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Sample records for aging population geriatric

  1. Oral-maxillofacial trauma of a geriatric population in a super-ageing country.

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    Ito, Ryohei; Kubota, Kosei; Inui, Akinari; Nakagawa, Hiroshi; Kon, Takao; Narita, Norihiko; Tamura, Yoshihiro; Oyama, Toshiaki; Satake, Anna; Furudate, Ken; Kobayashi, Wataru

    2017-12-01

    World population has been ageing, and oral-maxillofacial trauma of geriatric population is expected to increase. The aim of this study was to analyse the characteristic features of oral-maxillofacial trauma in the geriatric population. Data from 127 patients aged 65 years old or older, who were treated for oral-maxillofacial trauma at the Department of Oral and Maxillofacial Surgery, Hirosaki University, from 2000 to 2014, were retrospectively analysed. The data from 292 patients aged 20-64 years were used as a comparison. Oral-maxillofacial trauma in the geriatric population had been increasing over 15-year period. The male to female ratio was 1.05:1 in the older group and 2.3:1 in the younger group. In the older group, 117 patients (92.1%) had one or more underlying systemic diseases, and 16 (12.6%) had suffered injuries in association with acute medical disorders. The most common injuries in the older group were bone fractures (46.5%). The ratio of fractures in the older group was lower than in the younger group (69.2%). Trauma in the older group most frequently occurred because of falls from a standing height or lower (52.0%), and the mandible was the most common site of fracture (74.6%). A conservative form of treatment for maxillofacial fractures was most commonly (86.4%) chosen for the older group, whilst surgical treatment was most commonly in the younger group (55.0%). Oral-maxillofacial trauma in the geriatric population shows characteristic features in terms of aetiology, patterns and treatment modalities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Geriatric Expertise among Medical School Faculty: Preparing for the Challenges of an Aging Population

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    Laditka, Sarah B.; Jenkins, Carol L.; Eleazer, G. Paul; Kelsey, Susan G.

    2007-01-01

    This study examined non-geriatrician physicians' experiences in a geriatrics-focused faculty development program, and effects of the program on their geriatrics knowledge and their teaching and practice. In-depth interviews were conducted with all physicians (n = 26) participating in the Dean's Faculty Scholars in Aging program. Most participants…

  3. Immunity, aging, and geriatric depression.

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    Morimoto, Sarah Shizuko; Alexopoulos, George S

    2011-06-01

    Inflammatory processes are likely to play a causal role in geriatric depression. Geriatric depression occurs in the context of illnesses in which inflammatory processes are part of the pathogenesis. Both aging and depression are associated with immune responses, and the connectivity among mood-regulating structures may be modulated by inflammatory responses. Geriatric depression exacerbates the symptoms of comorbid disorders. Geriatric depression often occurs in persons exposed to chronic stress, a state precipitating geriatric depression and triggering proinflammatory responses. The successful treatment of comorbid conditions that increase central nervous system inflammatory responses has general health benefits and should be part of clinical practice. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Hyponatremia as a fall predictor in a geriatric trauma population.

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    Rittenhouse, Katelyn J; To, Tuc; Rogers, Amelia; Wu, Daniel; Horst, Michael; Edavettal, Mathew; Miller, Jo Ann; Rogers, Frederick B

    2015-01-01

    Approximately one in three older adults fall each year, resulting in a significant proportion of geriatric traumatic injuries. In a hospital with a focus on geriatric fall prevention, we sought to characterize this population to develop targeted interventions. As mild hyponatremia, defined as a serum sodium falls, unsteadiness and attention deficits, we hypothesized that hyponatremia is associated with falls in our geriatric trauma population. Gender, age, pre-existing conditions (cardiac disease, diabetes, hematologic disorder, liver disease, malignancy, musculoskeletal disorder, neurological disorder, obesity, psychiatric disorder, pulmonary disease, renal disease, thyroid disease), mechanism of injury and admitting serum sodium level were queried for all geriatric trauma admissions from 2008 to 2011. Mechanism of injury was coded as falls admissions and non-falls admissions. Admitting serum sodium levels were coded as hyponatremic (falls admissions and 293 (12.4%) patients who were hyponatremic. Gender, age, neurological disorder, hematologic disorder, and hyponatremia were found to be significant predictors of falls in both univariate and multivariable analyses. Hyponatremic patients are significantly more likely to be admitted for a fall than non-hyponatremic patients, when adjusting for age, neurological disorder, and hematologic disorder. Consequently, hyponatremia identification and management should be an integral part of any geriatric trauma fall prevention programme. Additionally, if hyponatremia is found during a geriatric fall workup, it should be corrected prior to discharge and closely monitored by a primary care physician to prevent recurrent episodes of falls. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Periorbital Rejuvenation Surgery in the Geriatric Population

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    Ann Yi-Chiun Chuang

    2010-09-01

    Full Text Available Periorbital aging is an unavoidable, progressive process that is often accompanied by visual obscurations and ocular discomfort. With surgical correction, patients may benefit not only functionally but also psychosocially when an aesthetic outcome is obtained. The periorbital anatomical structures in elderly patients are complex and interlocking, requiring a thorough evaluation and systematic approach. Most elderly patients are reluctant to undergo procedures that require prolonged surgical and recovery times if they think it is only for cosmetic improvement. We review contemporary periorbital surgical methods suitable for a geriatric population, namely procedures that are low-cost, low-risk, with short operative and recovery times, and that have excellent patient acceptability. It is feasible to select procedures that can be customized to the needs of the elderly.

  6. Aging in Rural Appalachia: Perspectives from Geriatric Social Service Professionals

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    Natalie D. Pope

    2014-09-01

    Full Text Available This paper uses qualitative methodology to explore the experience of growing old in rural Appalachia. Given the growing population of older adults seeking and utilizing services, it is important to understand the challenges and specific needs related to aging. Within the context of rural Appalachia, these challenges and needs may be different than those in urban areas or areas outside of the region itself. From interviews with 14 geriatric service providers in rural southeast Ohio, the authors were able to identity three prevalent themes associated with aging in rural North Central Appalachia: scarcity of resources, valuing neighbors and family, and the prevalence of drug use. These findings suggest that preparation and ongoing training of rural geriatric social workers should include attention to topics such as substance abuse and strengthening social support networks that often exist in these regions.

  7. Post Operative Cognitive Dysfunction (POCD in Geriatric Population

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    Rajesh MC

    2015-10-01

    Full Text Available Post-operative mental dysfunction and confusion in aged patients is a well recognized entity. Commonly known as post-operative delirium and cognitive dysfunction (POCD, these are important for any peri-operative physician dealing with geriatric population. The incidence is more in older patients with pre-existing impairment. Impact of POCD is grave. This can result in poor rehabilitation outcome and increased hospital stay. Incidence ranges from 15-50% with ˂5% for cataract surgery and as high as 60% after hip replacement procedures.

  8. Academic detailing to teach aging and geriatrics.

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    Duckett, Ashley; Cuoco, Theresa; Pride, Pamela; Wiley, Kathy; Iverson, Patty J; Marsden, Justin; Moran, William; Caton, Cathryn

    2015-01-01

    Geriatric education is a required component of internal medicine training. Work hour rules and hectic schedules have challenged residency training programs to develop and utilize innovative teaching methods. In this study, the authors examined the use of academic detailing as a teaching intervention in their residents' clinic and on the general medicine inpatient wards to improve clinical knowledge and skills in geriatric care. The authors found that this teaching method enables efficient, directed education without disrupting patient care. We were able to show improvements in medical knowledge as well as self-efficacy across multiple geriatric topics.

  9. Oxidative stress is related to frailty, not to age or sex, in a geriatric population: lipid and protein oxidation as biomarkers of frailty.

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    Inglés, Marta; Gambini, Juan; Carnicero, Jose A; García-García, Francisco J; Rodríguez-Mañas, Leocadio; Olaso-González, Gloria; Dromant, Mar; Borrás, Consuelo; Viña, Jose

    2014-07-01

    To ascertain whether indicators of oxidative damage to lipids (malondialdehyde (MDA)) and proteins (protein carbonylation) are biomarkers of frailty, after adjusting for age, sex, and other possible confounders. Cross-sectional cohort study. Community. Toledo Study for Healthy Aging participants (N = 742, aged 65-95), classified as frail (n = 54), prefrail (n = 278) and nonfrail (n = 410) according to the Fried criteria. Blood plasma was obtained using centrifugation (1,500 G, 15 minutes) and immediately frozen at -80°C. Plasma lipid peroxidation was determined by measuring the MDA formed from lipoperoxides using high-performance liquid chromatography and protein carbonylation was measured using Western blot. Age- and sex-adjusted levels of lipoperoxides (measured as MDA) and protein carbonylation in plasma proved to be related to frailty, even after including possible independent confounders. Circulating oxidative damage biomarkers, such as MDA and protein carbonylation, are related to frailty and not to age or sex. These parameters may be considered as potential biomarkers of frailty in the context of a multidisciplinary health-promoting approach for older adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  10. Are even geriatric patients becoming older and older? : Changes in the age structure of geriatric inpatients in the course of two decades.

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    Krause, O; Junius-Walker, U; Wiese, B; Hager, K

    2018-01-01

    The life expectancy of the German population has steadily risen in the course of the past decades. As especially the oldest members of the population are treated in geriatric clinics, it would be of interest to investigate whether the increase in population age can also be found among geriatric inpatients. The demographic data of inpatients of a geriatric clinic in Hannover in the years 1994, 2004 and 2014 were analyzed according to age, gender and classification as acute care or geriatric rehabilitation. The mean patient age rose by 6 years in the past two decades. This was the case for both men and women but the age of men (+7.5 years) rose more than that of women (+4.9 years). Whereas the patient average age increased, especially in the first decade (+3.9 years), this increase slowed down in the following decade (+1.7 years). The 80 to 89-year-old patients remained the biggest and steadily increasing group (in 1994: 41.1%, 2004: 46.9% and 2014: 51.3%). The greatest increase, however, was found for those aged 90 years and older (1994: 4.8%, 2004: 12.2% and 2014: 17.7%). The results confirm the professional experiences of many geriatricians in that they care for an increasingly aging clientele. Particularly very old male patients in geriatric clinics are increasing. All health professional groups involved will have to face this challenge.

  11. Decrease in Antioxidant Status of Plasma and Erythrocytes from Geriatric Population

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    Kumawat, Manjulata; Sharma, Tarun Kumar; Singh, Ishwar; Singh, Neelima; Singh, Sanjeev Kumar; Ghalaut, Veena Singh; Shankar, Vijay; Vardey, Satish Kumar

    2012-01-01

    Background: Ageing is associated with an accumulation of free radical damage, which leads to physiological and clinical modifications. The study aims to find out the status of lipid profile, antioxidant enzymes, malondialdehyde in geriatric population. Patients/methods: The study was conducted on 150 subjects (75 healthy control between the ages of 20–30 years and 75 elderly subjects between ages of 50–70 years as cases). The following parameters were analyzed using the standard reference methods: lipid profile, reduced glutathione, glutathione peroxidase, glutathione reductase, catalase, superoxide dismutase and malondialdehyde. Results: The present study was conducted to estimate the oxidative stress parameters in geriatric population. Highly significant increase in total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C), malondialdehyde, catalase and decrease in high density lipoprotein cholesterol (HDL-C), reduced glutathione, glutathione peroxidase, glutathione reductase, superoxide dismutase was observed in geriatrics when compared with their younger counterparts. Conclusion: This study concluded that there is enhanced oxidative stress and decreased antioxidant defence in geriatrics as compared to younger subjects which could play an important role in ageing. Dyslipidemia has become one of the important risk factors for the increasing prevalence of cardiovascular diseases. There is lack of awareness on the relationship between blood lipids and the risk of cardiovascular diseases in geriatric population. The strategy of early prevention should be adopted against dyslipidemia. PMID:23089922

  12. AUDIOLOGICAL EVALUATION IN GERIATRIC AGE GROUP

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    Satheesh

    2015-05-01

    Full Text Available INTRODUCTION: Age Related Hearing Loss (ARHL is defined as loss of hearing in elderly persons not influe nced by the extraneous factors like noise trauma etc or intrinsic like CVS related diseases or endocrinal disorders like Diabetes. Also termed as Presbycusis it is defined as the loss of hearing due to age related changes taking place in the auditory syste m starting from the pinna to the cortical centers in the brain. It does not include any other factor contributing or initiating the pathological changes in the auditory system resulting in hearing loss. All these changes in the tissues are not pathological but truly age related. The threshold of hearing is defined as the pure tone average across the frequencies of 0.5 to 8 kHz. The severity of hearing loss is graded as profound hearing loss : more than 90dB , severe to severe loss : 71 - 90 dB or more ; Moderate to severe hearing loss : 56 - 70 , Moderate hearing loss : 41 - 55 dB HL ; Mild hearing loss : 26 - 40 dB HL. Present study is to evaluate hearing loss in persons aged above 65 years both of those attending the Hospital for loss of hearing and those screened in a sur vey. AIM: To evaluate the hearing thresholds in individuals aged above 65 years attending the Government General Hospital and among the people attending the hearing screening done in the city of Warangal. The study also includes the review of the literature on ARHL. MATERIALS AND METHODS: 185 individuals aged above 65 years are evaluated for hearing thresholds with the help of pure tone audiometry and speech audiometry. Among the 185 individuals 102 are patients attending the Department of ENT for the compla ints of loss of hearing. The remaining 83 individuals are from the survey conducted to screen for hearing loss in the city of Warangal for the population aged above 65 years. Demographic data about the 185 individuals is collected. Pure tone audiogram and speech audiometry is done in all the patients. CONCLUSIONS

  13. Physical Therapy for Neurological Conditions in Geriatric Populations

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    Eli Carmeli

    2017-12-01

    Full Text Available With more of the world’s population surviving longer, individuals often face age-related neurology disorders and decline of function that can affect lifestyle and well-being. Despite neurophysiological changes affecting the brain function and structure, the aged brain, in some degree, can learn and relearn due to neuroplasticity. Recent advances in rehabilitation techniques have produced better functional outcomes in age-related neurological conditions. Physical therapy (PT of the elderly individual focuses in particular on sensory–motor impairments, postural control coordination, and prevention of sarcopenia. Geriatric PT has a significant influence on quality of life, independent living, and life expectancy. However, in many developed and developing countries, the profession of PT is underfunded and understaffed. This article provides a brief overview on (a age-related disease of central nervous system and (b the principles, approaches, and doctrines of motor skill learning and point out the most common treatment models that PTs use for neurological patients.

  14. Influence of geriatric oncology consultation on the management of breast cancer in older women: a French population-based study.

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    Somana-Ehrminger, Sophie; Dabakuyo, Tienhan S; Manckoundia, Patrick; Ouédraogo, Samiratou; Marilier, Sophie; Arveux, Patrick; Quipourt, Valérie

    2015-01-01

    The objective of the present population-based study was to assess the impact of geriatric oncology consultation on the management of elderly patients with breast cancer and to identify the predictive factors of breast cancer treatment in this population. A total of 206 women aged 75 years and older with breast cancer, diagnosed from January 2007 to December 2009 were included. The independent impact of geriatric oncology consultation on treatment was analyzed using multivariate logistic regression with adjustment for the other predictive factors of treatment. Patients who had a geriatric oncology consultation (19.4%) had more comorbidities (Charlson Comorbidity Index ≥ 1; P = 0.02), more advanced tumors (P = 0.025), more aggressive tumors (P = 0.029), were more likely to receive mastectomy and adjuvant therapy (P geriatric oncology database, 36 of the 40 patients consulted a geriatrician about oncological treatment, and 27 of these 36 patients received the treatment suggested by the geriatrician. For the whole population, geriatric oncology consultation remained a positive predictor for mastectomy and adjuvant therapy (odds ratio 2.32, P = 0.043), and a negative predictor for breast-conserving surgery and adjuvant therapy (odds ratio 0.38, P = 0.048). In the present study, we found that treatment of patients who underwent a geriatric oncology consultation generally followed the geriatricians' recommendations. The geriatric oncology consultation was a positive predictor of mastectomy and adjuvant therapy, and a negative predictor of breast-conserving surgery and adjuvant therapy. © 2014 Japan Geriatrics Society.

  15. Population Aging

    OpenAIRE

    David Weil

    2006-01-01

    Population aging is primarily the result of past declines in fertility, which produced a decades long period in which the ratio of dependents to working age adults was reduced. Rising old-age dependency in many countries represents the inevitable passing of this %u201Cdemographic dividend.%u201D Societies use three methods to transfer resources to people in dependent age groups: government, family, and personal saving. In developed countries, families are predominant in supporting children, w...

  16. Geriatric trauma.

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    Adams, Sasha D; Holcomb, John B

    2015-12-01

    The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

  17. Review of fall risk assessment in geriatric populations using inertial sensors

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    Howcroft, Jennifer; Kofman, Jonathan; Lemaire, Edward D

    2013-01-01

    Background Falls are a prevalent issue in the geriatric population and can result in damaging physical and psychological consequences. Fall risk assessment can provide information to enable appropriate interventions for those at risk of falling. Wearable inertial-sensor-based systems can provide quantitative measures indicative of fall risk in the geriatric population. Methods Forty studies that used inertial sensors to evaluate geriatric fall risk were reviewed and pertinent methodological f...

  18. Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India

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    Sreejith S. Nair

    2015-03-01

    Full Text Available Background: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India.Methods: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software.Results:We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196 as compared to males who had a prevalence of 42.4% (72 out of 170. The most common psychiatric disorder was depression (21.9%, and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of  affected individuals in 80+ age group.Conclusion: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly.  A system that ensures comprehensive health care will have to be developed for

  19. Antimicrobial Stewardship for a Geriatric Behavioral Health Population

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    Kristen Ellis

    2016-01-01

    Full Text Available Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU. Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02, and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01. There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04. Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit.

  20. Advocating vaccination of adults aged 60 years and older in Western Europe: statement by the Joint Vaccine Working Group of the European Union Geriatric Medicine Society and the International Association of Gerontology and Geriatrics-European Region.

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    Michel, Jean-Pierre; Chidiac, Christian; Grubeck-Loebenstein, Beatrix; Johnson, Robert W; Lambert, Paul Henri; Maggi, Stefania; Moulias, Robert; Nicholson, Karl; Werner, Hans

    2009-04-01

    Vaccines are an underused public health strategy for healthy aging. Considering the risks of vaccine-preventable diseases and the current low vaccine coverage rates in older European citizens, the two European geriatric and gerontological societies (European Union Geriatric Medicine Society [EUGMS] and International Association of Gerontology and Geriatrics-European Region [IAGG-ER]) convened a Joint Vaccine Working Group to develop a consensus document advocating routine vaccination of aging populations. The mandate of this Working Group was to improve the uptake of routine vaccinations in adults aged 60 years and over. The consensus statement underlines the need to establish, strengthen, and harmonize European policies that continue routine vaccinations to adulthood and that will include older populations. Improved vaccination rates will promote healthy aging by reducing the burden of vaccine-preventable infectious diseases in older populations, a population that is rapidly increasing in Europe.

  1. [Geriatrics].

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    Büla, C; Gold, G

    2007-01-10

    A new vaccine reduces the incidence and severity of zoster and its complications in older persons. A cost-effectiveness analysis highlights the implication of CDC's recent recommendation to vaccinate all persons aged 60 years and over. A meta-analysis confirms that the chronic use of sedatives in older persons provides modest benefits and important risks. Unfortunately, melatonin does not seem to be a useful alternative. A systematic review of interventions to prevent pressure ulcers provides scientific support to measures empirically used in most institutions. Finally, a randomized controlled trial questions the clinical benefit of atypical neuroleptics in Alzheimer's disease and a comprehensive review of pharmacological trials in mild cognitive impairment reports no benefit of any of the tested drugs on conversion rate to Alzheimer's disease.

  2. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population.

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    Chen, Po-Hung; Golub, Justin S; Hapner, Edie R; Johns, Michael M

    2009-03-01

    Dysphagia is an important problem for the elderly. While well characterized in acutely ill populations, the prevalence and quality-of-life changes associated with dysphagia remain poorly defined in the community geriatric population. This study recruited individuals 65 years and older from an independent-living facility. Two validated questionnaires were used: the M.D. Anderson Dysphagia Inventory (MDADI) and the general health Short Form-12 survey (SF-12v2). Each participant also answered two questions: "Do you have difficulties with swallowing?" and "Do you think that swallowing difficulties are a natural part of aging?" Fifteen percent of subjects reported difficulties with swallowing. Of these, over half suffered substantial quality-of-life impairment in one or more domains of the MDADI. With respect to the second question, 23.4% of subjects believed dysphagia to be a normal part of aging, 37.4% did not. The SF-12v2 only weakly correlated with the MDADI in this population. In conclusion, there is a relatively high prevalence of dysphagia in the community-based geriatric population; significant quality-of-life impairment is a frequent finding. General health measures do not appear to be sensitive to swallowing-related quality of life. Finally, individuals may inaccurately ascribe swallowing problems to normal aging, supporting the role of community education about dysphagia in the elderly.

  3. Artificial Neural Network (ANN) Model to Predict Depression among Geriatric Population at a Slum in Kolkata, India.

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    Sau, Arkaprabha; Bhakta, Ishita

    2017-05-01

    Depression is one of the most important causes of mortality and morbidity among the geriatric population. Although, the aging brain is more vulnerable to depression, it cannot be considered as physiological and an inevitable part of ageing. Various sociodemographic and morbidity factors are responsible for the depression among them. Using Artificial Neural Network (ANN) model depression can be predicted from various sociodemographic variables and co morbid conditions even at community level by the grass root level health care workers. To predict depression among geriatric population from sociodemographic and morbidity attributes using ANN. An observational descriptive study with cross-sectional design was carried out at a slum under the service area of Bagbazar Urban Health and Training Centre (UHTC) in Kolkata. Among 126 elderlies under Bagbazar UHTC, 105 were interviewed using predesigned and pretested schedule. Depression status was assessed using 30 item Geriatric Depression Scale. WEKA 3.8.0 was used to develop the ANN model and test its performance. Prevalence of depression among the study population was 45.7%. Various sociodemographic variables like age, gender, literacy, living spouse, working status, personal income, family type, substance abuse and co morbid conditions like visual problem, mobility problem, hearing problem and sleeping problem were taken into consideration to develop the model. Prediction accuracy of this ANN model was 97.2%. Depression among geriatric population can be predicted accurately using ANN model from sociodemographic and morbidity attributes.

  4. The evolution of gerontology and geriatrics in an era of a politics of aging.

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    Torres-Gil, Fernando M

    2017-01-01

    The fields of gerontology and geriatrics are facing unprecedented changes, pressures, and opportunities. The 21st century requires that we utilize contemporary approaches to modernizing these disciplines for new populations, new cohorts and new social, economic and political demands. This article draws on the authors professional, academic, and public policy experiences to suggest initiatives and paradigms that can set a road map to both change the last centuries' notions of longevity and social supports to one that accounts for technology, varied cohorts, a public/private sector divide, and the nexus of aging and diversity.

