Search

Sexual orientation consists of multiple components. This study investigated both sexual identity and same-sex sexual behavior. Data came from the New Zealand Mental Health Survey, a nationally representative community sample of New Zealanders aged 16 years or older, interviewed face-to-face (N = 12,992, 48% male). The response rate was 73.3%. Self-reported sexual identity was 98.0% heterosexual, 0.6% bisexual, 0.8% homosexual, 0.3% "Something else," and 0.1% "Not sure." Same-sex sexual behavior with a partner was more common: 3.2% reported same-sex sexual experience only and 1.9% reported both experience and a relationship. For analysis of childhood and lifecourse, five sexuality groups were investigated: homosexual, bisexual, and heterosexual divided into those with no same-sex sexual experience, experience only, and experience and relationship. The non-exclusively heterosexual groups were more likely to have experienced adverse events in childhood. Educational achievement and current equivalized household income did not differ systematically across the sexuality groups. Only 9.4% of the exclusively heterosexual lived alone, compared with 16.7% of bisexuals and 19.0% of homosexuals. Heterosexuals were more likely than bisexuals or homosexuals to have ever married or had biological children, with differences more marked for males than for females. Heterosexuals with no same-sex sexual experience were more likely to be currently married than the other two heterosexual groups. Restricting comparisons to heterosexual, bisexual, and homosexual identification ignores the diversity within heterosexuals. Differences between the bisexual and homosexual groups were small compared with the differences between these groups and the exclusively heterosexual group, except for sex (80.8% of bisexuals were female). [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to compare two versions of the Kessler 10-item scale (K10), as measures of population mental health status in New Zealand. Method: A nationwide household survey of residents aged ≥16 years was carried out between 2003 and 2004. The World Mental Health Composite International Diagnostic Interview (CIDI 3.0) was used to obtain DSM-IV diagnoses. Serious mental illness (SMI) was defined as for the World Mental Health Surveys Initiative and the USA National Comorbidity Survey Replication. Participants were randomly assigned to receive the ‘past month’ K10 or the ‘worst month in the past 12 months’ K10. There were 12 992 completed interviews; 7435 included the K10. The overall response rate was 73.3%. Receiver operator characteristic (ROC) curves were used to examine the ability of both K10 versions to discriminate between CIDI 3.0 cases and non-cases, and to predict SMI. Results: Scores on both versions of the K10 were higher for female subjects, younger people, people with fewer educational qualifications, people with lower household income and people resident in more socioeconomically deprived areas. Both versions of the K10 were effective in discriminating between CIDI 3.0 cases and non-cases for anxiety disorder, mood disorders and any study disorder. The worst month in the past 12 months K10 is a more effective predictor than the past 1 month K10 of SMI (area under the curve: 0.89 vs 0.80). Conclusions: Either version of the K10 could be used in repeated health surveys to monitor the mental health status of the New Zealand population and to derive proxy prevalence estimates for SMI. The worst month in the past 12 months K10 may be the preferred version in such surveys, because it is a better predictor of SMI than the past month K10 and also has a more logical relationship to 12 month disorder and 12 month service use. [ABSTRACT FROM AUTHOR]

In a national survey in new Zealand (N = 12 992), participants of Māori descent (N = 2936) reported their proficiency in speaking, reading, and writing Māori and in understanding spoken Maori. Only 6-10% reported that they could cope "very well" in these areas while 36-52% reported their proficiency as "no more than a few words or phrases". There was no evidence of subgroups of Māori with divergent proficiency across oral language or literacy. Six latent classes were fitted but these appeared to lie along a continuum, and analysis employing item response theory (IRT) and factor analysis confirmed this. A simple sum of scores across the four areas correlated very highly with the IRT factor score (r = 0.97). High proficiency was more common among older Māori and females, in the Midland region (lowest in the south), and for those with sole-Māori ethnicity, followed by multi-ethnic Māori (seldom seen in those of Māori descent but not ethnicity). [ABSTRACT FROM AUTHOR]

