Few studies have investigated the measurement error of the Mini-Mental State Examination (MMSE) in the same unit of measurement, also known as absolute reliability. This measurement can help determine whether an observed score change for an individual is likely to represent true change. The aim of this study was to investigate the absolute reliability of the MMSE among individuals with dementia that reside in nursing homes. Among 88 participants, 19 (21.6%) were men, 35 (39.8%) had Alzheimer's disease, 35 (39.8%) had vascular dementia, and the mean age was 84.0 years (range 65-98). The participants were tested and retested with the MMSE within 1-6 days. Both tests were administered by the same assessor at the same time of day. The mean MMSE score was 13.7 (range 0-28). The absolute difference between MMSE scores varied from 0 to 6 points, and the differences did not correlate with the corresponding score means (p = 0.874). The smallest detectable change (SDC) between two measurements was 4.00. The SDC was independent of depression, impaired vision and hearing, delirium within the last week, dementia type and age. However, the SDC was 5.56 among men and 3.50 among women (p = 0.003). In conclusion, for individuals with dementia that reside in nursing homes, it seems like their MMSE score needs to change by four or more points between two measurements in order for their score change to be reliably higher than the measurement error.Our aim is to culturally adapt the first section of the Patient Continuity of Care Questionnaire (PCCQ) for use among older Italian patients with chronic diseases and to test its psychometric properties. The PCCQ was translated, adapted to the Italian context, and completed by 236 older inpatients with chronic diseases at the point of discharge through a cross-sectional multi-centre validation study. Face and content validity were assessed. Exploratory factor analysis (EFA) with Mplus MLr estimator was conducted. Internal consistency was analysed through Cronbach's alpha and factor score determinacy coefficients. The overall content validity index of the 15-item Italian version of the questionnaire was 0.9. The EFA revealed a four-factor model yielding adequate fit indices. https://www.selleckchem.com/products/nf-kb-activator-1.html The factor score determinacy coefficients ranged from 0.87 to 0.94. The Cronbach's alpha coefficients ranged from 0.71 to 0.86 showing good reliability. The study provides health professionals with an instrument with adequate psychometric properties to assess patients' perception of the information received before hospital discharge.In many developed countries, long-term care expenditures are a major source of concern, which has urged policy makers to reduce costs. However, long-term care financing is highly fragmented in most countries and hence reducing total costs might be complicated by spillover effects spending reductions on one type of care may be offset elsewhere in the system if consumers shop around for substitutes. These spillovers may be substantial, as we show using a reform in the budget for municipalities for the most common type of publicly financed home care in the Netherlands, domestic help. This reform generated an exogenous change in the grant for domestic help that does not depend on changes in its demand. We show that the change in budget affected consumption of this care type, but that this effect was mitigated by offsetting changes in the consumption of three other types of home care that are financed through another public scheme and are organized through regional single payers. We find that a 10 euro increase in the grant for domestic help increased use of domestic help and nursing by 0.13 and 0.03 h per capita (4.4 and 5.2% of use in 2007), whereas it decreases use of individual assistance and personal care by 0.03 and 0.05 h per capita (4.1 and 2.9% of use in 2010 and 2007, respectively). As a result, the total spending effect is closer to zero than the effect on domestic help suggests. This finding means that the fragmentation of long-term care financing limits the ability to control expenditure growth.Depressive disorders are among the most widespread mental disorders in old age, with negative consequences for quality of life (QOL). Understanding QOL as a multidimensional construct, in this article we have a closer look on what specific aspects are affected by depression. We used a representative sample of the German population (n = 805) and one of individuals diagnosed with depression (n = 106) to compare QOL using the WHOQOL-BREF and the WHOQOL-OLD. Multivariate analysis showed that individuals diagnosed with depression exhibited lower QOL with regard to WHOQOL-BREF-dimensions physical health, psychological, social relationships and global QOL and with regard to WHOQOL-OLD-facets sensory abilities, past, present, and future activities and social participation. In addition, in the regression analysis, there were no significant differences between individuals with and without depression with regard to environment (WHOQOL-BREF), autonomy, death and dying, intimacy and overall (WHOQOL-OLD). Associations between depression and QOL in older age are selective in terms of which aspects of QOL are affected. From a methodological perspective, a multidimensional approach to QOL is recommended. From a clinical perspective, our research highlights those areas of QOL that are relevant for health professionals working with older people and that could be the focus of interventions.Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 years living in Jyväskylä, Central Finland. Mobility limitations were indicated as self-reported difficulty in walking 2 km. Categories were no difficulty (reference), difficulty, and unable to walk. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale and active aging with the University of Jyvaskyla Active Aging scale. Data were analyzed with OLS regression analyses, which were stratified by age. In all age-groups, having difficulties walking or being unable to walk 2 km was associated with lower active aging scores. Resilience moderated this association especially among the 75-year-olds, but not among the 85-year-olds The higher the resilience score, the higher the active aging score among those reporting no or some walking difficulties.