Research Proposal - Mental Disorders in the Elderly: A Population Study in 80-year Olds in the United States
Mental Disorders in the Elderly:
A Population Study in 80-year Olds in the United States
This paper discusses in detail the proposal on mental disorders in the elderly. Particularly, the proposed dissertation will be conducting a population study among 80-year-olds in the United States. In this proposal, the background, context and theme of the study are presented. Moreover, the objectives of the study and the research statements are formulated. Here, vital concepts, questions and assumptions are stated. Finally, the scope and limitation of the study, methodology to be used and the significance of the research are discussed.
Background of the Study
According to Health and welfare Canada (1988), mental health is broadly defined as the capacity of the individual to promote subjective well-being, to develop and use mental abilities, to achieve individual and collective goals consistent with justice and to attain and preserve conditions of fundamental equality. On the other hand, mental disorder refers to a recognized, medically diagnosable illness that results in a significant impairment of the individual's cognitive, affective or relational abilities (Conn, 2002).
Conn (2002) states that most mental disorders are generally no more prevalent among seniors than other age groups. The prevalence of mental disorders among seniors is determined depending on where they live. The prevalence of clinical depression among community-dwelling seniors is between 2% and 4% (Conn, 2002). A study of mental disorders among community living seniors in Edmonton, Canada by Newman, Bland and Orn (1998) shows that 11.2% were experiencing some form of depression; the prevalence rates for females is 14.1%, and 7.3% for males. Moreover, it is found that prevalence rates for depression are higher among long-term care residents and individuals with chronic medical conditions (Newman, Bland & Orn, 2002). In an earlier study, it is found that the six-month prevalence rate for all anxiety disorders in individuals over age 65 is 19.7% (Blazer, George & Hughes, 1991).
Common mental disorders among elderly include depression such as mania, and psychotic disorders such as anxiety disorders, dementia and delirium. Depression generally refers to a feeling of sadness or low mood (Conn, 2002). Studies suggest that the consequences of unrecognized and untreated depression in seniors may include increased morbidity and mortality, related to underlying medical illness and from suicide (Andersen et al., 2000).
Psychotic disorders in which delusions or hallucinations are present. In the generalized anxiety disorder (GAD), the anxiety and worry are intense and out of proportion to the situation. On the other hand, dementia is a brain disorder that affects thought and behavior (Tiemey & Charles, 2002). Studies examining the prevalence of behavioral symptoms have reported rates ranging from 20% to 90% (Deutsch & Rovner, 1991; Cohen-Mansfield & Werner, 1997). The prevalence for these behaviors are affected by the level of cognitive impairment, functional abilities, the environmental and social contexts, and the level of caregiver expertise in preventing and managing behavioral symptoms (Tiemey & Charles, 2002). Delirium is characterized by a sudden behavioral change, with agitation, inattention, disorientation and memory changes that fluctuate as the day progresses.
As mental disorders are prevalent among elderly, this dissertation will attempt to estimate this prevalence in 80-year olds in the US. This population study shall include review of previous researches on the same topic, interview and screening for mental disorders, and recommendations.
General Purpose of the Study
Generally, the purpose of the research is to conduct a population study on elderly with mental disorders in the US. This dissertation will specifically seek to estimate prevalence of mental disorders through a descriptive study on the topic. Moreover, this study will determine the prevalence of white matter lesions among 80-year-olds with mental disorders such as depression, anxiety disorder, dementia and delirium.
To support the aforementioned fundamental purpose, the research will attempt to answer the following questions:
1. What are the common mental disorders among elderly?
2. How prevalent are mental disorders among elderly in the US?
3. What is the percentage distribution of dementia?
4. How are mental disorders related to white matter lesions in the brain?
5. How prevalent are white matter lesions on 80-year olds with depression disorder? With anxiety disorder? With dementia? With delirium?
To carry out the overall aim, the following aims will be realized:
1. Determining the prevalence of mental disorders in elderly in the US.
2. Review of the available literature pertaining to common mental disorders in elderly in the US, its prevalence and the percentage distribution of these mental disorders.
