Smith, Alison; Gray, Juliet
Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia. PMID:27270199
Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L
Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. PMID:26096839
Pilgrim, A.L.; Baylis, D; Jameson, K.A; Cooper, C; Sayer, A.A.; Robinson, S. M.; Roberts, H. C.
Objectives: Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. Design: Longitudinal observational with follow- up at six months. Setting: Female acute Medicine for Older People wards at a U...
Full Text Available Abstract Background The search for preventive methods to mitigate functional decline and unwanted relocation by older adults living in the community is important. Preventive home visit (PHV models use infrequent but regular visits to older adults by trained practitioners with the goal of maintaining function and quality of life. Evidence about PHV efficacy is mixed but generally supportive. Yet interventions have rarely combined a comprehensive (biopsychosocial occupational therapy intervention protocol with a home visit to older adults. There is a particular need in the USA to create and examine such a protocol. Methods/Design The study is a single-blind randomized controlled pilot trial designed to assess the feasibility, and to obtain preliminary efficacy estimates, of an intervention consisting of preventive home visits to community-dwelling older adults. An occupational therapy-based preventive home visit (PHV intervention was developed and is being implemented and evaluated using a repeated measures design. We recruited a sample of 110 from a population of older adults (75+ who were screened and found to be at-risk for functional decline. Participants are currently living in the community (not in assisted living or a skilled nursing facility in one of three central North Carolina counties. After consent, participants were randomly assigned into experimental and comparison groups. The experimental group receives the intervention 4 times over a 12 month follow-up period while the comparison group receives a minimal intervention of mailed printed materials. Pre- and post-intervention measures are being gathered by questionnaires administered face-to-face by a treatment-blinded research associate. Key outcome measures include functional ability, participation, life satisfaction, self-rated health, and depression. Additional information is collected from participants in the experimental group during the intervention to assess the feasibility of
In a recent discussion about government proposals on care for older people (July 2009), the Radio 4 news presenter referred to a possible need to return to the attitude that it's the family's responsibility to look after its older members. Yet there is often already an expectation that the family – by which is usually meant children or grandchildren – can be relied upon to take an active part in the social life and any care arrangements for their older members. Indeed, social policy in much o...
Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.
R. Morgan; Pendleton, N; Clague, J E; Horan, M A
BACKGROUND: Little is known of the nature and origins of the attitudes that older people have towards ageing, disease, and medical treatments. Several studies on older people in the community have suggested under-reporting of symptoms. There may be several reasons for this, including the possibility that some older people regard disease processes as a natural feature of ageing and, consequently, feel that medical intervention may have little to offer. AIM: To investigate the perceptions of ol...
Drenth - van Maanen, A.C.
Appropriate prescribing is the result of pharmacotherapeutic decision-making to maximise the net health benefit of treatment, given the resources available. Several risk factors for inappropriate prescribing in older people have been identified, such as polypharmacy, impaired renal function, and frequent transfers between healthcare settings. The objectives of the studies described in this thesis were to describe the frequency and nature of risk factors for inappropriate prescribing in older ...
Drenth - van Maanen, A.C.
Appropriate prescribing is the result of pharmacotherapeutic decision-making to maximise the net health benefit of treatment, given the resources available. Several risk factors for inappropriate prescribing in older people have been identified, such as polypharmacy, impaired renal function, and fre
Late life bereavement has been associated with psychological problems, mainly depression. A few studies indicated that posttraumatic stress disorder (PTSD) was an important issue in late life bereavement reactions. This study aimed to assess the prevalence of PTSD in recently bereaved older people compared with married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety-six Danish older bereaved people (mean age 73 years, 113 males) were chosen from national registers and assessed two months postbereavement. They were compared with a control group of 276 married older people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES = 0.35; Cohen's d = 0.74). Additionally, 37% of the bereaved and 22% of the control group had mild to severe depression (ES = 0.19; Cohen's d = 0.37). The results suggested that late life spousal bereavement result in PTSD with equal frequency to general samples of bereaved persons. Furthermore, the prevalence of PTSD in the first months after bereavement was more elevated than the level of depression. This makes PTSD an important factor when studying late life bereavement reactions. PMID:20686978
The current paper examines the design process that led to an unusually successful interactive tutorial for older people. The paper describes the issues that make designing for older people different. These include differences between the designer and the target population and the difficulty that older people have in interacting with low-fidelity…
Between 30% and 60% of older patients experience functional decline after hospitalization, resulting in a decline in health-related quality of life and autonomy. This is associated with increased risk of readmission, nursing home placement and mortality, increased length of hospital stay and increas
Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).
... many people are affected or at risk for lactose intolerance? Skip sharing on social media links Share this: ... lactose do not get symptoms. 1 Who gets lactose intolerance and who is at risk for it? Lactose ...
Full Text Available Solveig T Tomstad,1,2 Ulrika Söderhamn,2 Geir Arild Espnes,3 Olle Söderhamn21Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, Norway; 2Centre for Caring Research – Southern Norway, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition.Aim: The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition.Methods: Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method.Findings: Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life
Deuter, Kate; Procter, Nicholas; Evans, David; Jaworski, Katrina
This discussion paper identifies and examines several tensions inherent in traditional approaches to understanding older people's suicide. Predicted future increases in the absolute number of elderly suicides are subject to careful interpretation due to the underreporting of suicides in older age groups. Furthermore, a significant number of studies of older people's death by suicide examine risk factors or a combination of risk factors in retrospect only, while current approaches to suicide prevention in the elderly place disproportionate emphasis on the identification and treatment of depression. Taken together, such tensions give rise to a monologic view of research and practice, ultimately limiting our potential for understanding older people's experience of suicide and suicidal behaviour. New approaches are necessary if we are to move beyond the current narrow focus that prevails. Fresh thinking, which draws on older people's experience of attempting to die by suicide, might offer critical insight into socially-constructed meanings attributed to suicide and suicidal behaviour by older people. Specifically, identification through research into the protective mechanisms that are relevant and available to older people who have been suicidal is urgently needed to effectively guide mental health nurses and health-care professionals in therapeutic engagement and intervention. PMID:26762697
Wadolowska, L.; Danowska-Oziewicz, M.; Niedzwiedzka, E.;
Food patterns of Polish older people were separated and described. The research included 422 people aged 65+ years, living in 5 geographical locations. Participants of the study were selected in quota sampling. Criteria for recruitment included sex, age (65-^74 or 75+ years) and family status...
Full Text Available In response to the review article written by Pavuluri and May  and to the original article by Tomasino et al  we will comment the recent neuroimaging findings of insular dysfunctions in Schizophrenia and Bipolar Disorders, focusing on people at genetic risk for developing psychotic symptoms. A disrupted insular functioning was reported in several studies, even though the results were not univocal with respect to the direction of the effect (some studies reported a reduced activation, other an augmented activation and the lateralization of the observed alterations (left, right or bilateral. We will conclude that an altered function of the insula during both cognitive and emotional task may be a candidate vulnerability marker for psychotic disorders.
Alessi, Cathy; Vitiello, Michael V.
Up to 40% of older adults have insomnia, with difficulty getting to sleep, early waking, or feeling unrefreshed on waking. The prevalence of insomnia increases with age. Other risk factors include medical and psychiatric illnesses, psychological factors, stress, daytime napping, and hyperarousal.Primary insomnia is a chronic and relapsing condition that may increase the risks of accidents.Primary insomnia is chronic insomnia without specific underlying medical, psychiatric, or other sleep ...
Research in social epidemiology and medical sociology has consistently shown that people in lower socioeconomic status groups experience poorer health and live shorter lives than those in higher status groups. However, investigations of such differentials among people aged 65 and over is still comparatively rare. In this issue of the journal Huisman et al report on the results of their analyses of socioeconomic status (housing tenure, education) and mortality among older people. These were ba...
Moya, Tatiana; Fleitlich-Bilyk, Bacy; Goodman, Robert
A representative sample of 7-14-year-old young people in southeast Brazil (N=1251) was assessed using standardized parent and youth interviews, thereby identifying an "at-risk" group of young people who met one or more DSM-IV criteria for anorexia and/or bulimia nervosa. These young people were compared with an age and gender matched comparison…
... people are affected by or at risk for endometriosis? Skip sharing on social media links Share this: ... menstruates. Factors that May Increase the Risk of Endometriosis Studies show that women are at higher risk ...
... people are affected by or at risk for Down syndrome? Skip sharing on social media links Share this: ... ethnicity. 4 , 5 Maternal Age and Risk for Down Syndrome Because the likelihood that an egg will contain ...
Baer, Britta; Bhushan, Anjana; Taleb, Hala Abou; Vasquez, Javier; Thomas, Rebekah
A focus on the right to the enjoyment of the highest attainable standard of health (hereinafter, "the right to health") draws attention to the health needs of older people, including the most marginalized among them. Many factors that influence vulnerability or impede the enjoyment of health and access to quality services result from an inability to freely exercise these human rights. A human rights approach can help to address the legal, social, and structural barriers to good health for older persons, clarifying the legal obligations of State and non-State actors to uphold and respect these rights. However, despite growing impetus for action, this area has historically received limited attention. Drawing on practice examples from different regions, this article unpacks the meaning of the right to health and other related human rights of older people in practice, covering both health care and underlying determinants of their health. Questions of availability, accessibility, acceptability, and quality are highlighted from the perspective of older people's health and well-being. The article brings together knowledge, principles, norms, and standards from the human rights law, health, and ageing arenas. By making links between these arenas, it is hoped that the article fills a gap in thinking on how to achieve the progressive realization of the right to health of older people and the effective promotion and protection of their other related human rights, which are crucial for the enjoyment of health. PMID:26994261
Barry, Maree; Nugent, Linda
Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork. PMID:26669407
Levels of poverty and wellbeing among older people in poor, urban settings in Africa have been under-researched, yet absolute numbers of older people are set to increase in this continent in the coming decades. The urban experience of wellbeing for older people is relatively unknown as research tends to focus on older people residing in rural places. This study addresses this research gap and investigates patterns of poverty and wellbeing among older people in two slum settlements in Nairobi....
Dean, Moira; Raats, Monique M.; Grunert, Klaus G.
This chapter discusses food-related satisfaction with life of older people, identifying some of the determinants and barriers to satisfaction with food-related quality of life, and discusses possible ways of enhancing older people's quality of life in the domain of food. Despite being strongly...... associated with life, and heavily contributing to the quality of life, food has so far been neglected and not much research has been conducted into people's satisfaction with their food-related life and its relationship to overall life satisfaction. As people age, their goals and available resources in terms...... of health, social networks, income and skills change. Changes in resources can be expected to have an impact on satisfaction with life....
van den Berg, Julia F.; Kok, Rob M.; van Marwijk, Harm W. J.; van der Mast, Roos C.; Naarding, Paul; Oude Voshaar, Richard C.; Stek, Max L.; Verhaak, Peter F. M.; de Waal, Margot W. M.; Comijs, Hannie C.
OBJECTIVES: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. DESIGN: Cross-sectional study. SETTING: Netherlands Study of Depression in Older Persons (NESDO). PARTICI
Socio-psychological variables that influence the extent to which older people (age: 50+) will be consumers of education are examined to arrive at criteria for programs appropriate to the developmental needs of this group. Research indicates that two primary influences are changes in learning abilities and interests. Secondary influences include…
Petersen, Poul Erik; Yamamoto, Tatsuo
The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health and social policy-makers will face tremendous challenges posed by the rapidly ch...
Vass, M; Hendriksen, C
is recommended at every encounter, and time consuming comprehensive follow-up will be demanded, 'polypharmacy consultations' surely will be built into GP contracts in the future. The authors state that a number of pharmacological regimens for older people are outperformed by non...
accessibility problems before the planning of housing intervention strategies. It is also critical that housing standards addressing accessibility intended to accommodate people with functional limitations are valid in the sense that their definitions truly support accessibility. However, there is a paucity of...... reasonably question the validity of the housing standards addressing accessibility. This thesis addresses housing accessibility methodology in general and the reliability of assessment and the validity of standards targeting older people with functional limitations and a dependence on mobility devices in...... particular. The overarching aim of the thesis was to develop and explore methods applicable for improving housing accessibility assessments and to explore feasible approaches to create housing standards that truly support accessibility and accommodate older people. A main methodological contribution of the...
Full Text Available We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.
Haustein, Sonja; Siren, Anu
demographic, health-related, or transport-related factors. This paper reviews these studies and compares the segments of older people that different studies have identified. First, as a result of a systematic comparison, we identified four generic segments: (1) an active car-oriented segment; (2) a car......The expanding older population is increasingly diverse with regard to, for example, age, income, location, and health. Within transport research, this diversity has recently been addressed in studies that segment the older population into homogeneous groups based on combinations of various...... people’s travel behaviour. Based on this, we proposed a theoretical model on how the different determinants work together to form the four mobility patterns related to the identified segments. Finally, based on current trends and expectations, we assessed which segments are likely to increase or decrease...
Curran, Stephen; Byrne, Andrew; Wattis, John
In the light of recent National Institute for Clinical Excellence (NICE) and Committee for the Safety of Medicines (CSM) guidance we discuss the importance of the diagnosis of depression in old age and review pharmacological interventions. An introductory section is followed by sections on each of the main antidepressant groups. This briefly describes their pharmacology and reviews research done specifically relevant to older people. Finally practical clinical applications are discussed.
Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas
Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. PMID:26843510
Full Text Available This article examines the needs of older people as well as manifestations of their activity. Third Generation Universities, which are being created around the world, make it possible to actualize the needs of older people. Through the example of the Society in Plotsk, the author examines the activity of older people attending a Third Generation University.
Clayton, Pamela M., Ed.; Fojcik, Vavrinec; Greco, Silvana; Hulkko, Johanna; Kelly, Eimer; Kostka, Miroslav; McGill, Paul; Machackova, D.; Maiello, Marco; Makela, Eija; Sinorova, Lenka; Troska, Robert; Ward, Mary
This document contains 7 papers that evolved from 44 case studies of access to vocational guidance for people at risk of social exclusion in 5 European countries. The following papers are included: "Introduction" (Pamela Clayton); "Access to Vocational Guidance in Italy" (Silvana Greco, Marco Maiello); "Access to Vocational Guidance in Ireland"…
Xu, Ziyan; Mayer, Benjamin; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Dvorsky, Diane; Metzler, Sibylle; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas
Suicidality is common among individuals at risk of psychosis. Emerging findings suggest that mental illness stigma contributes to suicidality. However, it is unclear whether stigma variables are associated with suicidality among young people at risk of psychosis. This longitudinal study assessed perceived public stigma and the cognitive appraisal of stigma as a stressor (stigma stress) as predictors of suicidal ideation among individuals at risk of psychosis over the period of one year. One hundred and seventy-two participants between 13 and 35 years of age were included who were at high or ultra-high risk of psychosis or at risk of bipolar disorder. At one-year follow-up, data were available from 73 completers. In multiple logistic regressions an increase of stigma stress (but not of perceived stigma) over one year was significantly associated with suicidal ideation at one-year follow-up, controlling for age, gender, symptoms, comorbid depression and suicidal ideation at baseline. Interventions to reduce public stigma and stigma stress could therefore improve suicide prevention among young people at risk of psychosis. PMID:27419651
Guyonnet, Sophie; Rolland, Yves
Malnutrition risk increases with age and level of care. Despite significant medical advances, malnutrition remains a significant and highly prevalent public health problem of developed countries. Earlier identification and appropriate nutrition support may help to reverse or halt the malnutrition trajectory and the negative outcomes associated with poor nutritional status. A nutrition screening process is recommended to help detect people with protein-energy malnutrition (PEM) or at malnutrition risk. Evidence supports that oral nutritional supplements and dietary counseling can increase dietary intake and improve quality of life in elderly with PEM or at malnutrition risk. This article examines nutritional screening and assessment tools designated for older adults. PMID:26195101
Private transport is important in enabling older people living in the community to maintain their independence and social networks. Access to this resource remains a major concern for older people. This study examines the demographic risk factors that restrict older people's access to private transport. The findings lead to policy recommendations directed towards self-reliance. Analysis, based on the study's household survey consisting of a sample of noninstitutionalised older Gold Coast peop...
Rojas-Fernandez, Carlos; Mikhail, Mina
Late-life depression is common in older people. Its incidence increases significantly after age 70 to 85, as well as among those living in long-term care facilities. Depression contributes to excess morbidity and complicates management of comorbid conditions in older people. Diagnosis and management of depression often present clinicians with a challenge. Indeed, symptoms of depression in older people may not always be the same as those associated with depression in younger people. Additional...
Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy
Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. PMID:26179452
G.G. URMURZINA; A.D. SOKOLOV; T.A. ZHUMAKOVA; N.B. BABAZADE
For the improvement of quality of life of older people development of gerontology service in the republic of Kazakhstan, grant to the older people of possibility to engage in labour, maintenance of their entrepreneurial activity is needed, involving in a civilized manner elucidative work. In all spheres of life older people are the powerful, but not used resource of society. Forming of new attitude is needed toward the place of old age in the vital loop.
Koskinen, Sanna; Salminen, Leena; Leino-Kilpi, Helena
Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray ...
TABATABAEI, Seyyede Farzane; TOUZANDEHJAN, Omid
Abstract. The problem of accommodating traffic is important when its inappropriateness is one of the main problems of older people and now most of the public places, passages, streets, parks and, entertainment places are inappropriate for them and they cannot easily enter the community and use facilities. If we do not consider urban poor conditions as well as physical and psychological problems that many older people suffer from at the age disability, in the next few decades the older people ...
markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia are now the most encountered diseases and causes of death in older people with intellectual disabilities. Although cardiovascular disease is a major risk for older people with intellectual disabilities...
Paisley, Peter; Serpell, Mick
Jont pain in oldder people The prevalence of chronic pain in older people in the community ranges from 25 to 76% and for those in residential care, it is even higher at 83 to 93%. The most common sites affected are the back, hip, or knee, and other joints. There is increased reporting of pain in women (79%) compared with men (53%). Common conditions include osteoarthritis and, to a lesser extent, the inflammatory arthropathies such as rheumatoid arthritis. The differential diagnosis includes non-articular pain such as vascular limb pain and nocturnal cramp, some neuropathic pain conditions (such as compressive neuropathies and postherpetic neuralgia), soft tissue disorders such as fibromyalgia and myofascial pain syndromes. In addition to an assessment of pain intensity, a biopsychosocial model should be adopted to ascertain the effect of the pain on the patient's degree of background pain at rest. The disease is often localised to the large load-bearing joints, predominantly the hips and knees. In contrast to osteoarthritis, the inflammatory arthritides typically present with symmetrical swollen, stiff, and painful small joints of the hands and feet, usually worse in the morning. PMID:27180497
Older people face many difficult challenges that amount to a deplorable violation of their basic human rights (poverty, discrimination, denial of social services, etc.). However, the world has been slow to react. Factors that limit global responses to the challenges of aging include: limited political will, the prevalence of neo-liberalism, and NGOs' longstanding advocacy for other seemingly "more" disadvantaged groups. Such oppression of and discrimination against older people require a concerted world-wide response. We contend that the introduction of an international convention on the human rights of older people is most relevant. Reinforced by a potent international monitoring system, the convention should contain comprehensive and legally binding provisions that require participating states to promote older people's rights. It is argued that international law would be a powerful force in defending and protecting older persons, operating as a baseline for establishing underlying values for national aging policies and linking older persons' concerns with other segments of society. PMID:18198162
Full Text Available Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray older people in society, using Finland as an example. The data consist of articles selected from three of the main Finnish daily newspapers during a 3-month period in the spring of 2012. The findings show that, overall, the society regards older people and their care as important. However, there were suggestions of paternalistic attitudes towards older people. Furthermore, the perceptions regarding different groups of older people could lead to the possibility of inequality. The media portrayals of older people worldwide seem to share similarities, although the findings of this study are particularly in accordance with the cultural attributes of the Nordic countries and societies.
Koskinen, Sanna; Salminen, Leena; Leino-Kilpi, Helena
Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray older people in society, using Finland as an example. The data consist of articles selected from three of the main Finnish daily newspapers during a 3-month period in the spring of 2012. The findings show that, overall, the society regards older people and their care as important. However, there were suggestions of paternalistic attitudes towards older people. Furthermore, the perceptions regarding different groups of older people could lead to the possibility of inequality. The media portrayals of older people worldwide seem to share similarities, although the findings of this study are particularly in accordance with the cultural attributes of the Nordic countries and societies. PMID:25261872
The objective of this study was to describe patterns of cognitive deficits and activities of daily living (ADLs) in older people with diabetes mellitus. We conducted a cross-sectional, population-based study on two hundred ninety-one homebound people aged 60 and older, 40% with diabetes mellitus, in...
With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisba...
Hayes, Nicky; Dearnley, Barbara
User involvement is high on the NHS agenda. At King's College Hospital, London, older people helped to develop the Improving Hospital Care for Older People project by producing teaching and learning materials for staff using e-learning. The project was set up by holding focus groups with older people. Staff surveys were also conducted to explore views and identify issues to be addressed. Older people's representatives were selected and directly involved in developing learning materials. This article describes the process of working together and includes the personal reflections of some of the key players. It discusses barriers to effective user involvement work between staff and older people, and identifies some benefits and opportunities presented by this approach. PMID:17518196
Full Text Available The existing literature on social exclusion among older people, though relatively limited, suggests that disadvantage among older people is cumulative in nature. Some aspects of disadvantage starting at early life stages have long-term consequences. As such, older people with disadvantages may be subject to higher risks of persistent social exclusion. This article aims to improve understanding of social exclusion and its persistence among senior Australians in three ways. Firstly, the incidence of social exclusion among older people is analysed using selected indicators. Secondly, the study examines whether an older person experiencing social exclusion at one time is more likely to experience it again (persistence. Thirdly, it investigates what factors may be protecting older people from social exclusion. The analysis is conducted using the first eight waves of the Household, Income and Labour Dynamics in Australia (HILDA Survey. The sample of older people is disaggregated into a younger group (55–64 years at wave 1 and an older group (65+ years. The article suggests that higher education and income, as well as better health conditions and previous employment experiences, are important protective factors from social exclusion for older Australians.
Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine
LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people. PMID:26223452
In the Netherlands, the number of people aged 70 and above has increased in the previous decades, and will continue to do so in the coming years. Nowadays, older people are often healthy and active, and strive for a high quality of life. However, in an aging population new problems arise: many peopl
Munk, T; Tolstrup, U; Beck, A M;
) (MD = 1.01 kg, 95% CI = 0.08-1.95, P = 0.03). Meta-analyses revealed no significant effect on physical function assessed using hand grip strength, and similarly on mortality. Narrative summation of effects on physical function using other instruments revealed inconsistent effects. Meta-analyses were......BACKGROUND: Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence for...... an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. METHODS: A systematic review of...
Caryl Nowson; Stella O'Connell
Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensa...
Ahern, Aoife; Hine, Julian
Investment in public transport in Northern Ireland and the Republic of Ireland has been predominantly in urban areas, with the development of a coherent rural transport policy being very much neglected. This has lead to high levels of car dependency in rural areas in both countries. This paper describes a project that focuses on one particularly vulnerable group: older people in rural areas. The project examined the problems that are faced by older people in rural areas in accessing services...
Walckiers, Denise; Van der Heyden, Johan; Tafforeau, Jean
Background Older people are a growing population. They live longer, but often have multiple chronic diseases. As a consequence, they are taking many different kind of medicines, while their vulnerability to pharmaceutical products is increased. The objective of this study is to describe the medicine utilization pattern in people aged 65 years and older in Belgium, and to estimate the prevalence and the determinants of excessive polypharmacy. Methods Data were used from the Belgian Health Inte...
Martin, A J
BACKGROUND: It has been established internationally that road traffic accidents (RTAs) involving older drivers follow clearly different patterns of timing, location and outcomes from those of younger age groups. Older pedestrians are also a vulnerable group and fewer analyses have been undertaken of the phenomenology of their injuries and fatalities. We studied the pattern of pedestrian RTAs in Ireland over a five-year period with the aim of identifying differences between older pedestrians (aged 65 or older) and younger adults. METHODS: We examined the datasets of the Irish National Road Authority (now the Road Safety Authority) from 1998-2002. We analysed patterns of crashes involving older pedestrians (aged 65) and compared them with younger adults (aged 18-64). RESULTS: Older people represented 36% (n = 134) of pedestrian fatalities and 23% of serious injuries while they only account for 19% of total RTAs. Mortality in RTA is more than doubled for older pedestrians compared to younger adults (RR 2.30). Most accidents involving older pedestrians happen in daylight with good visibility (56%) and in good weather conditions (77%). CONCLUSIONS: Older pedestrians are particularly vulnerable in RTAs. These occur more frequently during daylight hours and in good weather conditions. This may point to a need for prevention strategies that are targeted at the traffic environment and other road users rather than at older people.
Mänty, Minna; Rantanen, Taina; Era, Pertti; Avlund, Kirsten
Fatigue is considered an important indicator of aging-related declines in health and functional abilities. Previous studies have indicated strong associations between fatigue and depressive symptoms among younger populations and in patient groups with specific diseases. However, it is not known how...... different measures of fatigue are associated with depressive symptoms among general older populations. The purpose of this study is to describe the prevalence of depressive symptoms among community-dwelling older adults reporting mobility-related or general feelings fatigue. The study population consisted...... of 75-year-old community-living individuals (n = 561). Both, mobility-related and general fatigue, were associated in a stepwise relationship with depressive symptoms: a higher level of fatigue was related to higher level of depressive symptoms. Especially major general fatigue was strongly...
Ford, Chandra L.; WALLACE, STEVEN P.; Newman, Peter A.; Lee, Sung-Jae; Cunningham, William
Purpose: One in 4 persons living with HIV/AIDS is an older adult (age 50 or older); unfortunately, older adults are disproportionately diagnosed in late stages of HIV disease. Psychological barriers, including belief in AIDS-related conspiracy theories (e.g., HIV was created to eliminate certain groups) and mistrust in the government, may influence whether adults undergo HIV testing. We examined relationships between these factors and recent HIV testing among at-risk, older adults. Design and...
Pezzoli, L.; G. Giardini; Consonni, S.; Dallera, I; C. Bilotta; Ferrario, G; Sandrini, MC; Annoni, G; C. Vergani
Objectives: chronic obstructive pulmonary disease and asthma are major causes of hospitalisation and mortality among older patients but respiratory diseases are often under- or misdiagnosed because spirometry is not extensively used at this age. Design: we examined 715 elderly subjects with respiratory symptoms; all underwent a spirometric test and were administered the Mini Mental State Examination, Activities of Daily Living, Instrumental Activities of Daily Living and Geriatric Depression ...
Cruice, M.; Hill, R.; Worrall, L.; Hickson, L
Background: There is an increasing need in speech and language therapy for clinicians to provide intervention in the context of the broader life quality issues for people with aphasia. However, there is no descriptive research that is explicitly focused on quality of life (QoL) from the perspectives of older people with aphasia. Aims: The current study explores how older people with chronic aphasia who are living in the community describe their QoL in terms of what contributes to and det...
