Malnutrition Prevalence and Nutrient Intakes of Indonesian Older Adults in Institutionalized Care Setting: A Systematic Review of Observational Studies.

INTRODUCTION: Data on the prevalence of malnutrition and nutrient intakes among Indonesian older adults in institutionalized care setting are scattered and scarce. Thus, we conducted a systematic review of published and gray literature to estimate (1) the prevalence of malnutrition, (2) the level and distribution of habitual energy and nutrient intakes, and (3) the prevalence of inadequacy of energy and nutrient intakes among hospitalized and institutionalized older adults in Indonesia. METHODS: This systematic review was written following the PRISMA 2020 checklist. The population of this review was Indonesian older adults in institutionalized care settings, including hospital wards, orphanages, nursing homes, residential facilities, and rehabilitation centers. Malnutrition was assessed using body mass index, the Mini Nutritional Assessment (MNA) score, or the subjective global assessment (SGA) score. The dietary intakes (from food recalls, food records, or food frequency questionnaire) were compared with the Indonesian Recommended Dietary Allowances for people aged 65-80. The prevalence of inadequacy was calculated using two-thirds of the Recommended Dietary Allowance as a proxy for the estimated average requirement. RESULTS: The search yielded 330 studies from electronic databases, resulting in fifteen eligible studies. One report was obtained from an unpublished study. Based on the JBI criteria, most studies had low risk of bias and represented the target population. The prevalence of malnutrition in hospital, nursing home, and other institutionalized care ranged from 6.5% to 48.3% in hospitals and 3.2% to 61.0% in other institutionalized care units. In the hospital setting, there was a high prevalence of inadequacies for all nutrients, particularly protein (20%), calcium (more than 90%), and vitamin D intakes (more than 50%). In nursing homes, these proportions were exceptionally high for protein (66%) and calcium and vitamin D intakes (almost 100%). CONCLUSION: The high risk of malnutrition in Indonesian older adults in institutionalized care setting is pronounced, along with poor intakes of macronutrients and micronutrients in both settings.

Oral health assessment in institutionalized elderly: a scoping review.

When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.

[Pharmacological intervention in the medication review of institutionalised elderly patients under polypharmacy]. / Intervención farmacéutica en la revisión del tratamiento en pacientes mayores polimedicados institucionalizados.

OBJECTIVE: To describe the Drug-Related Problems (DRP) and their resolution after pharmacological review in institutionalised elderly patients under polypharmacy. DESIGN: Descriptive, retrospective cohort study from January to October of 2022. LOCATION: Twelve nursing homes at the Community of Madrid. PARTICIPANTS: 295 patients aged 65 or older taking at least 5 chronic medications prescribed prior to the treatment review. INTERVENTIONS: Medication reviews carried out by the pharmacist and agreed upon in face-to-face meetings between the primary care doctor, the nursing home doctor and the pharmacist. MAIN MEASUREMENTS: Detected DRP, types and resolution. A age, sex, and number of medications before and after the intervention. Pharmacological subgroups according to anatomical therapeutic chemical classification system (ATC) and active pharmaceutical ingredients involved in the detected DRPs. RESULTS: 1425 DRP were detected, with a mean of 4.85 (SD 3.33) DRPs/patient. The most frequent DRP was reconciliation error (32.52%), followed by pharmaceutical regimen and dosaje. Among the 1425 improvement proposals, 86.73% of them were accepted.Significant statistically differences were observed between the number of medications per patient prior to the pharmacotherapy review (12.29) and after it (10.20), obtaining an average difference of 2.09 (95%CI: 1.98-2.21; P<.001). CONCLUSIONS: It is found that the intervention of multidisciplinary team in which the pharmacist performs a revision of the medication decreased the number of prescribed medications. Therefore, it reduces polymedication and its associated risks.

Emotion regulation as a predictor of patterns of change in behavior problems in previously institutionalized youth.

