Hostname: page-component-84b7d79bbc-c654p Total loading time: 0 Render date: 2024-07-27T16:47:41.084Z Has data issue: false hasContentIssue false
  • English
  • Français

Life events and senile dementia. I. Admission, deterioration and social environment change

Published online by Cambridge University Press:  09 July 2009

Martin Orrell  and
Paul Bebbington
Martin Orrell*
Affiliation:
Department of Psychiatry, University College London Medical School and MRC Social and Community Psychiatry Unit, Institute of Psychiatry, London
Paul Bebbington
Affiliation:
Department of Psychiatry, University College London Medical School and MRC Social and Community Psychiatry Unit, Institute of Psychiatry, London
*
1Address for correspondence: Dr Martin Orrell, Department of Psychiatry, Princess Alexandra Hospital, Hamsted Road, Harlow, Essex CM 20 1QX.
Get access Rights & Permissions [Opens in a new window]

Synopsis

This study examines the frequency of life events before admission and before deterioration in 70 dementia patients, in comparison with 50 dementia controls living in the community and 50 fit elderly people matched for age and sex. We hypothesized that there would be an excess of events connoting changes in routine and the social environment. Specific scales were developed to measure these aspects of events. Our results supported the initial hypothesis, confirming that it is the social disruptiveness of change rather than the threat implied by life events that is associated with deterioration. The findings are discussed in the light of current models of the dementia process.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 2 , March 1995 , pp. 373 - 386
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amaducci, L. A., Fratiglioni, L., Rocca, W. A.Fieschi, C., Livrea, P., Pedone, D., Braco, L., Lippi, A., Gandolfo, C., Bino, G., Prencipe, N., Bonatti, M. L., Girottii, F., Carella, F., Tavolato, B., Ferla, S., Lenzi, G. L., Carolei, A., Gambi, A., Grigoletto, F. & Schoenberg, B. S. (1986). Risk factors for clinically diagnosed Alzheimer's disease: a case-control study of an Italian population. Neurology 36, 922–931.CrossRefGoogle ScholarPubMed
Amster, L. E. & Krauss, H. H. (1974). The relationship between life crises and mental deterioration in old age. International Journal of Aging and Human Development 5, 51–55.CrossRefGoogle ScholarPubMed
Anthony, K., Proctor, A. W., Silverman, A. M. & Murphy, E. (1987). Mood and behaviour problems following the relocation of elderly patients with mental illness. Age and Aging 16, 355–365.CrossRefGoogle ScholarPubMed
Baines, S., Saxby, P. & Ehlert, K. (1987). Reality orientation and Reminiscence therapy: a controlled cross-over study of elderly confused people. British Journal of Psychiatry 151, 222–231.CrossRefGoogle ScholarPubMed
Beattie, W. M. (1984). ‘Social’ senility. In Senile Dementia: Outlook for the Future (ed. Wertheimer, J. and Marois, M.), pp. 159–166, Alan R. Liss Inc: New York.Google Scholar
Bleathman, C. & Morton, I. (1992). Validation therapy: extracts from 20 groups with dementia sufferers. Journal of Advanced Nursing 17, 658–666.CrossRefGoogle ScholarPubMed
Broe, G. A., Henderson, A. S., Creasey, H., McCusker, E., Korten, A. E., Jorm, A. F., Longley, M. A. & Anthony, J. C. (1990). A case-control study of Alzheimer's disease in Australia. Neurology 40, 1699–1707.CrossRefGoogle ScholarPubMed
Brook, P., Degun, G. & Mather, M. (1975). Reality orientation, a therapy for psychogeriatric patients: a controlled study. British Journal of Psychiatry 127, 42–45.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression. Tavistock: London.Google ScholarPubMed
Buell, S. J. & Coleman, P. D. (1979). Dendritic growth in the aged human brain and failure of growth in senile dementia. Science 206, 854–856.CrossRefGoogle ScholarPubMed
Burvill, P. W., Hall, W. D., Stampfer, H. G. & Emmerson, J. P. (1991). The prognosis of depression in old age. British Journal of Psychiatry 158, 64–71.CrossRefGoogle ScholarPubMed
Chandra, V., Philipose, V., Bell, P. A., Lazaroff, A. & Schoenberg, B. S. (1987). Case-control study of late onset ‘probable Alzheimer's disease’. Neurology 37, 1295–1300.CrossRefGoogle ScholarPubMed
Copeland, J. R. M. (1990). Suitable instruments for detecting dementia in community samples. Age and Aging 19, 81–83.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., Gourlay, A. J., Gurland, B. J., Fleiss, J. L. & Sharpe, L. (1976). A semi-structured clinical for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. 1. Development and Reliability. Psychological Medicine 6, 439–449.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986). Psychiatric case nomenclature and a computerised diagnostic system for elderly subjects: GMS and AGECAT. Psychological Medicine 16, 89–99.CrossRefGoogle Scholar
Copeland, J. R. M., Gurland, B. W., Dewey, M. E., Kelleher, M. J., Smith, A. M. R. & Davidson, S. (1987). Is there more dementia, depression and neurosis in New York? A comparitive study of the elderly in New York and London using the computer diagnosis AGECAT. British Journal of Psychiatry 151, 466–473.CrossRefGoogle Scholar
Copeland, J. R. M., Cavidson, I. A., Dewey, M. E., Gilmore, C., Larkin, B. A., McWilliam, C., Saunders, P. A., Scott, A., Sharma, V. & Sullivan, V. (1992). Alzheimer's disease, other dementias, depression and pseudodementia: prevalance, incidence and three year outcome in Liverpool. British Journal of Psychiatry 161, 230–239.CrossRefGoogle ScholarPubMed
Crank, J. Z. and Zweig, J. P. (1980). Relative mortality of chronically ill geriatric patients with organic brain damage before and after relocation. Journal of the American Geriatric Society 28, 76–83.Google Scholar
Davies, A. D. M. (1993). Life events in the normal elderly. In The Psychiatry of Old Age (ed. Copeland, J. R. M., Abou-Saleh, M. T. & Blazer, D. G.) pp. 106–114. John Wiley: Chichester.Google Scholar
Davies, A. D. M., Saunders, C. & Newton, T. J. (1987). Age differences in the rating of life stress events: Does contextual detail make a difference? British Journal of Clinical Psychology 26, 299–303.CrossRefGoogle Scholar
Emmerson, J. P., Burvill, P. W., Finlay-Jones, R. & Hall, W. (1989). Life events, life difficulties and confiding relationships in the depressed elderly. British Journal of Psychiatry 155, 787–792.CrossRefGoogle ScholarPubMed
Evans, S. & Katona, C. (1993). The epidemiology of depressive symptoms in elderly primary care attenders. Dementia 4, 327–333.Google ScholarPubMed
Fairweather, D. S. (1991). Delirium. In Psychiatry in the Elderly (ed. Jacoby, R. and Oppenheimer, C.) pp. 647–675. Oxford University Press: Oxford.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Fry, P. S. (1989). Mediators of stress among community-based elders. Psychological Bulletin 65, 307–314.Google ScholarPubMed
Gall, C. M. (1992). Regulation of brain neurotrophin expression by physiological activity. Trends in Pharmacological Sciences 13, 401–403.CrossRefGoogle ScholarPubMed
Ghaziuddin, M. (1988). Behaviour disorder in the mentally handicapped: the role of life events. British Journal of Psychiatry 152, 683–686.CrossRefGoogle ScholarPubMed
Gilhooly, M. L. M. (1984). The social dimensions of senile dementia. In Psychological Approaches to the Care of the Elderly (ed. Hanley, I. and Lodge, J.), pp. 88–135. Croome Helm: London.Google Scholar
Gottfries, C. G., Gottfries, I. & Roos, B. E. (1970). Homovanillic acid and 5-hydroxyindoleacetic acid in cerebrospinal fluid related to mental and motor impairment in senile and presenile dementia. Acta Psychiatrica Scandanavica 468, 99–105.Google Scholar
Grant, I., McDonald, W. I., Patterson, T. & Trimble, M. R. (1989). Multiple sclerosis. In Life Events and Illness (ed. Brown, G. W. and Harris, T. O.), pp. 295–311. Unwin Hyman: London.Google Scholar
Hofman, A., Schulte, W., Tanja, T. A., van Duijn, C. M., Haaxma, R., Lameris, A. J., Otten, V. M. & Saan, R. J. (1989). History of dementia and Parkinson's disease in 1st degree relatives of patients with Alzheimer's disease. Neurology 39, 1589–1592.CrossRefGoogle ScholarPubMed
House, A., Dennis, M., Mogridge, L., Hawton, K. & Warlow, C. (1990). Life events and difficulties preceding stroke. Journal of Neurology. Neurosurgery and Psychiatry 53, 1024–1028.CrossRefGoogle ScholarPubMed
Jorm, A. F., van Duijn, C. M., Chandra, V., Fratiglioni, L., Graves, W. A., Heyman, A., Kokmen, E., Kondo, K., Mortimer, J. A., Rocca, W. A., Shalat, S. L., Soininen, H. & Hofman, A. (1991). Psychiatric history and related exposures as risk factors for Alzheimer's disease: a collaborative re-analysis of case control studies. International Journal of Epidemiology 20, 43–47.CrossRefGoogle ScholarPubMed
Karlsson, I., Brane, G., Melin, E., Nyth, A. L. & Rybo, E. (1988). Effects of environmental stimulation on biochemical and psychological variables in dementia. Acta Psychiatrica Scandanavica 77, 207–213.CrossRefGoogle ScholarPubMed
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer's disease. Neurology 43, 12–20.CrossRefGoogle ScholarPubMed
Kitwood, T. (1990). The dialectics of dementia: with particular reference to Alzheimer's disease. Aging and Society 10, 177–196.CrossRefGoogle Scholar
Kitwood, T. (1993). Person and process in dementia. International Journal of Geriatric Psychiatry 8, 541–545.CrossRefGoogle Scholar
Lam, D., Brewin, C. R., Woods, R. T. & Bebbington, P. E. (1987). Cognition and social adversity in the depressed elderly. Journal of Abnormal Psychology 96, 1, 23–26.CrossRefGoogle ScholarPubMed
Lam, D., Sewell, M., Bell, S. & Katona, C. (1989). Who needs continuing psychogeriatric care? International Journal of Geriatric Psychiatry 4, 109–114.CrossRefGoogle Scholar
Linn, M. W., Hunter, K. & Harris, R. (1980). Symptoms of depression and recent life events in the community elderly. Journal of Clinical Psychology 36, 3, 675–682.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Lishman, W. A. (1987). Organic Psychiatry, 2nd edn. Blackwell Scientific: Oxford.Google Scholar
Mechanic, D. (1980). Health and Social Policy. Prentice Hall: Englewood Cliffs.Google Scholar
Mechanic, D. (1991). Researching the idea of health. In Social Psychiatry – Theory, Methodology and Practice (ed. Bebbington, P.), pp. 23–34. Transaction Publishers: New Jersey.Google Scholar
Melin, L. & Götestam, K. G. (1981). The effects of rearranging ward routines on communication and eating behaviours of psychogeriatric patients. Journal of Applied Behaviour Analysis 14, 47–51.CrossRefGoogle ScholarPubMed
Minde, R., Haynes, E. & Rodenburg, M. (1990). The ward Milieu and its effect on the behaviours of psychogeriatric patients. Canadian Journal of Psychiatry 35, 133–138.CrossRefGoogle ScholarPubMed
Morris, R. G. (1993). Psychological approaches to the management of dementia. In The Psychology of Dementia (ed. Miller, E. and Morris, R. G.), pp. 110–132. John Wiley and Sons: Chichester.Google Scholar
Mortimer, J. A. (1987). Do psychosocial risk factors contribute to Alzheimer's disease? In Etiology of Dementia of Alzheimer's Type (ed. Henderson, A. S. and Henderson, J. H.), pp. 39–52. John Wiley and Sons: Chichester.Google Scholar
Murphy, E. (1982). Social origins of depression in old age. British Journal of Psychiatry 141, 135–142.CrossRefGoogle ScholarPubMed
Murphy, E. (1983). The prognosis of depression in old age. British Journal of Psychiatry 142, 111–119.CrossRefGoogle ScholarPubMed
Niino, N., Iijima, S., Mizoguchi, T., Eto, F. & Orimo, H. (1990). A case-control study of clinically diagnosed Alzheimer type dementia. Japanese Journal of Geriatrics 27, 693–698.Google ScholarPubMed
O'Dwyer, A. M. and Orrell, M. W. (1994). Stress, ageing and dementia. International Review of Psychiatry 6, 73–83.CrossRefGoogle Scholar
Orrell, M. W. (1994) Life Events in Senile Dementia. Ph.D. thesis. Institute of Psychiatry, University of London.Google Scholar
Orrell, M. W. & Bebbington, P. B. (1994). Life events in senile dementia 2. Affective symptoms. British Journal of Psychiatry (in the press).Google Scholar
Orrell, M. W. & Davies, A. D. M. (1994). Life events in the elderly. International Review of Psychiatry 6, 59–71.CrossRefGoogle Scholar
Orrell, M., Bergman, K., Elton, N., O'Brien, J. & Bebbington, P. E. (1990). Life events: the reliability of rating changes in routine and environment. Social Psychiatry and Psychiatric Epidemiology 25, 304–307.CrossRefGoogle ScholarPubMed
Orrell, M. W., Howard, R., Payne, A., Bergmann, K., Woods, R., Everitt, B. S. & Levy, R. (1992). Differentiation between organic and functional psychiatric illness in the elderly: an evaluation of four cognitive tests. International Journal of Geriatric Psychiatry 7, 263–275.CrossRefGoogle Scholar
Patrick, L. F. & Moore, J. S. (1986). Life-Event types and attributional styles as predictors of depression in elderly women. Journal of Geriatric Psychiatry 19, 241–262.Google ScholarPubMed
Patterson, C. & LeClair, J. K. (1989). Acute decompensation in dementia: recognition and management. Geriatrics 44, 20–32.Google Scholar
Pattie, A. H. & Gilleard, C. J. (1978). The two year predictive value of the Clifton Assessment Scale and the shortened Stockton Geriatric Rating Scale. British Journal of Psychiatry 133, 457–460.CrossRefGoogle Scholar
Pattie, A. H. & Gilleard, C. J. (1979). Manual for the Clifton Assessment Procedures for Elderly (CAPE). Hodder and Stoughton Education: Sevenoaks, Kent.Google Scholar
Pitt, B. (1993). Social factors and old age. In Social Psychiatry (ed. Bhugra, D. and Leff, J. P.), pp. 315–330. Blackwell Scientific Publications: Oxford.Google Scholar
Pruchno, R. A. & Resch, N. L. (1988). Intra-institutional relocation: morality effects. Gerontologist 28, 311–317.CrossRefGoogle Scholar
Reeve, W. & Ivison, D. (1985). Use of environmental manipulation and classroom and modified informal reality orientation with institutionalised confused elderly patients. Age and Aging 14, 119–121.CrossRefGoogle ScholarPubMed
Rockwood, K., Stolee, P. & Brahim, A. (1991). Outcomes of admission to a psychogeriatric service. Canadian Journal of Psychiatry 36, 275–279.CrossRefGoogle ScholarPubMed
Rook, K. S., Catano, R. & Dooley, D. (1989). The timing of major life events: effects of departing from the social clock. American Journal of Community Psychology 17, 233–258.CrossRefGoogle ScholarPubMed
Rosen, G. (1961). Cross cultural and historical approaches. In Psychopathology of Ageing (ed. Hoch, P. H. and Zubin, J.), pp. 1–20. Grune and Stralton: New York.Google Scholar
Russell, D. W. & Cutrona, A. C. (1991). Social support, stress and depressive symptoms in the elderly: test of a process model. Psychology and Aging 6, 190–201.CrossRefGoogle ScholarPubMed
Shalahat, S. L., Selzer, B., Pidcock, C. & Baker, E. L. (1987). Risk factors for Alzheimer's disease: a case control study. Neurology 37, 1630–1633.CrossRefGoogle Scholar
Shan Wang, H. (1977). Dementia in old age. In: Dementia, 2nd edn. (ed. Well, Charles E.), pp. 15–26. F. A. Davies: Philadelphia.Google Scholar
Soininen, H., MacDonald, E., Rekonen, M. & Riekkinen, P. J. (1981). Homovanillic acid and 5-hydroxyindoleacetic acid in cerebrospinal fluid of patients with senile dementia of Alzheimer type. Acta Neurologica Scandanavica 64, 101, 107.CrossRefGoogle ScholarPubMed
Stahler, G., Frazer, D. & Rappaport, H. (1984). The evaluation of an environmental remodelling program on a psychiatric geriatric ward. Journal of Social Psychology 123, 101–113.CrossRefGoogle ScholarPubMed
Swaab, D. F. (1991). Brain aging and Alzheimer's disease ‘Wear and Tear’ versus ‘Use It or Lose It’. Neurobiology of Aging 12, 317–324.CrossRefGoogle ScholarPubMed
Wilkinson, S. J., Downes, J., Owen, J., Davies, M. G. & Davies, A. D. M. (1986). Rating reliability for life events and difficulties in the elderly. Psychological Medicine 16, 101–105.CrossRefGoogle ScholarPubMed