Assessment of the decision-making capacity of elderly individuals diagnosed with major depression
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Scientia Medica (Porto Alegre. Online) |
Texto Completo: | https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26558 |
Resumo: | *** Assessment of the decision-making capacity of elderly individuals diagnosed with major depression ***AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression.METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naïve elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS São Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke’s Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student’s t, Pearson’s chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05.RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment.CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment. |
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Assessment of the decision-making capacity of elderly individuals diagnosed with major depressionAvaliação da capacidade de decisão de idosos diagnosticados com depressão maiormajor depressive disorderelderlyautonomygeriatricsgerontology.transtorno depressivo maioridosoautonomiageriatriagerontologia.*** Assessment of the decision-making capacity of elderly individuals diagnosed with major depression ***AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression.METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naïve elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS São Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke’s Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student’s t, Pearson’s chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05.RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment.CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment.*** Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior ***OBJETIVOS: Verificar se há alteração na capacidade de decisão em idosos com depressão maior.MÉTODOS: Foi realizado um estudo de coorte prospectiva com análise transversal inicial, no período de janeiro de 2014 a setembro de 2015. Para o grupo de estudo foram selecionados pacientes idosos do Ambulatório de Envelhecimento Cerebral do Hospital São Lucas da PUCRS, em Porto Alegre, RS, diagnosticados com depressão maior atual e ainda sem tratamento para esse transtorno. Um grupo controle foi composto por idosos da mesma comunidade, sem depressão ou problemas cognitivos. Para avaliação da capacidade de decisão foi utilizada a Escala de Avaliação de Capacidade de Decisão (ESCADE), desenvolvida e validada em uma etapa anterior da pesquisa. Esse instrumento dividide-se em quatro domínios: atividade diária, gestão financeira, autogestão e bem-estar. A Escala de Depressão Geriátrica, forma abreviada, e o instrumento Mini International Neuropsychiatric Interview, versão detalhada, foram utilizados para avaliar a presença de depressão. O Instrumento de Triagem para Demência Vellore e o Exame Cognitivo de Addenbrooke versão revisada foram aplicados para avaliar declínio cognitivo. A capacidade de decisão foi comparada entre os dois grupos de idosos. A mesma avaliação foi feita nos idosos com depressão após seis meses de tratamento psiquiátrico. A análise estatística incluiu os testes t de Student, qui-quadrado de Pearson, Mann-Whitney e Wilcoxon. Foi considerado significativo um p≤0,05.RESULTADOS: Participaram da pesquisa 48 idosos com depressão maior e 144 idosos no grupo controle. A pontuação média da ESCADE nos primeiros foi de 70,5±17,9, e nos controles de 94,6±9,6 (p<0,001), identificando menor capacidade de decisão nos idosos com depressão maior. Os domínios com maior diferença nas médias de pontuação foram o de autogestão (deprimidos 65,0±23,3 e controles 97,8±6,2) e o de bem-estar (deprimidos 52,2±27,1 e controles de 91,8±16,7). Comparando o grupo com depressão antes e após o tratamento, tanto para a pontuação geral quanto para cada um dos quatro domínios da ESCADE, a capacidade de tomada de decisão aumentou após o tratamento.CONCLUSÕES: O grupo de idosos com depressão maior atual apresentou menor capacidade de decisão em relação ao grupo controle. Houve melhora na capacidade de decisão após seis meses de tratamento psiquiátrico.Editora da PUCRS - ediPUCRS2017-07-24info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/2655810.15448/1980-6108.2017.3.26558Scientia Medica; Vol. 27 No. 3 (2017); ID26558Scientia Medica; v. 27 n. 3 (2017); ID265581980-61081806-556210.15448/1980-6108.2017.3reponame:Scientia Medica (Porto Alegre. Online)instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSporhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/26558/15772Copyright (c) 2017 Scientia Medicainfo:eu-repo/semantics/openAccessCrippa, AneliseGomes, IrenioTerra, Newton2017-08-29T19:47:29Zoai:ojs.revistaseletronicas.pucrs.br:article/26558Revistahttps://revistaseletronicas.pucrs.br/scientiamedica/PUBhttps://revistaseletronicas.pucrs.br/scientiamedica/oaiscientiamedica@pucrs.br || editora.periodicos@pucrs.br1980-61081806-5562opendoar:2017-08-29T19:47:29Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.none.fl_str_mv |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior |
title |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
spellingShingle |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression Crippa, Anelise major depressive disorder elderly autonomy geriatrics gerontology. transtorno depressivo maior idoso autonomia geriatria gerontologia. |
title_short |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
title_full |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
title_fullStr |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
title_full_unstemmed |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
title_sort |
Assessment of the decision-making capacity of elderly individuals diagnosed with major depression |
author |
Crippa, Anelise |
author_facet |
Crippa, Anelise Gomes, Irenio Terra, Newton |
author_role |
author |
author2 |
Gomes, Irenio Terra, Newton |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Crippa, Anelise Gomes, Irenio Terra, Newton |
dc.subject.por.fl_str_mv |
major depressive disorder elderly autonomy geriatrics gerontology. transtorno depressivo maior idoso autonomia geriatria gerontologia. |
topic |
major depressive disorder elderly autonomy geriatrics gerontology. transtorno depressivo maior idoso autonomia geriatria gerontologia. |
description |
*** Assessment of the decision-making capacity of elderly individuals diagnosed with major depression ***AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression.METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naïve elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS São Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke’s Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student’s t, Pearson’s chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05.RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment.CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-07-24 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26558 10.15448/1980-6108.2017.3.26558 |
url |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26558 |
identifier_str_mv |
10.15448/1980-6108.2017.3.26558 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26558/15772 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Scientia Medica info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Scientia Medica |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
dc.source.none.fl_str_mv |
Scientia Medica; Vol. 27 No. 3 (2017); ID26558 Scientia Medica; v. 27 n. 3 (2017); ID26558 1980-6108 1806-5562 10.15448/1980-6108.2017.3 reponame:Scientia Medica (Porto Alegre. Online) instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
instname_str |
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
instacron_str |
PUC_RS |
institution |
PUC_RS |
reponame_str |
Scientia Medica (Porto Alegre. Online) |
collection |
Scientia Medica (Porto Alegre. Online) |
repository.name.fl_str_mv |
Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
scientiamedica@pucrs.br || editora.periodicos@pucrs.br |
_version_ |
1809101751358324736 |