Longitudinal trajectories of psychopathology in previously institutionalized (PI) youth were identified and biobehavioral emotion regulation processes were examined as developmental mechanisms that predict these trajectories. Mental health data were collected from PI (N = 132) and nonadopted (NA; N = 175) youth across four time points (participant age ranged from 7- to 21-year-old). Using semiparametric group-based methods, the probability that each individual belonged to a distinct group that followed a specific pattern of behavior across time was estimated. We then tested whether unique aspects of emotion regulation (global, observed, and biological) were differentially associated with membership in externalizing and internalizing trajectory groups using multinomial logistic regression models. Four externalizing trajectories were identified for the PI and NA groups. For PI youth, global, observed, and biological emotion regulation processes were uniquely predictive of more adaptive externalizing trajectories. For NA youth, only parent-reported global emotion regulation was predictive of externalizing patterns. Three internalizing trajectories were identified for PI and NA youth. Generally, only parent-reported global emotion regulation predicted internalizing group membership for both PI and NA youth. Results suggest that biobehavioral emotion regulation processes may be particularly important predictors and potential points of intervention when targeting trajectories of externalizing behaviors in PI children.

Attachment and alexithymia predict emotional-behavioural problems of institutionalized, late-adopted and community adolescents: An explorative multi-informant mixed-method study.

OBJECTIVE: Compared to community adolescents (COM), adolescents placed in residential care (RC) or late adopted (LA) appear to show more emotional-behavioural problems. They also appear vulnerable in variables linked to emotional-behavioural problems, such as insecure-disorganized attachment and alexithymia. This study employs a mixed-method multi-informant approach to (1) compare adolescents placed in RC, LA and COM in emotional-behavioural problems, attachment and alexithymia and (2) investigate relationships and interplay of attachment and alexithymia concerning emotional-behavioural problems in these three groups. METHOD: Participants were 174 adolescents (50 RC, 33 LA and 91 COM; Mage = 15, 53% boys and 47% girls). Adolescents' internalizing and externalizing problems were assessed through both caregiver-reported and self-reported questionnaires, while attachment and alexithymia were assessed with a mixed method, using interviews and self-report questionnaires. RESULTS: The results showed RC adolescents as more vulnerable in all variables, while LA and COM did not differ. Accounting for the group, attachment and alexithymia cumulatively predicted 25-43% of internalizing problems, and 19-43% of externalizing problems depending on the method of assessment or problems' informant (all p < 0.01). Alexithymia was both an independent predictor and interacted with preoccupied attachment in predicting internalizing problems, while no predictors were isolated for externalizing ones, and the group never indicate an effect on problems' rates. CONCLUSIONS: The authors discuss the utility to maintain a research focus on attachment and alexithymia, also suggesting future directions of research. A need to determine potential distortions of results because of problems' informant and method of assessment is also highlighted.

Functional and emotional impact of COVID-19 lockdown on older adults with sarcopenia living in a nursing home: A 15-month follow-up.

This study aimed to detect the functional and emotional impact of COVID-19 lockdown on institutionalized older adults with sarcopenia during a 15-month follow-up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC-F questionnaire were included. Assessments were performed pre-lockdown (T1), 12 months (T2) after, and at a 15-month follow-up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up-and-Go test. Emotional assessments included Short-Form Health Survey, Geriatric Depression Scale-Short Form, and the Mini-Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducted.

Prevalence of frailty and its association with oral hypofunction in older adults: a gender perspective.