  5. Accuracy of forced oscillation technique to assess lung function in geriatric COPD population

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    Tse HN

    2016-05-01

    Full Text Available Hoi Nam Tse,1 Cee Zhung Steven Tseng,1 King Ying Wong,2 Kwok Sang Yee,2 Lai Yun Ng1 1Medical and Geriatric Department, Respiratory Unit, Kwong Wah Hospital, 2Department of Tuberculosis and Chest Unit, Wong Tai Sin Hospital, Hong Kong, People’s Republic of China Introduction: Performing lung function test in geriatric patients has never been an easy task. With well-established evidence indicating impaired small airway function and air trapping in patients with geriatric COPD, utilizing forced oscillation technique (FOT as a supplementary tool may aid in the assessment of lung function in this population. Aims: To study the use of FOT in the assessment of airflow limitation and air trapping in geriatric COPD patients. Study design: A cross-sectional study in a public hospital in Hong Kong. ClinicalTrials.gov ID: NCT01553812. Methods: Geriatric patients who had spirometry-diagnosed COPD were recruited, with both FOT and plethysmography performed. “Resistance” and “reactance” FOT parameters were compared to plethysmography for the assessment of air trapping and airflow limitation. Results: In total, 158 COPD subjects with a mean age of 71.9±0.7 years and percentage of forced expiratory volume in 1 second of 53.4±1.7 L were recruited. FOT values had a good correlation (r=0.4–0.7 to spirometric data. In general, X values (reactance were better than R values (resistance, showing a higher correlation with spirometric data in airflow limitation (r=0.07–0.49 vs 0.61–0.67, small airway (r=0.05–0.48 vs 0.56–0.65, and lung volume (r=0.12–0.29 vs 0.43–0.49. In addition, resonance frequency (Fres and frequency dependence (FDep could well identify the severe type (percentage of forced expiratory volume in 1 second <50% of COPD with high sensitivity (0.76, 0.71 and specificity (0.72, 0.64 (area under the curve: 0.8 and 0.77, respectively. Moreover, X values could stratify different severities of air trapping, while R values could not

  6. Toward the realization of a better aged society: messages from gerontology and geriatrics.

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    Arai, Hidenori; Ouchi, Yasuyoshi; Yokode, Masayuki; Ito, Hideki; Uematsu, Hiroshi; Eto, Fumio; Oshima, Shinichi; Ota, Kikuko; Saito, Yasushi; Sasaki, Hidetada; Tsubota, Kazuo; Fukuyama, Hidenao; Honda, Yoshihito; Iguchi, Akihisa; Toba, Kenji; Hosoi, Takayuki; Kita, Toru

    2012-01-01

    1. Recent medical advancements, and improvements in hygiene and food supply have led to Japan having the longest life expectancy in the world. Over the past 50 years, the percentage of the elderly population has increased fourfold from 5.7% in 1960 to 23.1% in 2010. This change has occurred at the fastest rate in the world. Compared with France, where the percentage of the elderly population has increased just twofold in the past 100 years, Japanese society is aging at an unprecedented rate. In addition, the percentage of the very elderly (aged 75 years and over), comprising more frail people, exceeded 10% of the nation's population in 2008. In such a situation, many elderly Japanese wish to spend their later years healthy, and wish to achieve great accomplishments in their lives. To achieve that, rather than considering an aging population as a negative social phenomenon, we should create a society where elderly people can enjoy a healthy, prosperous life through social participation and contribution. Factors that hamper the elderly from leading a healthy life include various psychological and social problems occurring in older age, as well as a high incidence of diseases. Therefore, gerontology, which focuses on health promotion of the elderly by encompassing the study of social welfare, psychology, environment and social systems; and geriatrics, which focuses on health care of elderly people and carried out research, education and practices to promote health in the elderly, are becoming more important. Furthermore, along with a need for multidisciplinary care to support geriatric medicine, the development of a comprehensive education system for aged-care professionals is awaited. Thus, we should now recognize the importance of gerontology and geriatrics, and a reform of medical-care services should be made in order to cope with the coming aged society. Population aging is a global phenomenon. The actions being taken by Japan, the world's most aged society, have

  7. Approaches for preventive psychiatry in the geriatric population

    Directory of Open Access Journals (Sweden)

    Amit Khanna

    2017-01-01

    Full Text Available In the last couple of decades, researchers have focused on finding strategies for the prevention of cognitive decline in the geriatric age group. Equivocal evidence is available from high-quality randomized controlled studies regarding causative role of modifiable midlife risk factors in cognitive decline and dementia. Among the cardiovascular risk factors, hypertension, hyperlipidemia, obesity, high saturated fat intake, and cigarette smoking have been found to be present in more than 50% of the cases of dementia and cognitive decline. Adopting healthy lifestyle changes with diet, regular moderate levels of physical activity, and abstinence from substance use have been found to have consistent evidence in the prevention of cognitive decline among other ambiguous findings across cultures. Studies assessing preventive and beneficial role of pharmacological treatment strategies such as preemptive use of disease modifying drugs, cerebroactive drugs, and nutritional supplements have been inconclusive. Psychological intervention strategies have shown some promising results. This review attempts to understand some of the perplexing issues in the prevention of cognitive decline in old age.

  8. Occupational health for an ageing workforce: do we need a geriatric perspective?

    Directory of Open Access Journals (Sweden)

    Koh David

    2006-05-01

    Full Text Available Abstract Extending retirement ages and anti-age discrimination policies will increase the numbers of older workers in the future. Occupational health physicians may have to draw upon the principles and experience of geriatric medicine to manage these older workers. Examples of common geriatric syndromes that will have an impact on occupational health are mild cognitive impairment and falls at the workplace. Shifts in paradigms and further research into the occupational health problems of an ageing workforce will be needed.

  9. Lower urinary tract symptoms and urinary incontinence in a geriatric cohort - a population-based analysis.

    Science.gov (United States)

    Wehrberger, Clemens; Madersbacher, Stephan; Jungwirth, Susanne; Fischer, Peter; Tragl, Karl-Heinz

    2012-11-01

    To assess prevalence and severity of lower urinary tract function in 85-year-old men and women. Little is known on the prevalence of lower urinary tract dysfunction in this geriatric age group, which is now the fastest growing sector of the population worldwide. The Vienna Trans-Danube Aging study (VITA) is a longitudinal, population-based study initiated in 2000 that included men/women aged 75 years living in a well-defined area in Vienna. The main purpose of the VITA study was to identify risk factors for incident Alzheimer's disease. All study participants alive in 2010 were contacted by mail to complete a detailed questionnaire on various aspects of lower urinary tract symptoms (LUTS) and urinary incontinence (UI). The response rate was 68%, resulting in a total of 262 questionnaires available for analysis (men n= 96; women n= 166). All study participants were 85 years of age. Urinary incontinence defined as any involuntary loss during the past 4 weeks was reported by 24% of men and 35% of women (P= 0.04). Stress UI was more frequent in women (39%) than in men (14%, P 0.05). Nocturia more often than twice was more prevalent in men (69%) than in women (49%) (P= 0.02). Overactive bladder, according to International Continence Society criteria, was present in 55% of women and 50% of men. No difference regarding quality of life impairment as the result of LUTS and UI was noticed between sexes. A few co-morbidities were identified to correlate with UI and storage symptoms. These data provide insights into the prevalence and severity of LUTS and UI in individuals in their eighties, to our knowledge the largest population-based study in this age group. Demographic changes in upcoming decades underline the importance of a thorough understanding of lower urinary tract dysfunction in a geriatric population. © 2012 BJU INTERNATIONAL.

  10. Influence of Yoga and Ayurveda on self-rated sleep in a geriatric population.

    Science.gov (United States)

    Manjunath, N K; Telles, Shirley

    2005-05-01

    Sleep in older persons is characterized by decreased ability to stay asleep, resulting in fragmented sleep and reduced daytime alertness. Pharmacological treatment of insomnia in older persons is associated with hazardous side effects. Hence, the present study was designed to compare the effects of Yoga and Ayurveda on the self rated sleep in a geriatric population. Of the 120 residents from a home for the aged, 69 were stratified based on age (five year intervals) and randomly allocated to three groups i.e., Yoga (physical postures, relaxation techniques, voluntarily regulated breathing and lectures on yoga philosophy), Ayurveda (a herbal preparation), and Wait-list control (no intervention). The groups were evaluated for self-assessment of sleep over a one week period at baseline, and after three and six months of the respective interventions. The Yoga group showed a significant decrease in the time taken to fall asleep (approximate group average decrease: 10 min, PYoga practice improved different aspects of sleep in a geriatric population.

  11. Dietary Intake of Minerals, Vitamins, and Trace Elements Among Geriatric Population in India.

    Science.gov (United States)

    Gupta, Aakriti; Khenduja, Preetika; Pandey, Ravindra Mohan; Sati, Hem Chandra; Sofi, Nighat Yaseen; Kapil, Umesh

    2017-11-01

    The geriatric population is at a high risk of developing deficiencies of essential micronutrients such as minerals, vitamins, and trace elements and their related deficiency signs and symptoms. Scarce data is available on the dietary intake of essential micronutrients among geriatric subjects in India. Hence, to fill the gap in the existing knowledge, a community-based cross-sectional study was conducted during 2015-2016 in District Nainital, Uttarakhand State, India. A total of 255 geriatric subjects were enrolled from 30 clusters (villages) identified by using population proportionate to size sampling methodology. Data were collected on sociodemographic profile and dietary intake of essential micronutrients (24-h dietary recall, food frequency questionnaire) from all the geriatric subjects. A high percentage of geriatric subjects did not consume the recommended daily intake for essential micronutrients such as energy (78%), protein (78%), calcium (51%), thiamine (33%), riboflavin (64%), niacin (88%), vitamin C (42%), iron (72%), folic acid (72%), magnesium (48%), zinc (98%), copper (81%) and chromium (89%) adequately. Food groups rich in essential micronutrients such as pulses, green leafy vegetables, roots and tubers, other vegetables, fruits, nonvegetarian food items, and milk and milk products were consumed irregularly by the subjects. The overall intake of energy and essential micronutrients was inadequate among the geriatric population in India, possibly due to poor quality and quantity of the diet consumed.

  12. Prognostic Value of Geriatric Conditions Beyond Age After Acute Coronary Syndrome.

    Science.gov (United States)

    Sanchis, Juan; Ruiz, Vicente; Bonanad, Clara; Valero, Ernesto; Ruescas-Nicolau, Maria Arantzazu; Ezzatvar, Yasmin; Sastre, Clara; García-Blas, Sergio; Mollar, Anna; Bertomeu-González, Vicente; Miñana, Gema; Núñez, Julio

    2017-06-01

    The aim of the present study was to investigate the prognostic value of geriatric conditions beyond age after acute coronary syndrome. This was a prospective cohort design including 342 patients (from October 1, 2010, to February 1, 2012) hospitalized for acute coronary syndrome, older than 65 years, in whom 5 geriatric conditions were evaluated at discharge: frailty (Fried and Green scales), comorbidity (Charlson and simple comorbidity indexes), cognitive impairment (Pfeiffer test), physical disability (Barthel index), and instrumental disability (Lawton-Brody scale). The primary end point was all-cause mortality. The median follow-up for the entire population was 4.7 years (range, 3-2178 days). A total of 156 patients (46%) died. Among the geriatric conditions, frailty (Green score, per point; hazard ratio, 1.11; 95% CI, 1.02-1.20; P=.01) and comorbidity (Charlson index, per point; hazard ratio, 1.18; 95% CI, 1.0-1.40; P=.05) were the independent predictors. The introduction of age in a basic model using well-established prognostic clinical variables resulted in an increase in discrimination accuracy (C-statistic=.716-.744; P=.05), though the addition of frailty and comorbidity provided a nonsignificant further increase (C-statistic=.759; P=.36). Likewise, the addition of age to the clinical model led to a significant risk reclassification (continuous net reclassification improvement, 0.46; 95% CI, 0.21-0.67; and integrated discrimination improvement, 0.04; 95% CI, 0.01-0.09). However, the addition of frailty and comorbidity provided a further significant risk reclassification in comparison to the clinical model with age (continuous net reclassification improvement, 0.40; 95% CI, 0.16-0.65; and integrated discrimination improvement, 0.04; 95% CI, 0.01-0.10). In conclusion, frailty and comorbidity are mortality predictors that significantly reclassify risk beyond age after acute coronary syndrome. Copyright © 2017 Mayo Foundation for Medical Education and

  13. Geriatric oncology: problems with under-treatment within this population.

    Science.gov (United States)

    Swaminathan, Divya; Swaminathan, Vikram

    2015-12-01

    We are currently faced with an aging population, which is rapidly growing worldwide. Two thirds of cancer occurs in the over 65-year age group. Societal conceptions from the past have created ageist stereotypes; old age is associated with frailty and the elderly are perceived to be destined for deterioration and loss of independence. Cancer within the elderly is also subject to these stereotypes, with elderly cancer patients considered by some not as likely to recover as younger patients with cancer. We summarise and review the current concerns regarding elderly management and treatments utilised for the management of oncological disease in the elderly, and discuss the impact of under-treatment within this population.

  14. Enhancing Geriatric Curriculum in Nursing School

    Science.gov (United States)

    Collins, Kevin

    2013-01-01

    People are living longer. The average age of the population is increasing, and is expected to keep growing. Any person age 65 and older is now considered "geriatric." However, although growing, this population is not receiving adequate nursing care, and results in increased pain, falls, and even death. Geriatric curriculum is becoming…

  15. The Donald W. Reynolds Consortium for Faculty Development to Advance Geriatrics Education (FD~AGE): a model for dissemination of subspecialty educational expertise.

    Science.gov (United States)

    Heflin, Mitchell T; Bragg, Elizabeth J; Fernandez, Helen; Christmas, Colleen; Osterweil, Dan; Sauvigné, Karen; Warshaw, Gregg; Cohen, Harvey Jay; Leipzig, Rosanne; Reuben, David B; Durso, Samuel C

    2012-05-01

    Most U.S. medical schools and training programs lack sufficient faculty expertise in geriatrics to train future physicians to care for the growing population of older adults. Thus, to reach clinician-educators at institutions and programs that have limited resources for enhancing geriatrics curricula, the Donald W. Reynolds Foundation launched the Faculty Development to Advance Geriatrics Education (FD~AGE) program. This consortium of four medical schools disseminates expertise in geriatrics education through support and training of clinician-educators. The authors conducted this study to measure the effects of FD~AGE. Program leaders developed a three-pronged strategy to meet program goals: FD~AGE offers (1) advanced fellowships in clinical education for geriatricians who have completed clinical training, (2) mini-fellowships and intensive courses for faculty in geriatrics, teaching skills, and curriculum development, and (3) on-site consultations to assist institutions with reviewing and redesigning geriatrics education programs. FD~AGE evaluators tracked the number and type of participants and conducted interviews and follow-up surveys to gauge effects on learners and institutions. Over six years (2004-2010), FD~AGE trained 82 fellows as clinician-educators, hosted 899 faculty scholars in mini-fellowships and intensive courses, and conducted 65 site visits. Participants taught thousands of students, developed innovative curricula, and assumed leadership roles. Participants cited as especially important to program success expanded knowledge, improved teaching skills, mentoring, and advocacy. The FD~AGE program represents a unique model for extending concentrated expertise in geriatrics education to a broad group of faculty and institutions to accelerate progress in training future physicians.

  16. Risk of falls in the rheumatic patient at geriatric age.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Sadura-Sieklucka, Teresa; Księżopolska-Orłowska, Krystyna

    2017-01-01

    Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient's falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.

  17. A STUDY ESTABLISHING THE IMPORTANCE OF BODY COMPOSITION ANALYSIS, REGULAR PHYSIOTHERAPY AND DIETARY MODIFICATIONS FOR INDEPENDENT AND HEALTHY LIVING AMONG GERIATRIC POPULATION: A DETAILED SYSTEMATIC REVIEW ARTICLE

    Directory of Open Access Journals (Sweden)

    Rohit Subhedar

    2015-10-01

    Full Text Available Background: This systematic review article aims towards comprehensive and elaborative collection of research articles related to the importance of body composition analysis, Physiotherapy and nutrition for independent geriatric lifestyle. The review article includes articles which suggest the importance of Body composition analysis, Physiotherapy interventions, specific exercises and a combination of fat free, fiber, fruit and fluid diet. Methods: A comprehensive electronic search was conducted using electronic databases Pub Med, MEDLINE, Google Scholar, Science Direct, Research gate, ICMJE, DOAJ, DRJI, IOSR, WAME and many others. In Total 3714, Research papers were reviewed which reported, Age ≥50 years, changes in Body composition in elderly , effects of Diet &Exercises on Body composition and effects of regular Physiotherapy in Geriatric health and obesity. Literature search was restricted to the studies conducted during 1980-2015. Results: Finally 55 papers along with references in research proposal were included. Review shows that ageing, body composition, Physiotherapeutic intervention and nutrition play an interdependent role in providing independent and healthy living among geriatric population. Conclusion: Combined and comprehensive interventions in form of periodic Body Composition Analysis, Physiotherapy interventions with Exercise therapy sessions and Nutritional Supplementation, will be more effective in combating ageing and independent healthy living among Geriatric population. Finally with this review we shall conclude that achieving perfect geriatric health depends upon awareness among the geriatric community to periodically analyze their body composition and regularly comply with exercise therapy sessions, subjective Physiotherapy modality sessions and nutritional supplementation. These principles help in achieving physically fit, healthy, happy and independent geriatric Community.

  18. Comprehensive geriatric assessment in the older cancer patient: coming of age in clinical cancer care

    Science.gov (United States)

    Owusu, Cynthia; Berger, Nathan A

    2015-01-01

    Cancer care at the extremes of life, in the young and the old, is characterized by unique issues associated with pediatrics and geriatric medicine, accentuated by the special vulnerabilities of these groups. In response to these needs, the field of pediatric oncology has been well honed to deal with the special problems associated with juvenile cancer patients. While most adult oncologists consider themselves well prepared to deal with older cancer patients, the current expansion of the geriatric population – their variable levels of fitness, frailty and vulnerability, the fact that cancer is primarily a disease of older adults, the significant expansion of agents and approaches to treat cancer, as well as their resultant toxicities and complications – has led to the development of specialized geriatric oncologists. Moreover, the special characteristics and needs of these patients have led to the evolution of new guidelines for evaluation, management and the conduct of research in older patients with cancer. PMID:25642321

  19. Relationship Between Mandarin Speech Reception Thresholds and Pure-tone Thresholds in the Geriatric Population

    Directory of Open Access Journals (Sweden)

    Chih-Hung Chien

    2006-01-01

    Conclusion: This study established the agreement between Mandarin SRTs and PTTs in the low tone area of speech frequencies in the geriatric population. In clinical settings, SRT test can be rapidly and easily performed and is relatively inexpensive. It is a vital indicator of the accuracy of PTT measurement.

  20. "Old Age Doesn't Come Alone": Discursive Representations of Health-in-Aging in Geriatric Medicine.

    Science.gov (United States)

    Coupland, Justine; Coupland, Nikolas

    1994-01-01

    Considers traditional approaches to identity across life span, then presents discursive perspective showing how, during interaction, individuals actively construct age-salient identities for themselves and others through talk. Conversational processes of age-identity management are explored in corpus of geriatric medical outpatient consultations.…

  1. Quality of Life in Geriatric Population in a Community Development Block of Kishanganj, Bihar, India

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    Somenath Ghosh

    2017-01-01

    Full Text Available Background: Ageing universally affects individual, family, community and society with reduction in quality of life on chronologic, biological, social, and psychological dimensions. Aim and Objectives: The study was done to assess quality of life in physical, psychological, social and environmental domains among elderly population in relation to sociodemographic character. Material and Methods: A cross-sectional study was conducted among census population of 63 elderly individuals in Chanamana village, a community development block of Potia, Kishanganj, Bihar from 1st June –31st July 2014. By interview technique the quality of life was assessed using World Health Organization Quality of Life-BREF (WHOQOL-BREF questionnaire. Mean score was computed and compared by Z -test and one-way ANOVA using SPSS software, version 19.0. Results: Among the study participants with alike gender distribution, majority (68.25% were in age group of 60-69 years, general caste (69.85%, joint family (84.12% and residing with their children (82.54%. Of them 47.62 percent were illiterates and 42.86 percent were still earning. The mean score in the distinct four domains had no significant difference in genders and age groups. Yet, residing with children and belonging to joint family were noted to be significantly improving the scores in all the four domains. Mean scores were also significantly superior in physical, psychological and environmental domains among persons who were married and had their own income. Conclusion: The study showed the quality of life within diverse domains among elderly population need to be addressed with certain socio-demographic factors (joint family, marital status, own earning and children accompanying the geriatric population.

  2. Validation of the Supportive and Palliative Care Indicators Tool in a Geriatric Population.

    Science.gov (United States)

    De Bock, Reine; Van Den Noortgate, Nele; Piers, Ruth

    2018-02-01

    Timely identification of patients in need of palliative care is especially challenging in a geriatric population because of prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification, yet has not been validated in a geriatric population. This study validates the SPICT in a geriatric patient population admitted to the hospital. This is a retrospective cohort study. Subject were patients admitted to the acute geriatric ward of a Belgian university hospital between January 1 and June 30, 2014. Data including demographics, functional status, comorbidities, treatment limitation decision (TLD), and one-year mortality were collected. SPICT was measured retrospectively by an independent assessor. Out of 435 included patients, 54.7% had a positive SPICT, using a cut-off value of 2 for the general indicators and a cut-off value of 1 for the clinical questions. SPICT-positive patients were older (p = 0.033), more frequently male (p = 0.028), and had more comorbidities (p = 0.015) than SPICT-negative patients. The overall one-year mortality was 32.2%, 48.7% in SPICT-positive patients, and 11.5% in SPICT-negative patients (p present versus 26.9% in SPICT-negative cases (p < 0.001). SPICT seems to be valuable for identifying geriatric patients in need of palliative care as it demonstrates significant association with one-year mortality and with clinical survival predictions of experienced geriatricians, as reflected by TLDs given.

  3. Cancer and Aging: General Principles, Biology, and Geriatric Assessment.

    Science.gov (United States)

    Li, Daneng; de Glas, Nienke A; Hurria, Arti

    2016-02-01

    Cancer is a disease of aging as older adults are much more likely to develop cancer compared with their younger counterparts. Understanding the biology of cancer and aging remains complex, and numerous theories regarding the relationship between the two have been proposed. Cancer treatment decisions in older patients are particularly challenging, because the evidence is scarce and the risk of toxicity increases with age. Determination of biologic age is essential due to heterogeneity of functional status, comorbidity, and physiologic reserves between patients of the same chronologic age. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The ageing of HIV: implications for geriatric medicine.

    LENUS (Irish Health Repository)

    Kearney, Fiona

    2010-09-01

    The prevalence of human immunodeficiency virus (HIV) in the over 50 age group is increasing as a consequence of younger adults ageing with HIV, in addition to new diagnoses in later life. We conducted searches in MEDLINE for English language studies published between January 1984 and January 2010 using search terms \\'HIV\\

  5. Experiencing aging or demystifying myths? - impact of different "geriatrics and gerontology" teaching strategies in first year medical students.

