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Results for “Institutionalization”

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At least 649 records · Page 36Linked to original sources

PubMed1993

Affective symptoms of institutionalized adults with mental retardation.

A survey of affective symptoms in two groups of institutionalized adults with mental retardation was conducted. The groups were comprised of subjects with prior diagnoses of affective disorders or other psychiatric disorders. Informants reported retrospectively on the presence or absence of DSM-III-R criteria for major depression and mania. Thirteen percent of the affective disorders group did not meet these criteria for depression or mania, whereas 20% of the other psychiatric disorders group did. Aggression was a frequent concomitant of psychopathology in both groups. These findings support previous reports that affective disorders may be underdiagnosed in this population. However, unlike prior investigations, most of the subjects (74%) in the present survey had severe to profound mental retardation.

Adult↗

PubMed1993

Epilepsy in institutionalized patients with encephalopathy: clinical aspects and nosological considerations.

This study was designed to correlate the prevalence of epilepsy with the severity and type of encephalopathy of 1,023 institutionalized patients and tentatively classify each according to the Proposals of the Commission on Classification and Terminology of the International League Against Epilepsy. Of this sample, 326 individuals were diagnosed with epilepsy. Sex distribution and mean age in the epilepsy and no epilepsy groups were similar, but degree of handicap was higher for those with epilepsy. Of these individuals 32.5% had a partial form. Of the 204 patients with generalized epilepsy (62.5%), 64 had a form with electroclinical characteristics of the idiopathic type; 57, a syndromic form (53 cases with a Lennox-Gastaut syndrome); and 83, a nonsyndromic form. Degree of handicap and frequency of seizures were lower in subjects with partial epilepsy and with those having electroclinical characteristics of the idiopathic type.

Activities of Daily Living↗

PubMed1993

Institutionalization, involuntary sterilization, and mental retardation: profiles from the history of the practice.

For much of the 20th century, the practice of sterilization was a common accompaniment to institutionalization for individuals with mental retardation. Following the Supreme Court's decision in Buck v. Bell (1927) supporting the practice, numerous states passed legislation and, consequently, over 60,000 individuals with mental retardation were sterilized in this country. In the present study we analyzed data on 212 individuals in Virginia who were sterilized. Our focus included gender, age at and date of sterilization, level of mental retardation, and location of subsequent discharge. The nature of these findings within the general context of the practice of sterilization was discussed.

Adolescent↗

PubMedDate not supplied

Femur fractures in institutionalized patients after hip spica immobilization.

The charts of 77 severely handicapped institutionalized children and young adults were retrospectively reviewed to assess the incidence of femur fractures. No fractures occurred in ambulatory patients. Four of 37 nonambulatory patients who did not have hip surgery (10.9%) had sustained a fracture at some time during their life. Six of 21 (29%) nonambulatory patients who were operated on for subluxed or dislocated hips sustained a femur fracture within 3 months after discontinuation of their spica casts. This risk factor should be taken into account when one considers operation in severely affected nonambulant spastic quadriplegic patients.

Adolescent↗

PubMed1995

A genetic diagnostic survey in an institutionalized population of 116 moderately to severely retarded male patients: the Rekem experience.

In this paper we report the results of a genetic-diagnostic survey of 116 institutionalized male patients who were moderately to severely retarded. In 31 patients (26.7%) a constitutional cause of their mental impairment was found: chromosomal abnormalities in 11 patients (9.5%), Mendelian disorders in 16 (13.8%), of which 8 fragile X patients (6.9%), and a MCA/MR syndrome in 4 patients (3.4%). Acquired forms of mental retardation occurred in 26 patients (22.4%): CNS-dysfunction due to pre-, peri- or postnatal causes were most likely in 18 patients (15.5%), while infections played a major role in 8 (6.9%). In 59 patients (50.9%) not etiological diagnosis could be made.

Adult↗

PubMed1996

Biochemical effects of calcium and vitamin D supplementation in elderly, institutionalized, vitamin D-deficient patients.

Forty-five subjects (41 women and 4 men) in long-stay and medium-stay facilities, aged 74 to 95 years (mean 86.4 years), with 25-hydroxy-vitamin D levels less than 12 ng/ml, were treated for six consecutive months with two tablets per day of a preparation containing vitamin D3 (800 IU/day) and calcium carbonate (1 g elemental calcium/day). Serum levels of 25-hydroxy-vitamin D were very low at baseline (5.6 +/- 0.4 ng/ml) and rose significantly under treatment, to normal values, 33.2 +/- 1.2 and 40.9 +/- 2.1 ng/ml after three and six months, respectively (p < 0.001 for both comparisons). Serum calcium increased significantly, by 4.5% (p < 0.001) during the first three months, and remained at a plateau thereafter. Corrected serum calcium rose by 8.9% (p < 0.001) during the trial. No patient developed hypercalcemia. Serum parathyroid hormone levels, which were elevated at baseline (71.6 +/- 5.8 pg/ml; normal, 12 to 54 pg/ml), decreased gradually and significantly throughout the treatment period, by 43.0% and 67.1% after three and six months, respectively (p < 0.001 for both comparisons). Serum alkaline phosphatase activity fell concomitantly, by 9.9% after three months (p < 0.01) and 36.5% after six months (p < 0.001). In conclusion, the preparation used in our study is effective in correcting both the vitamin D deficiency that is prevalent in elderly institutionalized patients and the resultant increase in bone turnover.

Administration, Oral↗

PubMed1997

Prospective study of the prevalence of Alzheimer-type dementia in institutionalized individuals with Down syndrome.

Institutionalized patients with Down syndrome (n = 307) were monitored for 5 to 10 years prospectively to determine prevalence of Alzheimer-type dementia. Clinical signs, cognitive functioning, and EEGs were assessed. When possible, postmortem neuropathological examinations were conducted. Progressive mental and physical deterioration was found for 56 of the residents. Mean age at onset of dementia was 56 years. Prevalence increased from 11% between ages 40 and 49 to 77% between 60 and 69. All patients 70 and over had dementia. Neuropathological findings were consistent with clinical diagnosis. Use of a dementia checklist, cognitive skills inventory, and EEG reliably detected Alzheimer-type dementia at an early stage.

Adult↗

PubMed1997

Food intake and Body Mass Index in the privately institutionalized elderly in Tehran.

Food intake and Body Mass Index (BMI) of privately institutionalized elderly in Tehran was studied using a 5-day food intake survey and anthropometric measurements. Thirty-seven males and sixty-three females in private institutions were selected. The intake of many nutrients including protein, calcium, zinc, vitamins A. riboflavin, folic acid and cobalamin, were deficient. Almost half the subjects were under the 5th percentile of standard BMI for their age and sex, indicating chronic energy malnutrition. More attention needs to be paid to this group of vulnerable people.

Aged↗

PubMed1997

[Predictive factors for institutionalization in the context of geriatric planning in the Gironde department (France)].

The objective of this study was to investigate the predictive factors over five years follow-up of institutionalization, relevant for starting interventions in the area of Gironde (South Western France). This study deals with a longitudinal study of community residents aged 65 years and older. Of the 2792 subjects initially included in the cohort in year 1988, 2493 were selected for this study, leading to the subjects whose type of housing was known at least once over the five year follow-up (1989-1993). The statistical analysis was made with a discrete Cox proportional hazard model. Of the 2493 subjects, 150 entered an institution during the five years of follow-up, leading to a cumulative incidence of 7.1%. In the multivariate analysis, the predictive factors found in this study were age, absence of phone in the house, living in home for the aged, cognitive decline evaluated with the Mini-Mental-Status-Examination (MMSE), dependency for one item of the Lawton's scale (Instrumental Activities of Daily Living or IADLs), namely the inability to do shopping, and limited social contact with the family. These different indicators are a basis for decision making to target home care services fitted to the needs of the area.

Activities of Daily Living↗

PubMed1998

Platelet fatty acids and peripheral blood lymphocyte subsets in an institutionalized elderly population.

The associations between platelet fatty acids and peripheral blood lymphocyte subsets were studied in 78 institutionalized elderly individuals (27 men and 51 women), aged 67 to 100. Platelet fatty acids were assessed by gas chromatography, and peripheral blood lymphocyte subsets were quantitated by immunophenotyping using flow cytometry. It was found that women had a higher number of total T-cells (CD3), T-helper (CD3+4+) cells, and B-cells (CD19). However, no gender differences were observed in the percentages of lymphocyte subsets. In elderly men, after adjusting for age and fatty acid intake, the platelet concentration of omega-3 polyunsaturated fatty acids was positively related to the percentage of CD3 and CD3+4+ bearing lymphocytes (rs = 0.59, P < 0.05; and rs = 0.55, P < 0.05, respectively), and the concentration of total saturated fatty acids was also positively associated with the percentage of B (CD19) cells (rs = 0.50, P < 0.05). However, similar relationships were not observed in elderly women. No significant associations were found between trans fatty acids and any of the lymphocyte subsets in the study population. These findings suggest that fatty acids may be related to immune function. Any effects may be important in the host immune defence, especially in elderly individuals.

Aged↗

PubMedDate not supplied

[Nutritional state of iron in the institutionalized aged: study of intake and hematological indices].

In this study we determined the nutritional state of iron in 93 elderly people who were institutionalized in Granada, by means of a determination of their ingested iron, as well as the determination of the serum iron, hematologic parameters (hemoglobin and hematocrit), and the corpuscular indexes (mean corpuscular volume and mean corpuscular hemoglobin). The elderly people had an iron intake that was considered to be adequate (10.2 +/- 2.1 mg/day), and this is not related to the hematological parameters studied. 4% of the men, and 22% of the women showed hemoglobin values that were considered to be low.

Aged↗

PubMed1998

[Frequency, characteristics and consequences of falls in a cohort of institutionalized elderly patients].

OBJECTIVE: Falls in the elderly are a major problem because of their high morbility and mortality rates and health expenditures. However, there are few studies about this problem in our country. The purpose of the present study was to know the frequency, features and consequences of falling among institutionalized elders. METHODS: We carried out a prospective cohort study using a sample of 190 persons aged 65 years and older living in two nursing homes. All subjects underwent a comprehensive evaluation at the onset of the study. During a mean follow-up period of 310 days, all falls were recorded. RESULTS: There were a total of 121 falls in 72 (37.9%) subjects, twenty five of whom (34.7%) experienced two or more falls. The fall incidence per person-year was 0.75. As compared with males, females had a density ratio (DR) of 2 (1.2-3.2; 95% confidence interval-CI). Falling was more frequent in the bedrooms and living rooms (43.8%). DISCUSSION: This results agree with others studies about the high fall incidence in the elderly and bring out new features about circumstances and consequences of falls.

Accidental Falls↗

PubMed1998

[The oral status in mentally retarded institutionalized patients].

BACKGROUND AND METHODS: An epidemiological survey of dental and periodontal health status was conducted in a group of 263 institutionalized mentally retarded patients. RESULTS: The periodontal status in the study population was very poor. 66% of the subjects presented with a probing depth more than 3.5 mm (PSR = 3 or 4), 29% showed the presence of bleeding or calculus (PSR = 1 or 2) and only 5% showed a normal periodontal status (PSR = 0). No statistical relationship was found between periodontal status and age, sex, type or duration of psychiatric therapy. Concerning the dental status a total of 59 (26%) subjects was totally edentulous. A significant increase in the prevalence of edentulousness with increasing age was recorded. The incidence of edentulousness was higher among women than among men, while it was not significantly influenced by the type of psychiatric pathology, type or duration of psychiatric therapy. The mean number of remaining teeth in every subject was 12.9 +/- 9; the mean number of sound teeth was 10.8 +/- 8 and the mean number of decayed teeth was 2.1 +/- 3. The number of decayed teeth decreased with increasing age and it was influenced by the type of psychiatric pathology, but not by the type or duration of psychiatric pathology. CONCLUSIONS: Analysis of the results showed a very poor dental but especially periodontal status in mentally retarded subjects as compared to those found in studies performed in normal subjects.

Adult↗

PubMed1976

Dimensions of adaptive behavior in institutionalized mentally retarded children and adults: developmental perspective.

Factor analyses were performed utilizing the subscale scores of the AAMD Adaptive Behavior Scale, Part One, for 3,354 institutionalized mentally retarded children and adults. Eight different age groups were studied to determine (a) the underlying dimensions of adaptive behavior measured by the scale, (b) similarity of factor structure across ages, (c) whether there were developmental changes revealed by factor scores, and (d) the extent to which the above findings would be related to level of retardation. Three salient factorial dimensions--Personal Self-Sufficiency, Community Self-Sufficiency, and Personal-Social Responsibility--appeared across a wide span of age ranges from childhood through senility. The implication of these factors was discussed in terms of the critical period of development, rate of growth, and maximum level of growth of subjects grouped by level of retardation.

Activities of Daily Living↗

PubMedDate not supplied

Mortality of the institutionalized old-old hospitalized with congestive heart failure.

BACKGROUND: Congestive heart failure is a major cause of mortality and morbidity in the elderly but the disease impact on the oldest and sickest population has not been defined. OBJECTIVES: To review the mortality and hospital readmission rate of institutionalized elderly persons with congestive heart failure and to examine the relation of baseline characteristics to subsequent clinical outcomes. METHODS: This was a retrospective analysis based on chart review of 231 residents of the Philadelphia (Pa) Geriatric Center (63 congregate housing tenants and 168 nursing home residents) 80 years and older, hospitalized with congestive heart failure from 1989 to 1995. Patients' demographic data and clinical, electrocardiographic, and echocardiographic findings were obtained from their initial (index) hospitalization records. Subsequent outcomes were obtained from their outpatient (nursing home or office) records. RESULTS: Thirteen percent died during the index hospitalization but the total mortality during the follow-up period was 87%. One hundred forty-six patients (63%) died in the first year with a mean +/- SD survival of 4+/-4 months and a readmission rate of 3.9 per patient-year. Eighty-five patients survived the first year with a readmission rate of 1.2 per patient-year and 54 patients subsequently died, with a mean +/- SD survival of 28+/-12 months. The first-year decedents and survivors were comparable in sex, age, medical history, and electrocardiographic findings. However, patients who died in the first year, compared with survivors, were more likely to be nursing home residents (81% vs 59%), have New York Heart Association class IV heart failure (54% vs 32%), have impaired left ventricular function by echocardiogram (53% vs 32%), and have renal insufficiency (32% vs 11%). CONCLUSIONS: Very elderly persons with congestive heart failure had a guarded long-term prognosis. Nursing home residency, class IV heart failure, impaired left ventricular function, and renal insufficiency were associated with higher risk for early death and repetitive hospitalizations.

Aged↗

PubMed1987

Hearing loss in an institutionalized mentally retarded population. Identification by auditory brainstem response.

We report the results of auditory brainstem response testing of 122 profoundly retarded institutionalized children, a segment of the retarded population heretofore generally regarded as untestable by behavioral audiometry. Major findings include: 32% of the study population showed, by auditory brainstem response, hearing loss exceeding 20 decibels of hearing level in one or both ears (12% showed conductive loss and 20% sensorineural loss); of the 15.6% with evidence of bilateral sensorineural loss, 7.37% had losses in the 30- to 50-dB range, and 8.19% had losses of 60 dB or greater; and evidence of abnormal brain-stem function was found in 11%. Results of otologic examinations and audiologic habilitative follow-up in selected children are also reported.

Adolescent↗

PubMed1996

Trinucleotide repeat expansion in the FRAXE locus is not common among institutionalized individuals with non-specific developmental disabilities.

Expansion of a polymorphic GCC-repeat at the FRAXE locus has been associated with expression of chromosome fragility at this site and cognitive impairment in some individuals previously testing negative for CGG-repeat expansion in the fragile X mental retardation-1 (FMR1) gene. To determine the frequency of FRAXE triplet repeat expansion among persons with developmental disability, 396 individuals from two institutions were studied, all of whom were negative for FMR1 repeat expansion. Clinically, there was a wide range of mental impairment, with the majority (61.1%) being severely to profoundly affected. The distribution of FRAXE GCC-repeat numbers in the study population was 5-38: 28 (5.6%) with 10-14 repeats; 366 (73.8%) with 15-19 repeats; 74 (14.9%) with 20-24 repeats; 20 (4.0%) with 25-29 repeats; and 5 (1.0%) with 30-38 repeats, with no individuals demonstrating repeat expansion. One profoundly retarded male was found to have a deletion of about 40 bp. Southern blots of HindIII-digested DNAs from individuals with > or = 26 repeats all showed normal patterns. These results suggest that FRAXE GCC-repeat expansion is not a common cause of developmental disability in institutionalized persons with mild to profound mental retardation.

Adult↗

PubMed2000

Prevalence and correlates of parkinsonism in an institutionalized population of geriatric patients with chronic schizophrenia.

BACKGROUND: Geriatric patients with chronic schizophrenia are at increased risk for parkinsonism and cognitive impairment, but the relationship between the two has been insufficiently studied. OBJECTIVES: (1) To determine the prevalence of parkinsonism in a cohort of institutionalized geriatric patients with chronic schizophrenia (N=79). (2) To examine the relationship of parkinsonism to potentially relevant variables including cognitive functioning, positive and negative symptoms, sex, age, age at first hospitalization, psychopharmacological regimen and tardive dyskinesia (TD). METHOD: Tremor, rigidity and bradykinesia were rated on a five-point severity scale. Clinically significant parkinsonism was defined by the unambiguous presence of at least two of those signs. TD was assessed with the Modified Simpson Dyskinesia Scale. Schizophrenic symptoms were rated with the Positive and Negative Syndrome Scale, and cognitive functioning with the Mini-Mental State Examination and the Consortium to Establish a Registry for Alzheimer's Disease battery. RESULTS: The prevalence of parkinsonism was 19% and was significantly higher in women than in men. Age was a significant predictor of parkinsonism. Independent of age, bradykinesia was significantly correlated with MMSE, fluency and naming. Tremor, rigidity and medication status did not correlate with any cognitive variable assessed. Cognitive measures did not differ between subjects meeting and not meeting criteria for clinically significant parkinsonism. Rigidity and bradykinesia were significantly correlated with negative symptoms but no parkinsonism sign correlated with positive symptoms. Twelve subjects received ratings consistent with both TD and parkinsonism; however, no parkinsonian variable predicted the co-occurrence of TD. CONCLUSIONS: The present correlations suggest potential overlap among the neural substrates for bradykinesia, cognitive impairment and negative symptoms; however, further research is required to clarify that issue.

Age Distribution↗