The Digital Divide Among Low-Income Homebound Older Adults: Internet Use Patterns, eHealth Literacy, and Attitudes Toward Computer/Internet Use.

The Digital Divide Among Low-Income Homebound Older Adults: Internet Use Patterns, eHealth Literacy, and Attitudes Toward Computer/Internet Use.

J Med Internet Res. 2013; 15(5): e93
Choi NG, Dinitto DM

Internet technology can provide a diverse array of online resources for low-income disabled and homebound older adults to manage their health and mental health problems and maintain social connections. Despite many previous studies of older adults’ Internet use, none focused on these most vulnerable older adults.This study examined Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts-homebound adults under age 60.Face-to-face or telephone surveys were conducted with 980 recipients of home-delivered meals in central Texas (78% were age 60 years and older and 22% under age 60). The eHealth Literacy Scale (eHEALS) and the efficacy and interest subscales of the Attitudes Toward Computer/Internet Questionnaire (ATC/IQ) were used to measure the respective constructs. Age groups were compared with chi-square tests and t tests. Correlates of Internet use were analyzed with multinomial logistic regression, and correlates of eHEALS and ATC/IQ scores were analyzed with OLS regression models.Only 34% of the under-60 group and 17% of the 60 years and older group currently used the Internet, and 35% and 16% of the respective group members reported discontinuing Internet use due to cost and disability. In addition to being older, never users were more likely to be black (OR 4.41; 95% CI 2.82-6.91, P<.001) or Hispanic (OR 4.69; 95% CI 2.61-8.44, P<.001), and to have lower incomes (OR 0.36; 95% CI 0.27-0.49, P<.001). Discontinued users were also more likely to be black or Hispanic and to have lower incomes. Among both age groups, approximately three-fourths of the current users used the Internet every day or every few days, and their eHEALS scores were negatively associated with age and positively associated with frequency of use. Among the 60 and older group, a depression diagnosis was also negatively associated with eHEALS scores. ATC/IQ efficacy among never users of all ages and among older adults was positively associated with living alone, income, and the number of medical conditions and inversely associated with age, Hispanic ethnicity, and Spanish as the primary language. Although ATC/IQ interest among older adults was also inversely associated with age, it was not associated with Hispanic ethnicity and Spanish as the primary language.This study is the first to describe in detail low-income disabled and homebound adults' and older adults' Internet use. It shows very low rates of Internet use compared to the US population, either due to lack of exposure to computer/Internet technology; lack of financial resources to obtain computers and technology; or medical conditions, disabilities, and associated pain that restrict use. Recommendations to reduce the digital divide among these individuals are provided. HubMed – depression


The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia: A Randomized Controlled Study.

Biol Res Nurs. 2013 May 2;
Chu H, Yang CY, Lin Y, Ou KL, Lee TY, O’Brien AP, Chou KR

Objective: The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with dementia. Method: The study had a prospective, parallel-group design with permuted-block randomization. Older persons with dementia (N = 104) were randomly assigned to the experimental or control group. The experimental group received 12 sessions of group music therapy (two 30-min sessions per week for 6 weeks), and the control group received usual care. Data were collected 4 times: (1) 1 week before the intervention, (2) the 6th session of the intervention, (3) the 12th session of the intervention, and (4) 1 month after the final session. Results: Group music therapy reduced depression in persons with dementia. Improvements in depression occurred immediately after music therapy and were apparent throughout the course of therapy. The cortisol level did not significantly decrease after the group music therapy. Cognitive function significantly improved slightly at the 6th session, the 12th session, and 1 month after the sessions ended; in particular, short-term recall function improved. The group music therapy intervention had the greatest impact in subjects with mild and moderate dementia. Conclusion: The group music intervention is a noninvasive and inexpensive therapy that appeared to reduce elders’ depression. It also delayed the deterioration of cognitive functions, particularly short-term recall function. Group music therapy may be an appropriate intervention among elderly persons with mild and moderate dementia. HubMed – depression


To be or not to be a bipolar disorder patient: problems with diagnosis.

J Nerv Ment Dis. 2013 May; 201(5): 435-7
Mazza M, Di Nicola M, Janiri L, Bria P

The diagnosis of bipolar disorder (BD) is predominantly clinical. Some authors have suggested that BD is underdiagnosed and that many patients, particularly those with major depressive disorder, actually have BD. Some studies have suggested that BD is wrongly diagnosed, probably because of the idea of a “bipolar spectrum.” To address this potential overdiagnosis, clinicians should carefully and systematically assess whether symptoms are included in diagnostic criteria and include the individual context of the patient. HubMed – depression