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In my clinical practice, I have noticed that ADHD diagnoses among women are on the rise and that more and more women are looking for answers to their difficulties. Most of the new patients who are diagnosed with Adult ADHD are relieved as they can make sense of their difficulties, which nearly always looks different to the typical male ADHD picture. Due to this traditional imagery of ADHD, these women are overlooked and less likely to be referred for mental health services.
It is worth remembering that ADHD is not gender biased. It was not so long ago where we all knew of ADHD in the context of naughty disruptive school boys bouncing off the walls. ADHD symptoms exist in both females and males and in the same proportions. We have a huge gap in the diagnosis profile with males almost three times more likely to be diagnosed with ADHD than females. ADHD really does look different in women.
In school or college women with ADHD are bright and intelligent. This is due to the fact that their symptoms are more subtle. However, they may underperform at critical times such as their exams, due to concentration issues.
There are support groups and medication would be an option for ADHD, many of our patients are coming to us at an older age and many of them women- you can contact ADDISS or speak to your GP to see what support is available for you in your area if you have suspected ADHD.
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Hear this: Men gab more on cellphonesWomen can no longer accuse men of being bad communicators. Men talk 35 percent more often on their wireless phones than women, according to a survey done by Cingular Wireless.
A longitudinal study with 393 community-dwelling older adults aged 65 years and over (110 men/ 283 women) resident in the North Zone of the city of Rio de Janeiro, Brazil. The fear of falling was assessed by the Falls Efficacy Scale-I-BR. The explanatory variables assessed were: number of comorbidities and medicines, history of falls, fracture from falling, use of walking aids, functional dependence in basic and instrumental activities of daily living, hearing and visual impairment, hand grip strength, walking speed, self-rated health, body mass index, depressive symptoms, cognitive impairment, living alone and activity level. Incidence, persistence and risk factors were estimated. Multivariate analysis was performed using Poisson Regression, obtaining relative risks (RR) and corresponding to 95% confidence intervals.
Studies show that the main risk factors for incidence are: being a woman, more advanced age, having a history of falls, impaired gait or balance and depression or depressive symptoms. Incidence rates range from 13% to 45%77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... . However, these studies are also rather heterogeneous in their populations, particularly regarding age ranges and sex (some studies were conducted only among women)77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... ,88. Murphy SL, Dubin J, Gill TM. The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J Gerontol A Biol Sci Med Sci. 2003;58(10):M943-7. .
Few studies have evaluated the persistence of fear of falling, which ranged from 46% to 80%. With different risk factors when compared with occurrence77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... ,99. Oh-Park M, Xue X, Holtzer R, Verghese J. Transient versus persistent fear of falling in community-dwelling older adults: incidence and risk factors. J Am Geriatr Soc. 2011;59(7):1225-31. -5415.2011.03475.x -5415.2011... . The main factors involved were: history of falls, living alone, cognitive impairment, body mass index, use of medicine for anxiety or depression and gait disturbance77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... .
Differentiating risk factors for incident and persistent fear is essential to establish appropriate assessment and intervention strategies. Another important point is that most longitudinal studies that evaluate fear of falling occurrence and related risk factors are based on one simple question77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... Only one study has assessed fear of falling using a structured scale, the Falls Efficacy Scale (FES). However, this study was conducted among older adults admitted to a care center, who were evaluated only just before discharge1515. Visschedijk JHM, Caljouw MAA, Bakkers E, Balen R, Archterberg. Longitudinal follow-up study on fear of falling during and after rehabilitation in skilled nursing facilities. BMC Geriatr. 2015;15:161. -015-0158-1 -015-0158-... . Another important issue is that our study is the first one conducted in Brazil and Latin American to assess fear of falling in a longitudinal design, which can provide answers regarding incidence, persistence and risk factors to be compared with international studies and understand this condition that affect quality of life in older adults.
Table 1 shows that 72% of the participants were women, 47.1% from 65 to 74 years old, 44% married or living with a companion, 78.5% had more than six years of schooling and 45% earned more than five minimum wages.
Few studies that have evaluated the FOF persistence have found percentages ranging from 46% to 80%77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... ,99. Oh-Park M, Xue X, Holtzer R, Verghese J. Transient versus persistent fear of falling in community-dwelling older adults: incidence and risk factors. J Am Geriatr Soc. 2011;59(7):1225-31. -5415.2011.03475.x -5415.2011... , being similar to our results, which found 71.3%. It has proven the importance of evaluating FOF persistence, since these other authors have shown substantial differences in the predictors for incident and persistent FOF.
Among risk factors for the incidence, we found that using seven or more medicines and reporting worse activity level than in the prior year increased the risk of developing fear of falling. We emphasize that both factors are modifiable and susceptible to intervention. Friedman et al. (2002)1212. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329-35. -5415.2002.50352.x -5415.2002... found that the use of four or more medicines (considered polypharmacy in older adults) was a risk factor. Austin et al.77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... found that using medicines for depression and/or anxiety was also a risk factor. Our study only evaluated the associations of medicines by the total number in use, regardless of their specific classes.
Other risk factors were associated with persistent FOF. The use of seven or more medicines was also a risk factor for persistence. Studies have assessed persistence by the use of psychotropics or medicines for depression and anxiety77. Austin N, Devine A, Dick N, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55(10):598-603. ;10.1111/j.1532-5415.2007.01317.x ;10.1111/j.1532-5415.2007... , disregarding the total number of medicines. 59ce067264
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