Neal, C. A.; Babb, J.; Brantley, S.; Kauahikaua, J. P.
From June 2014 through March 2015, Kīlauea Volcano's Púu ´Ō´ō vent on the East Rift Zone produced a tube-fed pāhoehoe lava flow -the "June 27th flow" - that extended 20 km downslope. Within 2 months of onset, flow trajectory towards populated areas in the Puna District caused much concern. The USGS Hawaiian Volcano Observatory (HVO) issued a news release of increased hazard on August 22 and began participating in public meetings organized by Hawai`i County Mayor and Civil Defense two days later. On September 4, HVO upgraded the volcano alert level to WARNING based on an increased potential for lava to reach homes and infrastructure. Ultimately, direct impacts were modest: lava destroyed one unoccupied home and one utility pole, crossed a rural roadway, and partially inundated a waste transfer station, a cemetery, and agricultural land. Anticipation that lava could reach Pāhoa Village and cross the only major access highway, however, caused significant disruption. HVO scientists employed numerous methods to communicate science and hazard information to officials and the at-risk public: daily (or more frequent) written updates of the lava activity, flow front locations and advance rates; frequent updates of web-hosted maps and images; use of the 'lines of steepest descent' method to indicate likely lava flow paths; consistent participation in well-attended community meetings; bi-weekly briefings to County, State, and Federal officials; correspondence with the public via email and recorded phone messages; participation in press conferences and congressional briefings; and weekly newspaper articles (Volcano Watch). Communication lessons both learned and reinforced include: (1) direct, frequent interaction between scientists and officials and at-risk public builds critical trust and understanding; (2) images, maps, and presentations must be tailored to audience needs; (3) many people are unfamiliar with maps (oblique aerial photographs were more effective); (4
Miller, Evonne; Brockie, Lauren
This paper explores the experiences of older community-dwelling Australians evacuated from their homes during the 2011 and 2013 Queensland floods, applying the novel creative methodology of poetic inquiry as an analysis and interpretative tool. As well as exploring how older adults managed during a natural disaster, the paper documents the process and potential of poetic inquiry in gerontological research. The first and second poems highlight the different social resources older people have to draw on in their lives, especially during a crisis. Poem 1 ("Nobody came to help me") illustrates how one older resident felt all alone during the flood, whereas Poem 2 ("They came from everywhere"), Poem 3 ("The Girls") and Poem 5 ("Man in Blue Shirt") shows how supported--from both family and the wider community--other older residents felt. Poem 4 ("I can't swim") highlights one participant's fear as the water rises. To date, few studies have explicitly explored older adult's disaster experience, with this paper the first to utilise a poetic lens. We argue that poetic presentation enhances understanding of older residents' unique experiences during a disaster, and may better engage a wider audience of policy-makers, practitioners, the general community and older people themselves in discussion about, and reflection on, the impact and experience of disasters. PMID:26162730
Full Text Available Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise. Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.
Nowson, Caryl; O'Connell, Stella
Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations. PMID:26287239
Snooks, Helen A; Halter, Mary; Close, Jacqueline C T; Cheung, Wai‐Yee; Moore, Fionna; Roberts, Stephen E
Introduction A high number of emergency (999) calls are made for older people who fall, with many patients not subsequently conveyed to hospital. Ambulance crews do not generally have protocols or training to leave people at home, and systems for referral are rare. The quality and safety of current practice is explored in this study, in which for the first time, the short‐term outcomes of older people left at home by emergency ambulance crews after a fall are described. Results will inform the development of care for this population. Methods Emergency ambulance data in London were analysed for patterns of attendance and call outcomes in 2003–4. All older people who were attended by emergency ambulance staff after a fall in September and October 2003, within three London areas, were identified. Those who were not conveyed to hospital were followed up; healthcare contacts and deaths within the following 2 weeks were identified. Results During 2003–4, 8% of all 999 calls in London were for older people who had fallen (n = 60 064), with 40% not then conveyed to hospital. Of 2151 emergency calls attended in the study areas during September and October 2003, 534 were for people aged ⩾65 who had fallen. Of these, 194 (36.3%) were left at home. 86 (49%) people made healthcare contacts within the 2‐week follow‐up period, with 83 (47%) people calling 999 again at least once. There was an increased risk of death (standard mortality ratio 5.4) and of hospital admission (4.7) compared with the general population of the same age in London. Comment The rate of subsequent emergency healthcare contacts and increased risk of death and hospitalisation for older people who fall and who are left at home after a 999 call are alarming. Further research is needed to explore appropriate models for delivery of care for this vulnerable group. PMID:17142584
Francis JCM Konings; Jolanda JP Mathijssen; Jasper M Schellingerhout; Ike HT Kroesbergen; Joyce Goede de; Ien AM Goor de
Background: Dehydration of elderly people living independently is a very important public health issue. This study compares two interventions to prevent dehydration in elderly people at risk: an educational intervention and an educational intervention in combination with a drink reminder device. Methods: This is an experimental two-armed parallel study. A Public Health Service develops the interventions and will be partnering with a general practice and a university to evaluate the effect...
Vervaeke, Hylke K.E.; Benschop, Annemieke; Van Den Brink, Wim; Korf, Dirk J.
Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged up to 18 years who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to…
Bissett, Susan; Preshaw, Philip
The authors provide an overview of oral health, why it is important for older people and how poor oral health can affect nutritional status and quality of life. Practical advice is given on assessment of oral health; cleaning of natural teeth and dentures; and care of oral problems that commonly affect older people. An oral healthcare education session is recommended to provide hands-on advice to caregivers. The article is not intended as an exhaustive reference and the reader should always ask for professional dental advice and assistance if in doubt about any aspect of oral care. PMID:22256725
Ramaswamy Deepa; Williams Jonathan; Oulhaj Abderrahim
Abstract Background 10 Hz electroencephalographic (EEG) alpha rhythms correlate with memory performance. Alpha and memory decline in older people. We wished to test if alpha-like EEG activity contributes to memory formation. Flicker can elicit alpha-like EEG activity. We tested if alpha-frequency flicker enhances memory in older people. Pariticpants aged 67–92 identified short words that followed 1 s of flicker at 9.0 Hz, 9.5 Hz, 10.0 Hz, 10.2 Hz, 10.5 Hz, 11.0 Hz, 11.5 Hz or 500 Hz. A few mi...
Thetford, Clare; Bennett, Kate M; Hodge, Suzanne; Knox, Paul C; Robinson, Jude
Some people fare better than others when faced with adversity; they appear to be more 'resilient'. This article explores the concept of resilience in the context of vision impairment using two linked sets of narrative interview data from 2007 to 2010. Three case studies were analysed in detail using a framework approach based upon a social-ecological model of resilience and vision impairment. Within the model a range of assets and resources are identified which influence an individual's capacity for resilience. A set of criteria were used to establish the extent to which each individual appeared to be resilient at each point in time. Analysis revealed that it is not merely the presence or absence of individual, social, and community resources - but how these resources interact with each other - that influences resilience and can create a risk to wellbeing. To possess only some of these resources is not sufficient; there is a co-dependency between these resources which requires the presence of other resources for resilience to be achieved. Resilience is not a fixed state; individuals can become more or less resilient as their circumstances and resources change over time. We suggest that the concept of resilience has much to offer the field of vision impairment as it allows the identification of enablers as well as areas of barriers to improving people's health and wellbeing and suggests further opportunities for service providers to engage with clients, even those who appear to be supported, as people's social, economic and emotional landscapes continue to change over time, rather than identifying deficit. PMID:26568213
LoGiudice, D; Watson, R
Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. PMID:25367725
This report documents the negative impacts of several projects financed by Canada's Export Development Corporation (EDC), how these investments put people and the environment at risk, and highlights the need for ensuring that EDC, an agency of the Canadian Government, is compelled to uphold public policies and international standards protecting human rights, the environment and the social needs of communities. By way of proving its case, authors of this report describe several international projects --the Three Gorges Dam in China; the Urra Hydro Project in Colombia; the Marcopper Mine in the Philippines; the BioBio Dam in Chile; the Ok Tedi Copper Mine in Papua New Guinea; the Yacyreta Dam in Argentina and Paraguay; and CANDU reactors in Argentina, China, Romania, South Korea and Turkey -- as proof of human rights violations and environmental disasters in which EDC has been an accessory. It is emphasized that unlike the World Bank and the U.S. export credit agencies, EDC is not required to undertake environmental assessment, or to take into account the impact on human rights or communities of project which they help to finance. The authors recommend amendments to the Export Development Act that would require the EDC to disclose information about proposed project at least 60 days before approval by the Board, including description of the project, the terms of financing, along with any environmental, social and human rights information collected. EDC should be required to establish an autonomous accountability mechanism, using the mechanisms of the World Bank Group as a model to track and guide EDC's policy implementation, and to receive and address complaints from external parties affected by EDC-supported activities. EDC should require social, environmental and human rights assessments, using World Bank standards and methodology as the base, and ensure implementation of recommendations by separately specifying them in the contract. EDC should not be
Pulopulos, Matias M.; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia
In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847
Barnes, Marian; Bennett, Gaynor
Involving frail older users of health and social care services in decision making presents particular challenges for those committed to hearing the voices of service users. Age Concern Scotland initiated a project in Fife, the User Panels project, intended to enable older people who were unable to leave their homes without assistance to meet together to develop a collective voice expressing the needs and experiences of older service users. This paper reports on an evaluation of that project. It considers methodological questions posed by the evaluation of projects which aim to empower users, as well as discussing key findings from the evaluation. Older people were recruited through contacts in service agencies and other local organizations. The largest group was aged between 86 and 90 years and all were experiencing difficulties relating to poor health, physical frailty or disability. The project was based on a belief in the value of meeting together as a means through which people could develop the confidence to express their views. Those who became members of the panels valued this experience and reported intrinsic benefits related to the social contact, opportunities for learning and development of self-esteem. Evidence concerning enhanced capacity to exercise control over key aspects of their lives was less convincing. The work of the panels was generally well received by local social work and health agencies and had influenced local action in some areas. Responses to some issues raised by the panels generated a less positive response and the article considers reasons for this. The model is considered to demonstrate benefits both for the older people who become involved and for officials seeking to improve the sensitivity of services to the needs of older people. PMID:11560582
Matias M Pulopulos
Full Text Available In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS. The cortisol awakening response (CAR is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93, we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase, but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people.
Pulopulos, Matias M; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia
In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847
Crane, M.; Warnes, A. M.
Rough sleeping in Britain has a long history, and interventions have alternated between legal sanctions and humanitarian concern. This paper critically examines recent changes in homeless policies and services, with particular reference to the needs of older people who sleep rough. The characteristics and problems of the group are first described. Single homeless people were formerly accommodated in direct-access hostels but, from the 1970s, individualised rehabilitation and resettlement have...
Ramos Pichardo, Juan Diego; Cabrero García, Julio; González Llopis, Lorena; Cabañero Martínez, María José; Muñoz Mendoza, Carmen Luz; Sanjuán Quiles, Ángela; Richart Martínez, Miguel; Reig Ferrer, Abilio
Despite the centrality of the difficulty concept in the study of disability, there has been little research on its significance from the point of view of people with functional limitations. The main objective of this study was to describe what older people understand when asked about difficulty in undertaking mobility activities. As a secondary objective, we considered whether there are any differences depending on the type of activities, according to the International Classification of Funct...
Full Text Available Tanvir Ahmed, Nadim HaboubiAdult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UKAbstract: Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.Keywords: malnutrition, older people, anorexia of aging, sarcopinia, nutritional assessment
Full Text Available Solveig T Tomstad1, Ulrika Söderhamn2, Geir Arild Espnes3, Olle Söderhamn21Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, NorwayBackground: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years in southern Norway. The study group included 158 (35.1% participants. Data were analysed using statistical methods.Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help
Kendall, Julie C; Hartvigsen, Jan; Azari, Michael F;
BACKGROUND: Non-pharmacological interventions have been shown to have some effectiveness in adults with dizziness; however, the effectiveness of these interventions in older people is unknown. PURPOSE: To determine the effects of conservative non-pharmacological interventions for dizziness in older......-reported dizziness. CONCLUSION: There is insufficient evidence to determine the effectiveness of non-pharmacological treatments for dizziness in older people. Current evidence suffers from high risk of bias and future well-designed trials are needed with adequate blinding, randomization and compliance....... over 60 years of age. Dizziness from a specific diagnosis such as Meniere's disease and benign positional paroxysmal vertigo were excluded. Outcome measures from included studies included self-reported dizziness and postural balance. DATA EXTRACTION: Two investigators independently extracted data...
There is an increasing emphasis on strategies designed to combat the exclusion of older people from society. The development of social policies oriented towards community care and community living has important consequences for housing policies and urban planning policies. How can the general hou...... necessary between social service and housing agencies? This report contains examples of good practice from six European cities: Birmingham, Vicenza, Copenhagen, Berlin, Amsterdam, and Niorth. The research study was supported by the European Commission.......There is an increasing emphasis on strategies designed to combat the exclusion of older people from society. The development of social policies oriented towards community care and community living has important consequences for housing policies and urban planning policies. How can the general...... housing stock and local neighbourhood facilites be made more responsive to the demands of older people? How can housing and planning measures contribute to the integration of older people in local communities? How can urban renewal be implemented in elderly-friendly forms? What forms of coordination are...
