PTSD & Korean War Veterans

Research Paper Title

Aging and Trauma: Post Traumatic Stress Disorder Among Korean War Veterans.

Background

Having experienced posttraumatic stress disorder 30 years prior to its recognition as a formal disorder, Korean War veterans are now an ageing population that requires unique clinical management.

The Korean War lasted from 25 June 1950 through 27 July 1953. Although many veterans of the Korean War experienced traumas during extremely stressful combat conditions. However, they would not have been diagnosed with post-traumatic stress disorder (PTSD) at the time because the latter did not exist as a formal diagnosis until the publication of the third edition of the Diagnostic and Statistical Manual (DSM) in 1980. Prior to 1980, psychiatric syndromes resulting from war and combat exposure where known by numerous other terms including shell shock, chronic traumatic war neurosis, and combat fatigue/combat exhaustion. Military psychiatrists attended to combat fatigue during the course of the Korean War, but as was true of World War I and II, the focus was on returning soldiers to duty. Combat fatigue was generally viewed as a transient condition.

Although now octo- and nonagenarians, in 2019 there are 1.2 million living Korean War veterans in the US, representing 6.7% of all current veterans. Understanding their war experiences and the nature of their current and past presentation of PTSD is relevant not only in formal mental health settings, but in primary care settings, including home-based primary care, as well as community living centres, skilled nursing facilities and assisted living facilities. Older adults with PTSD often present with somatic concerns rather than spontaneously reporting mental health symptoms. Beyond the short-term clinical management of Korean War veterans with PTSD, consideration of their experiences also has long-term relevance for the appropriate treatment of other veteran cohorts as they age in coming decades.

The purpose of this article is to provide a clinically focused overview of PTSD in Korean War veterans, to help promote understanding of this often-forgotten group of veterans, and to foster optimised personalised care. This overview will include a description of the Korean War veteran population and the Korean War itself, the manifestations and identification of PTSD among Korean War veterans, and treatment approaches using evidence-based psychotherapies and pharmacotherapies. Finally, the researches provide recommendations for future research to address present empirical gaps in the understanding and treatment of Korean War veterans with PTSD.

Reference

Palmer, B.W., Friend, S., Huege, S., Mulvaney, M., Badawood, A., Almaghraby, A. & Lohr, J.B. (2019) Aging and Trauma: Post Traumatic Stress Disorder Among Korean War Veterans. Federal Practitioner. 36(12), pp.554-562.

What is the Association with Several Physical, Mental, & Cognitive Health Outcomes with Gait Speed in Older Adults?

Research Paper Title

Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes.

Background

Although clinical gait speed may indicate health and wellbeing in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes.

The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44 meter walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults.

A cross-sectional design was used.

Methods

The study population comprised 432 high-functioning community-dwelling older adults (287 women) aged between 65 and 92.

Clinical and ambulatory gait speeds were measured using the 2.44 m walk test and a portable gait analysis device, respectively.

Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (BMI, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper and lower body strength, physical and mental health status, cognitive status and self-rated cognitive status).

Results

The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared.

Clinical gait speed was associated with 7 health outcomes, while the ambulatory gait speed was associated with 6 health outcomes.

The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied, however, the strength of associations were singly different between measures.

The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study.

Conclusions

The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed.

Both measures have construct validity because they have been associated with physical and health outcomes, however, they may have different predictive validity.

Further research should be done to compare their predictive validity in longitudinal designs.

Reference

De la Cámara, M.Á., Higueras-Fresnillo, S., Sadarangani, K.P., Esteban-Cornejo, I., Martinez-Gomez, D. & Veiga, Ó.L. (2020) Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes. Physical Therapy. pii: pzz186. doi: 10.1093/ptj/pzz186. [Epub ahead of print].

Mental Health: Exercise & Osteoarthritis in Older People

Research Paper Title

A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients.

Background

The purpose of this study was to investigate the physical activities, mental health, and health-related quality of life (HRQOL) of osteoarthritis patients.

Methods

This study was conducted using data from the first year of the 7th Korea National Health and Nutritional Examination Survey.

There were 8,150 participants included in the survey, and 665 participants had been diagnosed with osteoarthritis.

This study analysed the measurements of physical activities, depression, and HRQOL in participants with osteoarthritis.

Results

The mean age of the participants was 67 ± 9.9 years and 83.1% were female.

Participants rarely engaged in work-related physical activity, and engaged in leisure-related physical activities infrequently.

Most of the participants (85.9%) did not do regular exercise, but 1/3 of the participants walked for over 10 minutes a day.

“Pain/discomfort” had the least impact upon HRQOL, and among the depression subcategories, “difficult to sleep and tiredness” had the most impact.

Multiple logistic regression analysis showed that an adverse HRQOL score was statistically significantly associated with “location changes/physical activities” (p < 0. 01), “depression” (p < 0.001) and “age” (p < 0.001).

Conclusions

Exercise programmes should be in place which are manageable in everyday life for the elderly (> 65 years).

Changes in daily routine so that patients become more active, should be supported by the family and community, together with assistance in managing psychological problems such as depression.

Reference

Kim, D.J. (2019) A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients. Osong Public Health and Research Perspectives. 10(6), pp.368-375. doi: 10.24171/j.phrp.2019.10.6.07.

Suicide in Older Adults: A Critical Problem

Research Paper Title

Suicide in Older Adults.

Abstract

Suicide in older adults is a critical problem that nurses and other health professionals need to address. Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognise suicide risks and intervene to provide effective care for this vulnerable population.

Reference

Sorrell, J.M. (2020) Suicide in Older Adults. Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.17-20. doi: 10.3928/02793695-20191218-04.

Suicide in Older Adults: Intervention Required

Research Paper Title

Suicide in Older Adults.

Abstract

Suicide in older adults is a critical problem that nurses and other health professionals need to address.

Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognise suicide risks and intervene to provide effective care for this vulnerable population.

Reference

Sorrell, J.M. (2020) Suicide in Older Adults. Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.17-20. doi: 10.3928/02793695-20191218-04.

Benzodiazepines & Older Adults

Research Paper Title

Little Helpers No More: A Framework for Collaborative Deprescribing of Benzodiazepines in Older Adults.

Abstract

Benzodiazepines are a class of medications that tend to fly “under the radar” within the general population but nonetheless post a significant risk to older adults when not used appropriately.

The current article aims to shine a spotlight on this medication class along with a framework for a team-based approach to successfully de-escalate use when clinically appropriate.

Reference

Suss, T. & Oldani, M. (2020) Little Helpers No More: A Framework for Collaborative Deprescribing of Benzodiazepines in Older Adults. Journal of Pyschosocial Nursing and Mental Health Services. 58(1), pp.23-28. doi: 10.3928/02793695-20191218-05.