BACKGROUND: Previous studies have indicated an association between oral hypofunction and frailty in community-dwelling older adults. However, this issue has not been evaluated in institutionalized older patients. We aimed to determine the prevalence of physical frailty in this particularly vulnerable group and evaluate its association with oral hypofunction, analyzing possible differences by gender. METHODS: This cross-sectional study was conducted in private and public care homes in Guayaquil (Ecuador) from January 2018 until December 2019. Participants were classified as robust, pre-frail, and frail according to the Fried's frailty phenotype. Oral hypofunction was defined as the presence of at least three positive items in the following list: poor oral hygiene, oral dryness, reduced occlusal force, decreased masticatory function, and deterioration of swallowing function. The relationships between frailty and oral hypofunction were analyzed using logistic regression models for the whole sample and stratified by gender. Statistical analyses were performed using STATA 15.0 software (Stata Corp. LP, College Station, TX, USA). RESULTS: Among the 589 participants analyzed (65% women), the median age was 72 years (interquartile range: 66-82). Pre-frailty and frailty were presented in 66.7% and 28.9% of them respectively. Weakness was the most frequent item (84.6%). There was a significant relationship between frailty and oral hypofunction in women. In the overall sample, the frequency of frailty was 2.06 times higher (95% CI 1.30-3.29) in patients with oral hypofunction, and this association was maintained in women (ORa: 2.18; 95% CI 1.21-3.94). Reduced occlusal force and decreased swallowing function were items significantly associated with the presence of frailty (ORa: 1.95; 95% CI 1.18-3.22 and ORa: 2.11; 95% CI 1.39-3.19, respectively). CONCLUSION: The prevalence of frailty and pre-frailty was high among institutionalized older people and was associated with the presence of hypofunction, especially in women. Decreased swallowing function was the most strongly item associated with frailty.

Current services and outcomes of formerly institutionalised and never-institutionalised US adults with intellectual and developmental disabilities: A propensity score matching analysis.

BACKGROUND: Deinstitutionalization research shows better services and outcomes relative to institutional life but has not compared formerly institutionalised and never-institutionalised service users. METHODS: We used propensity score matching (PSM) to match formerly institutionalised and never-institutionalised participants on six personal characteristics. Data came from the 2018 to 2019 National Core Indicators In-Person Survey. We excluded current institution residents, and states with 25% + of missing data on former institutionalisation. RESULTS: Overall, 15.5% of participants in the 29-state full sample had lived in an institution for 1 year or more. Findings from the PSM sample showed that former-institution residents were more likely to use congregate living arrangements and less likely to live with family. They experienced more loneliness, less support-related choice, and had a consistent pattern of disability service-focused social connections. CONCLUSIONS: Many former institution residents remain disadvantaged relative to matched peers. There is a need to identify factors to enhance services and outcomes following deinstitutionalization.

Prevalence and associated factors of self-reported halitosis among institutionalized adolescents: Cross-sectional study.

OBJECTIVE: To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil. METHODS: This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured. RESULTS: The prevalence of self-reported halitosis in this sample was 51.5% (n = 35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12 months were not significantly associated with self-reported halitosis. CONCLUSION: It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.

The relationship between depression and risk of violence in portuguese community-dwelling older people.

BACKGROUND: Mental disorders are highly prevalent in older people, being depression a predominant disorder. Evidence points to a possible relationship between depression and violence against older people. Nonetheless, the role of the depressive symptomology severity in the risk of violence against older people remains unclear. Thus, this study's main objective was to analyze the relationship between geriatric depressive symptomatology and the risk of violence against older people. METHODS: This exploratory study involved 502 community-dwelling older persons aged 65 to 96 years (73.3 ± 6.5). Measures were performed using the Geriatric Depression Scale and the Risk Assessment of Violence against the Non-Institutionalized Elderly scale. RESULTS: One hundred nineteen older people (23.7%) had mild/moderate depressive symptomology, and twenty-six (5.2%) had severe depressive symptomology. There were significant relationships between the severity of depressive symptomatology and the risk of violence (p < 0.05). The presence of depressive symptomatology increased the likelihood of being victims of violence, particularly among women (odds ratio: 2-8, p < 0.05). CONCLUSIONS: The severity of depressive symptomatology plays an essential role in the risk of violence against community-dwelling older people. Moreover, it was found that older persons with depression symptomatology were at higher risk of being victims of violence. Our study findings support the need for protective measures within mental health national or regional policies to prevent depression and violence against community-dwelling older people.