3. Identifying main issues and problems.
4. Screening for mental disorders.
5. Determining the prevalence of white matter lesions.
6. Provide significant conclusion and insightful recommendations.
For this study, descriptive research method will be utilized. In this method, it is possible that the study would be cheap and quick. It could also suggest unanticipated hypotheses. Nonetheless, it would be very hard to rule out alternative explanations and especially infer causations. Thus, this study will use the descriptive approach. This descriptive type of research utilizes observations in the study. To illustrate the descriptive type of research, Creswell (1994) states that the descriptive method of research is to gather information about the present existing condition.
The purpose of employing this method is to describe the nature of a situation, as it exists at the time of the study and to explore the cause/s of particular phenomena. The researcher opts to use this kind of research considering the desire to obtain first hand data from the respondents so as to formulate rational and sound conclusions and recommendations for the study.
For this research design, the researcher will gather data, collate published studies from different local and foreign universities and articles from books and journals; and will make a content analysis of the collected documentary and verbal material. Afterwards, the researcher will summarize all the information, make a conclusion based on the hypotheses posited and provide insightful recommendations.
A total of 200 samples will be used for this study. The samples will include 80-year olds with mental disorders (depression, anxiety disorder, dementia and delirium). There will be 50 samples for each disorder. Each subject will be interviewed and screened for mental disorder. A process of screening will be used to diagnose mental disorder, including cognitive testing, a clinical examination, and imaging to determine etiology.
Cognitive testing will include the examination of nonverbal reasoning, memory and learning, processing speed, and executive function. The researcher will design the instruments that will be used in cognitive testing. The instruments will be initially sent to the supervisor for validation and approval. Moreover, white matter lesions will be examined to determine its prevalence on the specific mental disorder. The participants will undergo magnetic resonance imaging (MRI) of their brains to allow researchers to assess the extent of white-matter lesions.
Scope and Limitation
This research study only covers population study for American elderly with mental disorders. The outcome of this study will be limited only to the data gathered from books and journals on prevalence of mental disorders and from the data gathered from the result of the screening that will be conducted by the researcher.
As the research was completed in a relatively short period of time other factors and variables are not considered. This might have an impact on the results of the study.
Andersen, U. A. et al. (2000) Contacts to the health care system prior to suicide: A comprehensive analysis using registers for general and psychiatric hospital admissions, contacts to general practitioners and practicing specialists and drug prescriptions." Acta Psychiatric Scandinavica, 102, no. 2, p. 126-34.
Blazer, D., L. K. George and D. Hughes. (1991) The epidemiology of anxiety disorders: an age comparison. In C. Salzman and B. D. Lebowitz (eds.), Anxiety in the Elderly. New York, US: Springer.
Cohen-Mansfield, J. and P. Werner. (1997) Management of verbally disruptive behaviors in nursing home residents. Journal of Gerontology: Medical Science, 52A, no. 6, M369-M377.
Conn, D. K. (2002) An overview of common mental disorders among seniors. Health Canada. Available at [http://www.hc-sc.gc.ca]. Accessed 21/10/03].
Deutsch, L. and B. Rovner. (1991) Agitation and other noncognitive abnormalities in Alzheimer's disease. Psychiatric Clinics of North America, 14, no. 2, p. 341-351.
Health and Welfare Canada (1988) Mental health for Canadians: Striking a balance. Ottawa: Health and Welfare Canada.
Newman, S. C., R. C. Bland and H. T. Orn. (1998) The prevalence of mental disorders in the elderly in Edmonton: A community survey using GMS-AGECAT. Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy. Canadian Journal of Psychiatry, 43, no. 9, p. 910-914.
Tiemey. M. C. and Charles, J. (2002) The care and treatment of people with dementia and cognitive impairment: an update. Health Canada. Available at [http://www.hc-sc.gc.ca]. Accessed 21/10/03].