based health survey four groups of migrants aged 55-74 were selected for semi-structured interviews including the CIDI depression section. Data included interview transcriptions and observations of 11 respondents in each group (Turkish men, Turkish women, Moroccan men, and Moroccan women). The data were analysed using qualitative techniques. RESULTS: Construct bias, method bias and item bias of the CIDI was found in all groups. The poor match between the CIDI on the one hand and the taboo on mental health problems and the poor level of education of the respondents can partly explain this bias. CONCLUSIONS: The use of the CIDI in elderly migrants of Moroccan and Turkish descent is problematic, due to the presence of construct, method and item bias.

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PubMed2005

Does widowhood affect memory performance of older persons?

BACKGROUND: The loss of a spouse has been found to have a negative effect on physical and mental health and leads to increased mortality. Whether conjugal bereavement also affects memory functioning has largely been unexamined. The present study investigates the effect of widowhood on memory functioning in older persons. METHOD: The sample consisted of 474 married women and 690 married men aged 60-85 years in 1992, followed up in 1995 and 1998. During the study 135 (28%) of the women and 69 (10%) of the men lost their spouse. Linear regression analysis was used to examine whether widowed men and women differed from those who had not been widowed in rate of memory change over 6 years. Cross-domain latent-change models were subsequently used to evaluate the extent to which changes in memory are related to changes in other domains of functioning that may be affected by widowhood. RESULTS: Older adults who lost a spouse during follow-up showed a greater decline in memory over 6 years than those who remained married. A higher level of depressive symptoms at baseline was related to lower levels of memory functioning and a greater decline. Memory decline was unrelated to changes in depressive symptoms and physical health. CONCLUSIONS: Loss of the spouse is related to a greater decline in memory in older adults. The absence of an association with physical functioning and the weak association with mental functioning suggest that losing a spouse has an independent effect on memory functioning.

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PubMed2003

Integrating mental health care into residential homes for the elderly: an analysis of six Dutch programs for older people with severe and persistent mental illness.

Integrating mental health care into residential homes for the elderly is a potentially effective model to address the complex care needs of older chronically mentally ill people. Because no research was available on the implementation of such integrated care in practice, six programs already operating in the Netherlands were analyzed. At the administrative level, three types of cooperative arrangements existed: a psychiatric hospital renting a unit in a residential home for the elderly, a psychiatric hospital stationing mental health professionals in a residential home on a permanent basis, and a residential home employing its own psychiatrically trained staff. At the operational level, contrasting views emerged on the relation-ship between physical and mental health care; these were delivered separately or in integrated form. In either case, the employees trained as elder care workers or as psychiatric nurses had difficulties understanding each other because they held different ideas about good-quality care. These care visions can be characterized as the care-giving approach (care workers) versus the problem-oriented and the rehabilitation approaches (nurses). At the housing level, two models existed: mentally ill patients having apartments in a separate unit (concentrated housing) or located throughout the facility (dispersed housing). The most promising model appears to be the one in which a psychiatric hospital assigns mental health professionals to work in a residential home, where they remain administratively and operationally distinct from the standard residential services. Whether or not the psychiatric residents should be housed in separate units could not be decided based on this study.

Activities of Daily Living↗

PubMed2002

Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults.

The impact of three types of everyday activities (i.e., social, experiential, and developmental) on four cognitive functions (i.e., immediate recall, learning, fluid intelligence, and information-processing speed) and one global indicator of cognitive functioning (Mini-Mental State Exam score) over a period of 6 years was studied in a large 55--85 year-old population-based sample (N = 2,076). A cross-lagged regression model with latent variables was applied to each combination of 1 cognitive function and 1 type of activity, resulting in 15 (3 x 5) different models. None of the activities were found to enhance cognitive functioning 6 years later when controlling for age, gender, level of education, and health, as well as for unknown confounding variables. Conversely, one cognitive function (i.e., information-processing speed) appeared to affect developmental activity. It is suggested that no specific activity, but rather socioeconomic status to which activities are closely connected, contributes to maintenance of cognitive functions.

Activities of Daily Living↗