Zijlstra, Wiebren; Aminian, Kamiar
A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies i
Robinson, Sally; Howatson-Jones, Lioba
Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the…
... 158961.html Newer Drugs Helping Older People With Eye Disease Treatments keeping those with macular degeneration reading and ... of long-term follow-up in studies evaluating disease treatments." Study ... U.S. National Eye Institute. The findings were published recently in the ...
C.F. de Winter (Channa)
markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia are
Full Text Available This paper analyzes how older people, living in Spain, use smartphones and smartphone applications. Using a mixed methods approach, we compare quantitative results obtained by tracking mobile app usage amongst different generational samples with qualitative, focus-group discussions with active smartphone users. A sample of Spanish smartphone users were tracked during one month in the winter of 2014 (238 individuals, aged 20 to 76 years-old. This was followed by three focus group sessions conducted in the spring of 2015, with 24 individuals aged 55 to 81. As we learned, WhatsApp is currently the most popular application used by people of all ages, including older adults. Smartphones increasingly are playing a central role in the life of older participants, although the frequency of app access is negatively correlated with age. On the other hand, as our data indicates, older adults also use a number of different types of apps that are distinct from that of younger users. Older participants access personal information manager apps (calendar, address book and notes more often than other age groups. And comparatively, older participants use the smartphone less often in stable locations (home, office, relatives’ home with Wifi than somewhere else and with mobile data. As we argue, differences in age seem to reflect the evolution in personal interests and communication patterns that change as we grow older. Our study captures new trends in smartphone usage amongst this cohort. It also indicates how a combination of methods may help to assess the validity of the log and qualitative data. We highlight the relevance of conducting careful generational studies in smartphone use and some of the potentials and limitations of making predictive studies of ICT use as we change throughout the life course. Finally, we assert the value of the inclusion of older representatives within research, which ultimately may influence public decisions and the design of new
Health seeking behaviour is important in older people with hypertension and overweight, in terms of managing health factors that are related to their health and illness. However, health seeking behaviour of Thai older people is not well documented. This qualitative study aimed to describe health seeking behaviour of overweight hypertensive older people. Seven older women and three men participated in this study through purposive sampling. Qualitative data were gathered via in-depth interviews...
Anticancer drugs themselves can cause adverse health effects when administered to human patients. In addition, it has become apparent that personnel in human medicine, occupationally exposed to these anticancer drugs, may also be at risk. The past decades, the use of chemotherapy in veterinary medicine has been gaining popularity. Consequently, an increasing number of people in veterinary medicine may be exposed to anticancer drugs. This raises the question whether veterinary personnel and ow...
Walls, A W G; Steele, J G
The oral health of older people is changing with reducing numbers of people relying on complete dentures for function, and retaining some natural teeth. Despite this there are substantial numbers of older people whose ability to chew foods is compromised by their oral health status, either because they have few or no natural teeth. This alteration results in individuals selecting a diet that they can chew in comfort. Such diets are low in fruits and vegetables intake with associated reduction in both non-starch polysaccharide and micronutrient intakes. There is also a trend for reduced dietary intake overall. Salivary flow and function may have an impact in relation to the ability to chew and swallow. Whilst there are few differences in salivary function in fit healthy unmedicated subjects, disease resulting in reduced salivary flow and particularly polypharmacy, with xerostomia as a side effect, are likely to have a role in older people. This paper explores the relationships between oral health status and food's choice and discusses the potential consequences for the individual of such dietary change. PMID:15563930
Full Text Available We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality.We conducted a multicentre, open-label interventional, stratified (centre, parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5. Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes.Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation age of 78.0 y (4·9, 51.2% male, mean MNA 20.2 (2.1. Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%, lymphoma (14.9%, lung (10.4%, and pancreas (17.0%. Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01. At the second visit, the energy target was achieved in 57 (40.4% patients and the protein target in 66 (46.8% with the intervention compared respectively to 13 (13.5% and 20 (20.8% in the controls. Death occurred during the first year in 143 patients (42.56%, without difference according to the intervention (p = 0.79. No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups.Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect.ClinicalTrials.gov NCT
Greaves Colin J
Full Text Available Abstract Background Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Methods Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Results Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87
Poulsen, Tine; Siersma, Volkert Dirk; Lund, Rikke;
AIM: To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify this...... educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements...... Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability....
Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat
This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided
Wilson, L.; Alexander, A; Lumbers, M.
Decentralisation of many food retailers to edge-of-town and out-of-town locations has resulted in some older people experiencing difficulty in accessing food shops and those experiencing the greatest difficulties in food shopping are considered to be at the greatest nutritional risk. The present study examines how and to what extent usage of, and physical access to food shops might influence dietary variety. Shopping behaviour and dietary variety are investigated using focus groups, a consume...
Boucher, Barbara J
This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and low-impact fractures. Vitamin D is provided by skin synthesis by UVB-irradiation from summer sunshine and to a small extent by absorption from food. However, these processes become less efficient with age. Loss of mobility or residential care restrict...
Donnelly, Michael; Dempster, Martin
Current policy and practice emphasises much more than ever before a need for purchasers and providers to reduce appropriately the length of hospital stay. Consequently, a number of early discharge "schemes" have been developed. This paper presents the findings from an evaluation of a "home from hospital" (HFH) scheme. The HFH service provides a maximum of six weeks' intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early disc...
Blomberg, Staffan; Jan, Peterson
In his dissertation Blomberg (2004) investigates into how the care manager reform is incorporated into organizational practice in the care of older people in Sweden. He shows that it is made through different lines of argumentations following one another. Through applying neo-institutional theory this can be understood as “solutions seeking problems to solve” rather than the other way around. In this paper we develop the idea that these findings can be associated with a broader development...
Public policy on responding to the ageing “crisis” typically involves a focus on preventative interventions in primary care, tackling inequalities and increasing use of informal and voluntary care networks. Yet at present, the experiences of lesbian, gay, bisexual and trans (LGB&T) older people remains under-researched, despite evidence of increased risk of mortality and morbidity in LGBT populations (Williams et al., 2013; Addis et. al, 2009). Voluntary sector surveys (River, 2011; Guasp, un...
Bradley, Marie C; Motterlini, Nicola; Padmanabhan, Shivani; Cahir, Caitriona; Williams, Tim; Fahey, Tom; Hughes, Carmel M
Background: Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators.Methods: A retrospective cross-sectional study was carried out in t...
Older people are the world’s fastest growing population group. By 2050 eighty per cent of older persons will live in what are now developing countries. There is established and growing evidence of the difficulties families in developing countries are experiencing in providing adequate support for their older members. This thesis explores how international development is responding to the interests of older people. The research examines how older people are represented in international develop...
... people affected depends on the specific disorder. Cushing’s Syndrome Cushing’s syndrome is uncommon, affecting about 10 to 15 out ... Related A-Z Topics Congenital Adrenal Hyperplasia (CAH) Cushing Syndrome Newborn Screening All related topics NICHD News and ...
Saarnak, Christopher; Braae, Uffe Christian; Magnussen, Pascal;
countries were identified. The co-endemicity dataset was then combined with modelled data on population density for 2015 derived from the WorldPop database (http://www.worldpop.org). We used the open source GIS software QGIS and GRASS to overlay the two datasets and identified the number of people living in...
Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray, Leonard C
Background: Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important ...
Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray, Leonard C
Background Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important g...
Hamilton, Hilary J
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
Epidemiological studies suggest that anxiety and depression are less common in older than younger adults. One in ten people aged > or = 65 fulfils the diagnostic criteria for at least one common mental disorder. Older depressed patients have an increased risk of both cardiac and all-cause mortality. Both anxiety and depression in older patients are often unrecognised and untreated, and have a poor prognosis. There is a progressive decline in the prevalence of common mental disorders above the age of 55. Anxiety and depression often occur together, and share many risk factors. However, anxiety tends to follow threats or traumatic events, whereas depression follows loss events. Chronic diseases, cognitive impairment, pain and functional disability are risk factors for the onset of depression, but not anxiety. Depression is between two and three times more common among those with a chronic physical health problem. Even patients with major depression often remain unrecognised and untreated. Generalised anxiety disorder (GAD) is by far the most common anxiety disorder in older people but most GAD patients are not recognised in primary care and only a third of them receive any form of treatment. Older patients often deny feeling anxious or depressed and are more likely to present with insomnia, irritability, agitation and multiple somatic complaints. GPs may erroneously believe that depression is a normal reaction to the losses of old age, and may be reluctant to initiate treatment. A good case can be made for replacing the PHQ-9 with the 15-item version of the Geriatric Depression Scale which almost entirely avoids somatic questions. This is a screening not a diagnostic tool and does not evaluate symptom severity. PMID:22720455
Gallagher Paul F
Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
This paper examines how the rights associated with citizenship for older people and people at the end of life may be restricted, particularly in conservative communitarian views of citizenship, which demands economic participation as a condition of citizenship and devalues dependence on others. It identifies the characteristics of a citizenship social work, which implements radical communitarian values that favour participation and engagement as a source of solidarity in society. ...
Best practice recommendations: Despite the weak quality of the majority of studies included in this review, as evaluated according to the criteria set for randomised controlled trials, the small increase in weight gain and the decrease in mortality - for undernurished groups only - provides justification for continuing the prescription of protein and energy supplements. However, other interventions intended to improve nutritional status should be integrated. These could include providi...
Full Text Available With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia’s central business district (CBD. Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development.
Ahmed, Tanvir; Haboubi, Nadim
Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements. PMID:20711440
Sivberg, B. V.; L. Fagerström; B. M. Nordström; Thorsell, K. B. E.
In order to measure actual care needs in relation to resources required to fulfill these needs, an instrument (Time in Care) with which to evaluate care needs and determine the time needed for various care activities has been developed with the aim of assessing nursing intensity in municipal care for older people. Interreliability (ICC = 0.854) of time measurements (n = 10'546) of 32 nursing activities in relation to evaluated care levels in two nursing homes (staff n = 81) has been determine...
Goodman, Pat; Helen McAvoy, Helen; Cotter, Noëlle; Monahan,, Eugene; Barrett, Eimear; Browne, Stephen; Zeka, Ariana
Executive Summary This report covers a number of different aspects of fuel poverty and older people. 1. An exploration of existing government survey data from Northern Ireland and the Republic of Ireland with a particular focus on older people and conducting additional targeted analyses where required. 2. An original survey in the Republic of Ireland exploring the lived experience of older people in cold weather. 3. A feasibility study of data logging thermometers placed in the homes of older...
The main purposes of this thesis were to evaluate a high-intensity functional weight-bearing exercise programme, regarding its applicability (attendance, achieved intensity, adverse events) as well as its effect on physical functions and activities of daily living (ADL) among older people living in residential care facilities, with a special focus on people with dementia. Furthermore, a main purpose was to systematically review the applicability and effects of physical exercise on physical f...
Turner, Sue; Cooper Ueki, Madeline
Background: This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Methods: Using the broad themes housing, employment, social inclusion and isolation, care and…
Ceci, Christine; Purkis, Mary Ellen; Björnsdóttir, Kristin
This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work - ethnographic studies of home care practice undertaken in Canada and Iceland - and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way. PMID:23273554
This thesis describes research which explores the importance and feasibility of involving older people as equal partners in the creative design of digital devices for an ageing population. In exploring this topic, I have carried out two preliminary studies, a pilot study and a major empirical study. Firstly, I invited three groups of people, including very old people, active older people and postgraduate students, to evaluate a mock-‐up model of an interactive device intended for older p...
Iliffe, S; Kharicha, K.; Harari, D.; Swift, C.; Gillmann, G.; Stuck, A.E.
Background Social isolation is associated with poorer health, and is seen by the World Health Organisation (WHO) as one of the major issues facing the industrialised world.Aim To explore the significance of social isolation in the older population for GPs and for service commissioners.Design of study Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal.Setting A total of 2641 community-dwelling, non-disabled people aged 65 years and over in suburban ...
Shaw, K.; Cartwright, C.; Craig, J.
Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…
Menz Hylton B
Full Text Available Abstract Background Plantar hyperkeratotic lesions are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people. Methods A medical history questionnaire was administered to a random sample of 301 people living independently in the community (117 men, 184 women aged between 70 and 95 years (mean 77.2, SD 4.9, who also underwent a clinical assessment of foot problems, including the documentation of plantar lesion locations, toe deformities and the presence and severity of hallux valgus. Results Of the 301 participants, 180 (60% had at least one plantar hyperkeratotic lesion. Those with plantar lesions were more likely to be female (χ2 = 18.75, p 2 = 6.15, p vs 36.3 ± 8.4°; t = 2.68, df = 286, p vs 4.8 ± 1.3 hours, t = -2.46, df = 299, p = 0.01. No associations were found between the presence of plantar lesions and body mass index, obesity, foot posture, dominant foot or forefoot pain. A total of 53 different lesions patterns were observed, with the most common lesion pattern being "roll-off" hyperkeratosis on the medial aspect of the 1st metatarsophalangeal joint (MPJ, accounting for 12% of all lesion patterns. "Roll-off" lesions under the 1st MPJ and interphalangeal joint were significantly associated with moderate to severe hallux valgus (p p Conclusion Plantar hyperkeratotic lesions affect 60% of older people and are associated with female gender, hallux valgus, toe deformity, increased ankle flexibility and time spent on feet, but are not associated with obesity, limb dominance, forefoot pain or foot posture. Although there are a wide range of lesion distribution patterns, most can be classified into medial, central or lateral groups. Further
Research has shown that we presently live in an era where birth rates are low and life expectancy is high, drawing the conclusion that older people will be part of young people’s lives for longer. Intergenerational relationships refer to the relationship between two or more generations and are crucial for growth within both generations, young and old. There are many stereotypes attached to old age, and it has been found that young people take on these stereotypes through the media and society...