Relationship between frailty, nutrition, body composition, quality of life, and gender in institutionalized older people.

Our aim was to explore the relationship between frailty, nutrition, body composition, and how gender modifies this relationship among long-term care facility residents. We further investigated how body composition correlates with health-related quality of life (HRQoL) in both genders. In all, 549 residents (> 65 years of age) were recruited from 17 long-term care facilities for this cross-sectional study. Demographic information, diagnoses, use of medications, and nutritional supplements were retrieved from medical records. Participants' frailty status, cognition, nutritional status, HRQoL, and body composition were determined. Energy, protein, and fat intakes were retrieved from 1- to 2-day food diaries. The final sample consisted of 300 residents (77% women, mean age 83 years). The majority of participants, 62% of women and 63% of men, were identified as frail. Frail participants in both genders showed lower body mass index (p = 0.0013), muscle mass (MM) (p < 0.001), poorer nutritional status (p = 0.0012), cognition (p = 0.0021), and lower HRQoL (p < 0.001) than did prefrail participants. Women had higher fat mass, whereas men exhibited higher MM. The HRQoL correlated with the MM in both women, r = 0.48 [95% CI 0.38, 0.57] and men r = 0.49 [95% CI 0.38, 0.58]. Interventions aimed at strengthening and retaining MM of long-term residents may also support their HRQoL.

Multiple facets of attachment in residential-care, late adopted, and community adolescents: an interview-based comparative study.

In this study, 117 adolescents (12-19 years) from three groups (39 each), two groups from adverse caregiving environments as placed in residential-care (RC; i.e. istitutions) or late-adopted (LA; i.e. adopted after 12 months), and one of low-risk community adolescents (COM), were compared for the attachment distribution of categories in the Friends and Family Interview (FFI), and in several attachment-related domains where RC and LA showed difficulties during childhood. Only institutionalized adolescents showed more insecure and disorganized categories than both late-adopted and community peers, who did not differ. In the attachment-related domains, only RCs showed lower coherence, reflective functioning, secure-base/safe-haven parents, social and school competence, adaptive response, and more parental anger and derogation than the other two groups. Late-adoptees only showed higher hostility towards sibling(s) than COM.Therefore, only residential-care adolescents were at "high-risk" in attachment, but the analysis of attachment-related domains helped to detect vulnerabilities in both groups.

Evaluating the effectiveness of fluoride varnish in preventing caries amongst Long-Term Care Facility Residents.

OBJECTIVE: To evaluate the effectiveness of professionally applied fluoride varnish on the incidence of dental caries amongst older adults resident in LTCFs in Northern Ireland. BACKGROUND: The oral health status of older adults within Long-Term Care Facilities (LTCFs) is significantly worse than their community living peers. Whilst evidence suggests an important role for fluoride varnish in preventing caries in this population, very few studies have evaluated this intervention. MATERIALS AND METHODS: A quality improvement project was undertaken with dentate residents (n = 190) in nine LTCFs who had fluoride varnish applied by Dental Care Professionals on two separate occasions during a 12-month period (intervention group). Nine LTCFs were chosen as matched controls (control group) with comparable numbers of residents of similar medical status (n = 217). For the intervention group, oral hygiene training was also provided for the care home staff. RESULTS: A total of 407 patients (n = 271 female) were included in the analyses (mean age [SD]: 84.1 [6.6] years). After 12 months, the intervention group recorded a significant reduction in mean number of carious teeth (mean [95% CI]: -0.85 [-1.12, -0.58]; P < .001). Patients in the control group had significant increases in the mean number of carious teeth (mean [95% CI]: 0.21 [0.05, 0.37]; P = .012), mean plaque score (mean [95% CI]: 1.16 [0.28, 2.04]; P = .010) and mean DMFT score (mean [95% CI]: 0.13 [0.04, 0.22]; P = .004). CONCLUSIONS: This study demonstrates the potential role of fluoride varnish in combination with oral hygiene training for staff in the prevention and arrest of carious lesions among older adults in LTCFs.

