The present study expanded the story recognition and inference literature by investigating age differences within the older age range, differences as a result of mild cognitive impairment (MCI), and extending the focus of the investigation into the consistency of responding. 304 older adults completed a story recognition task across five different occasions. Old-old (00) adults and those with more severe MCI showed poorer ability to accurately recognize inferences, and less sensitivity to discriminate between statement types. Intraindividual variability was positively correlated with increasing age and cognitive impairment, and interactions revealed the greatest inconsistency involved the false, rather than inferred statements. The findings support our proposal that participants used two different recognition strategies, and their episodic memory ability defined the efficiency and frequency of use of the strategies. 00 and MCI adults may be less able to recognize that something plausible and consistent with an event may not have actually occurred.

Current classification systems for identifying individuals at the earliest stages of dementia, based primarily on cognitive measures, may be limited in scope. The present study examined physical functioning in a sample of 304 nondemented, older adults, classified based on presence and severity of mild cognitive impairment. In general, lower levels of physical functioning and greater inconsistency in physical functioning were found in older participants and in participants with increasing severity of cognitive impairment. Evaluation of the combined and unique contributions of level of and inconsistency in physical functioning to predicting cognitive status group membership revealed that, for some physical measures, inconsistency in physical functioning provided unique information beyond level of performance. These results are consistent with the notion that inconsistency in performance may be a behavioural marker of compromised neurological functioning and that information regarding physical functioning may prove useful for identifying individuals at the earliest stages of dementia.

Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 63-67).

Thesis (M. Arch.)--University of Hong Kong, 1999. / Includes special report study entitled: Elderly and their surroundings. Includes bibliographical references.

Thesis (M. Med. Sc.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 105-115).

Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 88-95).

published_or_final_version / Gerontology / Master / Master of Social Sciences

Background: Depression is the leading cause of premature death and disability worldwide. The globally aging population with increasing burdens of chronic diseases is certain to face increasing problems. Elderly people in whom physical and mental co-morbidities are common represent a group that is highly susceptible to the harm of depression. Worse still, the reduced accessibility of elderly to healthcare implies that the public health burden of depression seen in the healthcare sector is only tip of the clinical iceberg. Objectives: This review aims to synthesize the current evidence of public health burden of geriatric depression, and the public health challenges in tackling this growing threat in the context of under-detection, social disparities and population ageing, and to summarize its current situation in Hong Kong and compare with other Methods: A literature search was conducted in databases PubMed, Medline and Cochrane (January 2002-June 2012) using the keywords “depression, depressive episode, epidemiology, prevalence, incidence, elderly”. A total of 1285full-text articles were obtained, out of which 52 articles were potentially relevant. Critical appraisal was performed on articles after a priori specified inclusion and exclusion criteria were applied. After removing the duplicates and examining the contents, 15 articles were adopted for review. Results: Depression brings along heavy disease burden which highly associated with mortality and morbidity. Late-life depression accounts for 17-37% in primary care settings, while around 3% in the community. The ongoing problems of under-detection, under-treatment and the progressive population ageing increase the challenges and complexity of matter. Gender difference is identified, while social support, social relationships and socioeconomic status were shown to be highly correlated with elderly depression in both the East and the West. Conclusions: Elderly depression is a global threat causing increasing public health burden to healthcare systems and societies worldwide. Over the decades, public health sector is facing numerous challenges intackling it, including the practice-related challenges complicated by characteristics of elderly, policy-related challenges explained by the clinical iceberg concept, and societal related challenges. By understanding the older population and challenges in the community control of depression, it is the time to action and turn public health over a new leaf. / published_or_final_version / Public Health / Master / Master of Public Health

Introduction Geriatric depression is one of the major public health issues around the world. Geriatric depression is often being misinterpreted as a normal aspect of aging process, but it is indeed a complex psychological problem that would result in significant increases in DALYs. With effective treatments, depressive symptoms and signs can be reduced. Nevertheless, pharmacological intervention is often used as the first-line treatment for geriatric depression. In recent years, different types of non-pharmacological intervention have been getting more attention in terms of theirs effectiveness in treating geriatric depression. Objectives Primary objective is to determine whether two categories of non-pharmacological intervention (physical activity and reminiscence therapy) are effective in relieving depression in elderly that are 60 years old or older. The other objectives are to examine enduring effects of physical activity and reminiscence therapy, and compare the effectiveness of reminiscence therapy and physical activity in alleviating depressive symptoms in elderly compared with no intervention and/or other intervention. Methods Relevant studies published between the year of 2000 and 2013 were searched and identified through several electronic databases, including the Cochrane Library, PubMed, Medline, PsycINFO and Google Scholar, with a combination of keywords. All randomized controlled trials that examine physical activity and reminiscence therapy on elderly that are 60 years old or older, being diagnosed or indicated as suffering from depression were included. The methodological quality of each study was assessed. The outcome measure of this review is the depression symptom level. Main Result A total of 12 randomized controlled trials met the inclusion criteria, in which seven were about physical activity and five of them were about reminiscence therapy. Significant immediate reduction in depressive symptoms was found in five out of seven physical activity studies and in four out of five reminiscence studies. Three and two studies respectively on physical activity and reminiscence therapy had assessed the effect at follow-up and looked at the lasting effect. In two physical activity studies that have assessed the short-term effect beyond the completion of intervention, incongruent findings were found. Only one physical activity study has examined the long-term effect and it reported significant positive result. On the other hand, there were two reminiscence therapy studies assessing the short-term effect on depressive symptoms. These two studies reported significant improvement in depressive symptoms. Since there were few studies reporting the medium and long-term effect of physical activity and reminiscence therapy, no conclusion can be made on their enduring effect of reducing depressive symptoms. Conclusions Physical activity and reminiscence therapy appear to be effective non-pharmacological interventions for relieving depressive symptoms in elderly. They may complement pharmacological intervention and/or may offer alternative treatment option for elderly with depression. However, the mode, intensity, duration, type, format of physical activity and reminiscence therapy on depressive symptoms in elderly remain unclear. Further testing is need before these interventions can be routinely used to alleviate depressive symptoms in elderly with depression. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences