Self-Neglect, Psychiatric Disorders Often Linked

Article excerpt

SAN DIEGO -- Older adults who screened positive for self-neglect after home-based interviews had a high prevalence of undetected and untreated psychiatric disorders, Dorothy Edwards, Ph.D., reported at the annual meeting of the Gerontological Society of America.

The finding supports the use of home-based interventions to decrease institutionalization and improve function among this population, according to Dr. Edwards, who is with Washington University, St. Louis.

In a study that she said is the first of its kind, Dr. Edwards and her associates screened for self-neglect in a random sample of 524 older adults who received home-delivered meals in the St. Louis metropolitan area.

Self-neglect was defined as dehydration and malnutrition, poor personal hygiene, inadequate or inappropriate clothing, unsanitary living situations, social isolation, and denial or lack of concern about problems related to self-neglect.

Of the 524 adults, 82 (16%) screened positive for self-neglect. These 82 adults were asked to participate in separate in-home evaluations of cognitive and psychiatric evaluations.

Nearly half (45%) refused to participate, and two later withdrew from the study. This left a sample of 27 older adults who agreed to undergo further testing, Dr. Edwards said.

The mean age of this sample was 73, more than half (56%) were female, 64% had never married, and 44% were African American.

Dr. Edwards and her associates then administered the Structured Clinical Interview for DSM-IV Disorders, the Composite International Diagnostic Interview, and the dementia assessment from the Consortium to Establish a Registry for Alzheimer's Disease.

The researchers observed that 52% of the participants had environmental problems in their homes, such as accumulating garbage, rodents and insects, and sheets that hadn't been changed in a long time. …