Full Text Available BACKGROUND: China has the largest number of people with diabetes in the world. Over the last 30 years China has experienced rapid economic growth and a growing income gap between rich and poor. The population is ageing, however diabetes in older people has not been well studied to date. In this study we determined incidence and predictors of diabetes in older Chinese people. METHODS: During 2001, using a standard interview method, we examined 1,317 adults aged ≥65 years who did not have diabetes in the city of Hefei, and characterized baseline risk factors. Over 7.5 years of follow up, we documented incident diabetes using self-reported doctor diagnosis and the cause of death in the whole cohort, and HbA(1C ≥48 mmol/mol in a nested case-control sample. A multivariate Cox regression model was employed to investigate risk of diabetes in relation to baseline risk factors. RESULTS: During follow up, 119 persons had newly diagnosed diabetes. World age-standardised incidence of diabetes was 24.5 (95% CI 19.5-29.5 per 1,000 person-years. Risk of diabetes was significantly and positively associated with income, waist circumference and body mass index, smoking and uncontrolled hypertension, but negatively associated with having a hobby of walking and frequency of visiting children/other relatives and contacting neighbours/friends. Higher income was significantly associated with increased diabetes risk regardless of cardiovascular and psychosocial risk factors. Compared to those with middle income and no psychosocial risk factors, the hazard ratio for incident diabetes among participants with high income and psychosocial risk was 2.13 (95% CI 1.02-4.45. CONCLUSIONS: Increasing incidence of diabetes in relation to high income has become an important public health issue in China. Maintaining social networks and gentle physical activities and reducing psychosocial factors may be integrated into current multi-faceted preventive strategies for curbing the
People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…
Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.
The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…
Full Text Available Background: Approaches for investigating health-promoting lifestyle generally focus on physical activity and regular diet. To explore the perspectives of Iranian elders regarding health, healthy eating and physical activity (PA this study was conducted in 2012. Methods: Participants in this qualitative study were selected through purposeful sampling. Ten focus groups were conducted with 60 older adults in 3 elderly centers in Tehran. A moderator’s guideline that consisted of general and specific questions was used. Focus groups were audio recorded, transcribed verbatim and analysis was performed using conventional content analysis. Results: Participants explained their perspectives regarding health, healthy eating and PA in the following 5 categories: meaning of health was represented based on issues such as absence of pain and disorder, complete body wellbeing, staying away from hazards, complete individual satisfaction, experiencing positive events, effective communication, faithfulness and trust in God. The healthy eating category was featured by adequate eating, age balanced diet, refraining from under or over nutrition and sensible consumption of fruits and vegetables. The PA was described - according to the level of performing outdoor activities or household tasks. Expressions about the perceived benefits and barriers of healthy eating and PA were aligned the two remaining categories. Conclusions: Participants have referred to the association between both PA and dietary practices and health. Understanding how older people define physical activity and nutritional behavior and recognition of the most important perceived benefits and barriers that might contribute to have a healthy eating or adequate PA profile could procure insight into the type of interventions that are required to promote healthy lifestyle among Iranian older adults.
Yamada, Yukari; Vass, Mikkel; Hvas, Lotte;
important elements associated with a collaborative relationship were (i) visitor communication skills i.e. mastering 'enhancing motivation' and 'having patience and coping with frustrations' in difficult and problematic situations, (ii) professionalism, which includes 'professional instruction and guidance...... trust between visitor and the visited person seem to work as a vehicle, but little is known about which part of the encounters contributes to a collaborative relationship. Methods. We performed a retrospective qualitative analysis of visiting records written by preventive home visitors immediately after...... home visitor communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive...
Full Text Available OBJECTIVES AND METHODS: As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. RESULTS: 369 references were identified, from which 78 papers were selected. CONCLUSIONS: The review confirms the paucity of data on this topic and the need for more specific research. Although there is scarce evidence, the elderly seems to respond equally well to alcohol policy, screening instruments and brief interventions as do younger adults. According to a lifecycle approach, a future focus on the middle aged is also recommended.
Maria Mercedes Diaz Rodriguez
Full Text Available The city of León has pioneered the development of community health programs, developing comprehensive health programs such as the project ‘A New Initiative for the Americas’, a university hospital, a hospital ‘Mother´s Friend’, teaching assistance municipality, including many others. In the last five years, a group of professionals from different fields of medicine, psychology, and social work has focused on the task of working together with the community, National Police, My Family, MINED, as well as national and international NGOs to study the youth phenomenon and its impact on society. There have been five meetings with teenagers and young people promoted by the Departmental Board of Save the Children and Youth Leonesa, where the UNAN León is actively participating. Based on these meetings, a possibility of a descriptive cross-sectional study on the characterization of young people at risk of social exclusion of the peripheral area of the city of Leon arose, and the results are revealing.
Full Text Available Deprescribing has been proposed as a way to reduce polypharmacy in frail older people. We aimed to reduce the number of medicines consumed by people living in residential aged care facilities (RACF. Secondary objectives were to explore the effect of deprescribing on survival, falls, fractures, hospital admissions, cognitive, physical, and bowel function, quality of life, and sleep.Ninety-five people aged over 65 years living in four RACF in rural mid-west Western Australia were randomised in an open study. The intervention group (n = 47 received a deprescribing intervention, the planned cessation of non-beneficial medicines. The control group (n = 48 received usual care. Participants were monitored for twelve months from randomisation. Primary outcome was change in the mean number of unique regular medicines. All outcomes were assessed at baseline, six, and twelve months.Study participants had a mean age of 84.3 ± 6.9 years and 52% were female. Intervention group participants consumed 9.6 ± 5.0 and control group participants consumed 9.5 ± 3.6 unique regular medicines at baseline. Of the 348 medicines targeted for deprescribing (7.4 ± 3.8 per person, 78% of regular medicines, 207 medicines (4.4 ± 3.4 per person, 59% of targeted medicines were successfully discontinued. The mean change in number of regular medicines at 12 months was -1.9 ± 4.1 in intervention group participants and +0.1 ± 3.5 in control group participants (estimated difference 2.0 ± 0.9, 95%CI 0.08, 3.8, p = 0.04. Twelve intervention participants and 19 control participants died within 12 months of randomisation (26% versus 40% mortality, p = 0.16, HR 0.60, 95%CI 0.30 to 1.22 There were no significant differences between groups in other secondary outcomes. The main limitations of this study were the open design and small participant numbers.Deprescribing reduced the number of regular medicines consumed by frail older people living in residential care with no significant
Full Text Available Taking into account the current social and economic environment, managers of social organizations are under a constant pressure to get results and to optimize costs with an efficient allocation of resources. Performance management allows measuring the results of public and private organizations which provide social care for the elderly. The potential of social services to respond to current challenges is linked not only to financial resources, but also to the ability of social managers to develop methods, techniques and innovative practices. Since innovation requires change, the providers should promote management practices and structures that favour the expression of new ideas. The article presents the results of a mixed-type research methodology based on qualitative and quantitative methods, such as the in-depth semi-structured interview, focus-group, and questionnaire with public policymakers, as well as with private and public providers of social services for older people. Research was conducted during October – November 2014 and the instruments were developed by the team members. The aim of the research has been to find out the importance of performance and performance measurement among public and private managers of social services for older people, and also from the perspective of policymakers. Conclusions reveal that the managers of social services for elderly should be aware that measurement alone is not sufficient, as long as the information obtained is not used in other decision-making processes like: strategic planning, quality management, budgeting activities, increased productivity. The findings have implications for practitioners, researchers and policymakers.
Full Text Available Vitus Nyigo,1 Andrew Kilale,2 Stella Kilima,1 Elizabeth H Shayo,1 Kesheni P Senkoro,1 Jonathan Mshana,1 Adiel K Mushi,1 Lucas Matemba,1 Julius Massaga11National Institute for Medical Research, 2Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania Introduction: According to the 2011–2012 HIV and Malaria Indicator Survey, the prevalence of HIV infection in Tanzania is 5.1%, with limited information on its magnitude among older people, as the community believes that the elderly are not at risk. Consequently, little attention is given to the fight against HIV and AIDS in this group. The present study investigated the magnitude of HIV and AIDS infection among older people in rural and urban areas of the Tanzania mainland. Subjects and methods: The study was conducted in Mufindi and Babati districts of Iringa and Manyara regions, respectively, through multistage sampling procedures. Dried blood spot cards were used to collect blood samples for HIV testing among consenting participants. HIV testing was done and retested using different enzyme-linked immunosorbent assay kits. Results: A total of 720 individuals, 340 (47.2% males and 380 (52.8% females, were randomly selected, of whom 714 (99.2% consented to HIV testing while six (0.8% refused to donate blood. The age ranged from 50 to 98 years, with a mean age of 64.2 years. Overall, a total of 56 (7.8% participants were HIV-positive. Females had a higher prevalence (8.3% than males (7.4%, with Mufindi district recording the higher rate (11.3% compared to the 3.7% of Babati district. The prevalence was higher in the rural population (9.4% compared to 6.4% of their urban counterparts. Conclusion: Although HIV/AIDS is considered a disease of individuals aged 15–49 years, the overall prevalence among the older people aged 50 years and above for Mufindi and Babati districts was higher than the national prevalence in the general population. These findings
Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine
Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... the healthcare system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In...... order to transform the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare....
Rabiee, Parvaneh; Baxter, Kate; Glendinning, Caroline
Summary: English policy emphasises personalised and flexible social care support using ‘Personal Budgets’ (PB) – preferably as cash direct payments. However, most older people opt for their council to manage personal budgets on their behalf. It is not clear what benefits of personalisation are available to this group of older people. This article reports research into the choices available to older people using managed personal budgets to fund home care services in three councils. It focuses ...
The main purpose of this thesis was to study, whether drinkable yoghurt enriched with probiotic bacteria could have any effect on constipation and body weight (BW) among older people with dementia. Further, it concerns poor nutritional status among older people with physical and cognitive impairments and its relationship with factors commonly occur in older people living in residential care facilities. It also discusses how body composition changes with ageing and the associations between cha...
Michelle H M M T van Velthoven
Full Text Available BACKGROUND: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. METHODS: We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. RESULTS: The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial and for delivering behavioural interventions aimed at improving mental health (four trials, reducing sexual transmission risk (one trial, improving medication adherence (two trials and smoking cessation (one trial. Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. CONCLUSIONS: We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation
Full Text Available Abstract Background Pain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination. The nature of the relationships between pain intensity and depression in elderly persons experiencing pain is less clear. The objectives of this study were to explore which factors are associated with depressed mood in older people experiencing pain, and to test the hypothesis that older people experiencing pain are at risk of depressed mood according to the severity or frequency of their pain. In addition we explored whether other potentially modifiable factors might increase the risk of depressed mood in these persons. Methods The study is a secondary analysis of baseline data for four hundred and six community-dwelling non-disabled people aged 65 and over registered with three group practices in suburban London who had experienced pain in the past 4 weeks. Intensity and frequency of pain was measured using 24 item Geriatric Pain Measure (GPM and the presence of depressive symptoms using the 5 item Mental Health Inventory. Risk for social isolation was measured using the 6 item Lubben Social Network scale and instrumental activities of daily living (IADL were also measured. Results Overall 76 (19% had depressed mood. Pain frequency and severity were not statistically significantly associated with depressed mood in this population. In multivariate analyses, significant predictors of the presence of depressive symptoms were difficulties with basic ADLs (OR 2.8, 95% CI 18.104.22.168, risk for social isolation (OR 4.1, 95% CI 1.8–9.3, and basic education only (OR 2.2, 95% CI 1.1–4.4. Conclusion Older people experiencing pain are also likely to experience depression. Among those experiencing pain, social network and functional status seem to be more important predictors of depressive symptoms than the severity of pain. Further studies should evaluate whether improvement of social
Stahl, Sarah T.; Albert, Steven M.; Dew, Mary Amanda; Lockovich, Michael H.; Reynolds, Charles F.
Prevention of major depressive disorder is important because current treatments are only partially adequate in reducing symptom burden and promoting health-related quality of life. Lifestyle interventions may be a desirable prevention strategy for reasons of patient preference, particularly among older patients from minority groups. Using evidence from a randomized depression prevention trial for older adults, the authors found that coaching in healthy dietary practices was potentially effect...
The implementation of road pricing schemes is likely to be an inescapable measure in the future of managing road transport demand in highly congested environments. Since public acceptability is the ‘Holy Grail’ of charging policy-making, revealing the special attitudinal issues of older people may help the identification of some of the potential social dilemmas of road pricing. In an ageing society, where older people have a growing influence in politics in general, and potentially in the acc...
Intergenerational relationships refer to relationships between people in alternate generational groups. The increasing numbers of older people all over the world highlight the need for studies on psychological processes that enhance well-being through intergenerational relationships. People from different generations are co-dependent for care and support. Older people constitute a diverse group: some may experience a depletion of energy, physical, financial and emotional resources, while othe...
Ballin, Liora; Balandin, Susan
Background: There is a large body of research focusing on the experiences of loneliness of older adults, yet little is known about the loneliness experiences of older adults with lifelong disability. In this paper, the authors present some findings from a larger qualitative study on the loneliness experiences of older people with cerebral palsy.…
Williams, Angie; Wadleigh, Paul Mark; Ylanne, Virpi
The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an "a priori" framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait…
Petersen, P E; Kandelman, D; Arpin, S;
The aim of this report is (1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; (2) to explore what types of oral health services are available to older people, and (3) to identify some major barriers to and opportunities...
