Bellek Bozukluğuyla Başvuran Yaşlılarda Yalnızlığın Etkisi: Tek Merkez Deneyimi

Yıl 2024, , 202 - 213, 30.06.2024

Elif Sarıca Darol , Seda Göger

https://doi.org/10.31832/smj.1448484

Öz

Amaç: Bellek bozukluğu, amnestik hafif bilişsel bozukluk (HBB) veya geriatrik depresyonun ilk belirtisi olabilir. Yalnızlık yaşlı nüfusta bilinci ve duygu durumu etkilemektedir. Bu çalışma, hafıza bozukluğu olan yaşlı erişkinlerde yalnızlığın olası HBB ve depresif belirtiler üzerindeki etkisini araştırmayı amaçlamıştır.
Yöntem: Kesitsel tipte olan bu çalışmanın verileri Sakarya'da tek bir merkezden toplanmıştır. Dahil edilme kriterlerini karşılayan 120 yaşlı yetişkine Standardize Mini Mental Test (SMMT), geriatrik depresyon ve yalnızlık ölçekleri uygulanmıştır. İstatistiksel analiz için SPSS 22.0 ve HBB ve depresyonun olası risk faktörlerini belirlemek için lojistik regresyon analizi kullanılmıştır.P<0,05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Katılımcıların %41,7'sinde HBB, %56,7'sinde ise geriatrik depresyon tesbit edilmiştir.Düşük gelir düzeyi, eğitim seviyesindeki düşüklük ve yalnızlık değişkenleri depresyon için risk faktörleri olarak belirlenmiştir (sırasıyla p=0,011, p=0,021, p=0,000). Yalnızlık puanları ile olası HBB arasında korelasyon görülmemiştir (p=0,173). Ek olarak yaş ve cinsiyet değişkenleri HBB için risk faktörü olup, yaş azaldıkça risk azalmıştır (sırasıyla p=0,004, p=0,033). Kadınların sosyal yalnızlık puanları erkeklere göre daha yüksek bulunmuştur (p=0,015).
Sonuç: Çok kültürlü yaşlanan nüfusta yalnızlık, cinsiyetler arasında farklı şekillerde algılanmaktadır. Yalnızlığın HBB üzerinde potansiyel bir etkisi olduğuna dair net bir kanıt yoktur. Geriatrik depresyonda sosyal ve duygusal yalnızlık; risk faktörleri olarak değerlendirilebilir. Sağlık hizmeti sağlayıcıları, yalnız yaşayan yaşlı yetişkinlere, özellikle kadın alt grubuna yönelik rutin bakıma depresyon taraması ve yönetimini dahil etmeyi düşünmelidir.

Anahtar Kelimeler

Loneliness, Elderly, Gender, Mild Cognitive Impairment, Depressive Symptoms

Destekleyen Kurum

yok

The Impact of Loneliness in Older Adults Presenting with Memory Impairment: A Single-Center Experience

Öz

Background: Memory impairment may be the first sign of an amnestic mild cognitive impairment (MCI) or geriatric depression. Loneliness hurts consciousness and mood in the elderly population. This study aimed to investigate the impact of loneliness on possible MCI and depressive symptoms in older adults with memory impairment.
Method: The data of this cross-sectional study was collected from a single center in Sakarya. Standardized Mini Mental Test (SMMT), geriatric depression, and loneliness scales were applied to 120 older adults who met the inclusion criteria. SPSS 22.0 was used for statistical analysis. Logistic regression analysis were used to determine possible risk factors of MCI and depression. p<0.05 was considered statistically significant.
Results: MCI was observed in 41.7%, and geriatric depression in 56.7% of participant. The variables of income level, low education status, loneliness were identified as risk factors for depression (p=0.011, p=0.021, p=0.000 respectively). There was no correlation between the loneliness scores and possible MCI (p=0.173). In addition, age and gender variables are risk factors for mild cognitive impairment, and the risk decreases as age decreases (p=0.004, p=0.033 respectively ). Social loneliness scores were higher in women than men (p=0.015).
Conclusion: Loneliness in multi-cultural aging population is perceived in different ways between genders. There is no clear evidence that loneliness has a potential impact on MCI. In geriatric depression, social and emotional loneliness; may be considered risk factors. Healthcare providers should consider incorporating depression screening and management into routine care for lonely older adults especially woman subgroup.

Anahtar Kelimeler

Loneliness, Older Adults, Gender, Mild Cognitive Impairment, Depressive Symptoms

Kaynakça

• 1. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med 2004; 256: 183–94. (DOI: 10.1111/j.1365-2796.2004.01388.x.).
• 2. Albert MS, De Kosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011. 7(3):270-9. doi: 10.1016/j.jalz.2011.03.008. PMID: 21514249; PMCID: PMC3312027.
• 3. Petersen RC. Clinical practice. Mild cognitive impairment. N Engl J Med 2011; 364(23): 2227-34. (DOI: 10.1056/NEJMcp0910237).
• 4. Casey DA. Depression in Older Adults: A Treatable Medical Condition. Prim Care. 2017 Sep;44(3):499-510. doi: 10.1016/j.pop.2017.04.007. Epub 2017 Jul 18. PMID: 28797375.
• 5. Landeiro F, Barrows P, Nuttall Musson E, Gray AM, Leal J. Reducing social isolation and loneliness in older people: a systematic review protocol. BMJ Open. 2017;7(5):e013778. doi: 10.1136/bmjopen-2016-013778. PMID: 28515187; PMCID: PMC5623425.
• 6. Gardiner C, Geldenhuys G, Gott M. Interventions to reduce social isolation and loneliness among older people: an integrative review. Health Soc Care Community 2018; 26(2): 147–57 (DOI: 10.1111/hsc.12367).
• 7. Acikgoz A, Yoruk S, Sahan AG, Guler DS. Relationship Between Loneliness, Physical Activity, and Depressive Symptoms Among Older Adults: Across –Sectional Study Conducted During The Fourth Wave of The Covid -19 Pandemic in Türkiye. Turkish Journal of Geriatrics 2022; 25(Suppl 3): 386-395 (DOI: 10.31086/tjgeri.2022.298)
• 8. Gungen C, Ertan T, Eker E, Yasar R. Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. Turkish Journal of Psychiatry 2002; 13(Suppl 4): 273-81. PMID: 12794644. (in Turkish)
• 9. Akgul H,Yesilyaprak B. Adaption of loneliness scale for elderly into Turkish culture: Validity and reliability study. Elderly Issues Research Journal 2015; 8(Suppl 1): 34-45. (in Turkish)
• 10. Ertan T, Eker E, Sar V. Reliability and validity of the geriatric depression scale in Turkish elderly population. Archives of Neuropsychiatry 1997; 34(Suppl 1): 62-71. (in Turkish)
• 11. Aziz R, Steffens DC. What are the causes of late-life depression? Psychiatr Clin North Am 2013; 36(4): 497-516 (DOI: 10.1016/j.psc.2013.08.001)
• 12. Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med 2012; 172(14): 1078-83. (DOI: 10.1001/archinternmed.2012.1993).
• 13. AARP Foundation. Loneliness and social connections: A national survey of adults 45 and older [e-book]; 2018. [Internet]. Available from: https://www.aarp.org/content/dam/aarp/research/surveys_statistics/life-leisure/2018/loneliness-social-connections-2018.doi.10.26419-2Fres.00246.001.pdf Accessed: 06.09.2023.
• 14. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry. 2007;64(2):234-40. doi: 10.1001/archpsyc.64.2.234. PMID: 17283291.
• 15. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015 ;10(2):227-37. doi: 10.1177/1745691614568352. PMID: 25910392.
• 16. Penninkilampi R, Casey AN, Singh MF, et al. The Association between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2018; 66(4): 1619-1633. (DOI: 10.3233/JAD-180439).
• 17. Braak H, Tredici DK. Alzheimer’s disease: Pathogenesis and prevention. Alzheimer’s & Dementia 2012; 8(3): 227–233. (DOI: 10.1016/j.jalz.2012.01.011).
• 18. Smith L, Bloska J, Jacob L, Barnett Y, Butler L, Trott M, et al. Is loneliness associated with mild cognitive impairment in low‐ and middle‐income countries. Int J Geriatr Psychiatry 2021;36(9):1345-1353. (DOI: 10.1002/gps.5524).
• 19. Rawtaer I, Gao Q, Nyunt MS, Feng L, Chong MS, Lim WS,et al. Psychosocial Risk and Protective Factors and Incident Mild Cognitive Impairment and Dementia in Community Dwelling Elderly: Findings from the Singapore Longitudinal Ageing Study. J Alzheimers Dis 2017; 57: 603-611. (DOI: 10.3233/JAD-160862).
• 20. Lara E, Martín-María N, De la Torre-Luque A, Koyanagi A, Vancampfort D, Izquierdo Aet al. Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies. Ageing Res Rev 2019; 52: 7-16. (DOI: 10.1016/j.arr.2019.03.002).
• 21. Matud, M. P. Gender differences in stress and coping styles. Personality and Individual Differences 2004; 37(7): 1401–1415. (DOI:10.1016/j.paid.2004.01.010)
• 22. Maes M, Qualter PJ, Vanhalst J, Van den Noortgate W, Goossens L. Gender differences in loneliness across the lifespan: A meta-analysis. European Journal of Personality 2019; 33: 642–654. (DOI:10.1002/per.2220).
• 23. Reynolds E, Frank E, Perel JM, Imber SD, Cornes C, Morycz RK et al. Combined pharmacotherapy and psychotherapy in the acute and continuation treatment of elderly patients with recurrent major depression: A preliminary report. Am J Psychiatry 1992; 149: 1687–92. (DOI: 10.1176/ajp.149.12.1687).
• 24. Vieira ER, Brown E, Raue P. Yaşlı yetişkinlerde depresyon: tarama ve yönlendirme. J Geriatr Phys Ther. 2014 Ocak-Mart;37(1):24-30. doi: 10.1519/JPT.0b013e31828df26f. PMID: 23619921.
• 25. Tiikkainen P, Heikkinen RL. Associations between loneliness, depressive symptoms and perceived togetherness in older people. Aging Ment Health 2005; 9(6): 526–34. (DOI: 10.1080/13607860500193138).