    Science.gov (United States)

    Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo; de Oliveira, Isabella Noceli; Moreira-Almeida, Alexander; da Silva Ezequiel, Oscarina

    2017-02-08

    With the aging of the population comes a greater need for geriatric and gerontology teaching. However, there is currently a dearth of investigations on the impact of different educational methodologies for teaching in this area early in medical courses. The present study aims to determine the impact of two educational strategies on the topic "Geriatrics and Gerontology" ("experiencing aging" and "myths of aging") as compared to a control group (no intervention) on the attitudes, empathy and knowledge of first year medical students. An intervention-based study in education was conducted at the beginning of the first year of a medical course. Students submitted to educational strategies were compared against students with no intervention. The two strategies were: "Experiencing Aging" - also known as the "aging game" (simulation of the disabilities and physiological changes of aging), and "Myths of Aging" - a knowledge discussion based on a "quiz show", questioning common myths about aging. All students were assessed on their attitudes towards older persons (Maxwell-Sullivan, UCLA attitudes), empathy (Maxwell-Sullivan), knowledge on facts and positive view about aging (Palmore), and cognitive knowledge. Data were analysed using Student's t, Chi-squared or ANOVA tests. A total of 230 students were assessed. The "experiencing aging" intervention was associated with improvement in empathy but worsening of attitude. The "myths of aging" intervention was associated with an improved attitude overall and positive view about aging but with no change in empathy towards older persons. Educational strategies can influence the attitudes and empathy of students, leading to different outcomes. These data highlight the importance of assessing the outcomes of educational strategies in medical teaching to ascertain in what manner (how), situations (when) and settings (where) these activities should be introduced.

  6. Awareness and Practices of Non-Pharmacological Approaches for Management of Hypertension in a Geriatric Population

    OpenAIRE

    Debalina Sahoo; Harshida Gosai; Ujjwal Sahoo; J. M. Harsoda

    2014-01-01

    Background: There is an increase in the prevalence of hypertension all over the world, including India. Hypertension can be initially managed with non-pharmacological measures. This study aims to assess the knowledge of non-pharmacological measures to control hypertension and its application in a geriatric hypertensive population. Methods: The study was conducted at the Department of Physiology, SVU, Vadodara, India. A total 110 hypertensive patients were included in the study and a non-v...

  7. Prosthetic status and prosthetic needs amongst geriatric fishermen population of Kutch coast, Gujarat, India.

    Science.gov (United States)

    Kumar, Dola Rama Venkata; Raju, Datla Srinivasa; Naidu, Lakshmu; Deshpande, Sumit; Chadha, Manish; Agarwal, Abhinav

    2015-01-01

    Literature among fishermen of India is scanty. The external factors like diet, quality of dental hygiene and environmental factors have an effect on oral health. Moreover elderly age group offer very little importance towards their oral health. To assess the prosthetic status and prosthetic treatment needs among the geriatric fishermen population of Kutch coast, Gujarat, India. A cross sectional descriptive study was conducted among 1200 elderly people (above 60 years) of Kutch coast, Gujarat, India. They were interviewed and examined using a proforma designed with the help of WHO Oral Health Survey 1997. Chi square test was used for comparisons. Confidence level and p-value were set at 95% and 5% respectively. Out of 1200 elderly people, 836 were males and 364 were females. Considering the prosthetic status, majority (76.7%) had no prosthesis followed by full removable dentures (12.3%). An insight into the prosthetic needs showed that majority (27.3%) had a need for multiunit prosthesis. In this study, it was seen that overall prosthetic status was low and prosthetic need was high. Therefore new avenues have to be discovered to make the prosthetic treatment readily available to the elderly.

  8. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow

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    Tkacheva ON

    2018-02-01

    -Nutritional Assessment score, 17–23.5 in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25 in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5 in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men, but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more. Conclusion: The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population. Keywords: geriatric syndromes, comprehensive geriatric assessment, questionnaire, community-dwelling, Russia

  9. Chiropractic and geriatrics: a review of the training, role, and scope of chiropractic in caring for aging patients.

    Science.gov (United States)

    Killinger, Lisa Zaynab

    2004-05-01

    provide many primary health-care services to aging patients. This is particularly important to a nation that is straining to provide adequate geriatric health care in rural areas and areas with a shortage of health-care professionals. Continued improvements in geriatric education, and an increase in research and publication on chiropractic care of the aging patient are essential. As stated by Montes and Johnston in the Journal of Health Education: Training, as well as continual upgrading of the competencies for health educators, must include ways of dealing with the great disparities in health among populations, especially those most vulnerable and underserved. Faculty too must be prepared in ... this ever-changing health care delivery system. In a rapidly aging society, chiropractors, (along with all health professions)must prepare themselves to provide optimal health care to this important segment of our society, through excellence in chiropractic education, training,and practice.

  10. Management of diabetes mellitus type-2 in the geriatric population: Current perspectives

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    Sukhminder Jit Singh Bajwa

    2014-01-01

    Full Text Available The prevalence of diabetes mellitus (DM has increased exponentially throughout the world and there is rapid increase in elderly diabetics. DM is associated with increased mortality and considerable morbidity including stroke, heart disease, and diminished quality of life in the elderly. However, the unique features of geriatric diabetes have not been given due a prominence in medical literature. Hypoglycemia remains the biggest complicating factor and needs to be avoided in the elderly. Most people in the geriatric age group have some degree of renal insufficiency and medications need to be adjusted wisely with changing renal profile. Because safer and more effective pharmacological therapy is available, an individual approach to DM in the elderly is essential.

  11. Comprehensive geriatric assessment in elderly cancer patients: an experience in an outpatient population.

    Science.gov (United States)

    Arnoldi, Ermenegildo; Dieli, Maria; Mangia, Marina; Minetti, Bruno; Labianca, Roberto

    2007-01-01

    Cancer is an age-related disease, and the increase in life expectancy will lead to a progressive increase of cancer cases in the elderly (> or =70 years of age). We have created a group called GONG (Gruppo Oncologico Geriatrico) to apply cancer geriatric assessment in elderly cancer patients, in order to select which of them are eligible for oncological treatment or supportive care only. We applied this model to evaluate 153 patients from March 2004 to August 2005. Our model included three categories of patients: frail (at least one of the following items: Activities of Daily Living scale or =3 comorbidities unrelated to the tumor according to the Charlson Index, performance status or =3 according respectively to Karnofsky and the ECOG scale, > or =1 geriatric syndrome); borderline (patients with multiple comorbidities not affecting performance status or ability in daily activities); non-frail. Applying the aforementioned criteria, we found 30 borderline, 14 frail and 109 non-frail patients. Statistical analysis showed a significant difference in mortality between frail and non-frail patients (P patients. Our model was thus able to identify patients at higher risk of death. These results confirm the importance of cancer geriatric assessment also for the clinical evaluation of oncological patients. Additional randomized studies with a larger number of patients, also in an adjuvant setting, should be performed to confirm the effectiveness of this approach.

  12. Nutraceuticals for geriatrics

    Directory of Open Access Journals (Sweden)

    Charu Gupta

    2015-01-01

    Full Text Available Geriatrics is a medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. Treatment of geriatric patients requires a different strategy and is very complex. Geriatric medicines aim to promote health by preventing and treating diseases and disabilities in older adults. Development of effective dietary interventions for promoting healthy aging is an active but challenging area of research because aging is associated with an increased risk of chronic disease, disability, and death. Aging populations are a global phenomenon. The most widespread conditions affecting older people are hypertension, congestive heart failure, dementia, osteoporosis, breathing problems, cataract, and diabetes to name a few. Decreased immunity is also partially responsible for the increased morbidity and mortality resulting from infectious agents in the elderly. Nutritional status is one of the chief variables that explains differences in both the incidence and pathology of infection. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating. Thus there is an urgent need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with aging. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. The present review thus focuses on the phytochemicals of nutraceutical importance for the geriatric population.

  13. New glaucoma medications in the geriatric population: efficacy and safety.

    Science.gov (United States)

    Novack, Gary D; O'Donnell, Martin J; Molloy, D William

    2002-05-01

    Glaucoma can be considered a disease of the aging eye. Most medications used to treat glaucoma are in topical eyedrop form and may cause numerous untoward systemic effects in older persons. In recent years, several new ocular hypotensive medications have become available. These medications are being used more commonly because there is a growing trend by ophthalmologists to aggressively lower intraocular pressure. Therefore, geriatricians require a comprehensive knowledge of medications used to treat glaucoma, in addition to an understanding of their mechanism of action profiles of untoward effects and possible interactions with other diseases or medications. Therefore, we performed a review of the medications recently introduced into clinical practice. We selected drugs approved by the U.S. Food and Drug Administration between 1996 and September 2001. The safety profiles of these agents and their untoward side effects were reviewed by class: topical carbonic anhydrase inhibitors (brinzolamide: ocular tolerance, taste perversion), beta-adrenoceptor antagonists (timolol: bradycardia and bronchospasm), alpha-adrenergic agonists (brimonidine: oral dryness, headache, and fatigue), and prostaglandin analogs (latanoprost, bimatoprost, travoprost, and unoprostone isopropyl: ocular hyperemia, iris color changes). The function of this review is to make geriatricians more aware of the efficacy and untoward effects of medications recently introduced into clinical practice. We recommend that geriatricians perform a medication review on all medications their patients use, including eye drops.

  14. Probabilistic population aging.

    Science.gov (United States)

    Sanderson, Warren C; Scherbov, Sergei; Gerland, Patrick

    2017-01-01

    We merge two methodologies, prospective measures of population aging and probabilistic population forecasts. We compare the speed of change and variability in forecasts of the old age dependency ratio and the prospective old age dependency ratio as well as the same comparison for the median age and the prospective median age. While conventional measures of population aging are computed on the basis of the number of years people have already lived, prospective measures are computed also taking account of the expected number of years they have left to live. Those remaining life expectancies change over time and differ from place to place. We compare the probabilistic distributions of the conventional and prospective measures using examples from China, Germany, Iran, and the United States. The changes over time and the variability of the prospective indicators are smaller than those that are observed in the conventional ones. A wide variety of new results emerge from the combination of methodologies. For example, for Germany, Iran, and the United States the likelihood that the prospective median age of the population in 2098 will be lower than it is today is close to 100 percent.

  15. Implications of Age-Related Changes in Anatomy for Geriatric-Focused Difficult Airways

    Directory of Open Access Journals (Sweden)

    Shih-Yi Lee

    2017-09-01

    Full Text Available The structure and function surrounding the airway change by the age, which may ultimately result in having anatomic features of difficult airways in the elderly. Hence, we reviewed the literature focusing on the age-related anatomic changes and accordingly to compare the characteristics of difficult airways. With age, teeth wear and loss, protein and collagen synthesis reduction, and bone loss and muscle atrophy results in aged face (chin protrusion, cheek retraction and drooping, jaw restriction (temporo-madibular joint disc displacement and osteoarthritis, neck and back stiffness, and kyphotic deformities (degeneration of spinal articular cartilage, intervertebral discs, and spinal osteoporosis. These age-related changes in anatomy are compatible with the predictors of a difficult airway. We hope that these age-related anatomic approaches will prospectively allow a detailed understanding of the hallmarks resulting in geriatric-focused difficult airways in the future studies.

  16. Review of fall risk assessment in geriatric populations using inertial sensors

    Science.gov (United States)

    2013-01-01

    Background Falls are a prevalent issue in the geriatric population and can result in damaging physical and psychological consequences. Fall risk assessment can provide information to enable appropriate interventions for those at risk of falling. Wearable inertial-sensor-based systems can provide quantitative measures indicative of fall risk in the geriatric population. Methods Forty studies that used inertial sensors to evaluate geriatric fall risk were reviewed and pertinent methodological features were extracted; including, sensor placement, derived parameters used to assess fall risk, fall risk classification method, and fall risk classification model outcomes. Results Inertial sensors were placed only on the lower back in the majority of papers (65%). One hundred and thirty distinct variables were assessed, which were categorized as position and angle (7.7%), angular velocity (11.5%), linear acceleration (20%), spatial (3.8%), temporal (23.1%), energy (3.8%), frequency (15.4%), and other (14.6%). Fallers were classified using retrospective fall history (30%), prospective fall occurrence (15%), and clinical assessment (32.5%), with 22.5% using a combination of retrospective fall occurrence and clinical assessments. Half of the studies derived models for fall risk prediction, which reached high levels of accuracy (62-100%), specificity (35-100%), and sensitivity (55-99%). Conclusions Inertial sensors are promising sensors for fall risk assessment. Future studies should identify fallers using prospective techniques and focus on determining the most promising sensor sites, in conjunction with determination of optimally predictive variables. Further research should also attempt to link predictive variables to specific fall risk factors and investigate disease populations that are at high risk of falls. PMID:23927446

  17. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    Science.gov (United States)

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

  18. An ageing trauma population: The Auckland experience.

    Science.gov (United States)

    Fairfax, Lindsay M; Hsee, Li; Civil, Ian

    2015-05-15

    As the population ages, the number of elderly patients suffering injuries is increasing. Reports from North America have shown an increasing proportion of elderly admissions with a disproportionate number of deaths. However, this trend has not yet been examined in New Zealand. The aim of this study was to determine unique characteristics of geriatric patients as compared to the general trauma population. The trauma database at Auckland City Hospital (ACH) was queried for patients age 65 years and above admitted between 2005-2012. Demographics, mechanism of injury, length of stay, and disposition were recorded. 1644 patients were included. The proportion of elderly patient admissions increased from 15% to 20% over the study period (p=<0.001). There were 93 deaths (6%); mortality increased with age-9% for patients 85+ compared to 5% for age 65-84 (p=0.004). Elderly trauma patients accounted for 38% of all trauma deaths. Average length of stay for survivors was 9 +/- 10 days, with 63% discharged home (n=1042), 19% to rehabilitation (n=316) and 7% to rest home (n=111). Falls were the most common mechanism (n=1261, 76%), however these patients had lower mortality compared to road traffic collision (4% vs. 12%, p<0.001) and pedestrians struck (4% vs. 11%, p<0.001). ACH has seen a significant increase in elderly trauma admissions without a change in catchment or referral pattern. These patients have a higher mortality than those under 65, longer length of stay, and are less likely to return home. Specific education on fall prevention should be increased to lessen the burden on the health system as a whole. Given the linear increase in mortality, specialised geriatric care should be considered starting at age 75.

  19. Effect of nutritional status on clinical outcome in a population of geriatric rehabilitation patients.

    Science.gov (United States)

    Donini, Lorenzo M; De Bernardini, Laura; De Felice, Maria Rosaria; Savina, Claudia; Coletti, Cecilia; Cannella, Carlo

    2004-04-01

    In a geriatric patient, nutritional status (NS), particularly in the case of malnutrition (M), may influence not only clinical results but also achievement of targets expected by geriatric rehabilitation. The aim of this study was to evaluate the effect of nutritional status (NS) on the occurrence of Adverse Clinical Events (ACE) and on mortality in geriatric rehabilitation patients. We retrospectively examined the clinical records of 278 elderly subjects (154 women, 124 men), admitted to a geriatric hospital between September 2000 and December 2001 and evaluated for clinical, functional, cognitive and NS within the first 48 hours of admission. Clinical outcomes (ACE, mortality) were recorded during follow-up. Logistic regression analysis estimated models having mortality or the occurrence of ACE as outcome variables. Malnutrition was detected upon admission in 56.1% of the sample population. Incidence of ACE in malnourished subjects was higher than that in well-nourished patients (28.2 vs 13.1%). Equally, mortality among malnourished subjects was higher than among those whose NS was normal (23.1 vs 9.8%). The logistic regression models were able to predict: 1) mortality from comorbidity (OR 1.43; 95% CI 1.16-1.78; p=0.001) and NS (OR 2.64; 95% CI 1.29-5.4; p=0.008), and 2) occurrence of ACE from comorbidity (OR 1.69; 95% CI 1.36-2.1; p=0.000), cognitive (OR 1.22; 95% CI 1.11-1.35; p=0.000) and nutritional status (OR 2.38; 95% CI 1.19-4.8; p=0.015). NS emerged as the main independent predictor of both mortality and occurrence of ACE. Although most patients fell into the category of mild/moderate (energy) malnutrition (148/156), a mild deterioration of NS, for instance, reduction in triceps skinfold thickness (TSF) seemed to be sufficient to cause an increase in the incidence of ACE and in mortality.

  20. Research Ethics Issues in Geriatric Psychiatry

    OpenAIRE

    Dunn, Laura B.; Misra, Sahana

    2009-01-01

    With an aging population, and the prevalence of psychiatric illness in the older population expected to rise dramatically in coming decades, advances in geriatric psychiatry research are urgently needed. Ethical issues in the design, conduct, and monitoring of research involving older adults parallel these same issues related to human subjects research generally. Yet a number of special issues relevant to geriatric psychiatry research merit further discussion. These special issues include the...

  1. Prescribing patterns of antihypertensive drugs in geriatric population in tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Renoy Philip

    2016-03-01

    Full Text Available Hypertension is one of the major chronic diseases with high mortality and morbidity in the today’s world. Present study was to assess the prescribing pattern of antihypertensive medications in geriatric population suffering mainly from hypertension with or without co morbidities like Diabetes Mellitus (DM. A prospective observational study was carried out for a period of six months in an in-patient general medicine department. Elderly patients who have been diagnosed with pure hypertension as per JNC 7 guidelines and hypertension with co- morbid condition like diabetes mellitus and patients receiving or prescribed with antihypertensive drugs were included. A total of 150 prescriptions were analyzed. The present study revealed that there were 93 patients with pure Hypertension and 57 patients with co morbid conditions like Diabetes Mellitus (DM. Among antihypertensive drugs in pure hypertensive cases, 53.76% of cases were prescribed with monotherapy, followed by 46.23% by combination therapy. The commonly prescribed antihypertensive monotherapy is calcium channel blockers. The most commonly prescribed combination therapy in severe cases was angiotensin receptor blockers with diuretics. This prescribing pattern of antihypertensives was as per Joint National Committee-7report on hypertension. In case of geriatric patients suffering from hypertension with Type 2 diabetes mellitus, most commonly prescribed antihypertensive as monotherapy was found to be amlodipine and combination therapy was telmisartan + hydrochlorothiazide.

  2. Prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of rural Uttarakhand, India.

    Science.gov (United States)

    Gupta, Aakriti; Kapil, Umesh; Khandelwal, Ritika; Khenduja, Preetika; Sareen, Neha; Pandey, Ravindra Mohan; Upadhyay, Ashish Datt

    2018-03-15

    To assess the prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of India. Community-based cross-sectional study. Data were collected on sociodemographic profile and anthropometric parameters. Weight and height measurements were utilized for calculation of BMI. Nutrient intake data were collected using 24 h dietary recall. High-altitude region of Nainital District, Uttarakhand State, North India. Community-dwelling geriatric subjects (n 981) aged 60 years or above. We found that 26·6 % of the elderly subjects were underweight (BMI<18·5 kg/m2). Overweight (BMI 25·0-29·9 kg/m2) and obesity (BMI≥30·0 kg/m2) was seen among 18·0 % and 4·6 %, respectively. After controlling for potential cofounders, risk factors such as low level of education and income, chewing problems and lower number of daily meals were found to be associated with underweight. On the other hand, risk factors for overweight/obesity were lower age, high income and unskilled work. There is a need to develop and implement intervention strategies to prevent underweight, overweight and obesity among the geriatric population of India.

  3. Geriatric nutrition.

    Science.gov (United States)

    Markham, R W; Hodgkins, E M

    1989-01-01

    In recent decades, veterinary medicine has become more successful in prolonging the healthy, useful lives of pets. As a result, the practitioner spends a greater part of each practice day caring for the geriatric animal, both healthy and unhealthy. Because of their longevity, older pets are typically regular family members, with owners who seek the finest health care possible for their pets. The practice of geriatric medicine most properly should begin not when the dog or cat reaches some specific "golden" age, but rather when the wiggly, robust puppy or kitten receives its first examination. Like all parts of a sound preventive program, geriatric nutrition best follows from a well-considered juvenile and adult nutrition program. Furthermore, once it becomes senior, the "well" geriatric is as much a candidate for a diet designed especially to accommodate old age changes as is his unhealthy contemporary. In fact, evidence suggests that appropriate dietary management of the healthy, but often subclinical, patient may help postpone the signs of dysfunction and increase quality and length of life. A knowledge of the most significant nutrients and the impact of each on aging systems is now, and will become increasingly more, important to the progressive, skillful veterinarian.

  4. Palliative Aged Care: Collaborative Partnerships Between Gerontology, Geriatrics and Palliative Care

    Directory of Open Access Journals (Sweden)

    Meg Hegarty

    2007-09-01

    Full Text Available Palliative aged care is rapidly developing as a specialty area, involving the collaboration and combined expertise of the fields of gerontology, geriatric care, and palliative care. The similarities and differences between these fields provide rich ground for complementing and informing each other's practice and perspectives and in working together to develop health and social policy, which acknowledge the unique factors distinguishing the experience of many elderly people with life-limiting illness. In recent years, two significant projects have been initiated in Australia: (1 the Australian Palliative Residential Aged Care Project (APRAC, which developed evidence-based guidelines for palliative aged care; and (2 the joint development of a postgraduate online program in Palliative Care in Aged Care, by the Department of Palliative and Supportive Services and the Centre for Ageing Studies, a WHO Collaborating Centre, both of Flinders University, Adelaide. Both projects have reconciled the paradigms, philosophies, and evidence-based knowledge of both palliative care and aged care to create for the first time a set of guidelines and an educational program, which will inform and influence the development of practice in this important and developing clinical area.

  5. ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

    Science.gov (United States)

    Steinman, Theodore I

    2002-01-01

    The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

  6. An under-diagnosed geriatric syndrome: sleep disorders among ...

    African Journals Online (AJOL)

    Introduction: Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Methods: Two hundred and three patients (136 female) older than 75 years of age were included in the study.

  7. An under-diagnosed geriatric syndrome: sleep disorders among ...

    African Journals Online (AJOL)

    Abstract. Introduction: Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Methods: Two hundred and three patients (136 female) older than 75 years of age were included in the ...

  8. Comparison of escitalopram versus citalopram for the treatment of major depressive disorder in a geriatric population.

    Science.gov (United States)

    Wu, Eric; Greenberg, Paul E; Yang, Elaine; Yu, Andrew; Erder, M Haim

    2008-09-01

    To compare escitalopram versus citalopram for the treatment of major depressive disorder (MDD) in geriatric patients. Administrative claims data (2003-2005) were analyzed for patients aged > or =65 years with at least one inpatient claim or two independent medical claims associated with MDD diagnosis. Patients were continuously enrolled for at least 12 months, filled at least one prescription for citalopram or escitalopram and had no second generation antidepressant use during the 6-month pre-index date. Contingency table analysis and survival analysis were used to compare outcomes between the two treatment groups. Treatment persistence, hospitalization utilization, and prescription drug, medical, and total healthcare costs were analyzed. Outcomes were compared between patients initiated on escitalopram and those initiated on citalopram both descriptively and using multivariate analysis adjusting for baseline characteristics. Among 691 geriatric patients, escitalopram-treated patients (n=459) were less likely to discontinue treatment (hazard ratio [HR]=0.83, p=0.049) or switch to another second generation antidepressant (HR=0.62, p=0.001) compared to patients treated with citalopram (n=232). Patients treated with escitalopram had a significantly lower hospitalization rate (31.2% vs. 38.8%, p=0.045) and 66% fewer hospitalization days based on negative binomial regression (pescitalopram patients had comparable prescription drug costs, they had lower total medical service costs (regression: $9748 vs. $19,208, pescitalopram had better treatment persistence, fewer hospitalizations, and lower medical and total healthcare costs than patients treated with citalopram. Most of the cost reduction was attributable to significantly lower hospitalizations and total medical costs.

  9. The aging population: demographics and the biology of aging.

    Science.gov (United States)

    Kanasi, Eleni; Ayilavarapu, Srinivas; Jones, Judith

    2016-10-01

    Epidemiologic studies show that 11% of the world's population is over 60 years of age; this is projected to increase, by 2050, to 22% of the population. Oral aging is a current focus of several organizations including the Federation Dentaire Internationale, the World Health Organization and the American and Japanese Dental Associations. In their Tokyo Declaration, the Japanese Association identified the elderly population as one of its main target groups. One of the WHO goals is for each person to retain more than 20 teeth by age 80, despite the fact that the prevalence of periodontal disease is continuously rising as the population is aging. Every species has its own characteristic lifespan, which is determined by its evolutionary history and is modified by multiple diverse factors, including biological mechanisms. In humans, the gradual accumulation of products of cellular metabolism and extensive DNA damage contribute to the aging process. Aging is thought to be associated with a low-grade inflammatory phenotype in mammals, called 'inflammaging', and is the result of autophagic capacity impairing so-called 'housekeeping activities' in the cells, resulting in protein aggregation, mitochondrial dysfunction and oxidative stress. Delayed stem-cell proliferation, associated with aging, may impact the maintenance and survival of a living being, but excessive proliferation could also result in depleted reserves of stem cells. Studies are needed to address the association of delayed cell proliferation and wound healing with the onset of periodontal diseases and response to treatment. The effects of systemic diseases, medications, psychological effects and decreased interest or ability in performing oral-hygiene practices are thought to result in periodontal diseases, and ultimately in tooth loss, in aged individuals. Together with an aging population comes a responsibility for 'healthy' and 'successful' aging. This article describes the changing global demographic

  10. Awareness and Practices of Non-Pharmacological Approaches for Management of Hypertension in a Geriatric Population

    Directory of Open Access Journals (Sweden)

    Debalina Sahoo

    2014-06-01

    Full Text Available Background: There is an increase in the prevalence of hypertension all over the world, including India. Hypertension can be initially managed with non-pharmacological measures. This study aims to assess the knowledge of non-pharmacological measures to control hypertension and its application in a geriatric hypertensive population. Methods: The study was conducted at the Department of Physiology, SVU, Vadodara, India. A total 110 hypertensive patients were included in the study and a non-validated survey was conducted to examine knowledge of non-pharmacological measures to control hypertension in this group of patients. Frequencies, percentages, means and standard deviations were calculated and reported. Results: Only 10% of the respondents knew the normal values for blood pressure. Approximately 38% of the subjects did not measure their blood pressure regularly. A total of 24% subjects knew that body weight has a correlation with hypertension. About 27% said that there was no correlation between salt intake and hypertension, and 88% of the study population did not carry out any form of physical activity. Conclusion: Hypertension can be controlled by life style modifications such as exercise, weight management and a healthy diet. Public health and education measures targeting hypertensive population need to be taken to decrease the risk factors for cardiovascular diseases and, therefore, improve people's health and quality of life.

  11. Geriatrics and the triple aim: defining preventable hospitalizations in the long-term care population.

    Science.gov (United States)

    Ouslander, Joseph G; Maslow, Katie

    2012-12-01

    Reducing preventable hospitalizations is fundamental to the "triple aim" of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long-term care (LTC) because they often experience negative effects of hospitalization, including hospital-acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community- and institution-based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  12. Drug Delivery Innovations to Address Global Health Challenges for Pediatric and Geriatric Populations (Through Improvements in Patient Compliance).

    Science.gov (United States)

    Boateng, Joshua

    2017-11-01

    Despite significant advances in pharmaceutical and biotechnological drug discovery, the global population is plagued with many challenging diseases. These are further compounded by anticipated explosion in an ageing population, which presents several problems such as polypharmacy, dysphagia, and neurologic conditions, resulting in noncompliance and disease complications. For antibiotics, poor compliance, can result in development of drug-resistant infections which can be fatal. Furthermore, children, especially, in developing countries die unnecessarily from easily treatable diseases (e.g., malaria), due to poor compliance arising from bitter taste and inability to swallow currently available medication. Although some of these challenges require the discovery of new drug compounds, a significant number can be resolved by employing pharmaceutics approaches to reduce the incidence of poor patient compliance. Such solutions are expected to make swallowing easier and reduce the need to swallow several solid medications, which is difficult for vulnerable pediatric and geriatric patients. This commentary will explore the current state of the art in the use of drug delivery innovations to overcome some of these challenges, taking cues from relevant regulatory agencies such as the Food and Drug Administration, the European Medicines Agency, World Health Organization, and the peer-reviewed scientific and clinical literature. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  13. Paths for Future Population Aging.

    Science.gov (United States)

    Grigsby, Jill S.

    Population aging refers to an entire age structure becoming older. The age structure of a population is the result of three basic processes: fertility, mortality, and migration. Age structures reflect both past effects and current patterns of these processes. At the town, city, or regional level, migration becomes an important factor in raising…

  14. Feasibility of Using Pseudo-Continuous Arterial Spin Labeling Perfusion in a Geriatric Population at 1.5 Tesla.

    Directory of Open Access Journals (Sweden)

    Sigurdur Sigurdsson

    Full Text Available To evaluate the feasibility of using pseudo-continuous arterial spin labeling (pCASL perfusion in a geriatric population at 1.5-Tesla.In 17 participants (mean age 78.8±1.63 years we assessed; 1 inter-session repeatability and reliability of resting state perfusion in 27 brain regions; 2 brain activation using finger-tapping as a means to evaluate the ability to detect flow differences; 3 reliability by comparing cerebral blood flow (CBF with pCASL to CBF with phase contrast (PC-MR.The CBF (mean±standard deviation (SD for the whole brain grey matter (GM was 40.6±8.4 and 41.4±8.7 ml/100g/min for the first and second scan respectively. The within-subject standard deviation (SDw, the repeatability index (RI and intra-class correlation coefficient (ICC across the 27 regions ranged from 1.1 to 7.9, 2.2 to 15.5 and 0.35 to 0.98 respectively. For whole brain GM the SDw, RI and ICC were 1.6, 3.2 and 0.96 respectively. The between-subject standard deviation (SDB was larger than the SDw for all regions. Comparison of CBF at rest and activation on a voxel level showed significantly higher perfusion during finger tapping in the motor- and somatosensory regions. The mean CBF for whole brain GM was 40.6±8.4 ml/100g/min at rest and 42.6±8.6 ml/100g/min during activation. Finally the reliability of pCASL against the reference standard of PC-MR was high (ICC = 0.80. The mean CBF for whole brain measured with PC-MRI was 54.3±10.1 ml/100g/min and 38.3±7.8 ml/100g/min with pCASL.The results demonstrate moderate to high levels of repeatability and reliability for most brain regions, comparable to what has been reported for younger populations. The performance of pCASL at 1.5-Tesla shows that region-specific perfusion measurements with this technique are feasible in studies of a geriatric population.

  15. Challenges in the Management of Geriatric Obesity in High Risk Populations

    Science.gov (United States)

    Porter Starr, Kathryn N.; McDonald, Shelley R.; Weidner, Julia A.; Bales, Connie W.

    2016-01-01

    The global prevalence of obesity in the older adult population is growing, an increasing concern in both the developed and developing countries of the world. The study of geriatric obesity and its management is a relatively new area of research, especially pertaining to those with elevated health risks. This review characterizes the state of science for this “fat and frail” population and identifies the many gaps in knowledge where future study is urgently needed. In community dwelling older adults, opportunities to improve both body weight and nutritional status are hampered by inadequate programs to identify and treat obesity, but where support programs exist, there are proven benefits. Nutritional status of the hospitalized older adult should be optimized to overcome the stressors of chronic disease, acute illness, and/or surgery. The least restrictive diets tailored to individual preferences while meeting each patient’s nutritional needs will facilitate the energy required for mobility, respiratory sufficiency, immunocompentence, and wound healing. Complications of care due to obesity in the nursing home setting, especially in those with advanced physical and mental disabilities, are becoming more ubiquitous; in almost all of these situations, weight stability is advocated, as some evidence links weight loss with increased mortality. High quality interdisciplinary studies in a variety of settings are needed to identify standards of care and effective treatments for the most vulnerable obese older adults. PMID:27153084

  16. Lithuanian Population Aging Factors Analysis

    Directory of Open Access Journals (Sweden)

    Agnė Garlauskaitė

    2015-05-01

    Full Text Available The aim of this article is to identify the factors that determine aging of Lithuania’s population and to assess the influence of these factors. The article shows Lithuanian population aging factors analysis, which consists of two main parts: the first describes the aging of the population and its characteristics in theoretical terms. Second part is dedicated to the assessment of trends that influence the aging population and demographic factors and also to analyse the determinants of the aging of the population of Lithuania. After analysis it is concluded in the article that the decline in the birth rate and increase in the number of emigrants compared to immigrants have the greatest impact on aging of the population, so in order to show the aging of the population, a lot of attention should be paid to management of these demographic processes.

  17. Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices.

    Science.gov (United States)

    Lehmann, Susan W; Blazek, Mary C; Popeo, Dennis M

    2015-06-01

    The aging of the US population and shortage of geriatric psychiatrists mean that all medical students must be prepared to evaluate psychiatric symptoms in older patients. The authors sought to describe current geriatric psychiatry teaching practices during the psychiatry clerkship. Psychiatry clerkship directors at 110 American medical schools were surveyed about didactic and clinical experiences of geriatric psychiatry. Sixty-two (56 %) of programs responded. One fifth of programs lacked specific instruction in geriatric psychiatry. Programs were more likely to include instruction on dementia than late-life depression. Increased geriatric psychiatry educational offerings were associated with the following: number of geriatric psychiatrists on faculty, presence of a geriatric psychiatrist on the medical education committee, and inclusion of geriatric psychiatry specific items in clerkship learning objectives. Current practices in some clerkships are inadequate to prepare medical students to care for older patients with psychiatric symptoms.

  18. Food for the ageing population

    NARCIS (Netherlands)

    Raats, M.M.; Groot, de C.P.G.M.; Staveren, van W.A.

    2008-01-01

    The world’s ageing population is increasing and food professionals will have to address the needs of older generations more closely in the future. This unique volume reviews the characteristics of the ageing population as food consumers, the role of nutrition in healthy ageing and the design of food

  19. Attention-Deficit/Hyperactivity Disorder in Childhood Is Associated with Cognitive Test Profiles in the Geriatric Population but Not with Mild Cognitive Impairment or Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    N. Ivanchak

    2011-01-01

    Full Text Available The frequency of ADHD in the aging population and its relationship to late-life cognitive decline has not been studied previously. To address this gap in our understanding, the Wender-Utah ADHD Rating scale (WURS was administered to 310 geriatric subjects with cognitive status ranging from normal cognition to mild cognitive impairment to overt dementia. The frequency of WURS-positive ADHD in this sample was 4.4%. WURS scores were not related to cognitive diagnoses, but did show nonlinear associations with tasks requiring sustained attention. The frequency of ADHD appears stable across generations and does not appear to be associated with MCI or dementia diagnoses. The association of attentional processing deficits and WURS scores in geriatric subjects could suggest that such traits remain stable throughout life. Caution should be considered when interpreting cognitive test profiles in the aging population that exhibit signs and symptoms of ADHD, as attentional deficits may not necessarily imply the existence of an underlying neurodegenerative disease state.

  20. Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

    Directory of Open Access Journals (Sweden)

    Egemen Ayhan

    2013-12-01

    Full Text Available Background: The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. Aims: The aims of this retrospective study were: (1 to determine the factors affecting mortality of femoral neck fracture patients ≥65 years of age; (2 to compare patient mortality rates, radiological findings, and functional outcomes according to prosthesis type (unipolar or bipolar; and (3 to evaluate the persistence of inner bearing mobility of bipolar prostheses. Study Design: Retrospective comparative study. Methods: In total, 144 patients operated for hemiarthroplasty and aged ≥65 were included. We classified the patients into either unipolar or bipolar prosthesis groups. To reveal factors that affected mortality, age, sex, delay in surgery, and American Society of Anesthesiologists score were obtained from folders. Barthel Daily Living, Harris hip, and acetabular erosion scores were calculated and bipolar head movement was analysed for live patients. Results: One-year mortality was 31.94%. Age ≥75 (p=0.029, male sex (p=0.048, and delay in surgery ≥6 (p=0.004 were the patient characteristics that were related to increased mortality. There were no significant differences in sex, age, American Society of Anesthesiologists score, delay in surgery, mortality, or Barthel, Harris, acetabulum scores between the two groups. Twenty patients from each group were admitted for last follow-up. Bipolar head movement was preserved for 33.3% of patients. They were inactive patients with low Barthel and Harris scores. Conclusion: Although bipolar head movement was preserved in inactive patients, we suppose that this conferred no advantage to these patients, who could hardly walk. In this study, male patients, those aged ≥75 years, and those operated at ≥6 days had an increased risk of

  1. A review of geriatric education in Singapore.

    Science.gov (United States)

    Koh, Gerald C H

    2007-08-01

    The United Nations has identified the training and education of healthcare professionals and care providers involved in the care of older persons as a global priority. Singapore is no exception as it faces a rapidly ageing population. Older people have many medical needs of varying dimensions and their care requires a multidisciplinary healthcare team. The current status of geriatric education of health professionals involved in elderly care in Singapore is discussed in this paper. Important issues raised include the disparity between professions in the stages of development of geriatric education, questions on the adequacy of numbers and training of healthcare professionals providing geriatric care, as well as the need for geriatric education of caregivers.

  2. Geriatric Optometry--Today and Tomorrow.

    Science.gov (United States)

    Verma, Satya B.

    1982-01-01

    Although there is some geriatric content in optometry curriculum, such as pathology and diseases associated with aging, the emphasis would be better placed on aging as a normal process. Further education about the elderly population as a whole and further legislation for comprehensive care are needed. (MSE)

  3. National Database of Geriatrics

    DEFF Research Database (Denmark)

    Kannegaard, Pia Nimann; Vinding, Kirsten L; Hare-Bruun, Helle

    2016-01-01

    AIM OF DATABASE: The aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit. STUDY POPULATION: The database population consists of patients who were admitted to a geriatric hospital unit....... Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges. The database includes 14-15,000 admissions per year, and the database completeness has been stable at 90% during the past......, percentage of discharges with a rehabilitation plan, and the part of cases where an interdisciplinary conference has taken place. Data are recorded by doctors, nurses, and therapists in a database and linked to the Danish National Patient Register. DESCRIPTIVE DATA: Descriptive patient-related data include...

  4. Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study.

    Science.gov (United States)

    Yi, Sang-Wook

    2016-05-01

    Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; pdepression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; psuicide deaths was 0.61 (95% CI, 0.58 to 0.64). Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

  5. Prevalence and predictors of depression and anxiety among the elderly population living in geriatric homes in Cairo, Egypt.

    Science.gov (United States)

    Ahmed, Dalia; El Shair, Inas Helmi; Taher, Eman; Zyada, Fadia

    2014-12-01

    Anxiety and depression are common in the elderly and affect their quality of life. The rates of depression and anxiety are higher among those living in institutional settings and are usually undiagnosed. The aim of the study was to determine the prevalence and predictors of depression, anxiety and mixed form (i.e. depression and anxiety) in the elderly living at geriatric homes. A cross-sectional study was conducted on 240 elderly participants from four randomly selected geriatric homes in Cairo. A pretested interview questionnaire was used to collect data. A short version of the Geriatric Depression Scale (GDS-15), the Hamilton Anxiety Scale, the Katz scale for Activity of Daily living, the three-item loneliness scale and the Personal Wellbeing Index Scale were used. The prevalence of depression, anxiety and mixed disorder among the studied group were 37.5, 14.2 and 30%, respectively. Old age and the presence of comorbidities were predictors for depression and/or anxiety. Female sex, a lower social class, insufficient income, partial independence and loneliness feeling are significant predictors for depression. Being married and loneliness feeling are significant predictors for anxiety, whereas the functional status is a significant predictor for mixed depression and anxiety. Depression and/or anxiety were found in more than 80% of the studied group. An older age, female sex, insufficient income, a lower social class, a partially independent functional status, the presence of comorbidities, more frequent loneliness feeling and being married or divorced were found to be significant predictors for these problems. This study reflects the need for the screening of the elderly in geriatric homes for depression and/or anxiety, especially among high-risk groups, and developing interventions to prevent and control such problems.

  6. Effects of individual dietary counseling as part of a comprehensive geriatric assessment (CGA) on nutritional status: a population-based intervention study.

    Science.gov (United States)

    Nykänen, I; Rissanen, T H; Sulkava, R; Hartikainen, S

    2014-01-01

    Nutritional risk is relatively common in community-dwelling older people. To objective of this study was to evaluate the effects of individual dietary counseling as part of a Comprehensive Geriatric Assessment on nutritional status among community-dwelling people aged 75 years or older. Data were obtained from a subpopulation of participants in the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) intervention study in 2004 to 2007. In the present study, the population consist 173 persons at risk of malnutrition in the year 2005 in an intervention (n=84) and control group (n=89). Nutritional status, body weight, body mass index, serum albumin were performed at the beginning of the study and at a two-year follow-up. The nutritional screening was performed using the Mini Nutritional Assessment (MNA) test. A increase in MNA scores (1.8 95% confidence interval [CI]: 0.7 to 2.0) and in serum albumin (0.8 g/L, 95% CI: 0.2 to 0.9 g/L) were a significant difference between the groups. Nutritional intervention, even dietary counseling without nutritional supplements, may improve nutritional status.

  7. EMR-based TeleGeriatric system.

    Science.gov (United States)

    Pallawala, P M; Lun, K C

    2001-01-01

    As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socio-economic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. The TeleGeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes once a week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in the geriatric care will also benefit from this system. Integrated electronic medical record (EMR) system will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. The TeleGeriatric web based server is developed using Java Technology. The TeleGeriatric database server was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care have been chosen for the project. These 3 institutions and National University of Singapore are connected via ADSL protocol. ADSL connection supports high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation a nurse or a doctor in the remote site sends the patient's record to the TeleGeriatric server. The TeleGeriatric server forwards the request

  8. Age, sex and (the) race: gender and geriatrics in the ultra-endurance age.

    Science.gov (United States)

    Whyte, Greg

    2014-01-01

    Ultra-endurance challenges were once the stuff of legend isolated to the daring few who were driven to take on some of the greatest physical endurance challenges on the planet. With a growing fascination for major physical challenges during the nineteenth century, the end of the Victorian era witnessed probably the greatest ultra-endurance race of all time; Scott and Amundsen's ill-fated race to the South Pole. Ultra-endurance races continued through the twentieth century; however, these events were isolated to the elite few. In the twenty-first century, mass participation ultra-endurance races have grown in popularity. Endurance races once believed to be at the limit of human durability, i.e. marathon running, are now viewed as middle-distance races with the accolade of true endurance going to those willing to travel significantly further in a single effort or over multiple days. The recent series of papers in Extreme Physiology & Medicine highlights the burgeoning research data from mass participation ultra-endurance events. In support of a true 'mass participation' ethos Knetchtle et al. reported age-related changes in Triple and Deca Iron-ultra-triathlon with an upper age of 69 years! Unlike their shorter siblings, the ultra-endurance races appear to present larger gender differences in the region of 20% to 30% across distance and modality. It would appear that these gender differences remain for multi-day events including the 'Marathon des Sables'; however, this gap may be narrower in some events, particularly those that require less load bearing (i.e. swimming and cycling), as evidenced from the 'Ultraman Hawaii' and 'Swiss Cycling Marathon', and shorter (a term I used advisedly!) distances including the Ironman Triathlon where differences are similar to those of sprint and endurance distances i.e. c. 10%. The theme running through this series of papers is a continual rise in participation to the point where major events now require selection races to remain

  9. Mortality after trauma laparotomy in geriatric patients.

    Science.gov (United States)

    Joseph, Bellal; Zangbar, Bardiya; Pandit, Viraj; Kulvatunyou, Narong; Haider, Ansab; O'Keeffe, Terence; Khalil, Mazhar; Tang, Andrew; Vercruysse, Gary; Gries, Lynn; Friese, Randall S; Rhee, Peter

    2014-08-01

    Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy. A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006-2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality. A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2-4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy. Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies. Published by Elsevier Inc.

  10. Prediction of liver volume - a population-based approach to meta-analysis of paediatric, adult and geriatric populations - an update.

    Science.gov (United States)

    Small, Ben G; Wendt, Bernd; Jamei, Masoud; Johnson, Trevor N

    2017-05-01

    Liver volume is a critical scaling factor for predicting drug clearance in physiologically based pharmacokinetic modelling and for both donor/recipient graft size estimation in liver transplantation. The accurate and precise estimation of liver volume is therefore essential. The objective here was to extend an existing meta-analysis using a non-linear mixed effects modelling approach for the estimation of liver volume to other race groups and paediatric and geriatric populations. Interrogation of the PubMed® database was undertaken using a text string query to ensure as objective a retrieval of liver volume data for the modelling exercise as possible. Missing body size parameters were estimated using simulations from the Simcyp Simulator V13R1 for an age and ethnically appropriate population. Non-linear mixed effect modelling was undertaken in Phoenix 1.3 (Certara) utilizing backward deletion and forward inclusion of covariates from fully parameterized models. Existing liver volume models based on body surface area (BSA) and body weight and height were implemented for comparison. The extension of a structural model using a BSA equation and incorporating the Japanese race and age as covariates and exponents on LV0 (θ Baseline ) and body surface area (θ BSA ), respectively, delivered a comparatively low objective function value. Bootstrapping of the original dataset revealed that the confidence intervals (2.5-97.5%) for the fitted (theta) parameter estimates were bounded by the bootstrapped estimates of the same. In conclusion, extension and re-parameterization of the existing Johnson model adequately describes changes in liver volume using the body surface area in all investigated populations. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Urban Biometeorology: analysis of the air pollution and climate change on cognition and physical abilities of geriatric population of São Paulo City

    Science.gov (United States)

    Teixeira Gonçalves, Fabio Luiz; Jacob, Wilson; Alucci, Marcia; Busse, Alexandre; Duarte, Denise; Monteiro, Leonardo; Trezza, Beatriz; Tribess, Arlindo; Batista, Rafael; Ambrizzi, Tercip

    2013-04-01

    This is a multidisciplinary Project, which emphasizes geriatric population impacts, i. e., over 65 years old, of meteorological variables and air pollutants (such as particulate matter) associated to human health, and concerning to the real climatology and climate change in the Metropolitan Region of São Paulo. This is a biometeorological study, human subdivision, based on ISB (International Society of Biometeorology). According to the society, the environmental effects are considered meteorotropics where one or more environmental variables (meteorological or climatic even air pollution) affect one or more individuals of a population. Atmospheric pollution will be analyzed using a personal particulate matter multi-collector, concerning the impact of unfavorable meteorological conditions where the impacts will be evaluated comparing the test results during dry season (high air pollutant concentrations) and wet season (low pollutant concentrations). Therefore, the aim of this study will be to evaluate the cognitive and physical performance of a geriatric population in a pre-selected group of aged people which are considered as capable (healthy). This performance is affected by environmental conditions which thermal comfort (where meteorological variables act together) and air pollution are the meteorotropic ones. Consequently, one of the aims of the study is to establish a human thermal comfort index for geriatric populations. Architectural premises (thermal performance and ergonomics) will be also developed. An acclimatized chamber will be used to simulate the extremes of São Paulo climate and to propose a thermal comfort index. Indoors (chamber) and outdoors will be used in order to compare the impact on the selected aged people. Finally, the climate change will be based on GCM's global models which show the meteorological variations in order to calculate their impact on a comfort index. The physical and cognitive performances and architectural premises (thermal

  12. UK medical teaching about ageing is improving but there is still work to be done: the Second National Survey of Undergraduate Teaching in Ageing and Geriatric Medicine.

