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Biomedical subjects

J Teresi

Publications and source records attributed to J Teresi.

At least 37 records · Page 2Linked to original sources

Neuropsychological discriminators of long-term inpatient or outpatient status in chronic schizophrenia.

This study investigates specific neuropsychological functions discriminating schizophrenic patients with hospitalization beyond 18 months from patients residing in the community without rehospitalization beyond 3 years. Twenty-six Research Diagnostic Criteria-diagnosed chronic schizophrenic outpatients and 26 inpatients matched for sex, ethnicity, socioeconomic status, and chronicity completed a comprehensive neuropsychological battery and responded to an inventory of psychopathology. Discriminant function analyses showed that measures of motor coordination, preservation, memory, and attention discriminated between patient groups. Bilateral simultaneous fine motor coordination was the most potent discriminator between patient groups, independent of psychopathology. Implications for treatment and research on course and outcome in schizophrenia are discussed.

Activities of Daily Living↗

Impacts associated with special care units in long-term care facilities.

This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status. No deleterious or beneficial effects were associated with SCU residence during a 6-month period.

Cognition Disorders↗

Informal versus formal supports for impaired elderly people: determinants of choice on Israeli kibbutzim.

Among 269 functionally impaired elderly people residing on 53 Israeli kibbutzim, those cared for principally by informal caregivers were compared with those cared for principally by formal caregivers. The major findings were that the variables differentiating between primary reliance on formal versus informal care are similar to those that have been found in other studies, and that the availability of formal resources was not accompanied by withdrawal of informal supports.

Aged↗

Factors relating to institutional risk among elderly members of Israeli kibbutzim.

Characteristics of 269 functionally impaired elderly persons and their primary caregivers were examined in relation to long-term care planning. Contrary to expectation, there were no differences in rates of institutional risk between those elderly residents of Israeli kibbutzim cared for primarily by formal caregivers and cared for by informal caregivers. Lack of informal caregivers emerged as an important risk factor for institutional risk, even in the service-rich environment of kibbutzim.

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The EASI: a self-administered screening test for cognitive impairment in the elderly.

The Early Assessment Self Inventory (EASI), a rapid self-administered screening test for cognitive impairment in the elderly, was constructed to permit individuals to be assessed in a group or singly without examiner intervention. This paper-and-pencil device requires a fourth-grade reading level and makes minimal demands on literacy while assessing orientation, recent and remote memory, language, visual-construction, calculation, and attention. In the present study, the EASI was group-administered to 146 elderly persons attending senior centers and completed individually without examiner intervention by 19 outpatients at a memory disorders clinic. Participants were 60 to 95 years old with 5 to 18 years of education. The EASI demonstrated good internal consistency and test-retest reliability and was significantly correlated with the Mini-Mental State Exam and the Mattis Dementia Rating Scale, both widely used screening instruments. Neuropsychological measures of memory, attention, and verbal fluency correlated as well with the EASI as with the examiner-administered screening instruments, suggesting that the EASI may provide an efficient method of screening for cognitive impairment.

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Comparison of self-administered and rater-administered methods of assessing levels of severity of depression in elderly patients.

Eighty consecutive attenders (M age = 75 years) in a primary care group practice associated with a teaching hospital in New York were assessed for depression using a self-administered questionnaire, the Zung Self-Rating Depression Scale (SDS), and a rater-administered interview, the Short-CARE. The sample was 75% female and 85% black or Hispanic. The response rate of completed interviews was 65% for the Zung SDS and 100% for the Short-CARE. Among the reasons indicated by subjects for not filling out the Zung SDS were visual problems (n = 13, 28%), illiteracy (n = 4, 9%), and lack of motivation/wanted it read to them (n = 16, 34%). Additionally, using the Primary Care Physicians' Questionnaire (PCPQ), results from the Short-CARE and the Zung SDS were compared to primary care physicians' judgments regarding the presence of depression in these patients. The convergent validity coefficient for the Zung SDS with the PCPQ was .65 (kappa = .29); the comparable coefficients for the PCPQ and the Short-CARE Depression Scale were .73 and .46 respectively.

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The mental health of old homeless men.

