| Abstract |
Dementia and depression are very common disorders among elderly people and results in the diminution of the well being of the aged and their families Aim: The assessment of the magnitude of dementia and depression among the elderly people living in different settings in the catchment area of the Health Centre of Chrisoupolis (HCCh) in Northern Greece, and to test the possible effectiveness of a shared-care intervention for later life dementia and depression in this area. Research plan : 1. the measurement of the frequency in the elderly people of cognitive impairments and mood disorders in the Primary Health Care environment. 2. the assessment of the commorbidity that often coexists with the disorders mentioned above 3. the estimation of the effectiveness of the intervention of the General Practitioner in order to do early diagnose and cure, patients with dementia and/or depression. Study population and Methods: 536 subjects aged 65 years and over, including 48 subjects living in a old peoples home (OPH), 75 subjects who were taking part in activities at the Open Centre for the elderly (OCE) and 413 subjects randomly selected from those visiting the HCCh were eligible for the study. All participants, who had initially received a comprehensive neuropsychiatric assessment at the HCCh, were followed-up approximately 1 year later. Subjects were assigned to continued usual care (n=233) and subjects received feedback plus care management of chronic illness (n=303). A structured clinical interview with a detailed medical history, clinical examination, hematological and biochemical control and the completion of Mini-Mental State Examination (MMSE), Scale Geriatric Depression Scale (GDSS) and Activities of Daily Living (ADL) were used at the baseline and at the end of intervention. Results: the risk for the appearance of cognitive disorders decreases significantly (p<0.001) by the intervention in the HCCh intervention group (RR=0.450, p=0.05) and sufficiently in the group of OCE intervention (RR=0.236, p=0.067). Concerning depression, the risk decreases significantly (p<0.001) by the intervention in the HCCh intervention group (RR=0.198, p<0.001). Conclusions: Shared care interventions by GPs, primary care teams in collaboration with other specialists and especially neurologists and psychiatrists, in different community settings seems to be an effective strategy in reducing the risk of dementia and depression among elderly people. This is possible to be achieved with: a) Frequent control of elderly people concerning cognitive impairments and mood disorders. b) Treatment of somatic diseases which are related to the appearance or the aggravation of dementia and depression c) Prevention, consulting and treatment in order to avoid the manifestation of those disorders and ensure treatment of the reversible types of dementia. Researching proposals: ό Are the positive results of our study, in the elderly people permanent? ό Is this program applicable in general population? ό Is it possible to screen reversible and therapeutic manageable types of dementias and what is the result of this intervention in those?
|
'Ανοια και κατάθλιψη στην τρίτη ηλικία. Η παρέμβαση του Γενικού/Οικογενειακού γιατρού στην Πρωτοβάθμια Φροντίδα Υγείας