Impact of the COVID-19 pandemic on the University of British Columbia Geriatric Dentistry Program: Clinical education and service.

BACKGROUND AND OBJECTIVE: In Canada, the COVID-19 pandemic was associated with significant morbidity and mortality in older adults, particularly those in long-term care (LTC). Access to oral health services was limited during the pandemic due to public health restrictions. The aim of this paper was to describe the impact of the pandemic on the clinical education and service of the University of British Columbia (UBC) Geriatric Dentistry Program (GDP), which provides care to LTC residents. METHODS: Data were collected from UBC GDP AxiUm dental software records, including number of dental appointments in 2019 and 2020. Data on revenue in 2019 and 2020 based on clinical production were collected through financial summary reports. Data on the number of educational rotations were collected from summary reports from scheduling software. RESULTS: In 2020, significant reductions in clinical service, revenue, and productivity were observed in the UBC GDP relative to 2019. The number of GDP appointments for June-December 2020 was lower by 68%. The clinical productivity reduced by 67% for the same period. Expenses were slightly reduced. The overall number of LTC clinical rotations for students were only slightly lower for undergraduate students in 2020 than in 2019, and it increased for graduate students. CONCLUSION: The COVID-19 pandemic and associated public health restrictions had a negative impact on the clinical service and productivity of the UBC GDP in 2020 relative to 2019. However, clinical educational rotations to LTC were slightly increased in 2020 relative to 2019. Dental care for LTC residents can be provided if rigorous administrative controls, engineering controls and personal protective equipment are employed.

Cognitive behavioral program on aggression and self-concept among institutionalized children with conduct disorder.

PURPOSE: To explore the effect of cognitive-behavioral programs on aggression and self-concept among institutionalized children with conduct disorder. A quiz-experimental design was employed in this study. BACKGROUND: Conduct Disorder (CD) is defined as repetitive and persistent behavior that violates the rules of society and social norms. It is also characterized by aggressive behaviors toward people or animals, dishonesty or theft, destruction of property, or serious violation of rules, and persists in children or adolescents in the past 12 months before age 18. METHOD: This research was carried out at the Dammam Observation Center in Saudi Arabia and the Cairo Caring Center in Egypt. Approximately 100 institutionalized children with conduct disorder who had evidence of conduct disorder were included in the study as part of a purposive sampling procedure. The information was gathered through the use of three different tools: Aggressive behavior and self-concept scales, as well as a sociodemographic data sheet. RESULTS: According to the findings, children with conduct disorder exhibited less aggression after participating in cognitive behavioral sessions (p = .011), resulting in lower mean aggression scores for the intervention group than the control group. After the training, about 64% of them had a moderate level of self-concept, whereas 44% of them had a moderate level of self-concept before the program. The study also revealed a statistically significant negative correlation between aggressive behavior and self-concept. CONCLUSION: The post-intervention remediation of aggressive behaviors and self-concept improvement point to the positive effect of the cognitive-behavioral program. The current study recommended that a cognitive-behavioral program is an effective, low-cost, and noninvasive intervention to improve self-concept and minimize aggressive behavior among institutionalized children with conduct disorder.

Institutionalized Risks and Shiduers' Post-loss Experience: A Qualitative Analysis Among Older Bereaved Chinese Parents Who Have Lost Their Only Child.