The recent focus on the young homeless mentally ill has diverted attention from other subgroups of the homeless, particularly the aging, who compose one fourth of the homeless population. A total of 86 street-dwelling and 195 non-street-dwelling (177 flophouse-, 18 apartment-dwelling) men aged 50 and older on the Bowery in New York City were studied. Although 23% evidenced psychosis or had prior psychiatric hospitalization (PPH group), depression was more prevalent with one third of all men categorized as clinically depressed. Only 5% evidenced gross organic mental disease. Several groups were identified for intervention because of their increased susceptibility to depression: alcoholics, relatively younger men, those with organic mental symptoms, street men. With respect to the PPH men, they did not appear to be distinct from the other homeless men on various social and health indices, although they differed substantially from age-matched community men. Thus these men must be viewed as homeless first, and in addition, as having the handicap of mental illness. Contrary to the popular stereotype, there was no evidence of widespread isolation among the PPH men, and despite their disturbances, most showed an adequate capacity for survival.

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Effects of treatment for isolated systolic hypertension on cognitive status and depression in the elderly.

The Systolic Hypertension in the Elderly Program (SHEP) was designed as a feasibility study and in part dealt with the effects of the treatment of isolated systolic hypertension on cognitive status and depression. Subjects were 60 years of age or older with a systolic blood pressure of 160 mmHg or greater and diastolic of less than 90 mmHg; free of several specified illnesses or chronic conditions. These volunteers were randomly assigned to treatment (n = 443) and placebo (n = 108) groups. The behavioral assessments at baseline and 1 year later were the SHORT-CARE instrument for depression, cognitive impairment, and disability and other tests of cognitive status (Digit Symbol Substitution and the Trail Making tests). Although the treatment regime was highly successful in controlling the hypertension, it did not have a significant impact on changes in cognitive function or level of depression; a behavioral benefit was not evident but the results are consistent with the view that an effective treatment regime for isolated systolic hypertension in the elderly can be behaviorally safe.

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Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population.

Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year. Three different methods of determining buffering effects were examined: Dividing the sample into high- and low-stress groups and contrasting differences in percentage variance accounted for by social networks between the two groups; Examining the group as a whole to assess if any Network Variable X Stress interactional terms are significant; Examining the group as a whole to assess whether there is a reduction in the beta value of stress with respect to psychological symptoms when network variables are added to the analysis. Method 1 indicated a direct network effect, but none of the methods indicated a buffering effect. Of clinical relevance was the nonlinearity of the network effects, that is, depending upon a person's stressor level, different network dimensions must be emphasized and strengthened.

Adaptation, Psychological↗

Social networks, stress, and physical health: a longitudinal study of an inner-city elderly population.

Research examining the relationship between social networks, stress, and physical symptoms has been limited by rudimentary network measures and the lack of longitudinal data. Using 19 network variables, the authors followed 133 elderly residents of mid-Manhattan hotels for 1 year. The findings indicated that social networks exert a direct effect on reducing subsequent physical symptoms. Moreover, social networks also act to reduce symptoms by buffering the effect of increased levels of stress. Of clinical relevance was the finding that combining knowledge of patients' social networks with their current health status predicts their future health status with an exceedingly high degree of certainty. Consequently, intervention to reinforce a network can be as clinically significant as implementing a medical procedure.

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Differences among black, Hispanic, and white people in knowledge about long-term care services.

This article provides data obtained through telephone interviews with 1,608 white, black, Mexican American, or Puerto Rican respondents. The study was designed to measure differences among ethnic groups in knowledge and attitudes toward long-term care services and the extent to which knowledge and attitudes affect service use. Across all groups, there is less knowledge about long-term, community-based care than institutional services. The extent of knowledge about services is limited among all groups, but especially among Puerto Ricans. There are marked differences among groups in attitudes toward services. Minority groups are far more likely to perceive care of the elderly as a family responsibility and to stress the importance of ethnic factors in service delivery. Despite differences among groups, knowledge and attitudes are less directly related to use of services than is activity limitation. This may be because only a very small proportion of the respondents had any experience with service use.

Black or African American↗

Studies of body image. IV. Figure drawings in normal and abnormal geriatric and nongeriatric groups.

Figure drawings were obtained from 72 normal adults, 48 adult psychiatric inpatients, 30 senior citizens, and 33 elderly inpatients in a mental hospital. Blind analyses were carried out for "emotional indicators" and other characteristics such as body image disturbance and intellectual impairment. Significant differences were found on almost all measures between the normal elderly and the normal adult. They were also found to discriminate between the normal adult group and the adult psychiatric patients. Very few differences were found between the normal elderly and elderly psychiatric patients, or between normal elderly and adult psychiatric patients. These results imply that norms based upon figure drawings of children or adults may not apply to the elderly and that, therefore, figure drawings may be a less useful diagnostic tool for elderly people than they are for children or adults.

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