    Science.gov (United States)

    Gordon, Adam Lee; Blundell, Adrian; Dhesi, Jugdeep K; Forrester-Paton, Calum; Forrester-Paton, Jayne; Mitchell, Hannah K; Bracewell, Nicola; Mjojo, Jocelyn; Masud, Tahir; Gladman, John R F

    2014-03-01

    in 2008, a UK national survey of undergraduate teaching about ageing and geriatric medicine identified deficiencies, including failure to adequately teach about elder abuse, pressure ulcers and bio- and social gerontology. We repeated the survey in 2013 to consider whether the situation had improved. the deans of all 31 UK medical schools were invited to nominate a respondent with an overview of their undergraduate curriculum. Nominees were invited by email and letter to complete an online questionnaire quantifying topics taught, type of teaching and assessment undertaken, and the amount of time spent on teaching. one school only taught pre-clinical medicine and declined to participate. Of the 30 remaining schools, 20 responded and 19 provided analysable data. The majority of the schools (95-100%) provided teaching in delirium, dementia, stroke, falls, osteoporosis, extra-pyramidal disorders, polypharmacy, incontinence, ethics and mental capacity. Only 68% of the schools taught about elder abuse. Thirty-seven per cent taught a recognised classification of the domains of health used in Comprehensive Geriatric Assessment (CGA). The median (range) total time spent on teaching in ageing and geriatric medicine was 55.5 (26-192) h. There was less reliance on informal teaching and improved assessment:teaching ratios compared with the 2008 survey. there was an improvement in teaching and assessment of learning outcomes in ageing and geriatric medicine for UK undergraduates between 2008 and 2013. However, further work is needed to increase the amount of teaching time devoted to ageing and to improve teaching around elder abuse and the domains of health used in CGA.

  13. [Geriatric medicine in future].

    Science.gov (United States)

    Kameyama, M

    1989-01-01

    Geriatrics in future will be most concerned with persons aged 80 years or more (very elderly) in Japan. Clinical and pathological features of very elderly patients were reported with comparison to the 65-79 age group. Many very elderly do not show clear-cut clinical signs and symptoms, but have serious underlying diseases. We propose here a concept of "clinical threshold". On evaluating the laboratory data, we must consider the grades of "activity of daily living (ADL)" of the aged patients, because ADL may significantly modify the test results. Furthermore in clinical practice, we should pay attention to both the psychosocial states and physical findings of the patients. "The old age syndrome" proposed by Parker is useful in geriatric medicine. Extensive studies on dementia, especially of Alzheimer's type are required urgently. Molecular biology approaches to this disease have shown great advances in geriatrics. To prevent geriatric disease, well-controlled exercise and diet are important as well as reasonable psychosocial integrity.

  14. Emerging geriatric challenge.

    Science.gov (United States)

    Dhar, H L

    2005-10-01

    India is a vast country with diversity, both physical and cultural. 72% of World's second largest population live in rural experiencing varying degrees of socioeconomic change. However, there is no nationwide registry of older people and exact statistics about elderly population is not available. Community-based data on morbidity and disability are also not available. India is one of the few countries in the world where men out number women at all ages till about 70 years and only in very old age (80+) there are more women than men. One of the main social effect of extension of life in later years is the extended period of widowhood for women mainly due to cultural practice of men marrying younger women and widow marriage as well as divorce are uncommon. Much progress has been made in the health care services in the last 50 years giving much emphasis to mother and child programme with special emphasis on controlling population. But elderly population has been neglected, there is no separate ward for elderly in hospitals, no specialized courses in the Universities for training doctors and nurses for elderly care. Recently, Indian Medical Association has organized an ambitious project for rural elderly with emphasis on Geriatric care. Still recently, emphasis has been given for developing infrastructural facilities including creating training, courses on Geriatric Medicine and integrating with alternative system for better care of elderly. However, due to increasing awareness of policy makers to multiple issues related to aging, some progress has been made like old age pension scheme, income tax rebate for elderly, old homes and day care centers and law to help retired citizens in evicting tenants etc. but environment is not as elderly-friendly as in European countries, as the State is not likely to have adequate resources in the presence of other priorities in the country.

  15. Use of games as a learner-centered strategy in gerontology, geriatrics, and aging-related courses.

    Science.gov (United States)

    Schmall, Vicki; Grabinski, C Joanne; Bowman, Sally

    2008-01-01

    Based on their experience as designers and/or users of games as a learner-centered strategy in gerontology, geriatric, and aging-related courses and training programs, the authors note multiple advantages of using games as a learning tool, list six relevant games (including order information), and suggest a variety of ways games can be used. They offer guidelines to apply in selecting appropriate games and discuss key aspects of the instructor or facilitator's role in preparing learners for game playing, monitoring game play, and debriefing students once game play has ended. Outcomes for learners and course instructors are shared.

  16. Geriatric Medical Education and Training in the United States

    Directory of Open Access Journals (Sweden)

    Michéle J. Saunders

    2005-12-01

    Full Text Available Medical education in geriatrics is an important requirement to ready the profession to provide comprehensive health care to the world's and also Taiwan's aging population. The predoctoral curricula and postdoctoral training programs in the United States were developed and supported by government agencies and professional education societies. Geriatric medical education in American medical schools has improved in the past 20 years, yet is still facing many challenges. The purposes of this paper are to review the current progress of, and propose some main principles and policies for the development of geriatric medical education and current progress in the United States. Geriatric medical education should be mandatory to adequately prepare medical students, residents, fellows, and practicing physicians to treat the elderly. The current progress and practice of geriatric medical education at the University of Texas Health Science Center at San Antonio are presented as an example.

  17. A new age approach to an age old problem: using simulation to teach geriatric medicine to medical students.

    Science.gov (United States)

    Fisher, James M; Walker, Richard W

    2014-05-01

    simulation-based teaching is increasingly used in medical education, but no studies have evaluated its impact on learning in geriatric medicine. We developed and delivered a simulation teaching session on delirium, falls, elder abuse and breaking bad news. Simulation mannequins, professional role-players and simulated clinical documentation were all incorporated into scenarios. We evaluated the effect of this intervention on student learning and on students' attitudes towards geriatric medicine. third year Newcastle University MBBS students at Northumbria base unit received the simulation-based teaching session. Students' knowledge was assessed using a three question test mapped to learning outcomes for the elder abuse, delirium and falls stations. Each student undertook the test on three occasions: the day before the teaching session, immediately after the session and ∼1 month later, allowing evaluation of learning over time. Test scores were also compared with those achieved by another cohort of third year MBBS students at a different base unit, who received traditional ward-based and didactic teaching but no simulation teaching. student knowledge improved significantly after the simulation session and this was maintained when reassessed a month later. Students who received the simulation-based training outperformed those who received usual teaching. Student feedback was overwhelmingly positive and the vast majority of students agreed that the session had a positive impact on their perceptions of geriatric medicine. our findings demonstrate the efficacy of simulation-based teaching in undergraduate geriatric medicine, its acceptability to students and its positive influence on students' perceptions of the specialty.

  18. Geriatric oral health issues in India.

    Science.gov (United States)

    Shah, N

    2001-06-01

    An overview of the demographics and oral health status of the elderly population of India is presented. India is a vast country with a population of one billion people. Of this, people older than 60 years constitute 7.6%, which in actual number is 76 million. There are several factors that affect the oral health of elderly. The dentist:population ratio is 1:27,000 in urban areas and 1:300,000 in rural areas, whereas 80% of the elderly population reside in rural India. Forty per cent of the elderly live below the poverty line and 73% are illiterate. Ninety per cent of the elderly have no social security and the dependency ratio is 12.26. Incidence of oral cancer, which is considered an old-age disease, is highest in India, 13.5% of all body cancers are oral cancers. Preventive dental care is almost nonexistent to the rural masses and very limited in urban areas. Above all, there is no orientation of dental graduates towards the special needs of the geriatric population. Recommendations include: the establishment of Continuing Dental Education programmes on geriatric oral care; inclusion of a geriatric component in undergraduate and postgraduate curricula; initiation of a diploma, certificate and degree courses in geriatric dentistry; research on various aspects of ageing and age-related oral health problems; provision of preventive and curative treatment for various oral diseases to the elderly.

  19. [Medicine for the elderly or science of old age? Max Bürger's contribution to geriatric medicine and gerontology].

    Science.gov (United States)

    Blumenthal, Sandra; Bruns, Florian

    2015-01-01

    The fact that, due to demographic changes, gerontology and geriatrics are gaining ever more importance gives rise to more questions regarding the history of the science of aging. Based on unpublished sources and relevant publications by Max Bürger, the doyen of gerontological research in Germany, our contributions trace the beginnings of age research in Germany. Our results confirm Bürger as the dominant expert in this field in the first decades of its emergence. Bürger was primarily interested in basic medical-scientific research, and less in clinical geriatrics. His scientific goal was not to establish a medicine for the elderly but a theory of life changes ("biomorphosis"). From the start, he saw aging as a physiological process--a view that is still valid today. His concept of "biomorphosis", however, did not catch on and reveals a constriction in Bürger's thinking, which was to some extent influenced by Hans Driesch's vitalism. Interdisciplinary approaches are noticeable in the natural sciences rather than the humanities or social sciences. Bürger's research was also influenced by the political system he lived in. During National Socialism, which Bürger joined--at least formally--in 1937, his research into labour economics and aging met with considerable interest in connection with the general mobilisation of resources. East Germany also had an interest in questions of labour productivity in old age and the extension of the working life, which meant that Bürger remained a sought-after physician and scientist up into the 1960s. As he grew older himself, Bürger's initially deficit-oriented view of old age gave way to a more positive presentation that attached greater weight to the resources of old age.

  20. Graduate and undergraduate geriatric dentistry education in a selected dental school in Japan.

    Science.gov (United States)

    Kitagawa, N; Sato, Y; Komabayashi, T

    2011-11-01

    Geriatric dentistry and its instruction are critical in a rapidly ageing population. Japan is the world's fastest-ageing society, and thus, geriatric dentistry education in Japan can serve as a global model for other countries that will soon encounter the issues that Japan has already confronted. This study aimed at evaluating geriatric dental education with respect to the overall dental education system, undergraduate geriatric dentistry curricula, mandatory internships, and graduate geriatric education of a selected dental school in Japan. Bibliographical data and local information were collected. Descriptive and statistical analyses (Fisher and chi-squared test) were conducted. Japanese dental schools teach geriatric dentistry in 10 geriatric dentistry departments as well as in prosthodontic departments. There were no significant differences found between the number of public and private dental schools with geriatric dentistry departments (P = 0.615). At Showa University School of Dentistry, there are more didactic hours than practical training hours; however, there is no significant didactic/practical hour distribution difference between the overall dental curriculum and fourth-year dental students' geriatric dental education curriculum (P = 0.077). Graduate geriatric education is unique because it is a 4-year PhD course of study; there is neither a master's degree programme nor a certificate programme in geriatric dentistry. Overall, both undergraduate and graduate geriatric dentistry curricula are multidisciplinary. This study contributes to a better understanding of geriatric dental education in Japan; the implications of this study include developing a clinical/didactic curriculum, designing new national/international dental public health policies, and calibrating the competency of dentists in geriatric dentistry. 2011 John Wiley & Sons A/S.

  1. Graduate and Undergraduate Geriatric Dentistry Education in a Selected Dental School in Japan

    Science.gov (United States)

    Kitagawa, Noboru; Sato, Yuji; Komabayashi, Takashi

    2010-01-01

    Geriatric dentistry and its instruction are critical in a rapidly aging population. Japan is the world’s fastest-aging society, and thus geriatric dentistry education in Japan can serve as a global model for other countries that will soon encounter the issues that Japan has already confronted. This study aimed to evaluate geriatric dental education with respect to the overall dental education system, undergraduate geriatric dentistry curricula, mandatory internships, and graduate geriatric education of a selected dental school in Japan. Bibliographic data and local information were collected. Descriptive and statistical analyses (Fisher and Chi-square test) were conducted. Japanese dental schools teach geriatric dentistry in 10 geriatric dentistry departments as well as in prosthodontic departments. There was no significant differences found between the number of public and private dental schools with geriatric dentistry departments (p = 0.615). At Showa University School of Dentistry, there are more didactic hours than practical training hours; however, there is no significant didactic/practical hour distribution difference between the overall dental curriculum and fourth-year dental students’ geriatric dental education curriculum (p=0.077). Graduate geriatric education is unique because it is a four-year Ph.D. course of study; there is neither a Master’s degree program nor a certificate program in Geriatric Dentistry. Overall, both undergraduate and graduate geriatric dentistry curricula are multidisciplinary. This study contributes to a better understanding of geriatric dental education in Japan; the implications of this study include developing a clinical/didactic curriculum, designing new national/international dental public health policies, and calibrating the competency of dentists in geriatric dentistry. PMID:21985207

  2. How healthy is our geriatric population? a community-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Sherin S Paul

    2015-01-01

    Full Text Available Introduction: With the rise in aged population there is a greater need to look into their nutritional and physical disability aspects which is otherwise neglected. The study aimed to assess the prevalence of malnutrition, anemia and physical disability among the community-dwelling aged population. Materials and Methods: A cross-sectional study was carried out in a rural block of north Tamil Nadu. Seventeen villages were selected using cluster sampling based on probability proportional to size. A total of 340 participants of age 60 years and above were selected from these clusters using simple random sampling. Nutritional status and physical disability were assessed using mini nutritional assessment scale and Barthel index. Blood samples were collected for anemia. Appropriate data entry and statistical analysis were done in EPIDATA and SPSS 16. Statistical Analysis Used: Besides calculating prevalence chi square and logistic regression tests were done to identify associated risk factors. Results and Conclusions: The overall prevalence of "at risk of malnutrition," anemia and physical disability were 10.9%, 38.2% and 20.6%, respectively. None of the community-dwelling aged population was found to be malnourished. Anemia and physical disability were significantly higher among the older age group [(OR 2.29 (1.17-4.89, (OR 2.81 (95% CI 1.31-6.04, respectively]. Similarly women were more affected with physical disability than men (OR 2.27 (1.28-4.02. Further studies need to be done to explore the reasons for high prevalence of anemia.

  3. Health trends in a geriatric and special needs clinic patient population.

    Science.gov (United States)

    Lee, Katherine J; Ettinger, Ronald L; Cowen, Howard J; Caplan, Daniel J

    2015-01-01

    To quantify differences and recent changes in health status among patients attending the Geriatric and Special Needs Dentistry (GSND) and Family Dentistry (FAMD) clinics at the University of Iowa College of Dentistry. A total of 388 randomly selected records from patients attending the GSND or FAMD clinics from 1996-2000 or from 2006-2010 were reviewed. Univariate and bivariate analyses were conducted, followed by multivariable logistic regression analyses to compare characteristics of patients across clinics. Between the two GSND cohorts, the mean number of medications reported increased from 4.0 to 6.5 (p Special Care Dentistry Association and Wiley Periodicals, Inc.

  4. Geriatric issues in renal transplantation.

    Science.gov (United States)

    Bia, M J

    1999-01-01

    There are an increasing amount of data which are compelling us to consider the issue of age in dealing with decisions regarding both renal transplant recipients and donors. These geriatric issues in transplantation can be summarized as follows: (1) The explosion of a geriatric population of patients with ESRD, in association with data showing a survival advantage of transplantation over wait-listed dialysis patients, demands an increase in expertise in transplantating patients over 60 years old. (2) The critical shortage in cadaveric organ supply is creating a variety of solutions including expanding the donor pool with older kidneys in which long term survival may be shorter than in kidneys from younger donors. (3) The donor shortage, in association with data demonstrating improved survival of living related and unrelated donor transplants, is generating an increased number of older (> 60 years old) individuals who want to donate to a relative, spouse or friend. Future efforts should be directed toward continued research designed to evaluate the efficacy and safety of these trends. We also need to provide improved training in geriatrics for nephrologists so that we and transplant surgeons can deliver better medical care to an aging population of patients with ESRD.

  5. Twitter discussions about the predicaments of robots in geriatric nursing: forecast of nursing robotics in aged care.

    Science.gov (United States)

    Eriksson, Henrik; Salzmann-Erikson, Martin

    2017-08-17

    People use social media to express perceptions, attitudes and a wide range of concerns regarding human life. This study aims at analysing the ongoing discussions on the internet microblog Twitter and offers some coming predicaments regarding developments in geriatric nursing regarding nursing robots. Data were retrospectively collected from Twitter. 1322 mentions were included in the final analyses, where principles of interpreting data by using netnography were utilized. Many ideas are presented expressing functional, psychological and social aspects of robots in nursing care. Most postings come from metropolitan cities around the globe. The discussion focuses on market-driven, science fiction solutions for aged care. Twitter users overall seem to be positive using various nursing robots in aged care. These discussions offer a window into the attitudes and ideas of this group of users. We suggest that monitoring Twitter discussions on social media can provide valuable insights into current attitudes as well as forecast coming trends.

  6. New frontiers of cognitive rehabilitation in geriatric age: the Mozart Effect (ME).

    Science.gov (United States)

    Cacciafesta, M; Ettorre, E; Amici, A; Cicconetti, P; Martinelli, V; Linguanti, A; Baratta, A; Verrusio, W; Marigliano, V

    2010-01-01

    The ME was described for the first time in 1993. Subsequently other studies with similar designs were performed. The present study, therefore, proposes: (i) to verify the existence of the benefits of exposure to music in elderly subjects with mild cognitive impairment (MCI), (ii) to explore whether it is possible to find any lasting improvement after training, conducted for a long period of time, with such musical pieces, in the measurable cognitive performances. The study we conducted showed that the ME is present in geriatric patients with MCI; the influence on spatial-temporal abilities remains constant in time if the stimulation is maintained. The continuation of our study will consist of increasing the number of individuals examined and in having them listen to music during the study of ECG rhythms and during the acquisition of cerebral functional magnetic resonance imaging (fMRI), and, at the same time, testing them by neuropsychometric methods. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Quality of life among the geriatric population in a rural area of Dakshina Kannada, Karnataka, India

    Directory of Open Access Journals (Sweden)

    Shahul Hameed

    2014-05-01

    Full Text Available Background: Aging is an inevitable developmental phenomenon bringing along a number of changes in the physical, psychological, hormonal and the social conditions. These changes are expected to affect the quality of life of the elderly. Methods: In the rural area, cross‐sectional community‐based study was conducted among elderly population aged 60 years and above. WHO Quality of Life BREF (WHOQOL BREF questionnaire was used to assess quality of life. Results: Among the study population, the mean perceived overall quality of life scores were 62.1}16.4 and the mean perceived overall health status scores were 59.8}17.4. Males were found to have better social relations compared to females. Among <70 years better physical domain scores were seen compared to ≥70 years. Among the literates and currently married elderly, all the domain scores were higher compared to illiterates and those without partners respectively. Conclusion: All the domains of quality of life were significantly affected for those who were illiterate or were single. Males were found to have better social relations compared to females. Such perceived quality of life study helps to highlight the inequalities among the elderly, which can be targeted to improve the quality of life.

  8. Quality of life among the geriatric population in a rural area of Dakshina Kannada, Karnataka, India

    Directory of Open Access Journals (Sweden)

    Shahul Hameed

    2014-01-01

    Full Text Available Background: Ageing is an inevitable developmental phenomenon bringing along a number of changes in the physical, psychological, hormonal and the social conditions. These changes are expected to affect the quality of life of the elderly. Methods: In the rural area, cross-sectional community-based study was conducted among elderly population aged 60 years and above. WHO Quality of Life BREF (WHOQOL BREF questionnaire was used to assess quality of life. Results: Among the study population, the mean perceived overall quality of life scores were 62.1±16.4 and the mean perceived overall health status scores were 59.8±17.4. Males were found to have better social relations compared to females. Among <70 years better physical domain scores were seen compared to ≥70 years. Among the literates and currently married elderly, all the domain scores were higher compared to illiterates and those without partners respectively. Conclusion: All the domains of quality of life were significantly affected for those who were illiterate or were single. Males were found to have better social relations compared to females. Such perceived quality of life study helps to highlight the inequalities among the elderly, which can be targeted to improve the quality of life.

  9. Perceptions, attitudes, and experiences of hematology/oncology fellows toward incorporating geriatrics in their training.

    Science.gov (United States)

    Maggiore, Ronald J; Gorawara-Bhat, Rita; Levine, Stacie K; Dale, William

    2014-01-01

    The aging of the U.S. population continues to highlight emerging issues in providing care generally for older adults and specifically for older adults with cancer. The majority of patients with cancer in the U.S. are currently 65 years of age or older; therefore, training and research in geriatrics and geriatric oncology are viewed to be integral in meeting the needs of this vulnerable population. Yet, the ways to develop and integrate best geriatrics training within the context of hematology/oncology fellowship remain unclear. Toward this end, the current study seeks to evaluate the prior and current geriatric experiences and perspectives of hematology/oncology fellows. To gain insight into these experiences, focus groups of hematology/oncology fellows were conducted. Emergent themes included: 1) perceived lack of formal geriatric oncology didactics among fellows; 2) a considerable amount of variability exists in pre-fellowship geriatric experiences; 3) shared desire to participate in a geriatric oncology-based clinic; 4) differences across training levels in confidence in managing older adults with cancer; and 5) identification of specific criteria on how best to approach older adults with cancer in a particular clinical scenario. The present findings will help guide future studies in evaluating geriatrics among hematology/oncology fellows across institutions. They will also have implications in the development of geriatrics curricula and competencies specific to hematology/oncology training. © 2013.

  10. [Adaptations of psychotropic drugs in patients aged 75 years and older in a departement of geriatric internal medecine: report of 100 cases].

    Science.gov (United States)

    Couderc, Anne-Laure; Bailly-Agaledes, Cindy; Camalet, Joëlle; Capriz-Ribière, Françoise; Gary, André; Robert, Philippe; Brocker, Patrice; Guérin, Olivier

    2011-06-01

    The elderly often with multiple diseases are particularly at risk from adverse drug reactions. Nearly half of iatrogenic drug in the elderly are preventable. Some medications such as psychotropic drugs are particularly involved in iatrogenic accidents. We wanted to know if the tools of the comprehensive geriatric assessment or other factors could influence the changes of psychotropic drugs in a geriatric departement. Our prospective study of four months in 100 patients aged 75 years and older hospitalized in the Geriatric Internal Medecine Departement of University Hospital of Nice investigated what were the clinical or biological reasons and tools used during changes of psychotropic drugs. We compared these changes according to the comprehensive geriatric assessment tools and we analyzed the changes based on lists of potentially inappropriate medications by Laroche et al. and from the instrument STOPP/START. The Mini Mental State Examination (MMSE) was the tool that has most influenced the changes in psychotropic including a tendency to increase and the introduction of anxiolytics when MMSE < 20 (p = 0.007) while neuroleptics instead arrested and decreased (p = 0.012). The comprehensive geriatric assessment has its place in decision support during the potentially iatrogenic prescriptions of drugs such as psychotropic and new tools such as STOPP/START can also be a help to the prescriber informed.

  11. Differences in Health at Age 100 According to Sex: Population-Based Cohort Study of Centenarians Using Electronic Health Records.

    Science.gov (United States)

    Hazra, Nisha C; Dregan, Alex; Jackson, Stephen; Gulliford, Martin C

    2015-07-01

    To use primary care electronic health records (EHRs) to evaluate the health of men and women at age 100. Population-based cohort study. Primary care database in the United Kingdom, 1990-2013. Individuals reaching the age of 100 between 1990 and 2013 (N = 11,084, n = 8,982 women, n = 2,102 men). Main categories of morbidity and an index of multiple morbidities, geriatric syndromes and an index of multiple impairments, cardiovascular risk factors. The number of new female centenarians per year increased from 16 per 100,000 in 1990-94 to 25 per 100,000 in 2010-13 (P < .001) and of male centenarians from four per 100,000 to six per 100,000 (P = .06). The most prevalent morbidities at the age of 100 were musculoskeletal diseases, disorders of the senses, and digestive diseases. Women had greater multiple morbidity than men (odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.42-1.89, P < .001). Geriatric syndromes, including falls, fractures, hearing and vision impairment, and dementia, were frequent; 30% of women and 49% of men had no recorded geriatric syndromes. Women had greater likelihood of having multiple geriatric syndromes (OR = 2.14, 95% CI = 1.90-2.41, P < .001). Fewer men than women reach the age of 100, but male centenarians have lower morbidity and fewer geriatric syndromes than women. Research using EHRs offers opportunities to understand the epidemiology of aging and improve care of the oldest old. © 2015 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  12. Ageing populations: the challenges ahead

    DEFF Research Database (Denmark)

    Christensen, Kaare; Doblhammer, Gabriele; Rau, Roland

    2009-01-01

    If the pace of increase in life expectancy in developed countries over the past two centuries continues through the 21st century, most babies born since 2000 in France, Germany, Italy, the UK, the USA, Canada, Japan, and other countries with long life expectancies will celebrate their 100th...... birthdays. Although trends differ between countries, populations of nearly all such countries are ageing as a result of low fertility, low immigration, and long lives. A key question is: are increases in life expectancy accompanied by a concurrent postponement of functional limitations and disability...

  13. Efficacy and safety of endoscopic retrograde cholangiopancreatography in aged and elderly geriatric patients to treat acute cholecystitis

    Directory of Open Access Journals (Sweden)

    GAO Feng

    2013-03-01

    Full Text Available ObjectiveTo retrospectively evaluate the therapeutic efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP for treating acute cholecystitis in geriatric patients 75 years and older in age. MethodsThe clinical records of our institute were searched to identify aged (75-84 years old and elderly (85 years and older patients who underwent ERCP between January 2008 and December 2012 for new or long-term cholecystitis. The cholecystitis was clinically characterized as acute attack time(s of one to five days and diagnosis was confirmed by imaging analysis (including abdominal ultrasound, computed tomography, and/or magnetic resonance cholangiopancreatography. All surgeries were carried out with the endoscopic nasogallbladder drainage (ENGBD procedure. Postoperative symptoms (such as abdominal pain and fever and clinical findings (such as C-reactive protein (CRP level, imaging findings, and bile drainage volume and consistency were recorded, along with follow-up data of outcome and symptomology, for summary evaluation. ResultsA total 24 patients, including 13 men and 11 women between the ages of 75 and 88 (mean: 81.00±3.23 years, underwent ERCP examination. The cases included general cholecystitis (75.0%, n=18 and acalculous cholecystitis (25.0%, n=6. In addition, 13 (54.2% cases had biliary stones and two (8.3% cases had bile pancreatitis. The ENGBD tube was successfully inserted into the gallbladder in all cases. Twenty-one (87.5% patients experienced relief of abdominal pain and fever within 24 h of the surgery. CRP level decreased to normal for all (100% patients within six days of the surgery. Two (8.3% patients experienced hyperamylasemia within three days of the surgery, and both cases resolved prior to hospital release. There were no cases of ERCP-related hemorrhage, perforation, pancreatitis, or death. Follow-up time ranged from three to 12 months, during which 23 (95.8% patients showed long-term remission. The presence

  14. Hematologic and biochemical RIs for an aged population of captive African Green monkeys (Chlorocebus aethiops sabaeus).

    Science.gov (United States)

    Scallan, Elizabeth M; Sample, Saundra H; Beierschmitt, Amy M; Palmour, Roberta M

    2017-09-01

    Established RIs for geriatric African Green monkeys (Chlorocebus aethiops sabaeus) are critical for clinical differentiation of normal aging from disease-related changes in this population. The aim of this study was to establish hematologic and serum biochemical RIs for a Caribbean captive population of geriatric (≥ 15 years of age) African Green monkeys, or Vervets. Inclusion and exclusion criteria were defined for a cohort of 109 healthy, aged (15- to 30-year-old, median 19-year-old) Vervets. Both male (34) and female (75) monkeys were included in RI generation. Complete manual and analyzer-generated blood counts and serum biochemistry profiles were performed at Ross University School of Veterinary Medicine, West Farm, St. Kitts, West Indies. All results were evaluated using Reference Value Advisor. Isolated outliers were identified using Dixon's outlier range statistic and not included in determination of RIs for individual analytes. Reference intervals were determined using parametric and nonparametric methods depending on the distribution. Data, including mean, median, maximum, and minimum values, were tabulated. Of the 109 animals, 12 monkeys were excluded due to abnormal physical examination results (2 monkeys), and ≥ 2 confirmed outliers (9 monkeys), or evidence of disease based on laboratory data (one monkey). This study provides useful RIs for assessment of hematology and serum biochemical variables in a geriatric population of African Green monkeys in the Caribbean. © 2017 American Society for Veterinary Clinical Pathology.

  15. Geriatric syndromes in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Tomasz Gołębiowski

    2016-06-01

    Full Text Available The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than among general population. The causes of higher prevalence of those syndromes are not well known, but uremic environment and overall renal replacement therapy may have an important impact on its progress. The patient with geriatric syndrome require comprehensive treatment as well as physical rehabilitation, psychiatric cure and support in everyday activities.Herein below we would like to review recent literature regarding to particular features of main geriatric syndromes in a group of nephrological patients.

  16. K-means cluster analysis of rehabilitation service users in the Home Health Care System of Ontario: examining the heterogeneity of a complex geriatric population.

    Science.gov (United States)

    Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

    2012-12-01

    To examine the heterogeneity of home care clients who use rehabilitation services by using the K-means algorithm to identify previously unknown patterns of clinical characteristics. Observational study of secondary data. Home care system. Assessment information was collected on 150,253 home care clients using the provincially mandated Resident Assessment Instrument-Home Care (RAI-HC) data system. Not applicable. Assessment information from every long-stay (>60 d) home care client that entered the home care system between 2005 and 2008 and used rehabilitation services within 3 months of their initial assessment was analyzed. The K-means clustering algorithm was applied using 37 variables from the RAI-HC assessment. The K-means cluster analysis resulted in the identification of 7 relatively homogeneous subgroups that differed on characteristics such as age, sex, cognition, and functional impairment. Client profiles were created to illustrate the diversity of this geriatric population. The K-means algorithm provided a useful way to segment a heterogeneous rehabilitation client population into more homogeneous subgroups. This analysis provides an enhanced understanding of client characteristics and needs, and could enable more appropriate targeting of rehabilitation services for home care clients. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Preventive geriatrics the cross-talk between arterial and brain aging: A lifelong condition.

    Science.gov (United States)

    Scuteri, Angelo; Tesauro, Manfredi; Di Daniele, Nicola

    2017-01-01

    Arterial aging - clinically evaluable noninvasively as carotid-femoral Pulse Wave Velocity (PWV), an index of arterial stiffness - has emerged as a risky condition for cardiovascular events and cognitive decline. With advancing age, arterial aging is less and less dependent on blood pressure levels. We propose a life-course approach to the cross-talking between arterial and brain aging aimed at preventing disabling conditions at older ages. This vision is supported by growing evidence that "silent" alteration in large artery as well as in brain structure and function are already detectable at young ages. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Standard Populations (Millions) for Age-Adjustment - SEER Population Datasets

    Science.gov (United States)

    Download files containing standard population data for use in statististical software. The files contain the same data distributed with SEER*Stat software. You can also view the standard populations, either 19 age groups or single ages.

  19. Depression is the predominant factor contributing to morale as measured by the Philadelphia Geriatric Morale Scale in elderly Chinese aged 70 years and over.

    Science.gov (United States)

    Woo, J; Ho, S C; Wong, E M C

    2005-11-01

    To examine factors contributing to the total Philadelphia Geriatric Morale Scale (PGMS) and its two subscales: reconciled ageing and unstrained affect. The PGMS was administered to 759 community-living subjects aged 70 years and over. Information regarding socioeconomic status, health conditions, sensory impairment, physical symptoms, social support, activities of daily living as measured by the Barthel Index, life satisfaction, and the Geriatric Depression Score, was collected. Associations between these factors and PGMS and its subscale were examined using univariate analysis (Mann-Whitney; Kruskal-Wallis tests), and multivariate analysis using the classification and regression tree (CART) method. Gender, old age, physical, socioeconomic and social factors were significantly associated with PGMS. There was a strong correlation with GDS (r = 0.77, p finance were factors contributing to quality of life in elderly Hong Kong Chinese. Copyright (c) 2005 John Wiley & Sons, Ltd.

  20. Nutritional status of an elderly population in Southwest China: a cross-sectional study based on comprehensive geriatric assessment.

    Science.gov (United States)

    Shi, R; Duan, J; Deng, Y; Tu, Q; Cao, Y; Zhang, M; Zhu, Q; Lü, Y

    2015-01-01

    Few data is available on the nutritional status of old Chinese. The present study aimed to describe the nutritional status and clinical correlates for malnutrition risk in the older people. Cross-sectional study. Hospital- and community-based older people were recruited in the region of Chongqing, China. 558 individuals aged 60 years old or over between April 2011 and October 2012. Comprehensive geriatric assessment was performed and nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). Nutrition-associated factors were analyzed, including health status (chronic diseases, depression, cognition, function impaired), social factors (education status, marital status, the type of work before 60 years old) and life style factors (smoking, drinking, diet). The mean age was 73.1±8.0 years and 43.9% were men. Prevalence of malnutrition and risk for malnutrition were 3.2% and 19.3 %, respectively. Several factors increased poor nutrition independently including self-rated health, comorbidity, chronic obstructive pulmonary disease, gastrointestinal disease and cognitive impairment. Fish decreased the risk of poor nutrition. The prevalence was relatively low in older people of Chongqing, Southwest China. Poor nutrition was found to be increased due to the common health problems. Thus the patients with these problems should pay more attention on nutritional status. The older people should often have fish because of their nutritional benefit.

  1. Geriatric imaging

    International Nuclear Information System (INIS)

    Guglielmi, Giuseppe; Peh, Wilfred C.G.; Guermazi, Ali

    2013-01-01

    Considers all aspect of geriatric imaging. Explains clearly how to distinguish the healthy elderly from those in need of treatment. Superbly illustrated. Written by recognized experts in field. In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent ''the norm.'' It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

  2. Population Aging and Potential Growth in Asia

    OpenAIRE

    Otsu, Keisuke; Shibayama, Katsuyuki

    2016-01-01

    We study the effects of projected population aging on potential growth in Asian economies over the period 2015–2050. We find that an increase in the share of the population over 64 years of age will significantly lower output growth through decreased labor participation. Population aging can also reduce economic growth through increased labor income taxes and dampened productivity growth.

  3. Geriatric dentistry content in the curriculum of the dental schools in Chile.

    Science.gov (United States)

    León, Soraya; Araya-Bustos, Francisca; Ettinger, Ronald L; Giacaman, Rodrigo A

    2016-09-01

    The purpose of this study was to identify the status of pre-doctoral geriatric dentistry education among all Chilean dental schools. Chile is one of the most rapidly ageing countries in Latin America. Consequently, specific knowledge and training on the needs of elderly populations need to be emphasised in dental schools. The current extent and methods of teaching geriatric dentistry among the dental schools in Chile are unknown. A web-based questionnaire was developed and sent to all 19 Chilean dental schools to identify which schools had a formal programme on geriatric dentistry and ask about their format, content and type of training of the faculty who taught in the programmes. Data were analysed, and a comparison was made among the schools. Sixteen (84%) of the participant schools reported teaching at least some aspects of geriatric dentistry, using various methodologies, but only 7 (37%) had specific courses. Of those schools reporting a didactic content on geriatric dentistry, 71% included clinical training, either in the school's dental clinics or in an extramural service. Contents mostly included demographics of ageing, theories of ageing and medical conditions. More than half of the faculty (57%) stated that they had formal training in geriatric dentistry, 43% were trained in prosthodontics, public health or other areas. Although most dental schools taught geriatric dentistry, only some had a specific course. Most schools with formal courses followed the international curriculum guidelines for geriatric dentistry. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  4. The aging population in Brazil

    Directory of Open Access Journals (Sweden)

    Fabio Nasri

    2008-03-01

    Full Text Available Brazil is currently in an advanced stage of both the mortality andfertility transitions, which allows one to confi dently forecast the agedistribution and population size over the next four decades. Whereasthe elderly population with more than 65 years will increase at highrates (2 to 4% per year the young population will decline. Accordingto United Nations projections, the elderly population will increasefrom 3.1% of the population in 1970 to 19% in 2050. The changingage distribution of the Brazilian population brings opportunities andchallenges that could lead to serious social and economic issues ifnot dealt with properly in coming decades.

  5. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    Science.gov (United States)

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  6. Successful aging. How increased life expectancy and medical advances are changing geriatric care.

    Science.gov (United States)

    Cassel, C K

    2001-01-01

    If the unprecedented increase in life expectancy has a downside, it is the exposure of risk to chronic age-related disorders. As clinicians work to foster healthy aging, we must also seek ways to prevent the disabling disorders that keep many older persons from enjoying their longevity. The high prevalence of chronic illness and functional limitation among older persons underscores the need for strategically directed health and social services. Successful patient management must extend beyond diagnosis and disease treatment and include promotion of function and prevention of decline. Achieving this goal requires a seamless continuum of management and interdisciplinary caregiving. There also must be a focus on improving the understanding of the science of aging. New treatment approaches for managing aging may one day include cognitive enhancers, designer hormones, telomerase, antioxidants, and gene therapy.

  7. Circadian variations of cortisol, melatonin and lymphocyte subpopulations in geriatric age.

    Science.gov (United States)

    Mazzoccoli, G; Vendemiale, G; La Viola, M; De Cata, A; Carughi, S; Greco, A; Balzanelli, M; Tarquini, R

    2010-01-01

    A number of age-related changes in the 24-hour hormonal and non-hormonal rhythms have been found in older human beings. Lymphocyte subpopulations present circadian variation of some of their subsets and this variation may influence magnitude and expression of the immune responses. Numerous interactions exist among the nervous, endocrine and immune systems, mediated by neurotransmitters, hormones and cytokines. The aim of this study is to evaluate circadian variations of some endocrine and immune factors in older adults. Cortisol and melatonin serum levels were measured and lymphocyte subpopulation analyses were performed on blood samples collected every four hours for 24 hours from ten healthy young and middle-aged subjects and from ten healthy elderly subjects. There was a statistically significant difference between the groups in the observed values of CD20 (higher in young and middle-aged subjects) and CD25 and DR+ T cells (higher in elderly subjects). In the group of young and middle-aged subjects a clear circadian rhythm was validated for the time-qualified changes of all the factors studied. In the group of elderly subjects a number of rhythms were absent or altered. The results of the current study show that aging is associated with enhanced responsiveness of T cell compartment and alterations of circadian rhythmicity.

  8. The geriatric clinic: dry and limp: aging queers, zombies, and sexual reanimation.

    Science.gov (United States)

    McGlotten, Shaka; Moore, Lisa Jean

    2013-06-01

    This essay looks to the omission of aging queer bodies from new medical technologies of sex. We extend the Foucauldian space of the clinic to the mediascape, a space not only of representations but where the imagination is conditioned and different worlds dreamed into being. We specifically examine the relationship between aging queers and the marketing of technologies of sexual function. We highlight the ways queers are excluded from the spaces of the clinic, specifically the heternormative sexual scripts that organize biomedical care. Finally, using recent zombie theory, we gesture toward both the constraints and possibilities of queer inclusion within the discourses and practices that aim to reanimate sexual function. We suggest that zombies usefully frame extant articulations of aging queers with sex and the dangerous lure of medical treatments that promise revitalized, but normative, sexual function at the cost of other, perhaps queerer intimacies.

  9. Undergraduate Teaching in Geriatrics and Pediatrics in Portuguese Medical Schools: An Observational Study.

    Science.gov (United States)

    Amaral, Mariana; Matias, Filipa; Massena, Lígia; Cardoso, Nuno

    2016-12-30

    Motivated by the contracting nature of the Portuguese age pyramid, and thereby the ever increasing geriatric population, the aim of this study was to compare the number of European Credit Transfer and Accumulation System Credits dedicated to Geriatrics with Pediatrics in Portuguese Medical Schools. An observational, descriptive and cross-sectional study was conducted and included six Portuguese Medical Schools that have six years of training and a total of 360 credits. The study plans were obtained from the medical schools' websites or requested. Schools were grouped in modular/classic teaching methodology and the courses were categorized in mandatory/optional and specific/related. The credits of Geriatrics and Pediatrics were compared. Four schools had classical methodology and two had a modular one. Overall, they had more credits dedicated to Pediatrics than Geriatrics. Three schools offered mandatory courses specifically oriented to Geriatrics (1.5 - 8 credits) compared to all schools mandatory courses courses on Pediatrics (5.7 - 26.5 credits). The ratio of averages of mandatory specific courses (Pediatrics/Geriatrics) was 12.4 in the classical and 1.5 in the modular group. Pediatrics teaching has revealed to be superior to Geriatrics in all categories. Based on our results, we consider the Portuguese Geriatrics' undergraduate teaching sub-optimal. Nowadays, geriatric population is quantitatively similar to pediatric population. Efforts should be made to adequate Geriatrics teaching to our reality in order to provide a more adequate health care to this age group.

  10. Age groups and the measure of population aging

    Directory of Open Access Journals (Sweden)

    Hippolyte d'Albis

    2013-09-01

    Full Text Available BACKGROUND Measures of population aging are important because they shape our perception of demographic trends. Indicators of aging based on fixed ages contributed to a dramatic portrayal of demographic evolutions, some of which were associated with the myth of decline. OBJECTIVE We propose a new measure of population aging, based on the relative age of each individual in the population. Our approach builds on previous work by Aghevli and Mehran (1981 and relies on optimal grouping techniques that are used to determine the various age groups within a population. The cutoff ages for these groups, such as the age from which an individual is considered to be an older person, are then endogenous variables that depend on the entire population age distribution at any given moment. METHODS We show how to apply optimal grouping techniques to age distributions and how to calculate various indicators of aging, which are invariant with respect to proportional rescaling of distributions. We compute these indicators for the US, and a sample of 13 other industrialized countries. RESULTS We find that, contrary to common arguments for an aging population, the share of elderly individuals within the total population has not increased much, and has remained stable in these countries. These results complement and reinforce the earlier findings of Sanderson and Scherbov (2005, 2007 who also reassessed the aging phenomenon.

  11. [Frailty in older population: a brief position paper from the French society of geriatrics and gerontology].

    Science.gov (United States)

    Rolland, Yves; Benetos, Athanase; Gentric, Armelle; Ankri, Joël; Blanchard, François; Bonnefoy, Marc; de Decker, Laure; Ferry, Monique; Gonthier, Régis; Hanon, Olivier; Jeandel, Claude; Nourhashemi, Fathi; Perret-Guillaume, Christine; Retornaz, Frédérique; Bouvier, Hélène; Ruault, Geneviève; Berrut, Gilles

    2011-12-01

    Frailty in the older population is a clinical syndrome which evaluate a risk level. The Frailty syndrome defines a reduction of the adaptation capacity to a stress. It can be modulated by physical, psychological and social factors. The screening of the frailty syndrome is relevant for older people without disability for basic activities of daily living. The clinical criteria of frailty must be predictive of the risk of functional decline and adverse outcomes, consensual at the international level, and easy to perform in primary care as well as in the clinical researches.

  12. Falls and other geriatric syndromes in Blantyre, Malawi: A ...

    African Journals Online (AJOL)

    Background: The prevalence of geriatric syndromes (falls, immobility, intellectual or memory impairment, and incontinence) is unknown in many resource-poor countries. With an aging population such knowledge is essential to develop national policies on the health and social needs of older people. The aim of this study ...

  13. The American Geriatrics Society/National Institute on Aging Bedside-to-Bench Conference: Research Agenda on Delirium in Older Adults

    Science.gov (United States)

    Mikhailovich, Anna

    2015-01-01

    The American Geriatrics Society, with support from the National Institute on Aging and the John A. Hartford Foundation, held its seventh Bedside-to-Bench research conference, entitled “Delirium in Older Adults: Finding Order in the Disorder” on February 9–11, 2014, to provide participants with opportunities to learn about cutting-edge research developments, draft recommendations for future research involving translational efforts, and opportunities to network with colleagues and leaders in the field. This meeting was the first of three conferences that will address delirium, sleep disorders, and voiding difficulties and urinary incontinence, emphasizing, whenever possible, the relationships and potentially shared clinical and pathophysiological features between these common geriatric syndromes. PMID:25834932

  14. Population Aging: Facts, Challenges, and Responses

    OpenAIRE

    David E. Bloom; Axel Boersch-Supan; Patrick McGee; Atsushi Seike

    2011-01-01

    The world’s population is growing older, leading us into uncharted demographic waters. There will be higher absolute numbers of elderly people, a larger share of elderly, longer healthy life expectancies, and relatively fewer numbers of working-age people. There are alarmist views – both popular and serious – in circulation regarding what these changes might mean for business and economic performance. But the effects of population aging are not straightforward to predict. Population aging doe...

  15. Scleroderma of geriatric age and scleroderma-like paraneoplastic syndrome – description of two cases

    Directory of Open Access Journals (Sweden)

    Magdalena Marek

    2016-06-01

    Full Text Available Systemic sclerosis (Ssc is an autoimmune connective tissue disease of unknown origin, characterized by progressive fibrosis of the skin and internal organs. Immune reactions taking part in Ssc pathogenesis may contribute to cancer development; therefore patients with risk factors for this disease require observation for a neoplastic process. On the other hand, symptoms of Ssc may be a mask of various cancers. Differentiating between the idiopathic form of Ssc and scleroderma-like paraneoplastic syndrome often causes a lot of difficulties. The article presents two cases of Ssc at the beginning of the disease after 60 years of age. The first case was diagnosed as Ssc, whereas in the second case the defined diagnosis was scleroderma-like syndrome in the course of colorectal cancer. This paper presents an analysis of differential diagnostic procedures which were performed and led to the final diagnosis, mentions types of cancers co-occurring with Ssc and suggests a screening scheme for cancer development in patients with a diagnosis of Ssc.

  16. Scleroderma of geriatric age and scleroderma-like paraneoplastic syndrome - description of two cases.

    Science.gov (United States)

    Marek, Magdalena; Rudny, Robert

    2016-01-01

    Systemic sclerosis (Ssc) is an autoimmune connective tissue disease of unknown origin, characterized by progressive fibrosis of the skin and internal organs. Immune reactions taking part in Ssc pathogenesis may contribute to cancer development; therefore patients with risk factors for this disease require observation for a neoplastic process. On the other hand, symptoms of Ssc may be a mask of various cancers. Differentiating between the idiopathic form of Ssc and scleroderma-like paraneoplastic syndrome often causes a lot of difficulties. The article presents two cases of Ssc at the beginning of the disease after 60 years of age. The first case was diagnosed as Ssc, whereas in the second case the defined diagnosis was scleroderma-like syndrome in the course of colorectal cancer. This paper presents an analysis of differential diagnostic procedures which were performed and led to the final diagnosis, mentions types of cancers co-occurring with Ssc and suggests a screening scheme for cancer development in patients with a diagnosis of Ssc.

  17. Dental care for aging populations in Denmark, Sweden, Norway, United kingdom, and Germany

    DEFF Research Database (Denmark)

    Holm-Pedersen, Poul; Vigild, Merete; Nitschke, Ina

    2005-01-01

    This article reviews access to and financing of dental care for aging populations in selected nations in Europe. Old age per se does not seem to be a major factor in determining the use of dental services. Dentition status, on the other hand, is a major determinant of dental attendance. In addition...... care to these patients. One reason may be that the fee for treating these patients is too low, considering high dental office expenses. Another reason may be problems related to management of medically compromised patients. This raises an important question: does inadequate training in geriatric...

  18. Psychosocial Issues in Geriatric Rehabilitation.

    Science.gov (United States)

    Rodriguez, Ricardo M

    2017-11-01

    Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation. An argument is made for the importance of comprehensive geriatric assessment in older adults to identify salient issues that may impact rehabilitation and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Geriatric imaging

    Energy Technology Data Exchange (ETDEWEB)

    Guglielmi, Giuseppe [Scientific Institute Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Italy). Dept. of Radiology; Peh, Wilfred C.G. [Khoo Teck Puat Hospital, Singapore (Singapore). Dept. of Diagnostic Radiology; Guermazi, Ali (eds.) [Boston Univ. School of Medicine, Boston, MA (United States). Dept. of Radiology

    2013-08-01

    Considers all aspect of geriatric imaging. Explains clearly how to distinguish the healthy elderly from those in need of treatment. Superbly illustrated. Written by recognized experts in field. In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent ''the norm.'' It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

  20. The prevalence of ocular lesions associated with hypertension in a population of geriatric cats in Auckland, New Zealand.

    Science.gov (United States)

    Carter, J M; Irving, A C; Bridges, J P; Jones, B R

    2014-01-01

    To provide an estimate of the prevalence of ocular lesions associated with hypertension in geriatric cats in Auckland, New Zealand and to evaluate the importance of examination of the ocular fundi of cats over eight years of age. A total of 105 cats ≥8 years of age were examined and clinical signs recorded. Blood was collected for the laboratory measurement of the concentrations of blood urea nitrogen (BUN), glucose and creatinine in serum, urine was collected for determination of urine specific gravity (USG), and blood pressure (BP) was measured using high definition oscillometry equipment. A cat was determined to have systemic hypertension with a systolic BP ≥160 mm Hg and a diastolic BP ≥100 mm Hg. Each animal had an ocular fundic examination using a retinal camera to diagnose ocular lesions associated with hypertension, including retinopathies, choroidopathies and optic neuropathies. Blood pressure was successfully recorded in 73 cats. Of these, 37 (51%) had no hypertensive ocular lesions and no underlying disease diagnosed, 24 (33%) had no hypertensive ocular lesions detected, but underlying disease such as chronic kidney disease, hyperthyroidism or diabetes mellitus was diagnosed, and 12 (16%) cats had evidence of hypertensive ocular lesions. Ten of the cats with hypertensive ocular lesions were hypertensive at the time of the first visit and two were normotensive. One additional cat had hypertensive ocular lesions, but it was not possible to obtain consistent BP readings in this animal. Chronic kidney disease was the most commonly diagnosed concurrent disease in cats with hypertensive ocular lesions (n=6). Mean systolic BP for cats with hypertensive ocular lesions (168.0 (SE 6.29) mm Hg) was higher than for those with no ocular lesions (144.7 (SE 3.11) mm Hg) or those with no lesions but with underlying disease (146.0 (SE 4.97) mm Hg) (p=0.001). Ocular fundic examination of cats over eight years of age allows identification of cats with

  1. Reappraising 'the good death' for populations in the age of ageing.

    Science.gov (United States)

    Pollock, Kristian; Seymour, Jane

    2018-03-06

    This is the second in an occasional series of paired commentaries in Age and Ageing, the Journal of the British Geriatrics Society and the Journal of the American Geriatrics Society (JAGS). The aim is to address issues of current significance and to foster dialogue and increased understanding between academics and clinicians working in comparative international settings. Both commentaries address the urgent need to improve palliative care for older people, with a critique of some stereotypes surrounding palliative care and the 'good death'. The companion commentary, published in JAGS, was written by Alexander Smith and Vyjeyanthi Periyakoil, and is grounded in their experience as academic clinicians (Smith AK, Periyakoil V. Should we bury 'The Good Death'? Journal of the American Geriatrics Society 2018; in press). In the present paper, we offer a perspective on the outcome and wider consequences of misalignment between current UK policy and aspirations for end of life care in relation to epidemiological trends and patient experience of death and dying.

  2. Is Asia Prepared for an Aging Population?

    OpenAIRE

    Peter S. Heller

    2006-01-01

    Many Asian countries (such as China, Singapore, Korea, Thailand, Malaysia, Indonesia, India, and the Philippines) will experience a significant aging of their populations during the next several decades. This paper explores how these aging Asian countries are addressing and anticipating the challenges of an aging society. It suggests that Asia's preparedness for an aging population is decidedly mixed. While growth policies have been successful, much work is still needed in many countries to e...

  3. Excess mortality for operated geriatric hip fracture in Hong Kong.

    Science.gov (United States)

    Man, L P; Ho, A Wh; Wong, S H

    2016-02-01

    Geriatric hip fracture places an increasing burden to health care systems around the world. We studied the latest epidemiology trend of geriatric hip fracture in Hong Kong, as well as the excess mortality for patients who had undergone surgery for hip fracture. This descriptive epidemiology study was conducted in the public hospitals in Hong Kong. All patients who underwent surgery for geriatric hip fracture in public hospitals from January 2000 to December 2011 were studied. They were retrieved from the Clinical Management System of the Hospital Authority of Hong Kong. Relevant data were collected using the Clinical Data Analysis and Reporting System of the Hospital Authority. The actual and projected population size, and the age- and sex-specific mortality rates were obtained from the Census and Statistics Department of Hong Kong. The 30-day, 1-year and 5-year mortality, and excess mortality following surgery for geriatric hip fracture were calculated. There was a steady increase in the incidence of geriatric hip fracture in Hong Kong. The annual risk of geriatric hip fracture was decreasing in both sexes. Female patients aged 65 to 69 years had the lowest 1-year and 5-year mortality of 6.91% and 23.80%, respectively. Advancing age and male sex were associated with an increase in mortality and a higher excess mortality rate following surgery. The incidence of geriatric hip fracture is expected to increase in the future. The exact reason for a higher excess mortality rate in male patients remains unclear and should be the direction for future studies.

  4. Endodontic treatment in geriatric patients

    Directory of Open Access Journals (Sweden)

    Milly Armilya Andang

    2007-11-01

    Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

  5. Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine.

    Science.gov (United States)

    Fisher, James Michael; Garside, Mark J; Brock, Peter; Gibson, Vicky; Hunt, Kelly; Briggs, Sally; Gordon, Adam Lee

    2017-07-01

    there is concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field-in the decade since, UK postgraduate training has undergone a fundamental restructure. to explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. an online survey was sent to all UK higher medical trainees in geriatric medicine. survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. two hundred and sixty-nine responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. there are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  6. Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population.

    Directory of Open Access Journals (Sweden)

    Jessica S Wang

    Full Text Available Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange.Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs, histamine H2-receptor antagonists (H2 blockers, hydroxymethylglutaryl CoA reductase inhibitors (statins, angiotensin-converting enzyme (ACE inhibitors, angiotensin receptor blockers (ARBs, and inhaled corticosteroids (ICS. There was limited electronic medication reconciliation support available. Main measures were presence and accuracy of therapeutic interchange during hospitalization, and rate of medication reconciliation errors on discharge. We examined charts of 303 patients taking 555 medications at time of admission in the six medication classes of interest. A total of 244 (44.0% of medications were therapeutically interchanged to an approved formulary drug at admission, affecting 64% of the study patients. Among the therapeutically interchanged drugs, we identified 78 (32.0% suspected medication conversion errors. The discharge medication reconciliation error rate was 11.5% among the 244 therapeutically interchanged medications, compared with 4.2% among the 311 unchanged medications (relative risk [RR] 2.75, 95% confidence interval [CI] 1.45-5.19.Therapeutic interchange was prevalent among hospitalized patients in this study and elevates the risk for potential medication errors during and after hospitalization. Improved electronic systems for managing therapeutic interchange and medication reconciliation

  7. A Reflection on Aging: A Portfolio of Change in Attitudes toward Geriatric Patients during a Clerkship Rotation

    Science.gov (United States)

    Del Duca, Danny; Duque, Gustavo

    2006-01-01

    The process of students' evaluation in medical schools has changed from a tutor-led evaluation system based on students' performance to a student-based evaluation that involves self-reflection and their level of change in skills and attitudes. At the McGill University Division of Geriatric Medicine, we developed an innovative system of evaluation…

  8. How fast is population ageing in China?

    OpenAIRE

    Yinhua mai; Xiujian Peng; Wei Chen

    2009-01-01

    Using adjusted 2000 population census data, this paper conducts China's population projections to 2050. Three fertility and four mortality scenarios yield 12 sets of results. Despite the below-replacement fertility, China's population will continue growing for many years. However, there are substantial differences among the twelve scenarios. The maximum population could range from less than 1.4 billion to more than 1.6 billion. One of the notable trends is the rapid population ageing. By the ...

  9. The association between anorexia of aging and physical frailty: Results from the national center for geriatrics and gerontology's study of geriatric syndromes.

    Science.gov (United States)

    Tsutsumimoto, Kota; Doi, Takehiko; Makizako, Hyuma; Hotta, Ryo; Nakakubo, Sho; Makino, Keitaro; Suzuki, Takao; Shimada, Hiroyuki

    2017-03-01

    The present study examined the association between anorexia of aging and physical frailty among older people. An observational, cross-sectional cohort design was used with a sample of 4417 elderly Japanese citizens living in a community setting. Frailty was operationalized as the following frailty components: slowness, weakness, exhaustion, low level of physical activity, and weight loss. Participants were grouped as non-frail, pre-frail, and frail, and categorized as anorexic or not using questionnaire cutoff scores. Measured covariates were as follows: sociodemographic variables, medical history, life style, body mass index, blood nutrition data, self-rated health, depressive symptoms, and cognitive function. The prevalence of anorexia of aging in each group was as follows: non-frail, 7.9%; pre-frail, 14.8%; frail, 21.2% (P for trend<0.001). After adjusting for all covariates, independent associations were identified between anorexia of aging and slowness (OR 1.42, 95% CI: 1.14-1.75, P=0.002), exhaustion (OR 1.39, 95% CI: 1.11-1.74, P=0.004) and weight loss (OR 1.37, 95% CI: 1.05-1.79, P=0.019), but not weakness or low level of physical activity. Anorexia of aging is importantly associated with frailty and the following frailty components: slowness, exhaustion, and weight loss. Future research should prospectively examine frailty's causal connection with anorexia of aging. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. Geriatric interventions: the evidence base for comprehensive health care services for older people.

    Science.gov (United States)

    Cordato, Nicholas J; Saha, Sabari; Price, Michael A

    2005-05-01

    Specialist geriatric services apply a comprehensive, multidisciplinary evaluation and management approach to the multidimensional and usually interrelated medical, functional and psychosocial problems faced by at-risk frail elderly people. This paper examines currently available data on geriatric interventions and finds ample evidence supporting both the efficacy and the cost-effectiveness of these specialist interventions when utilised in appropriately targeted patients. It is proposed that substantial investment in these programs is required to meet the future demands of Australia's ageing population.

  11. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  12. Assesment of Disabled Geriatric Health Council Reports

    Directory of Open Access Journals (Sweden)

    Cem Sahin

    2014-12-01

    Full Text Available Aim: In this study it is aimed to evaluate geriatric patients who apply to health council. Material and Method:The study retrospectively assessed 3112 patients admitted to the disability ward, of which 601 geriatric patients were included in the study. Results: Of the 601 patients, 53.1% were men and 46.9% were women. The mean age of these patients was 60 (std ± 18.35 years. Some of the reasons for admission in the hospital were need for social services (45.6% and determination of disability rate (21.6%. Most common diseases in patients aged %u226565 years were hypertension (21.6%, diabetes (12.6%, and chronic obstructive lung disease and dilated cardiomyopathy (3.7%; p 0.05. Internal disability rate was not statistically significant (p > 0.05, but total disability was statistically significant (p < 0.05. Moreover, prevalence of additional conditions was statistically significant (p < 0.05 in patients aged %u226565 years.Discussion: Rapid increases in life expectancy and number of older people has increased the prevalence of disabilities among older people. Being diagnosed with chronic diseases should not be the end of life for geriatric populations. Their mood, social life, general health, and mental profile should progress. Sufficient attention should be paid to the special needs of older patients thereby leading to a wider use of facilities.

  13. Population aging and endogenous economic growth

    OpenAIRE

    Prettner, Klaus

    2010-01-01

    This article investigates the consequences of population aging for long-run economic growth perspectives. We introduce age specific heterogeneity of households into a model of research and development (R&D) based technological change. We show that the framework incorporates two standard specifications as special cases: endogenous growth models with scale e ects and semi-endogenous growth models without scale effects. The introduction of an age structured population implies that aggregate laws...

  14. Substance Abuse in Aging Population

    Directory of Open Access Journals (Sweden)

    Alireza Jazayeri

    2006-10-01

    Full Text Available substance abuse' specially opiates and prescribed drugs are spreading among the older adults. Most of the time it begins as an attempt to medicate chronic pains, medical conditions and loneliness. In other instances, it simply is the continuation of a problem that begun in young adulthood. But scholars and specialists in both fields of Addiction and Gerontology, rather neglected this fast growing problem, to the extent that we almost have no data on the epidemiology, prevention and treatment modalities among the substance abusing old adults in Iran. This paper reflects the necessity of designing age specific programs to identify and treat this group. Besides, some of the most effictive methods of treatment in other countries are reviewed.

  15. Population Aging and Economic Growth in Asia

    OpenAIRE

    David E. Bloom; David Canning; Jocelyn Finlay

    2008-01-01

    The decline in the total fertility rate between 1960 and 2005, coupled with an increase in life expectancy and the dynamic evolution of past variation in birth and death rates, is producing a significant shift in age structure in Asia. The age distribution has shifted from one with a high youth-age population share to one with a high old-age population share. We illustrate the role of these separate forces in shaping the age distribution. We also argue that the economic consequences of popula...

  16. Estimating population age structure using otolith morphometrics

    DEFF Research Database (Denmark)

    Doering-Arjes, P.; Cardinale, M.; Mosegaard, Henrik

    2008-01-01

    Traditional age reading is a rather subjective method that lacks true reproducibility, producing ageing error that propagates up to stock assessment. One alternative is represented by the use of otolith morphometrics as a predictor of age. An important issue with such a method is that it requires...... known-age fish individuals. Here we used known-age Atlantic cod (Gadus morhua) from the Faroe Bank and Faroe Plateau stocks. Cod populations usually show quite large variation in growth rates and otolith shape. We showed that including otolith morphometrics into ageing processes has the potential...... populations. The intercalibration method was successful but generalization from one stock to another remains problematic. The development of an otolith growth model is needed for generalization if an operational method for different populations is required in the future....

  17. [Introduction to geriatric oncology].

    Science.gov (United States)

    Wedding, U; Höffken, K

    2002-01-01

    The demographic changes will result in a profound increase of the number of elderly people within the next years. As a consequence of the age dependent increase of the incidence and mortality rate of cancer these changes will bring an increase in the number of elderly people with cancer. There is a number of differences between young and old patients diagnosed with cancer. This must result in an adaption of standardised oncological procedures, mainly designed for younger patients, to the special situation of elderly patients. The differences between young and old patients with cancer may be depicted by a structured geriatric assessment. Suggestions for the structure of such an assessment exist. Ongoing clinical trials have to demonstrate, whether or not the inclusion of a geriatric oncological assessment in the decision making process will result in an improvement of treatment results in elderly cancer patients diagnosed with cancer.

  18. Geriatric health care in India - Unmet needs and the way forward

    Directory of Open Access Journals (Sweden)

    Prabha Adhikari

    2017-01-01

    Full Text Available India has nearly 120 million elderly people with various physical, psychosocial, economic, and spiritual problems. While the functionally and cognitively fit can access usual health-care facilities provided by the government, these people need active aging program to keep them independent. Health ministry has created geriatric centers and geriatric clinics in most of the states; however, these centers may not serve the functionally and cognitively impaired elderly. There is great need for mobile units, day-care centers and hospices, and need for training of personnel in home nursing. Routine care clinics cannot handle the burden of geriatric population to address their multimorbidity and several other age-related problems. There is a need for a rapid training of health-care professionals of various disciplines in geriatric care. Government must support nongovernmental organizations and other agencies which provide day care, home care, and palliative care so that these services become affordable to all the elderly.

  19. PREPARING FOR THE GERIATRIC TSUNAMI – AN EMERGENCY DEPARTMENT PARADIGM SHIFT

    Directory of Open Access Journals (Sweden)

    James Ducharme, MD CM, FRCP

    2017-03-01

    Full Text Available The Emergency Department has witnessed multiple paradigm shifts within a very short period of time. It is likely that the aging of the population will create the greatest shift to date. As the number of people over age 75 swells, the demands on the emergency department to have available multi-disciplinary geriatric capabilities to manage their complex non-medical problems risk overwhelming the ability of the department to manage the acutely ill and injured as is its mandate. Crowding could spiral out of control, resulting in worsening outcomes for emergency department patients. Anticipating the geriatric tsunami and preparing a health care system, both in and outside of a hospital will be critical. Creating a geriatric emergency department in isolation risks having governments designate the emergency department as the portal of entry for all community geriatric needs, which can only compromise further acute care, care already threatened by tightened budgets, increasing health care costs and insufficient community resources.

  20. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    Science.gov (United States)

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  1. Planning for an ageing population: strategic considerations

    LENUS (Irish Health Repository)

    O'Shea, Dr Eamon

    2005-01-01

    This report presents both the proceedings of the Council’s conference, Planning for an Ageing Population: Strategic Considerations, and the Council’s discussion paper, ‘The Older Population: Information Issues and Deficits’, which was introduced at that conference.\\r\

  2. A National Survey on the Effect of the Geriatric Academic Career Award in Advancing Academic Geriatric Medicine.

    Science.gov (United States)

    Foley, Kevin T; Luz, Clare C; Hanson, Katherine V; Hao, Yuning; Ray, Elisia M

    2017-05-01

    A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician-educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician-educators with no similar alternatives. GACA recipients were surveyed in this cross-sectional, multimethod study to assess the effect of the award on career development, creation and dissemination of educational products, funding discontinuation consequences, and implications of program closure for the future of geriatric health care. Uninterrupted funding resulted in fulfillment of GACA goals (94%) and overall career success (96%). Collectively, awardees reached more than 40,700 learners. Funding interruption led to 55% working additional hours over and above an increased clinical workload to continue their GACA-related research and scholarship. Others terminated GACA projects (36%) or abandoned academic medicine altogether. Of respondents currently at GWEP sites (43%), only 13% report a GWEP budget including GACA-like support. Those with GWEP roles attributed their current standing to experience gained through GACA funding. These consequences are alarming and represent a major setback to academic geriatrics. GACA's singular contribution to the mission of geriatric medicine must prompt vigorous efforts to restore it as a distinct funding opportunity. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  3. A comparison of results from two mycology laboratories for the diagnosis of onychomycosis: a study of 85 cases in a geriatric population.

    Science.gov (United States)

    Scherer, William P; Scherer, Michael D

    2004-01-01

    An investigative study was performed to compare the results from two mycology laboratories for the diagnosis of onychomycosis in a geriatric population and to determine the possible pharmacologic treatments based on the two laboratories' results. In this study, 85 cases of suspected onychomycosis involving men and women 65 years and older from a nursing home setting in South Florida were used. Samples were taken from the hallux toenail and sent to two different mycology laboratories for fluorescent potassium hydroxide preparation and microscopic examination of a fungal culture. Of the 85 cases studied, the two mycology laboratories reported similar potassium hydroxide preparation results for 58.8% of the patients and similar fungal culture results for genus and species identification for 37.6% of the patients. When the potassium hydroxide preparation and fungal culture results were combined, the two mycology laboratories reported similar results for only 27.1% of the patients. As a result of the two mycology laboratories' findings, the possible US Food and Drug Administration-approved pharmacologic treatments may differ for 43.5% of the patients studied. The discrepancy between the two independent laboratories leaves physicians to question the reproducibility of fluorescent potassium hydroxide preparation and fungal culture analysis in a geriatric patient population for the diagnosis of onychomycosis.

  4. Aging and decreased glomerular filtration rate: An elderly population-based study.

    Science.gov (United States)

    Abdulkader, Regina C R M; Burdmann, Emmanuel A; Lebrão, Maria Lúcia; Duarte, Yeda A O; Zanetta, Dirce M T

    2017-01-01

    Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases. This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging]), a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when 0.20 g/g. The prevalence of GFR cardiovascular disease (43 versus 24%, pcardiovascular disease and hypertension were associated with GFR<60 mL/min/1.73m2. Decreased GFR was highly prevalent among the geriatric population in a megalopolis of a developing country. It was rarely present without simultaneous chronic comorbidities or kidney damage.

  5. Migration, fertility, and aging in stable populations.

    Science.gov (United States)

    Alho, Juha M

    2008-08-01

    Fertility is below replacement level in all European countries, and population growth is expected to decline in the coming decades. Increasing life expectancy will accentuate concomitant aging of the population. Migration has been seen as a possible means to decelerate aging. In this article, I introduce a stable, open-population model in which cohort net migration is proportional to births. In this case, the migration-fertility trade-off can be studied with particular ease. I show that although migration can increase the growth rate, which tends to make the age distribution younger, it also has an opposite effect because of its typical age pattern. I capture the effect of the age pattern of net migration in a migration-survivor function. The effect of net migration on growth is quantified with data from 17 European countries. I show that some countries already have a level of migration that will lead to stationarity. For other countries with asymptotically declining population, migration still provides opportunities for slowing down aging of the population as a whole.

  6. An interprofessionally developed geriatric oncology curriculum for hematology–oncology fellows

    Science.gov (United States)

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2016-01-01

    Objective Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. Methods A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies’ publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows’ evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Results Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. Conclusion An interprofessional team approach was a successful method for identifying areas of learners’ educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. PMID:25487037

  7. Gerontology and geriatrics in Dutch medical education.

    Science.gov (United States)

    Tersmette, W; van Bodegom, D; van Heemst, D; Stott, D; Westendorp, R

    2013-01-01

    The world population is ageing and healthcare services require trained staff who can address the needs of older patients. In this study we determined how current medical education prepares Dutch students of medicine in the field of Gerontology and Geriatrics (G&G). Using a checklist of the essentials of G&G, we assessed Dutch medical education on three levels. On the national level we analysed the latest National Blueprint for higher medical education (Raamplan artsopleiding 2009). On the faculty level we reviewed medical curricula on the basis of interviews with program directors and inspection of course materials. On the student level we assessed the topics addressed in the questions of the cross-institutional progress test (CIPT). The National Bluepr int contains few specific G&G objectives. Obligatory G&G courses in medical schools on average amount to 2.2% of the total curriculum measured as European Credit Transfer System units (ECTS). Only two out of eight medical schools have practical training during the Master phase in the form of a clerkship in G&G. In the CIPT, on average 1.5% of questions cover G&G. Geriatric education in the Netherlands does not seem to be in line with current demographic trends. The National Blueprint falls short of providing sufficiently detailed objectives for education on the care of older people. The geriatric content offered by medical schools is varied and incomplete, and students are only marginally tested on their knowledge of G&G in the CIPT.