In China, older adults whose only child has died are known as shiduers; these people are not only deeply impacted by their individual bereavement from losing their child but are also influenced by macro institutional factors. To further investigate this unintended consequence of the one-child policy and to illustrate the mechanism of influence of institutional factors on the sufferings and grief experiences of this population, this study conducted in-depth semi-structured interviews with 20 shiduers in Wuhan, China. In line with Ulrich Beck's theory of risk society, the findings argue that the crises inherent in institutional factors not only affect the post-loss experiences of shiduers in harmful ways but also pose a number of life difficulties that are difficult to control and mitigate. More importantly, most shiduers' life difficulties are rationalized, gradually transforming into manufactured and widespread shidu risks that persist long-term throughout their aging process.

The prevalence and intensity of intestinal helminths among institutionalized children in three states of South-East Nigeria.

Background: Intestinal helminthiasis is one of the most common and neglected diseases affecting all age groups, especially among school children. It is a disease condition of suboptimal environment and poor personal hygiene, and is more prevalent in children in institutionalized centers. Aims: This study was aimed to determine the prevalence, pattern, and intensity of intestinal helminthiasis among children in motherless babies' homes/orphanages and the relationship between the prevalence and demographic characteristics of the children. The outcome may be useful in strengthening these homes through advocacy to the appropriate authorities on general health promotion and awareness for the management of the homes. Subjects and Methods: It was a descriptive cross-sectional study carried out over 7 months (March-September 2017) in three states of the South-East Nigeria. Prior to the studies ethical clearance and permissions from relevant bodies were obtained. A total of 198 children aged 3 months to 17 years were recruited using multi-stage sampling methods from the homes and orphanages in Anambra, Ebonyi, and Enugu states. Their stool samples were collected and analyzed for ova of intestinal helminths using ether concentration and Kato-Katz techniques.Frequency tables were designed for relevant variables while quantitative variables were summarized using median and interquartile range (IQR). The relationship between demographic factors and presence of intestinal helminths amongst study participants was tested using Chi-square test and Fisher's exact test (FET) where appropriate. All analyses were done at the 5% level of significance, and a P value <.05 was considered statistically significant. Results: : Children aged 1-5 years constituting the highest proportion 110 (55.6%). The median age (IQR) of the participants was 2.5 years (3 months to 17 years). They comprised of 89 (44.9%) males and 109 (55.1%) females with a male: female ratio of 1:1.2. The overall prevalence of intestinal helminths among institutionalized children was 5/198 (2.5%). Ascaris lumbricoides only was seen in four out of five (80%) infested subjects while mixed infestation of A. lumbricoides and Trichuris trichiura was seen in one out of five (20%) subjects. All the infected subjects had light intensity of 100-300 EPG. It was noted that three out of five infested subjects were preschool children. However, the difference between the age groups and intestinal infestation was not statistically significant (P > 0.05). All the subjects with helminthic infection were females. Gender and location of motherless babies' homes/orphanages were not significantly associated with the presence of infestation (P > 0.05). Conclusion: This study showed that the prevalence and intensity of intestinal helminthiasis amongst the surveyed children in the South-Eastern Nigeria are 2.5% and more common among preschool aged children.

Association between sleep quality and depression among institutionalized and community older people - Brazilian Western Amazonia.

BACKGROUND: The transition in the population pyramid is a reality in several locations around the world and projections of an increase in the older population in Brazil demonstrate the relevance of studies on factors that may interfere in the functionality and quality of life in this age group. Thus, the present study aims to assess depression levels and their relationship with sleep quality in institutionalized and community older adults. METHODS: This cross-sectional study included 220 older people of both sexes, divided into two groups, institutionalized older adults, and community older adults. The older adults were monitored by Community Health Agents (CHA), through identification of everyone in their micro area using a method of random name generation, based on geographic location. Due to the small number of institutionalized older adults, all residents in the institutions were recruited, according to the inclusion and exclusion criteria. The Geriatric Depression Scale (GDS-15) and Pittsburgh Sleep Quality Index (PSQI) were used to assess depression and sleep quality. RESULTS: Among the 220 older adults, 175 were community members and 45 were institutionalized. The survey revealed that institutionalized older adults had a higher percentage of severe depression compared to community dwelling older adults (p <  0.039). CONCLUSION: Older adults in the community present greater symptoms of depression and better sleep than institutionalized older adults. There was a direct association between sleep quality and depression. In our sample, being institutionalized and female positively influenced and feeling alone negatively influenced depressive symptoms.

Early institutionalized care disrupts the development of emotion processing in prosody.

Millions of children worldwide are raised in institutionalized settings. Unfortunately, institutionalized rearing is often characterized by psychosocial deprivation, leading to difficulties in numerous social, emotional, physical, and cognitive skills. One such skill is the ability to recognize emotional facial expressions. Children with a history of institutional rearing tend to be worse at recognizing emotions in facial expressions than their peers, and this deficit likely affects social interactions. However, emotional information is also conveyed vocally, and neither prosodic information processing nor the cross-modal integration of facial and prosodic emotional expressions have been investigated in these children to date. We recorded electroencephalograms (EEG) while 47 children under institutionalized care (IC) (n = 24) or biological family care (BFC) (n = 23) viewed angry, happy, or neutral facial expressions while listening to pseudowords with angry, happy, or neutral prosody. The results indicate that 20- to 40-month-olds living in IC have event-related potentials (ERPs) over midfrontal brain regions that are less sensitive to incongruent facial and prosodic emotions relative to children under BFC, and that their brain responses to prosody are less lateralized. Children under IC also showed midfrontal ERP differences in processing of angry prosody, indicating that institutionalized rearing may specifically affect the processing of anger.

Higher prevalence of geriatric depression, catastrophizing pain and sleep disorders in institutionalized elders: a cross-sectional study in Galle District, Sri Lanka.

BACKGROUND: Population aging is a significant social problem in the twenty first century. Recent economic and social changes lead increasing number of elders to spend their lives in elderly homes. Institutionalized elders have to face many physical and psychological problems which negatively impact their quality of life. Geriatric depression (GD), catastrophizing pain (CP) and sleep disorders (SD) are some common problems among them. METHODS: Present study was designed to assess the prevalence of GD, CP and SD and their correlations in institutionalized elders. A descriptive cross-sectional study was conducted in elderly homes (n = 20) in the Galle district of Sri Lanka enrolling 310 subjects. GD, CP and SD were assessed using validated Sinhala versions of Geriatric Depression Scale (GDS), Pain Catastrophizing Scale (PCS) and Pittsburgh Sleep Quality Index (PSQI) respectively. Data were analyzed using SPSS version 25.0 for windows by using descriptive statistics, the Pearson's chi-square test and Pearson's bivariate correlation (p < 0.05). RESULTS: Among the participants (response rate: 95.7%), 34.8% (n = 108) and 65.2% (n = 202) were males and females respectively. Age range of the subjects was 60-103 years with the mean age of 74.97 years (SD 8.852). Most of the study subjects (n = 234, 75.5%) had spent five or less than 5 years in elderly homes at the time of the study and 52.8% (n = 164) of them were unmarried. GD was present in 76.5% (95% CI: 71.7-81.2) of subjects and of them 44% had moderate to severe depression. PCS revealed that 29% (95% CI: 24.0-34.1) had CP. SD were identified in 55.5% (95% CI: 49.5-61.0) of elders and according to PSQI, 86% (95% CI: 82.3-90.0) had poor quality sleep. Positive correlations between GD and CP (r = 0.24, p < 0.01), GD and SD (r = 0.13, p = 0.02), CP and SD (r = 0.32, p < 0.01) were statistically significant. CONCLUSIONS: Prevalence of GD, CP and SD were significantly higher in this sample of institutionalized elders who were apparently healthy. Findings highlighted the importance of early screening of physical and psychological problems in institutionalized elders to assure better quality of life and to reduce the burden to health care system of the country.