Høst, Dorte; Hendriksen, Carsten; Borup, Ina
This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....
Gutheil, Irene A.; Heyman, Janna C.
This study examined an intervention to help high-functioning community-dwelling older people communicate their wishes for care at the end of life with someone they would trust to make health care decisions for them if necessary. Groups consisted of dyads of older people and their potential or designated health care agents randomly assigned to the…
Milbourne, Paul; Doheny, Shane
This paper explores the relations between older people, poverty and place in rural Britain. It develops previous work on rural poverty that has pointed both to the significance of older people within the rural poor population and to their denials of poverty. The paper also connects with recent discussions on the complexity of relations between…
Laditka, Sarah B.; Laditka, James N.; Houck, Margaret M.; Olatosi, Bankole A.
Attitudes toward older people can influence how they are treated and their cognitive and physical health. The populations of the United States and many other countries have become more ethnically diverse, and are aging. Yet little research examines how ethnic diversity affects attitudes toward older people. Our study addresses this research gap.…
Martorell, Ingrid; Medrano, Marc; Sole, Cristian; Vila, Neus; Cabeza, Luisa F.
With the increasing number of older people in the world and their interest in education, universities play an important role in providing effective learning methodologies. This paper presents a new instructional methodology implementing inquiry-based learning (IBL) in two courses focused on alternative energies in the Program for Older People at…
Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James
Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…
Buffel, Tine; Verte, Dominique; De Donder, Liesbeth; De Witte, Nico; Dury, Sarah; Vanwing, Tom; Bolsenbroek, Anouk
This article presents a theoretical framework for exploring the dynamics between older people and their immediate social living environment. After introducing a gerontological perspective that goes beyond "microfication," a literature review presents findings from studies that have explored the role of place and locality for older people. Next,…
Y.M. Drewes; J.M. Koenen; W. de Ruijter; D.J.A. van Dijk - van Dijk; G.M. van der Weele; B.J.C. Middelkoop; R. Reis; W.J.J. Assendelft; J. Gussekloo
Background: Preventive care traditionally aims to prevent diseases or injuries. For older people, different aims of prevention, such as maintenance of independence and wellbeing, are increasingly important. Aim: To explore GPs' perspectives on preventive care for older people. Design and setting: Qu
Nyman, Samuel R.
This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…
Levin, Lena; Ulleberg, Pål; Siren, Anu Kristiina;
Measures enhancing the mobility of older people, helping them live independently and for longer, are advantageous for society as a whole. They are good business for society and they are good for the well-being and welfare of older people who often want to stay in their own home for as long as pos...
Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun
Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527
Piantadosi, Cynthia; Chapman, Ian M; Naganathan, Vasi; Hunter, Peter; Cameron, Ian D.; Visvanathan, Renuka
Background The difficulty of recruiting older people to clinical trials is well described, but there is limited information about effective ways to screen and recruit older people into trials, and the reasons for their reluctance to enrol. This paper examines recruitment efforts for a community-based health intervention study that targeted older adults. Methods One year randomized control trial. Undernourished men and women, aged ≥ 65 years and living independently in the community were recru...
Forster Anne; Young John; Barber Sally; Clegg Andrew; Iliffe Steve
Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to a...
Morrell, C Jane; Curran, Stephen; Topping, Annie; Shaik, Kauserjan; Muthukrishnan, Venkatesh; Stephenson, John
Background: Depression is common among older people but more common among those living in care homes. Depression is not easily detected among older adults because of the presentation, and the tendency for older people not to complain of depression, particularly those living in care homes. In general, care home staff have limited training in recognising depression. Depression is undertreated and residents may not receive a therapeutic dose of antidepressant. The true prevalence of depression a...
Nakulan, Anisha; Sumesh, T. P.; Kumar, Sebind; Rejani, P. P.; K. S. Shaji
Background: Depression is the most common mental health problem in late-life. We need more information about the incidence and prevalence of major and minor syndromes of depression in older people. This will help in service development. Aims: To estimate the prevalence of depressive disorders among community resident older people in Kerala, India and to identify factors associated with late-life depression. Materials and Methods: Two hundred and twenty community resident older subjects were a...
Nestor Pabiona Blace
Full Text Available This study determined whether the functional ability and participations in activities affect the life satisfaction of the older people. Data were gathered from the 780 older people through survey interview, Instrumental Activities of Daily Living Scale and Life Satisfaction Index for the Third Age Scale. The functional ability, participation in physical activities and activities with formal support networks are statistically significant predictors of life satisfaction among the older people. These variables, when combined explain a statistically significant portion (23.7% of the variance in their life satisfaction. The older people who have better health status enjoy their lives more than those who have poor health conditions. After reaching the age of sixty, the older people are still capable of working and be active participants in the labor sector. The results have theoretical implications on the activity theory of aging since high levels of participation in the activities mean high levels of life satisfaction.
Cianelli, Rosina; Villegas, Natalia; Lawson, Sarah; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda; Yaya, Alexandra
Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention. PMID:23790277
Baus, Adam; Zullig, Keith; Long, Dustin; Mullett, Charles; Pollard, Cecil; Taylor, Henry; Coben, Jeffrey
Nationally, nearly 40 percent of community-dwelling adults age 65 and older fall at least once a year, making unintentional falls the leading cause of both fatal and nonfatal injuries among this age group. Addressing this public health problem in primary care offers promise. However, challenges in incorporating fall risk screening into primary care result in a problem of missed opportunities for screening, counseling, intervention, and ultimately prevention. Given these barriers, this study e...
Sheaff, Rod; Windle, Karen; Wistow, Gerald; Ashby, Sue; Beech, Roger; Dickinson, Angela; Henderson, Catherine; Knapp, Martin
In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the 'Improving the Future for Older People' initiative (IFOP), one strand of the national 'Innovation Forum' programme, set up in 2003. The nine sites set themselves one headline target to be achieved jointly over three years; a 20 per cent reduction in the number of emergency bed-days used by people aged 75 and over. Three ancillary targets were also monitored: emergency admissions, delayed discharges and project sustainability. Collectively the sites exceeded their headline target. Using a realistic evaluation approach, we explored which aspects of network governance appeared to have contributed to these emergency bed-day reductions. We found no simple link between network governance type and outcomes. The governance features associated with an effective IFOP network appeared to suggest that the selection and implementation of a small number of evidence-based services was central to networks' effectiveness. Each service needed to be coordinated by a network-based strategic group and hierarchically implemented at operational level by the responsible network member. Having a network-based implementation group with a 'joined-at-the-top' governance structure also appeared to promote network effectiveness. External factors, including NHS incentives, health reorganisations and financial targets similarly contributed to differences in performance. Targets and financial incentives could focus action but undermine horizontal networking. Local networks should specify which interventions network structures are intended to deliver. Effective projects are those likely to be evidence based, unique to the network and difficult to implement through vertical structures alone. PMID
Creech, A.; Varvarigou, M.; Hallam, S.; McQueen, H.; Gaunt, H.
The research reported here focuses on the organizational structure and facilitator strategies observed in musical activities with older people. The observations formed one part of the Music for Life Project, funded by the ESRC New Dynamics of Ageing Programme (http://www.newdynamics.group.shef.ac.uk/), which investigated the social, emotional and cognitive benefits of participation in community music making, amongst older people. Three hundred and ninety eight people aged 50+ were recruited f...
Bunn, F; Dickinson, A.; Simpson, C.; Narayanan, V.; Humphrey, D; Griffiths, C; W. Martin; Victor, C.
Background: Falls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings.Methods: A s...
Hossein Matlabi; Abdolreza Shaghaghi; Shahriar Amiri
Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practicability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and muscle-strengthening activity was planned for t...
This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people's social connectedness. Voluntar...
Witham, Miles D; Donnan, Peter T.; Thenmalar Vadiveloo; Sniehotta, Falko F.; Crombie, Iain K; Zhiqiang Feng; McMurdo, Marion E. T.
BACKGROUND: Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. METHODS: We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical...
Chouliaras, Leonidas; Topiwala, Anya; Cristescu, Tamara; Ebmeier, Klaus P
Common causes of memory loss in older people are mild cognitive impairment, the various types of dementia, and psychiatric illness, mainly depression. Around 10% of patients with mild cognitive impairment progress to dementia each year. Alzheimer's disease accounts for 60-80% of cases. Other common types of dementia are vascular, fronto-temporal, Lewy body, Parkinson's, and mixed type dementia. There is evidence to suggest that dementia pathology is established before the onset of symptoms, and thus mild cognitive impairment can be considered as a predementia stage. NICE guidance suggests examination of: attention, concentration, short- and long-term memory, praxis, language and executive function. Particular attention should be paid to any signs of neglect, state of dress, agitation or poor attention. Dysphasia and difficulty in naming objects is often present. Mood symptoms (including suicidal ideation) may be primary or comorbid. Abnormal thoughts and perceptions should be probed for, as psychotic symptoms are common. Primary care options for cognitive testing include the General Practitioner Assessment of Cognition or the Abbreviated Mental Test Score. Physical examination should include observation of gait, inspection for tremor; examination for rigidity, bradykinesia, frontal release signs, upper motor neurone lesions, pulse and BP. Structural brain imaging can improve diagnostic accuracy, exclude other pathologies and act as a prognostic marker of dementia progression but the overlap in structural changes between the dementias makes imaging alone insufficient for diagnostic purposes. NICE guidelines recommend referral to a memory clinic for patients with mild cognitive impairment, those at high risk of dementia, such as patients with learning disabilities, Parkinson's disease, or patients who have had several strokes. PMID:25726616
the healthcare system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In......Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... who refused referral were recruited in relation to a systematic falls screening programme performed by preventive home visitors. Accepters were selected among 72 participants successively completing the falls assessment clinic programme. The time between the interviews was 12 months; different levels...
Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles
This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's…
Covey, Herbert C.
Describes disengagement, activity, lifespan, subcultural, and continuity theories of social gerontology in light of participation in higher education by older students. Argues that continuity theory holds the most promise in accounting for older students. Emphasizes the need to stress the positive roles of old age. (JAC)
Full Text Available Eltayeb Marouf, Alan J SinclairInstitute of Diabetes for Older People – IDOP, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire, UKAbstract: Type 2 diabetes mellitus affects 5.9% of the world adult population, with older people and some ethnic groups disproportionately affected. Treatment of older people with diabetes differs in many ways from that in younger adults since the majority have type 2 disease and are at particular risk of macrovascular rather than disabling microvascular disease. Insulin therapy, the most effective of diabetes medications, can reduce any level of elevated HBA1c if used in adequate doses. However, some clinicians are often reluctant to initiate insulin therapy in older people with diabetes mainly out of their concerns about adverse reactions to insulin, particularly hypoglycemia. There is evidence suggesting that insulin aspart appears to act similarly to regular human insulin in older people with type 2 diabetes mellitus. Insulin aspart can be used in the treatment of older people with diabetes, but this should be individualized. There is evidence that it improves postprandial glucose control, improves long-term metabolic control, reduces risk of major nocturnal hypoglycemia and increases patient satisfaction compared with soluble insulin.Keywords: older people, diabetes, insulin aspart, hypoglycemia
Full Text Available Abstract Background In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1 HIV infected and on antiretroviral therapy (ART for at least 1 year; 2 HIV infected and not yet eligible for ART; 3 older people who had lost a child due to HIV/AIDS; 4 older people who have an adult child with HIV/AIDS; 5 older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion The systematic exploration of health and well being among older people, using eight self-reported and
Full Text Available Bjørg Dale, Ulrika SöderhamnCentre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care.Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons' own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO instrument was filled out at baseline and 6 months after the self-care talks.Results: The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care.Conclusion: Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.Keywords: adapting, decision-making, knowledge, self-care talks
Menz, Hylton B; Auhl, Maria; Ristevski, Sonja; Frescos, Nicoletta; Munteanu, Shannon E
Background Ill-fitting footwear is a common problem in older people. The objective of this study was to determine the accuracy of shoe fitting in older people by comparing the dimensions of allocated shoes to foot dimensions obtained with a three-dimensional (3D) scanner. Methods The shoe sizes of 56 older people were determined with the Brannock device®, and weightbearing foot scans were obtained with the FotoScan 3D scanner (Precision 3D Ltd, Weston-super-mare, UK). Participants were provid...
Full Text Available Smart homes are homes with technologically advanced systems to enable domestic task automation, easier communication, and higher security. As an enabler of health and well-being enhancement, smart homes have been geared to accommodate people with special needs, especially older people. This paper examines the concept of “smart home” in a technologically driven society and its multi-functional contribution to the enhancement of older people’s lives. Discussion then focuses on the challenges in the use of smart homes among older people such as accessibility and ethical issues. Finally, some implications and recommendations are provided.
The health of Aboriginal Australians is poorer than that of all other Indigenous cultures in developed nations, and recent studies suggest high rates of dementia and other conditions that are common in old age. This has implications for health promotion, provision of services and planning for older age in these communities. This article provides an overview on the health of Older Aboriginal Australians. PMID:27155822
Hellström, Amanda; Nilsson, Camilla; Nilsson, Annina; Fagerström, Cecilia
Background Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the a...
Iliffe, S. R.; Clegg, A.; Barber, S.; Young, J.; Forster, A.
Background: Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design: The Home-Based Older People’s Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to assess t...
Atherton, Iain Maitland
This thesis investigates the effects of national patterns of migration on informal support for older adults in contemporary Scotland. It argues that geography matters, and develops a multi-scale conceptual framework to analyse the relationships among population mobility, contrasting local contexts in which older people live, and care and support from the intergenerational family and the community. 130 older persons from three locales with different migration patterns are recruited to the stud...
Puvill, Thomas; Lindenberg, Jolanda; Slaets, Joris P J;
retrospectively appreciated their annual change in health. Functional status was assessed with the Groningen Activity Rating Scale and all were followed for vital status. RESULTS: Functional decline was reflected by all reports of change in health (all p < .001). When incongruent, change in nurse...... appreciation of health by older people is superior to change in self-ratings and nurse-ratings in reflecting change in physical health, possibly because similar norms and values are applied in the assessment. The nurse's norms, like the norms of older people, may shift with the ageing of the researched cohort......BACKGROUND: Self-rated health is assumed to closely reflect actual health status, but older people's shifting norms and values may influence this association. We investigated how older people's change in self-ratings, in comparison to their retrospective appreciation and change in nurse ratings...
Subjective memory complaints are common in older people. They are inconsistently related to current cognitive impairment, but are more consistently correlated to future development of dementia. Subjective memory complaints are also related to depression and personality traits. Many patients with...
Jones, Alasdair; Goodman, Anna; Roberts, Helen; Steinbach, Rebecca; Green, Judith
Access to transport is an important determinant of health, and concessionary fares for public transport are one way to reduce the 'transport exclusion' that can limit access. This paper draws on qualitative data from two groups typically at risk of transport exclusion: young people (12-18 years of age, n = 118) and older citizens (60+ years of age, n = 46). The data were collected in London, UK, where young people and older citizens are currently entitled to concessionary bus travel. We focus on how this entitlement is understood and enacted, and how different sources of entitlement mediate the relationship between transport and wellbeing. Both groups felt that their formal entitlement to travel for free reflected their social worth and was, particularly for older citizens, relatively unproblematic. The provision of a concessionary transport entitlement also helped to combat feelings of social exclusion by enhancing recipients' sense of belonging to the city and to a 'community'. However, informal entitlements to particular spaces on the bus reflected less valued social attributes such as need or frailty. Thus in the course of travelling by bus the enactment of entitlements to space and seats entailed the negotiation of social differences and personal vulnerabilities, and this carried with it potential threats to wellbeing. We conclude that the process, as well as the substance, of entitlement can mediate wellbeing; and that where the basis for providing a given entitlement is widely understood and accepted, the risks to wellbeing associated with enacting that entitlement will be reduced. PMID:23317663
Ariza-Vega, Patrocinio; Kristensen, Morten Tange; Martín-Martín, Lydia;
OBJECTIVE: To determine one year mortality and predisposing factors in older people who had surgery after a hip fracture. DESIGN: Prospective cohort study. SETTING: Public acute hospital, trauma service. PARTICIPANTS: A total of 281 patients, 65 years or older, admitted with a hip fracture within...
Oude Voshaar, R.C.; Purandare, N.; Hardicre, J.; McCollum, C.N.; Burns, A.
OBJECTIVE: To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people. METHODS: Prospective cohort study with 2.5 years of follow-up including 96 nondepressed older subjects in primary care. Presence of SCE was measured at baseline by transcrania
Jang, Miseon; Lee, Yeunsook
This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…
Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high
Anticancer drugs themselves can cause adverse health effects when administered to human patients. In addition, it has become apparent that personnel in human medicine, occupationally exposed to these anticancer drugs, may also be at risk. The past decades, the use of chemotherapy in veterinary medic
Cyrille P Launay
Full Text Available The aims of this study were 1 to confirm that combinations of brief geriatric assessment (BGA items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED; and 2 to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS.Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day, use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year. The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry.Area under receiver operating characteristic (ROC curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010. Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003. Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4 and a low likelihood ratio of positive test under 5.6.Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.
Barton, S; Karner, C.; Salih, F.; Baldwin, D S; Edwards, S.J.
Background Anxiety and related disorders include generalised anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder and phobic disorders (intense fear of an object or situation). These disorders share the psychological and physical symptoms of anxiety, but each disorder has its own set of characteristic symptoms. Anxiety disorders can be difficult to recognise, particularly in older people (those aged over 65 years). Older people tend to be more rel...
Zaaiman, Anna Petronella
This study, which is part of a research project conducted to explore the experiences of quality of life of older people living in a residential facility, focuses specifically on the psychosocial needs of these residents. Psychosocial needs refer to the innate psychological nutriments that prompt older people to take purposeful, self-directed action in an attempt to satisfy these needs and ultimately foster well-being. These may include needs for mastery, acknowledgement, social interaction an...
Notenboom, Kim; Beers, Erna; Van Riet-Nales, Diana A.; Egberts, Toine C. G.; Leufkens, Hubert G. M.; Jansen, Paul A F; Bouvy, Marcel L
Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews. Setting A community pharmacy and a geriatric outpatient ward. Participants Community-dwelling people aged 70 and older (N = 59). Measurements Participants were interviewed at home. Two researchers ...
Burgess Leonie; George Stacey; Ratcliffe Julie; Laver Kate; Crotty Maria
Abstract Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE) before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style f...
Poulsen, Tine; Siersma, Volkert Dirk; Christensen, Ulla;
To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline.......To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline....
Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of ...
Tomlin A; Sinclair A
Ali Tomlin, Alan Sinclair Institute of Diabetes for Older People, University of Bedfordshire, Luton, Bedfordshire, UK Abstract: Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impa...
Gussekloo, Jacobijn; de Bont, L E; von Faber, M; Eekhof, J A; de Laat, J A; Hulshof, J H; Van Dongen, E; Westendorp, R. G.
BACKGROUND: Very few older people with severe hearing loss use hearing aids to reduce the negative consequences of reduced hearing in daily functioning. AIM: Assessment of a screening test and a standardised auditory rehabilitation programme for older people from the general population with untreated severe hearing loss. DESIGN OF STUDY: Intervention study and qualitative exploration. SETTING: Leiden 85-Plus Study, a prospective population-based study of 85-year-old inhabitants of Leiden, the...
Verdelho, Ana; Madureira, Sofia; Moleiro, Carla; Ferro, José M; O'Brien, John T; Poggesi, Anna; Pantoni, Leonardo; Fazekas, Franz; Scheltens, Philip; Waldemar, Gunhild; Wallin, Anders; Erkinjuntti, Timo; Inzitari, Domenico; Study, LADIS
Depressive symptoms (DS) have been associated with increased risk of cognitive decline. Our aim was to evaluate the longitudinal influence of DS on cognition in independent older people, accounting for the severity of white matter changes (WMC).......Depressive symptoms (DS) have been associated with increased risk of cognitive decline. Our aim was to evaluate the longitudinal influence of DS on cognition in independent older people, accounting for the severity of white matter changes (WMC)....
Toçi, Ervin; Burazeri, Genc; Sorensen, Kristine; Jerliu, Naim; Ramadani, Naser; Roshi, Enver; Brand, Helmut
Aims: Health literacy among older people has received little attention in transitional countries of Southeast Europe. Our aim was to assess the level and socioeconomic correlates of health literacy among older people in Kosovo, a post-war country in the Western Balkans. Study Design: Cross-sectional study. Place and Duration of Study: Kosovo, between January-March 2011. Methods: This nationwide survey, conducted in Kosovo in 2011, included 1753 individuals aged ≥65 years (886 men, 867 wome...
Andrea Montagnani; Roberto Nardi; Michela Cercignani; Valerio Verdiani
Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency) with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplement...
Gilhooly, M.; Gilhooly, K; Phillips, LH; Harvey, D.; Brady, A; Hanlon, P.
Objectives. This study examined relationships between quality of life (QoL) in older people and cognitive functioning in both abstract and real-world problem solving. Design. Contributions of levels of mental, physical and social activities, self-rated and objective health status, self-rated cognitive functioning, socio-economic status, gender, real-world and abstract problem solving were examined in a regression study of factors related to QoL in older people. Method. Participants (N...
van Houwelingen, Anne H.; den Elzen, Wendy P.J.; le Cessie, Saskia; Blom, Jeanet W.; Gussekloo, Jacobijn
This study explores the combination of four common health problems in older people and whether problems on four domains result in an additional effect on indicators of poor health. For this purpose, a total of 2681 participants (32% male, mean age 82 years) of the Integrated Systematic Care for Older People (ISCOPE) study were screened on the presence of health problems on four domains (functional, somatic, mental, social) with the postal ISCOPE questionnaire. Extensive interview data on heal...
Swift Cameron; Harari Danielle; Carmaciu Claudia; Kharicha Kalpa; Iliffe Steve; Gillman Gerhard; Stuck Andreas E
Abstract Background Pain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination. The nature of the relationships between pain intensity and depression in elderly persons experiencing pain is less clear. The objectives of this study were to explore which factors are associated with depressed mood in older people experiencing pain, and to test the hypothesis that older people experiencing pain are at ri...
Doebler, Stefanie; Glasgow, Nina
Objectives: There are few studies on relationships between deprivation and the self-reported health of people aged over 64 years, and no studies fully representative of Northern Ireland’s older population. This paper addresses this gap. Methods: Deprivation of older people as reported in the 2001 and 2011 Censuses and the relationship with self-reported health are analyzed over a ten-year span using multilevel modeling. The data are from the Northern Ireland Longitudinal Study (NILS) linked t...
The aim of this thesis was to study the effects of exercise on mental health among older people living in residential care facilities. The aim was also to study the reliability of an assessment scale for balance function and the usefulness of an assessment scale for depressive symptoms among older people, including people with cognitive impairments. The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about its absolute reliability. The...
Barrett, Catherine; Whyte, Carolyn; Comfort, Jude; Lyons, Anthony; Crameri, Pauline
This paper presents data from a small study exploring the impacts of homophobia on the lives of older lesbian and gay Australians. Eleven in-depth interviews were conducted with older lesbians (6) and gay men (5) ranging in age from 65 to 79 years. The study found that participants’ sense of self was shaped by the dominant medical, legal and religious institutions of their youth that defined them as sick, immoral or criminal. Participants described enforced “cure” therapies, being imprisoned,...
Full Text Available Alzheimer’s disease (AD is the most common form of dementia in old age, and is characterized by prominent impairment of episodic memory. Recent functional imaging studies in AD have demonstrated alterations in a distributed network of brain regions supporting memory function, including regions of the default mode network. Previous positron emission tomography studies of older individuals at risk for AD have revealed hypometabolism of association cortical regions similar to the metabolic abnormalities seen in AD patients. In recent functional magnetic resonance imaging (fMRI studies of AD, corresponding brain default mode regions have also been found to demonstrate an abnormal fMRI task-induced deactivation response pattern. That is, the relative decreases in fMRI signal normally observed in the default mode regions in healthy subjects performing a cognitive task are not seen in AD patients, or may even be reversed to a paradoxical activation response. Our recent studies have revealed alterations in the pattern of deactivation also in elderly individuals at risk for AD by virtue of their APOE e4 genotype, or evidence of mild cognitive impairment (MCI. In agreement with recent reports from other groups, these studies demonstrate that the pattern of fMRI task-induced deactivation is progressively disrupted along the continuum from normal aging to MCI and to clinical AD and more impaired in e4 carriers compared to non-carriers. These findings will be discussed in the context of current literature regarding functional imaging of the default network in AD and at-risk populations.
Christensen, Kaare; Thinggaard, Mikael; Oksuzyan, Anna;
A rapidly increasing proportion of people in high-income countries are surviving into their tenth decade. Concern is widespread that the basis for this development is the survival of frail and disabled elderly people into very old age. To investigate this issue, we compared the cognitive and phys......A rapidly increasing proportion of people in high-income countries are surviving into their tenth decade. Concern is widespread that the basis for this development is the survival of frail and disabled elderly people into very old age. To investigate this issue, we compared the cognitive...... and physical functioning of two cohorts of Danish nonagenarians, born 10 years apart....
Full Text Available The article deals with the optimization of labor activity of the elderly, considered optimization factors of labor activity (macro meza- and microfactors, stages and principles of psychological work with the elderly, an attempt to create a model of a psychologist with an older man on the stage of retirement.
Rest, van de O.
Background It has been suggested that the intake of fish and marine n-3 polyunsaturated fatty acids could protect against age-related cognitive decline and impaired mental well-being. However, results from observational studies are inconclusive and data from randomized controlled trials in older pe
Sener, Arzu; Oztop, Hulya; Dogan, Nuri; Guven, Seval
This study examined the influence of socioeconomic (age, education, marital status, income, and health) and demographic variables and the quantity and quality of relationships with adult children, grandchildren, siblings and friends on life satisfaction of the elderly. Participants were 200 persons older than 60 years of age. Hierarchical…
Andresen, Mette; Puggaard, Lis
participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub...
Nolan, Brian; Winston, Nessa
Housing is an important aspect of living standards and quality of life for older persons, but the housing-related problems they may face encompass rather different circumstances, relating to the condition of the dwelling, how well equipped it is, whether housing costs represent a serious burden, and whether the neighbourhood environment is…
Geiger, Karin; Schneider, Nils; Bleidorn, Jutta; Klindtworth, Katharina; Jünger, Saskia; Müller-Mundt, Gabriele
Background Frail older people are an increasingly important group in primary care due to demographic change. For these patients, a palliative care approach may be useful to sustain the quality of life in the last phase of their lives. While general practitioners (GPs) play a key role in the primary care for older patients, general palliative care is still in its infancy and little is known in Germany about caring for frail older people towards the end of life. This study aims to explore the t...
Zarkin, G A; Lindrooth, R C; Demiralp, B; Wechsberg, W
OBJECTIVE: To estimate the costs, effectiveness, and cost-effectiveness of prevention interventions for out-of-treatment substance abusers at risk for HIV. This is the first cost-effectiveness study of an AIDS intervention that focuses on drug use as an outcome. STUDY DESIGN: We examined data from the North Carolina Cooperative Agreement site (NC CoOp). All individuals in the study were given the revised NIDA standard intervention and randomly assigned to either a longer, more personalized en...
Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. PMID:26243326
U. Taş (Ümit); E.W. Steyerberg (Ewout); S.M. Bierma-Zeinstra (Sita); A. Hofman (Albert); B.W. Koes (Bart); A.P. Verhagen (Arianne)
textabstractBackground: To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk. Methods. Data were obtained from the Rotterdam Study, including subjects
Full Text Available This article explores the activities and convictions of older right-to-die activists who belong to a small but very active interest group based in Scotland, UK, called Friends at the End (FATE. The analysis presented here is based on knowledge gained through seventeen months of ethnographic research with the organisation. While FATE activists currently campaign for a legal right to a medically assisted death, many are also open to taking matters into their own hands, either by travelling to the Swiss organisation Dignitas or by opting for what is known as ‘‘self-deliverance’’. FATE members’ openness to different means of securing a hastened death contrasts sharply with the more limited demands of the UK’s main right-to-die organisation, Dignity in Dying, and highlights their specific orientation to freedom, which, it is argued here, results from the organisation’s older demographic.
Ensuring patients are adequately hydrated is a fundamental part of nursing care, however, it is clear from the literature that dehydration remains a significant problem in the NHS with implications for patient safety. The development of dehydration is often multifactorial and older age is an independent risk factor for the condition. However, the media often blame nursing staff for simply not giving patients enough to drink. This article discusses the scale of the problem in acute care settings and aims to raise awareness of the importance of hydration management and accurate documentation in nursing practice. It suggests that intentional hourly rounding may provide an opportunity for nurses to ensure older patients are prompted or assisted to take a drink. PMID:27125939
Zammit, Paul; Fiorini, Anthony
Depression in older persons is associated with being placed in a nursing home. Depression is linked to increased medical morbidity in nursing home residents. 150 patients living in two nursing homes in Malta were included in the study. The geriatric depression scale was used to identify depression. Data for risk factors for depression and management of residents for this pathology was also collected. 67.3% (p value
Goodman, J.; Gray, P.D.G.; Khammampad, K.; Brewster, S.
Although landmarks are an integral aspect of navigation, they have rarely been used within electronic navigation aids. This paper describes the design of a pedestrian navigation aid for a handheld computer, which guides the user along a route using photographs of landmarks, together with audio and text instructions that reference these landmarks. This aid was designed with older users in mind who often find their mobility hampered by declines in sensory, cognitive and motor abilities. It was ...
Full Text Available To become dependent on professional support to accomplish the daily activities of life can be considered a turning point, involving a range of challenging changes in life. The purpose of the study was to describe the experiences of older home-dwelling individuals in transition from self-supported to supported living from a lifeworld perspective. Five women and five men were interviewed, and a descriptive phenomenological design was used. The findings showed that an attitude of acceptance was an essential characteristic for this group. An attitude of acceptance comprised: flexibility and tolerance, recognition and hopes, and valuation of self and situation. Finding themselves in a situation they had to submit to, they took an attitude of acceptance. An attitude of acceptance implied acknowledgement of the situation as well as positivity and desires to manage. This attitude may represent a significant potential for improvement. Awareness of this is crucial to support older individuals in a healthy way through the transition process. An attitude of acceptance, however, also implied an acceptance of discontinuity in their lives, renunciations, and denigration of own needs. But this aspect of the acceptance was trivialized by the participants and not equally obvious. Insight into this complexity is vital to avoid ignorance of older individuals’ vulnerability in the transition process.
Pawlyn, Charlotte; Gay, Francesca; Larocca, Alessandra; Roy, Vivek; Ailawadhi, Sikander
Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients' tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here. PMID:27038805
Chepngeno-Langat, Gloria; Falkingham, Jane C; Madise, Nyovani J; Evandrou, Maria
The article explores the way that social networks and personal experiences affect perceived HIV-related concerns among people aged 50 years or older living in a low resource neighborhood with high HIV prevalence in Nairobi, Kenya. Multiple logistic regression is used to model the association between the reporting of an HIV-related concern and individual-level characteristics, personal experiences, and social interaction. The main concerns regarding HIV reported by older people in the study included caring for orphaned children (65%), caring for people with AIDS (48%), and losing material and social support from adult children (36%). Interestingly, 38% of respondents voiced concerns about HIV infection among older people. Respondents who had been individually affected by HIV and AIDS, who were part of a wide social network, or who participated in community activities were frequently more likely to report a concern. The findings highlight the significance of the role of social interaction and social networks in the diffusion of information and knowledge. These findings have implications for HIV and AIDS policy and programs, highlighting the potential for social networks and community-level interventions to educate and increase awareness about HIV and AIDS among older people. Community leaders can make good peer educators and communication agents for HIV/AIDS campaigns. Additionally, the recognized high level of personal vulnerability to HIV infection among older people suggests the need for targeted sexual behavior change programs among this often neglected group. PMID:22324649
Moone, Rajean Paul; Lightfoot, Elizabeth
Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities. PMID:19459127
Pitarque, Alfonso; Meléndez, Juan; Sales, Alicia; Mayordomo, Teresa; Escudero, Joaquín; Algarabel, Salvador
We present an associative recognition experiment comparing three samples of healthy people (young people, older people with high cognitive reserve [HCR], and older people with low cognitive reserve [LCR], with each sample consisting of 40 people), manipulating stimuli repetition during the study phase. The results show significant differences among the three samples in their overall performance. However, these differences are not due to a different use of familiarity, but rather due to a different way of using recollection: although there are no differences in the hit rates between the HRC and LRC samples, the LCR group makes significantly more recollective false alarms than the HCR group. Moreover, repetition provokes an increase in the recollective false alarms in the LCR group, but this does not occur in the group of young people or in the HCR group. These findings are explained in terms of recollection-based monitoring errors and seem to provide support for the cognitive reserve hypothesis. PMID:26982550
Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that
Stevenson, M R; Wallace, L J; Harrison, J; Moller, J; Smith, R J
This paper outlines the commonalties and unique differences in injury experience among the indigenous people in the United States and Australia. Injury mortality rates among Indigenous people in the United States and Australia are approximately 2-3 times greater than rates for the non-Indigenous population in each country. Motor vehicle-related injuries accounted for one-third of the injury deaths for Native Americans and Australian Aboriginals. Suicide accounted for more deaths in Native Americans (15.5 per 100,000) than it did for Australian Aboriginals (11.1 per 100,000), whereas the injury death rate in Australian Aboriginals due to poisoning was almost twice that of Native Americans. Culturally appropriate interventions tailored to specific local settings and problems will be necessary to reduce injury mortality among Indigenous people. PMID:9848955
A patient's whole body is affected by diabetes but in particular this chronic disease can cause foot complications. Damage to the nerve and blood supply to the feet as a result of diabetes causes lack of sensation and ischaemia. These problems can lead to diabetic foot ulceration, which, if left untreated, can result in amputation or even death. An essential part of nurses' role in caring for older patients with diabetes in community, acute and residential settings is learning to recognise the signs of a high-risk diabetic foot, and when and where to get help for its treatment. PMID:23008915
Full Text Available Abstract Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit, amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects logistic regression. Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive, and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit. Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population.
Clark, M J; Fitzgerald, G
OBJECTIVE: To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over. SETTING: The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state. METHODS: The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed. RESULTS: People aged 65 years ...
Full Text Available Yannis DionyssiotisPhysical and Social Rehabilitation Center, Amyntaio, Florina, GreeceAbstract: Falls are a serious problem facing the elderly. The prevention of falls that contribute to disability, mainly in elderly people, is an important issue. Ensuring the greatest possible functionality for elderly people is an important element in the prevention of disability. This paper analyzes the importance of falls, risk factors for falls, and interventions to prevent falls. Recent publications as well as research regarding the prevention and rehabilitation for falls are reviewed.Keywords: falls, elderly, rehabilitation, risk factors
Wassink-Vossen, Sanne; Collard, Rose M; Oude Voshaar, Richard C; Comijs, Hannie C; de Vocht, Hilde M; Naarding, Paul
BACKGROUND: Knowledge about characteristics explaining low level of physical activity in late-life depression is needed to develop specific interventions aimed at improving physical health in depressed people above the age of 60. METHODS: This cross-sectional study used data from the Netherlands Stu
Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie
Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted. PMID:24686287
Peel, N; Kassulke, D; McClure, R
Objective: This study aimed to identify the distribution of fall related injury in older people hospitalised for acute treatment of injury, in order to direct priorities for prevention. Setting: A follow up study was conducted in the Brisbane Metropolitan Region of Australia during 1998. Methods: Medical records of patients aged 65 years and over hospitalised with a fall related injury were reviewed. Demographic and injury data were analysed and injury rates calculated using census data as the denominator for the population at risk. Results: From age 65, hospitalised fall related injury rates increased exponentially for both males and females, with age adjusted incidence rates twice as high in women than men. Fractures accounted for 89% of admissions, with over half being to the hip. Males were significantly more likely than females to have fractured their skull, face, or ribs (p<0.01). While females were significantly more likely than males to have fractured their upper or lower limbs (p<0.01), the difference between proportions of males and females fracturing their hip was not significant. Males were more likely than females (p<0.01) to have fall related head injuries (13% of admissions). Compared with hip fractures, head injuries contributed significantly to the burden of injury in terms of severity, need for intensive care, and excess mortality. Conclusions: The frequency and impact of hip fractures warrants continued emphasis in falls program interventions for both males and females to prevent this injury. However, interventions that go beyond measures to slow and protect against bone loss are also needed to prevent fall related head injuries. PMID:12460962
Andersson, Jonas E; Rönn, Magnus
spatial innovation is juxtaposed with sociopolitical reform work of the welfare regime. The present study is an explorative study of programming competition documents and winning entries that were part of the Swedish governmental initiative of 2010,” Growing older, Living well,” to innovate space for......, eldercare and space. Consequently, architecture competitions that focus on the emerging ageing society could be seen as a restrained type of space for architects to digress. National welfare goals and existing means to achieve these goals act as inhibitors for an innovative spatial preparation for the......In the context of the universal ageing process that is currently taking place in western society, the organization of architecture competitions that deals with space for dependent ageing comes of relevance. Based on the welfare regime theory, it could be argued that this type of architecture is...
Elskamp, Annemijn; Hartholt, Klaas; Patka, Peter; van Beeck, Ed; Cammen, Tischa
textabstractBackground/Objectives: Falls are a major public health problem. Older persons are frequently underrepresented in trials, including falls prevention trials. Insight into possible reasons for non-participation could help to improve trial designs and participation rates among this age-group. The aim of this study was to explore reasons why older people refuse to participate in falls prevention trials. Setting: A qualitative study. Participants: Community-dwelling adults aged ≥ 65. ye...
Among older adults, moderate regular physical activity, even if below the level to show fitness effect, leads to multiple health benefits. However, despite well-documented benefits of physical activity, the majority of adults in developed countries do not exercise. There is a need to investigate what influences attitude toward physical activity among older people to develop suitable health promotion scheme. The purpose of this study was to identify correlates of attitude toward physical activ...
Roos, Vera; Sedick, Samiera
This study explored the perceptions of older people in a residential care facility regarding how they are portrayed in the print media and the implications of such portrayal for intergenerational relations. Twenty-one older residents in a residential care facility participated voluntarily in the study (men = 9, women = 12; age range 60 to 85 years). Data were collected using exploratory interviews and focus groups followed by the thematic analysis of the data. The findings suggest that the ol...
Yardley, Lucy; Kirby, Sarah; Ben-Shlomo, Yoav; Gilbert, Rebecca; Whitehead, Sarah; Todd, Chris
Objective: To determine the extent to which older people are willing to engage in different falls prevention activities, and how this may vary in different sectors of the older population. Methods: A survey sent to patients aged over 54 in ten general practices in the Southampton, Bristol and Manchester areas of the UK in 2006 yielded 5,440 respondents. The survey assessed willingness to attend classes of strength and balance training (SBT), carry out SBT at home, or accept suppo...
Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high health care expenditures. In the Utrecht Proactive Frailty Intervention Trial (U-PROFIT, in Dutch:’ Om U’), we designed and evaluated a strategy for proactive patient-centred primary care of frail...
Portegijs, Erja; Iwarsson, Susanne; Rantakokko, Merja; Viljanen, Anne; Rantanen, Taina
Background: Life-space mobility refers to the spatial area an individual moves through, the frequency and need for assistance. Based on the assumption that measurement scale properties are context-specific, we tested the scale distribution, responsiveness, and reproducibility of the 15-item University of Alabama at Birmingham Study of Aging Life-Space Assessment in older people in Finland, specifically accounting for season. Methods: Community-dwelling older men and women in...
Szczepura Ala; Wild Deidre; Nelson Sara
Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorde...
Bielderman, A.; Schans, C. van der; Lieshout, M.R. van; Greef, M.H. de; Boersma, F.; Krijnen, W.P.; Steverink, N.
BACKGROUND: Due to the rapidly increasing number of older people worldwide, the prevalence of frailty among older adults is expected to escalate in coming decades. It is crucial to recognize early onset symptoms to initiate specific preventive care. Therefore, early detection of frailty with appropriate screening instruments is needed. The aim of this study was to evaluate the underlying dimensionality of the Groningen Frailty Indicator (GFI), a widely used self-report screening instrument fo...