  8. [Progress in geriatric care through telemedicine].

    Science.gov (United States)

    Jürgens, C; Tost, F

    2006-09-01

    A constantly aging population leads to an increasing number of elderly patients. As a result, the treatment of chronic illnesses becomes a significant part of daily routine. Today's concepts in social services and healthcare require time consuming and barely cost-effective efforts for the special needs of geriatric care. The use of telemedicine offers a possible solution, because telemedical methods may help to realize improved monitoring systems for optimized and effective patient management. This report provides an overview of the scenarios and advantages of telemedicine in general. In addition, we provide information on practical experiences in a project on telemedical glaucoma management in Mecklenburg-Vorpommern.

  9. Is It safe? Nonoperative management of blunt splenic injuries in geriatric trauma patients.

    Science.gov (United States)

    Trust, Marc D; Teixeira, Pedro G; Brown, Lawrence H; Ali, Sadia; Coopwood, Ben; Aydelotte, Jayson D; Brown, Carlos V R

    2018-01-01

    Because of increased failure rates of nonoperative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting, and well-powered multicenter data are lacking. We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age Injury Severity Score of 16 or higher was the only independent risk factor associated with failure of NOM in geriatric patients (odds ratio, 2.778; confidence interval, 1.769-4.363; p Injury Severity Score of 16 or higher, Glasgow Coma Scale score of 8 or less, and cardiac disease. However, failure of NOM was not independently associated with mortality (odds ratio, 1.429; confidence interval, 0.776-2.625; p = 0.25). Compared with younger patients, geriatric patients had a higher but comparable rate of failed NOM of BSI, and failure rates are lower than previously reported. Failure of NOM in geriatric patients is not an independent risk factor for mortality. Based on our results, NOM of BSI in geriatric patients is safe. Therapeutic, level IV.

  10. The Growth of Older Inmate Populations: How Population Aging Explains Rising Age at Admission.

    Science.gov (United States)

    Luallen, Jeremy; Cutler, Christopher

    2017-09-01

    Older inmates are the fastest growing segment of the prison population; however, the reasons for this are not well understood. One explanation is that the general population is aging, driving prison age distributions to change. For this article, we study the role of population aging in prison growth by investigating how the baby boom phenomenon of post-World War II has contributed to the growth of older inmate populations. We identify the impact of population aging using simulation methods that explain prison growth as the combination of criminal justice processes. Overall, we find evidence that population aging has played a significant role in explaining the growth of older inmate populations, in particular among inmates aged between 50 and 64 years, contributing to as much as half of the observed increase in these groups since 2000. This finding stands in contrast to the notion that population aging has little explanatory power in describing the growth of prison populations and implies that older inmate groups are more sensitive to compositional changes in the general population. We argue that prediction-based modeling of prison growth should more seriously consider the impacts and consequences of demographic shifts among older prisoner populations. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. General considerations on the population ageing

    Directory of Open Access Journals (Sweden)

    Alina Nuta

    2016-05-01

    Full Text Available This article presents one of the most important issues of the current context, the ageing of the population, with major consequences on the financial stability of the nation. This restructure of the population (that change the shape of the population pyramid , as a result, on the one hand, of the reducing in the fertility rate, on the other hand, increasing in life expectancy and last but not least, due to migration, unbalance national budgets, generating negative effects in economic, financial and social terms.

  12. Quantifying policy tradeoffs to support aging populations

    Directory of Open Access Journals (Sweden)

    Sergei Scherbov

    2014-03-01

    Full Text Available Background: Coping with aging populations is a challenge for most developed countries. Supporting non-working adults can create an unsustainable burden on those working. One way of dealing with this is to raise the normal pension age, but this has proven unpopular. A complementary approach is to raise the average labor force participation rate. These policies are generally more politically palatable because they often remove barriers, allowing people who would like to work to do so. Objective: To conceptualize and estimate the trade-off between pension age and labor force participation rate policies. Methods: We project the populations of European countries and apply different levels of labor force participation rates to the projected populations. We introduce the notion of a relative burden, which is the ratio of the fraction of the income of people in the labor market in 2050 that they transfer to adults out of the labor market to the same fraction in 2009. We use this indicator to investigate the trade-offs between changes in normal pension ages and the general level of labor force participation rates. Results: We show that, in most European countries, a difference in policies that results in an increase in average labor force participation rates by an additional one to two percentage points by 2050 can substitute for a one-year increase in the normal pension age. This is important because, in many European countries, without additional increases in labor force participation rates, normal pension ages would have to be raised well above 68 by 2050 to keep the burden on those working manageable. Conclusions: Because of anticipated increases in life expectancy and health at older ages as well as because of financial necessity, some mix of increases in pension ages and in labor force participation rates will be needed. Pension age changes by themselves will not be sufficient.

  13. Intergenerational Transfers, Population Aging and Social Protection ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Latin American countries are rapidly catching up to the industrialized countries of the North in terms of birthrate and lifespan. Depending on the choice of policy, the aging population could generate increased public debt or increased private investment. This grant will allow researchers to analyze social protection systems in ...

  14. Population genomics of Bronze Age Eurasia

    DEFF Research Database (Denmark)

    Allentoft, Morten E.; Sikora, Martin; Sjögren, Karl-Göran

    2015-01-01

    investigated this by using new, improved methods to sequence low-coverage genomes from 101 ancient humans from across Eurasia. We show that the Bronze Age was a highly dynamic period involving large-scale population migrations and replacements, responsible for shaping major parts of present-day demographic...

  15. The challenges of human population ageing

    DEFF Research Database (Denmark)

    Sander, Miriam; Oxlund, Bjarke; Jespersen, Astrid

    2015-01-01

    -in-community'? what tools will effectively promote social engagement and prevent social detachment among older individuals? is there a risk that further extension of human lifespan would be a greater burden to the individual and to society than is warranted by the potential benefit of longer life?......, social, public health and public policy challenges, whose full implications on a societal level are only just beginning to be fully appreciated. Some of these implications are discussed in this commentary, an outcome of Cultures of Health and Ageing, a conference co-sponsored by the University...... of Copenhagen (UCPH) and the Center for Healthy Ageing at UCPH, which took place on 20-21 June 2014 in Copenhagen, Denmark. Questions discussed here include the following: what is driving age-structural change in human populations? how can we create 'age-friendly' societies and promote 'ageing...

  16. [Respiratory symptoms and lung function in a geriatric population of a Galician rural community: a pilot study].

    Science.gov (United States)

    González Barcala, F J; Takkouche, B; Montes Martínez, A; Zamarrón Sanz, C; Salgueiro Rodríguez, M; Rodríguez Suárez, J R

    2003-04-01

    Respiratory diseases are a frequent cause of health demands and have a large impact on morbidity and mortality of the Galician population, especially among the older one. Recent work shows that the diagnosis and treatment of these diseases is not optimal. This increases the utilisation of health care resources. We studied 28 patients of the municipality of Val del Dubra (Northwest Spain) aged between 65 and 74 years. We performed a spirometric exploration and carried out a questionnaire interview on respiratory symptoms, life style, and occupational and health-related antecedents. Among men, 54% of were or are smokers. None of the women ever smoked. Respiratory symptoms were more frequent among women than among men (80% versus 54%). In the spirometric study, the largest volumes and flux are observed among non-smoking males who do not report dyspnea. Respiratory symptoms are frequent in the rural population aged between 65 and 74 years. Tobacco consumption is similar to other Spanish communities, but different from that seen in other countries. Male gender, non-smoking status and absence of respiratory symptoms are associated with higher spirometric figures.

  17. Urologic symptoms and burden of frailty and geriatric conditions in older men: the Aging Study of PyeongChang Rural Area

    Directory of Open Access Journals (Sweden)

    Jang IY

    2018-02-01

    Full Text Available Il-Young Jang,1,2 Chang Ki Lee,3 Hee-Won Jung,4,5 Sang Soo Yu,2 Young Soo Lee,1 Eunju Lee,1 Dae Hyun Kim6,7 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 2PyeongChang Health Center & County Hospital, PyeongChang, Gangwon-Do, Republic of Korea; 3Goldman Urology Clinic, Seoul, Republic of Korea; 4Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST, Daejeon, Republic of Korea; 5Geriatric Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-Do, Republic of Korea; 6Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; 7Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA Purpose: Frailty is an important consideration in the management of lower urinary tract symptoms and erectile dysfunction in older men; frailty increases vulnerability to treatment-related adverse outcomes, but its burden is not known. The authors aimed to examine the burden of frailty and associated geriatric conditions in community-dwelling older men.Patients and methods: A cross-sectional study was conducted with 492 community-dwelling older men (mean age, 74.2 years; standard deviation, 5.6 years. All the participants were administered the International Prostate Symptom Score (IPSS (range: 0–35 and a five-item version of the International Index of Erectile Function (IIEF-5 (range: 5–25. Frailty phenotype was assessed based on exhaustion, inactivity, slowness, weakness, and weight loss. Prevalence of frailty phenotype and geriatric conditions were assessed by the IPSS severity category (mild, 0–7; moderate, 8–19; severe, 20–35 points and the first IIEF-5 question, which assesses the confidence in erectile function (low, 1–2; moderate, 3; high, 4–5 points.Results: Older men with severe urologic

  18. Energy implications of an aging population

    Energy Technology Data Exchange (ETDEWEB)

    1980-08-01

    This study provides various demographic, medical, and economic information relative to energy usage on a segment of the population, the elderly, which is growing in absolute numbers and relative population percentage. This growth is expected to continue well into the twenty-first century. The US aging population numbered 3.1 million in 1900, and by 1977 it had climbed to 23.5 million. It can be stated with reasonable certainty that this figure will rise to 31 million in the year 2000 and 43 million in the year 2020. These figures, corresponding to more than 10% of our population, are by no means insignificant. As our fossil-fuel reserves are being depleted and the cost of energy mounts, it becomes apparent that the elderly will become increasingly vulnerable to the energy crisis, primarily beause of their physical tendency to infirmity, their economic and social situation, and their susceptibility to psychological depression. This white paper concentrates on those aspects of aging and the nation's energy problem which are not usually related in our everyday consideration of these as separable problems. It seeks to identify the peculiar energy problems of the aged and to consider alternatives in the solution of these problems in light of modern technology.

  19. Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.

    Science.gov (United States)

    Camina-Martín, M Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, J Antonio; Redondo-del-Río, M Paz

    2015-07-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 Elsevier Ireland Ltd. All rights

  20. [Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group].

    Science.gov (United States)

    Camina-Martín, María Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, José Antonio; Redondo-Del-Río, María Paz

    2016-01-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. Copyright © 2015 SEGG. Published by Elsevier

  1. Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).

    Science.gov (United States)

    Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy

    2016-09-01

    The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Christianity Facing the Ageing of Global Population

    Directory of Open Access Journals (Sweden)

    Anna Sanecka

    2015-12-01

    Full Text Available The ageing population is a great challenge for the whole world including churches, Christian communities, Christian families and the so-called “Christian countries”. The respect and support for elderly people is almost a common rule of social life in developed countries regardless of religious views. But in the Christian world this obligation has very strong religious justification – obligation enshrined in the Commandments of Old (the fourth/fifth Commandment and New (the second one of The Greatest Commandments of Love Testaments. Therefore between the Christianity – understood as a set of different communities sharing their beliefs in Jesus Christ – and aging population there are many very different connections including among others: honour and respect, privilege, obligations, giving – receiving relations, duty, charity, solidarity, dependency. They are present both in the teaching and the practice of different Christian communities starting with Churches, through NGOs and Christian societies, ending with Christian families. The paper shows some of these connections. It also tries – based on a case of Poland – to answer the question whether the Christianity is ready to face the aging of global population

  3. Population ageing alongside health care spending growth

    Directory of Open Access Journals (Sweden)

    Jakovljević Mihajlo

    2017-01-01

    Full Text Available The Silver Tsunami or population ageing has become a globally widespread phenomenon. The purpose of this review is to observe its dynamics and consequences from a local Balkan perspective. The main drivers of this unique demographic evolution are extended longevity, improved early childhood survival, absorption of women into the labor markets, and consequences of sexual revolution leading to falling female fertility. This process lasting well over a century is taking its toll on contemporary societies. Major side effects are shrinking young labor force and growing pool of elderly and retired citizens in many countries. This equation tends to worsen further in the future threatening long-term financial sustainability of public social and health insurance funds. Notable health expenditure growth, accelerating worldwide since the 1960s, is to a large degree attributable to ageing itself. Growing share of senior citizens increases demand for medical services and costs of health care provision. Home-based care provided by the family caregivers presents another important reality putting a huge burden on modern communities. Serbs are no exception in this landscape. Historical demographic evolution of this nation gives a clear evidence of advanced and accelerated ageing, which is well documented in post-World War II era. This synthesis of rich published evidence shows clear upward parallel trend between the pace of population aging and the growth of health expenditure. National authorities shall be forced to consider reform of the current health care financing pattern inherited from the demographic growth era. This might be the only way to smooth out the impact of population ageing on the financial sustainability of the health system and long-term medical care in Serbia. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. OI 175014

  4. Slowed ageing, welfare, and population problems.

    Science.gov (United States)

    Wareham, Christopher

    2015-10-01

    Biological studies have demonstrated that it is possible to slow the ageing process and extend lifespan in a wide variety of organisms, perhaps including humans. Making use of the findings of these studies, this article examines two problems concerning the effect of life extension on population size and welfare. The first--the problem of overpopulation--is that as a result of life extension too many people will co-exist at the same time, resulting in decreases in average welfare. The second--the problem of underpopulation--is that life extension will result in too few people existing across time, resulting in decreases in total welfare. I argue that overpopulation is highly unlikely to result from technologies that slow ageing. Moreover, I claim that the problem of underpopulation relies on claims about life extension that are false in the case of life extension by slowed ageing. The upshot of these arguments is that the population problems discussed provide scant reason to oppose life extension by slowed ageing.

  5. Ageing Populations in Post-Industrial Democracies

    DEFF Research Database (Denmark)

    Vanhuysse, Pieter; Goerres, Achim

    of the state against the interests of a growing elderly voting bloc to safeguard fiscal viability, and looks at highly-topical responses such as pension cuts and increasing retirement age. It also examines the rise of ‘grey parties’, and asks what, if anything, makes such pensioner parties persist over time...... of the elderly population bring into question the very basis of the welfare state’ - Canadian Public Policy ‘a collection of articles which examine different aspects of the relationship between age and political power in advanced nations. In particular, several of the papers question whether older people show...... by the age of the electorate (particularly pension reform and generosity), while it seems that the interests of the elderly are not necessarily privileged during the design of labour market reforms.’ - Intergenerational Justice Review‘Pieter Vanhuysse and Achim Goerres wish to shed light on the consequences...

  6. Advances in research, education and practice in geriatric medicine, 1982-2012.

    Science.gov (United States)

    Flicker, Leon

    2013-10-01

    Over the last 30 years, major advances in the provision of services for frail older people in Australasia have taken place. This has been spurred on by the accumulation of the evidence for benefits of the multidisciplinary team model of comprehensive geriatric assessment and management. Current research is now uncovering mechanisms of frailty associated with the ageing process and will lead to further interventions in the management of the health problems of older people. These interventions will almost certainly include both medical and lifestyle strategies. Although there have been major improvements in the education of health professionals in aspects of geriatrics, more concerted efforts are required for the ageing population. © 2013 ACOTA.

  7. Preventing painful age-related bone fractures: Anti-sclerostin therapy builds cortical bone and increases the proliferation of osteogenic cells in the periosteum of the geriatric mouse femur.

    Science.gov (United States)

    Thompson, Michelle L; Chartier, Stephane R; Mitchell, Stefanie A; Mantyh, Patrick W

    2016-01-01

    Age-related bone fractures are usually painful and have highly negative effects on a geriatric patient's functional status, quality of life, and survival. Currently, there are few analgesic therapies that fully control bone fracture pain in the elderly without significant unwanted side effects. However, another way of controlling age-related fracture pain would be to preemptively administer an osteo-anabolic agent to geriatric patients with high risk of fracture, so as to build new cortical bone and prevent the fracture from occurring. A major question, however, is whether an osteo-anabolic agent can stimulate the proliferation of osteogenic cells and build significant amounts of new cortical bone in light of the decreased number and responsiveness of osteogenic cells in aging bone. To explore this question, geriatric and young mice, 20 and 4 months old, respectively, received either vehicle or a monoclonal antibody that sequesters sclerostin (anti-sclerostin) for 28 days. From days 21 to 28, animals also received sustained administration of the thymidine analog, bromodeoxyuridine (BrdU), which labels the DNA of dividing cells. Animals were then euthanized at day 28 and the femurs were examined for cortical bone formation, bone mineral density, and newly borne BrdU+ cells in the periosteum which is a tissue that is pivotally involved in the formation of new cortical bone. In both the geriatric and young mice, anti-sclerostin induced a significant increase in the thickness of the cortical bone, bone mineral density, and the proliferation of newly borne BrdU+ cells in the periosteum. These results suggest that even in geriatric animals, anti-sclerostin therapy can build new cortical bone and increase the proliferation of osteogenic cells and thus reduce the likelihood of painful age-related bone fractures. © The Author(s) 2016.

  8. Home geriatric physiological measurements

    International Nuclear Information System (INIS)

    Tamura, Toshiyo

    2012-01-01

    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the ‘smart-house’ project. This review concludes by discussing future challenges of the future aged society. (topical review)

  9. The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly

    Science.gov (United States)

    Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah

    2009-01-01

    On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…

  10. Aging in Hong Kong: the institutional population.

    Science.gov (United States)

    Woo, Jean; Chau, Patsy P H

    2009-09-01

    The Hong Kong population is aging rapidly, such that there are concerns about residential care adequacy in terms of number of places as well as quality of care. A total of 1820 residents living in a representative sample of residential care facilities were surveyed. The survey showed a substantial proportion with cognitive dysfunction, mood problems, communication and vision problems, chronic disabling diseases, impairment in activities of daily living, and undernutrition. Programs of activities and rehabilitation were generally unavailable. Those in for-profit facilities had a worse profile. An approximate estimation of numbers of staff required based on case mix revealed considerable understaffing among the for-profit facilities. Issues of quality of care would be all the more important with anticipated future increase in the institutional population of older people.

  11. [Geriatrics and gerontology in Senegal].

    Science.gov (United States)

    Coumé, Mamadou; Touré, Kamadore; Faye, Atoumane; Moreira, Therese Diop

    2013-01-01

    Senegal is dealing positively with its demographic transition. On September 1st 2006, the Senegalese government introduced the "Plan Sesame", a national free health care program for elderly people aged 60 years and over. The University of Dakar academic authorities support the Sesame plan through an innovative training program in geriatrics and gerontology. Such programs aim to address the challenge of ageing in a developing country.

  12. Can Geriatric Psychiatry Patients Complete Symptoms Self-Reports Using Tablets? A Randomized Study.

    Science.gov (United States)

    Moussaoui, Ghizlane; Yu, Ching; Laliberté, Vincent; Elie, Dominique; Mahdanian, Artin A; Dawson, Benjamin; Segal, Marilyn; Looper, Karl J; Soham, Rej

    2017-09-01

    With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection. This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. traditional paper forms to complete self-report psychiatric symptoms. Geriatric psychiatry outpatients (n = 72) and adult psychiatry inpatients (n = 50) were recruited to complete the Brief Symptom Inventory (BSI-53), the Activities of Daily Living (ADL), and Patient Health Questionnaire (PHQ-9) questionnaires. Geriatric psychiatry outpatients completed the iPad and paper questionnaires at similar rates (91.7% vs. 97.2%, Fisher's Exact p = .61). In two-way ANOVA, including patients aged ≥ 60 (n = 85), outpatient status (F(1,81) = 4.48, p = .037) and iPad format (F (1,81) = 8.96, p = .04) were associated with a shorter time to completion. The effect of questionnaire formats was especially prominent in the inpatient group on time to completion. Older adults with mental illness demonstrate a similar ability to complete self-report questionnaires whether iPads or paper forms. iPad questionnaires may even require less time to complete in geriatric psychiatry inpatients. Patients also found iPad questionnaires to be easy to use and read. Tablets could potentially be used for psychiatric symptom assessment for clinical, research, and population health purposes.

  13. Morbidity pattern and its relation to functional limitations among old age rural population in Kerala, India

    Directory of Open Access Journals (Sweden)

    R Anil Das

    2017-01-01

    Full Text Available Background: In the present era of demographic transition, morbidity pattern among geriatric population and its relation to functional limitations is an important health issue in developing countries. Objective: The objective of this study was to assess the reported morbidities and its relation to functional limitations among rural geriatric population. Materials and Methods: A community-based cross-sectional study was carried out among 167 old age participants aged ≥60 years to assess morbidities and its relation to functional limitations in a rural area of Kerala, India. Sociodemographic details, blood pressure, diabetes, visual impairment, and other reported diagnosed morbidities were assessed by interview using structured pro forma. Functional limitations for activities of daily living were assessed by 10-item Barthel index scale. Results: Overall prevalence of any morbidity was 89.2% (149/167 and moderate or severe functional limitation was 9% (15/167. One morbidity was reported by 34.1% (57, two morbidities 24% (40, three or more 31.1% (52 of the participants. Most common morbidities include hypertension (63, 37.7%, diabetes and visual impairment (61, 36.5% in each, joint pains or backache (51, 30.5%. Age group was significantly associated with joint pain/backache and visual impairment while gender with diabetes, hypertension, and chest diseases. Higher functional limitation is significantly more among those with joint pain or backache (P < 0.05. Among those with moderate and severe functional limitation, majority (12, 80% had ≥3 morbidities. Conclusion: The reported morbidities are high, but moderate or severe functional limitation is more common among those with joint pain or backache and ≥3 morbidities.

  14. A scoping review of anorexia of aging correlates and their relevance to population health interventions.

    Science.gov (United States)

    Roy, Mathieu; Gaudreau, Pierrette; Payette, Hélène

    2016-10-01

    Anorexia of aging (AA, i.e., loss of appetite and/or reduction of food intake with aging) is an important public health issue. It leads to unintentional weight loss, which is an independent risk factor for morbidity and mortality among seniors. AA has mainly been studied from a biological perspective and regarded as a normal physiological consequence of aging, rather than a negative health outcome with underlying determinants. Some potentially modifiable correlates have however been found to be associated with this geriatric condition. Here, we conducted a scoping review of the literature to: 1) identify AA correlates, and 2) discuss their relevance to population health interventions. Our results indicate two main categories of AA correlates, namely, physiopathological and non-physiopathological. The first category relates to physiological dysfunctions, pathologies involving (or culminating in) biomarker dysregulation, and polypharmacy. These correlates are difficult to modify, especially through population health interventions. The second category, which contains fewer correlates, includes potentially modifiable public health targets, such as food-related properties, psychological, sociocultural, and environmental issues. We conclude that there are several AA correlates. Some of them are modifiable and could be targeted for development and implementation as appropriate population health interventions to prevent appetite loss and promote maintenance of adequate food intake in aging. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Professional development and exposure to geriatrics: medical student perspectives from narrative journals.

    Science.gov (United States)

    Shield, Renée R; Farrell, Timothy W; Campbell, