Based on a representative sample of elderly subjects, a description of the limitations in activities of daily living (ADL) and instrumental ADL (IADL) at subthreshold levels of dementia and depression is presented and compared against a sample of psychiatric non-cases and samples with specified levels of the respective illnesses. Additionally, it was analyzed whether these limitations are useful diagnostic markers with regard to subdiagnostic psychiatric disorders. Even at subthreshold levels of depression and dementia, elderly people suffer quite extensively from ADL and IADL limitations. However, multifactorial analyses indicate little evidence that these limitations are specific for psychiatric morbidity, be it at subdiagnostic or specified levels. By and large, ADL and IADL limitations in an elderly sample have to be considered instead as consequences of physical health-related comorbidity. Thus, issues regarding the treatment of ADL and IADL limitations at subdiagnostic as well as specified levels of psychiatric morbidity may not be solved from a psychiatric point of view alone, and a multifactorial, i.e., multiprofessional, perspective is strongly recommended.

Activities of Daily Living↗

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Alzheimer's disease: stage-related interventions.

Although there are different kinds of dementia, Alzheimer's Disease (AD) accounts for the largest percentage of cases in those individuals over 60 years of age. The initial presenting symptom of AD is forgetfulness. As the disease evolves, patients continue to manifest more serious cognitive deficits and to also experience difficulties associated with adaptive capabilities. For those patients who have not died of medical complications the final stage of AD is one where total care of the patient is provided by others. The task of appropriately caring for these affected elderly persons imposes enormous cognitive, physical, emotional, and financial strain on human and social resources. Factors contributing to this burden and strain are derived from the changes accompanying the patient's clinical condition and also include decisions about use of varied allocated medical, nursing, psychosocial, and community treatment and support services. The selection of appropriate services and the coordination of these diverse and fragmented providers is increasingly organized by the case manager. The purpose of this paper is to outline the progressive clinical symptomatology of AD so that case managers may more accurately link current and future patient needs with community resources.

Activities of Daily Living↗

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[Why is academic education in gerontology and geriatrics necessary?].

In contrast to the importance social and medical policies have acquired throughout the developed countries, universities in the Federal Republic of Germany do offer only few programs for scientific and professional education in this field. Nevertheless there is a still growing demand for more and better basic knowledge in all social and medical services concerned with the care of the elderly. This underlines the need for well-developed and wide-spread programs in gerontological and geriatric education, which in fact might enhance a better intergenerational understanding and communication and provide a more humane delivery of all kinds of services to the elderly.

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PubMedDate not supplied

[Do the so-called "geriatric agents" fulfill the criteria of a rational drug therapy?].

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