Introduction and Aims. Onset and lifetime use of drugs have not previously been reported for all adult ages in New Zealand. This paper reports such results and, for people born in New Zealand, compares age of onset across ethnic groups. Design and Methods. A nationally representative cross-sectional survey was carried out in 2003–2004, with oversampling of Māori and Pacific people. Participants were aged 16 years or more, living in permanent private dwellings. In the Composite International Diagnostic Interview (CIDI 3.0), participants were asked if they had ever used drugs (alcohol, tobacco and five groups of other drugs) and the age of first use (except for tobacco). Estimates are weighted. Results. The response rate of 73.3% yielded 12 992 interviews. The percentage of participants who had ever used drugs was: 94.6% for alcohol, 50.8% for tobacco and 42.6% for any extramedical drug, including 41.6% for cannabis, 4.2% for cocaine and 2.9% for opioids. Use was much more common in recent cohorts for extramedical drugs. The median age of onset in each age cohort was always lowest for alcohol, then cannabis, then opioids, then cocaine. Among those born in New Zealand, Māori were more at risk of use than ‘Others’ with the lowest risk for Pacific people. Discussion and Conclusions. Interventions to prevent or to delay the onset of drug use need to occur before and during adolescence. The major cohort differences and the widespread experience of cannabis use help to explain the diversity of opinion in New Zealand about how to deal with this drug.[Wells JE, McGee MA, Baxter J, Agnew F, Kokaua J for the New Zealand Mental Health Survey Research Team. Onset and lifetime use of drugs in New Zealand: Results from Te Rau Hinengaro: The New Zealand Mental Health Survey 2003–2004. Drug Alcohol Rev 2009;28:166–174] [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment. Method: A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months. Results: The response rate was 73.3%. There were 12 992 participants (2595 Māori and 2236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need. Conclusions: Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those with serious disorder. [ABSTRACT FROM AUTHOR]

Objective: To estimate the 12 month prevalence of DSM-IV disorders in New Zealand, and associated interference with life and severity. Method: A nationally representative face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper the outcomes reported are 12 month prevalence, interference with life and severity for individual disorders. Results: The prevalence of any disorder in the past 12 months was 20.7%. The prevalences for disorder groups were: anxiety disorders 14.8%, mood disorders 7.9%, substance use disorders 3.5%, eating disorders 0.5%. The highest prevalences for individual disorders were for specific phobia (7.3%), major depressive disorder (5.7%) and social phobia (5.1%). Interference with life was higher for mood disorders than for anxiety disorders. Drug dependence, bipolar disorder and dysthymia had the highest proportion of severe cases (over 50%), when severity was assessed over the disorder itself and all comorbid disorders. Overall, only 31.7% of cases were classified as mild with 45.6% moderate and 22.7% serious. Conclusions: Compared with other World Mental Health survey sites New Zealand has relatively high prevalences, although almost always a little lower than for the US. For all disorders, except specific phobia, interference with life was reported to be moderate, on average, which has lead to less than a third of cases being classified as mild. Most people who have ever met full DSM-IV criteria, including the impairment criterion, and who experience symptoms or an episode in the past 12 months find that their disorders impact on their lives to a non-trivial extent. [ABSTRACT FROM AUTHOR]

Objective: To estimate the 12 month and lifetime use of health services for mental health problems. Method: A nationwide face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. Results: Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. Conclusions: A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries. [ABSTRACT FROM AUTHOR]

Objective: To estimate the lifetime prevalence and projected lifetime risk at age 75 years of DSM-IV disorders in New Zealand. Method: A nationwide face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0), was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are lifetime prevalence and projected lifetime risk at age 75 years. Results: The lifetime prevalence of any disorder was 39.5%. The lifetime prevalences for disorder groups were: anxiety disorders, 24.9%; mood disorders, 20.2%; substance use disorders, 12.3%; and eating disorders, 1.7%. The prevalences for all disorders were higher in the younger age groups. Females had higher prevalences of anxiety, mood and eating disorders compared with males; males had higher prevalences of substance use disorders. The estimated projected lifetime risk of any disorder at age 75 years was 46.6% with the median age of onset being 18 years. Adjustment for age, sex, education and household income did not remove all differences between Māori and the composite other ethnic group in the risk of disorder (hazard ratio = 1.1–1.4). After adjustment, hazard ratios for Pacific people ranged from 0.8 to 2.5. Conclusions: These results confirm those of other studies: mental disorders are relatively common and tend to have early onset. Females are more likely to experience anxiety, mood and eating disorders than males, who experience more substance use disorders. Adjustment for socioeconomic factors and demography does not explain all ethnic differences, although remaining differences are small relative to cohort and even sex differences. [ABSTRACT FROM AUTHOR]

