A Comparison between Demographic and Clinical Characteristics of Younger and Older Elderly New Referrals to an Out-Patient Psychogeriatric Service

By Heinik, Jeremia; Berkman, Pinhas et al. | The Israel Journal of Psychiatry and Related Sciences, January 1, 2000 | Go to article overview

A Comparison between Demographic and Clinical Characteristics of Younger and Older Elderly New Referrals to an Out-Patient Psychogeriatric Service


Heinik, Jeremia, Berkman, Pinhas, Solomesch, Isaac, Bleich, Avi, The Israel Journal of Psychiatry and Related Sciences


Abstract: We compared the demographic and clinical characteristics of 37 subjects under and 41 subjects over 75 years of age who were consecutive new referrals to an out-patient psychogeriatric service in order to examine if an age-related dichotomy emerges in this population. Even though the groups were similar in most demographic (gender, education, years in Israel, family status) and some clinical aspects (number of physical diagnoses, medications taken) they differed significantly in some other clinical variables. "Functional" disorders, independence in performing household activities and Activities of Daily Living (ADL) and more recommendations for ambulatory follow-up were more prominent in the younger group. This profile has much in common with elderly patients newly referred to the general mental health services. The older group had more "organic" disorders, significant need for assistance in household activities and ADL, and more recommendations for follow-up in day-care centers, a profile more characteristic of patients who are treated in memory/dementia clinics. Thus, from a services organizational point of view, it is possible to subdivide out-patient elderly individuals with cognitive and emotional disturbances into separate groups, each with its own characteristics and needs.

Introduction

Services programmers in ambulatory psychogeriatrics have to deal with two central issues when only the patient's chronological age is considered. The first is concerned with the lower age limit of admittance into these services.

Traditionally, the arbitrary dichotomy of 65 years and over is the cut-off point (1). Practically, however, several questions arise with regard to the diagnostic, clinical and management complexities of those individuals younger than 65 who are afflicted by presenile dementia (2, 3) (i.e., are they "psychogeriatric" cases?) and the growing number of patients with long-standing psychiatric functional disorders who have been treated on an ambulatory basis and who reach their 65th birthday (i.e., should they be "automatically" transferred to a psychogeriatric service?) (4). The second issue encompasses possible additional cut-off points: Should all elderly individuals afflicted by cognitive and emotional disturbances be uniformly considered as simply being 65 years and older (5), or should they be subdivided into several age-related groups (e.g., "young" elderlies, "old" elderlies), each with its own clinical characteristics and management needs? Epidemiological and clinical data clearly support such heterogeneity (6, 7, 8).

The present study is concerned with this second issue. We compared demographic and clinical characteristics of elderly individuals under and over 75 years of age who were new referrals to a specialized psychogeriatric out-patient service, in order to examine if such a dichotomy emerges from such an approach within this population.

Methods

Included in this study were all new referrals for ambulatory psychogeriatric evaluation at the Psychogeriatric Center, Ichilov Hospital (Tel Aviv), during the period from 14 April to 14 June 1996. A new referral was defined as a patient who had never before attended a psychiatric service or had been treated elsewhere, or one who was treated in our service but more than one year had elapsed since the last visit (9).

Evaluations were carried out on women over 60 years old and men over 65 years old regardless of the age of onset and nature of the psychiatric disorder. Each patient was comprehensively evaluated by a multi-disciplinary team (a psychiatrist, a geriatrician, a nurse and a social worker). Laboratory and neuroimaging screening examinations are routinely requested in our institution for all cases of cognitive decline (10).

A detailed questionaire was completed for each study patient and included: a) demographic data (age, gender, country of origin, duration of stay in Israel, familial status, years of education), b) clinical data (ICD-10 [11] psychiatric diagnosis, physical diagnoses, prescription medications taken), c) functional data (whether the individual requires assistance in household activities [broadly defined by us to include several instrumental activities of daily living, IADL, in addition to housekeeping) and in the basic activities of daily living [ADL - eating, dressing, bathing, mobility and sphincter control]), d) the recommendations made, i. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

A Comparison between Demographic and Clinical Characteristics of Younger and Older Elderly New Referrals to an Out-Patient Psychogeriatric Service
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.