Objective: To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. Method: A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Results: Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). Conclusion: The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of chronic physical conditions, and the risk factors for those conditions, among those with 12 month mental disorder; to estimate the prevalence of 12 month mental disorder among those with chronic physical conditions. Method: A nationally representative face-to-face household survey was carried out in October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. Mental disorders were measured with the World Mental Health version of the Composite International Diagnostic Interview (CIDI 3.0). Physical conditions were self-reported. All associations are reported adjusted for age and sex. Results: People with (any) mental disorder, relative to those without mental disorder, had higher prevalences of several chronic physical conditions (chronic pain, cardiovascular disease, high blood pressure and respiratory conditions) and chronic condition risk factors (smoking, overweight/obesity, hazardous alcohol use). Around a quarter of people with chronic physical conditions had a comorbid mental disorder compared with 15% of the population without chronic conditions. Significant relationships occurred between some mental disorders and obesity, cardiovascular disease and diabetes for females, but not for males. Conclusions: This paper provides evidence of substantial comorbidity between mental disorders and chronic physical conditions in New Zealand. This should be borne in mind by clinicians working in both mental health and medical services. [ABSTRACT FROM AUTHOR]

Objective: To describe prevalence and correlates of suicidal behaviour in the New Zealand population aged 16 years and over. Method: Data are from Te Rau Hinengaro: The New Zealand Mental Health Survey, a nationally representative household survey conducted from October 2003 to December 2004 in a sample of 12 992 participants aged 16 years and over to study prevalences and correlates of mental disorders assessed using the World Mental Health Composite International Diagnostic Interview. Lifetime and 12 month prevalences and onset distributions for suicidal ideation, plans and attempts, and sociodemographic and mental disorder correlates of these behaviours were examined. Results: Lifetime prevalences were 15.7% for suicidal ideation, 5.5% for suicide plan and 4.5% for suicide attempt, and were consistently significantly higher in females than in males. Twelve-month prevalences were 3.2% for ideation, 1.0% for plan and 0.4% for attempt. Risk of ideation in the past 12 months was higher in females, younger people, people with lower educational qualifications, and people with low household income. Risk of making a plan or attempt was higher in younger people and in people with low household income. After adjustment for sociodemographic factors, there were no ethnic differences in ideation, although Māori and Pacific people had elevated risks of plans and attempts compared with non-Māori non-Pacific people. Individuals with a mental disorder had elevated risks of ideation (11.8%), plan (4.1%) and attempt (1.6%) compared with those without mental disorder. Risks of suicidal ideation, plan and attempt were associated with mood disorder, substance use disorder and anxiety disorder. Major depression was the specific disorder most strongly associated with suicidal ideation, plan and attempt. Less than half of those who reported suicidal behaviours within the past 12 months had made visits to health professionals within that period. Less than one-third of those who had made attempts had received treatment from a psychiatrist. Conclusions: Risks of making a suicide plan or attempt were associated with mental disorder and sociodemographic disadvantage. Most people with suicidal behaviours had not seen a health professional for mental health problems during the time that they were suicidal. [ABSTRACT FROM AUTHOR]

Objective: To show the disability associated with 1 month mental disorders and chronic physical conditions for the New Zealand population, controlling for comorbidity, age and sex. Method: A nationally representative face-to-face household survey was carried out from October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. Mental disorders were measured with the World Mental Health (WMH) Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Disability was measured with the WMH Survey Initiative version of the World Health Organization Disability Assessment Schedule (WMH WHO-DAS) in the long-form subsample (n = 7435). Outcomes include five WMH WHO-DAS domain scores for those with 1 month mental disorders and with chronic physical conditions. Results: Mood disorders were associated with more disability than anxiety or substance use disorders. Experiencing multiple mental disorders was associated with substantial role impairment. Mental disorders and chronic physical conditions were associated with similar degrees of disability on average. The combination of mental and physical disorders had additive effects on associated disability. Conclusions: Mood disorders are disabling. The investigation of disability in relation to 1 month rather than 12 month disorders is likely to provide a clearer indication of the disability associated with mood disorders. Although some researchers have queried whether negative mood can lead to ‘over-reporting’ of disability, recent conceptualizations of disability provide a perspective which may ease such concerns. Comorbidity, of mental disorders or of mental and physical disorders, is disabling. [ABSTRACT FROM AUTHOR]

Objective: To compare ethnic groups for the 12 month prevalence of mental disorders and 12 month treatment contact in Te Rau Hinengaro: The New Zealand Mental Health Survey. Method: Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken in 2003 and 2004, was a nationally representative face-to-face household survey of 12 992 New Zealand adults aged 16 years and over, including Māori (n = 2595), Pacific people (n = 2236) and a composite Other ethnic group (predominantly European) (n = 8161). Ethnicity was measured using the 2001 census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used to measure disorder. The overall response rate was 73.3%. Results: The 12 month prevalence of any mental disorder was highest in Māori (29.5%; 26.6, 32.4), followed by Pacific people (24.4%; 21.2, 27.6) and Others (19.3%; 18.0, 20.6). Adjustment for age, sex, education and household income reduced differences: Māori (23.9%; 21.3, 26.4), Pacific (19.2%; 16.4, 22.1) and Other (20.3%; 18.9, 21.6). A similar pattern was seen for serious disorder and most individual disorders or disorder groups. After adjustment, Māori were most different from Pacific people and Others for substance use disorder. Both Māori and Pacific people had a higher prevalence of bipolar disorder than Others. Pacific people had the lowest prevalence of major depressive disorder. Among those with disorder, the proportion with a visit for mental health problems to any service was highest among Others (41.1%; 38.1, 44.1), with Māori (32.5%; 28.3, 36.7) intermediate and Pacific (25.4%, 19.4, 31.4) lowest. Adjustment did not alter ethnic differences in service contact. Conclusion: Māori, and to a lesser extent Pacific people, have a higher prevalence of 12 month mental disorders than Others. Differences are reduced after adjusting for sociodemographic correlates. Relative to need, Pacific people in particular and Māori are less likely than Others to have contact with services (health or non-health), regardless of sociodemographic circumstances. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence of mental disorders (period prevalence across aggregated disorders, 12 month and lifetime prevalence) among Māori in Te Rau Hinengaro: The New Zealand Mental Health Survey. Method: Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken between 2003 and 2004, was a nationally representative face-to-face household survey of 12 992 New Zealand adults aged 16 years and over, including 2595 Māori. Ethnicity was measured using the 2001 New Zealand census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0), was used to measure disorder. The overall response rate was 73.3%. This paper presents selected findings for the level and pattern of mental disorder prevalence among Māori. Results: Māori lifetime prevalence of any disorder was 50.7%, 12 month prevalence 29.5% and 1 month prevalence 18.3%. The most common 12 month disorders were anxiety (19.4%), mood (11.4%) and substance (8.6%) disorders and the most common lifetime disorders were anxiety (31.3%), substance (26.5%) and mood (24.3%) disorders. Levels of lifetime comorbidity were high with 12 month prevalence showing 16.4% of Māori with one disorder, 7.6% with two disorders and 5.5% with three or more disorders. Twelve-month disorders were more common in Māori females than in males (33.6% vs 24.8%) and in younger age groups: 16–24 years, 33.2%; 25–44 years, 32.9%; 45–64 years, 23.7%; and 65 years and over, 7.9%. Disorder prevalence was greatest among Māori with the lowest equivalized household income and least education. However, differences by urbanicity and region were not significant. Of Māori with any 12 month disorder, 29.6% had serious, 42.6% had moderate and 27.8% had mild disorders. Conclusion: Mental disorders overall and specific disorder groups (anxiety, mood and substance) are common among Māori and measures of severity indicate that disorders have considerable health impact. Findings provide a platform for informing public health policy and health sector responses to meeting mental health needs of Māori. [ABSTRACT FROM AUTHOR]

Background In randomized trials there may be no overriding reason whether or not to have a placebo control. Purpose We assessed the effects of an open trial design (no placebo and people know what tablets they are given) compared with a blinded, placebo-controlled design on recruitment, compliance and retention within a randomized trial of secondary osteoporotic fracture prevention. Methods We undertook a randomized controlled comparison nested within a placebo-controlled trial of nutritional supplementation amongst people aged 70 years or over who had previously sustained a fracture, recruited in a UK teaching hospital. Randomization was 2 : 1 in favour of the blinded, placebo-controlled trial design. Results From 180 eligible participants randomized to receive information based on the open trial design, 134 (74.4%) consented to take part, compared with 233 (65.1%) of 358 people randomized to the blinded, placebo-controlled design (difference 9.4%, 95% confidence interval 1.3–17.4%). Reluctance to take a placebo and the desire to know tablet allocation were reasons given for not taking part in the blinded, placebo-controlled design. There was no significant difference in tablet compliance. Open trial participants were more likely to remain in the trial for one year (difference 13.9%, 95% confidence interval 3.1–24.6%), mainly reflecting the high retention of the open trial no tablet group compared to the open trial tablet group (difference 23.6%, 95% confidence interval 11.9–35.2%). The odds ratio for reporting an adverse event in the open trial compared to the blinded, placebo-controlled design was 0.64 (95% confidence interval 0.28–1.49), and for reporting a fracture was 0.81 (0.36–1.85). Conclusions We conclude that using an open trial design may enhance participant recruitment and retention and thus improve generalizability and statistical power, but withdrawal rates may differ between the study allocations and may threaten the internal validity of the trial. [ABSTRACT FROM AUTHOR]

A review is presented to the article "The Diversity and Prevalence of Sexual Orientation Self-Labels in a New Zealand National Sample" by Lara M. Greaves, Fiona Kate Barlow, Carol H. J. Lee, Correna M. Matika, Weiyu Wang, Cinnamon-Jo Lindsay, et al., published in an earlier issue of the journal.

Focuses on a study which provided a profile of disorders and disabilities in the older population. Setting and design of the study; Results; Conclusion.

Dementia is an important cause of disability in the elderly. There is evidence that cognitive impairment in dementia is on a continuum with cognitive impairment in the non-demented elderly. In order to investigate this possibility, we need detailed knowledge about the population distribution of cognitive function and change in cognitive function. The aim of this study is to describe the change in different domains of cognitive function over 4 years in a population-based sample of non-demented elderly people, and to investigate the effect of sociodemographic variables and baseline cognitive function on change in each of the cognitive domains. Respondents from two group general practice lists (n =503) were interviewed using the Cambridge Cognitive Examination (CAMCOG) at the incidence wave of the Cambridge City Over-75 Cohort Study and after a mean time period of 3.9 years. One hundred and thirty five of 212 non-demented subjects seen at follow-up completed the CAMCOG at both interviews. The annual rate of change in total CAMCOG score was -1.6 points per year (p <0.001). There was statistically significant decline in all of the CAMCOG subscales. Greater decline in the Memory subscale was associated with less education (p =0.03). Greater decline in the Attention/Calculation subscale was associated with manual social class (p =0.05). Greater decline in the Perception subscale was associated with older age (p =0.03). Decline in specific cognitive domains may indicate a reversible phase of cognitive impairment and deserves further investigation. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Increases in longevity will involve a significant increase among the number of drivers in the very old, who are at greater risk of being involved in road accidents. Data are thus needed from studies of older populations to characterize those still driving, the reasons for giving up and to help formulate appropriate policies for dealing with the problems faced and created by an increase in older drivers.Methods: A driving questionnaire was administered to surviving members of a cohort comprising a representative sample of individuals aged >/=84, the Cambridge City over 75 Cohort. Out of 546 survivors 404 completed the driving questionnaire at the 9-year follow-up. In addition, subjects were assessed, at baseline and at each follow-up, for cognitive performance using the Mini-Mental State Examination (MMSE) and for physical impairment using the Instrumental of Activities in Daily Living (IADL) scale.Results: Of the sample, 37% had driven in the past, and 8.4% were still driving, the majority regularly. The drivers tended to be younger (mean age 86.6 years), men (71%) and to be married (67.7%). Although physical disability and cognitive impairment are common in this age group, current drivers had few physical limitations on their daily activities and were not impaired on MMSE. None of the current drivers had visual impairment and 22.6% had hearing loss. Of those who had given up driving, 48.5% had given up at the age of >/=80. The commonest reasons for giving up driving were health problems (28.6%), and loss of confidence (17.9%). One-third reported giving up driving on advice.Conclusion: A process of self-selection takes place among older drivers. People over the age of 84 who are still driving have generally high levels of physical fitness and mental functioning, although some have some sensory loss. Given the likely increase in the number of older drivers over the next decades, safety will be improved most by strategies aimed at the entire driving population with older drivers in mind, rather than relying on costly screening programmes to identify the relatively small numbers of impaired older people who continue to drive. [ABSTRACT FROM AUTHOR]

Presents a study which described the activities of daily living within five British centers in England and Wales, using data collected from the Medical Research Council Cognitive Function and Ageing Study. How the study was structured; Utilization of the self-reported Townsend disability scale; Implication of findings; Discussion on results.

A response by J.E. Wells, M.A. McGee, and A.L. Beautrais to a letter to the editor on their article regarding sexual orientation in the 2011 issue is presented.

A correction to the article "Multiple Aspects of Sexual Orientation: Prevalence and Sociodemographic Correlates in a New Zealand National Survey," that was published in the 2011 issue of the journal "Archives of Sexual Behavior" is presented.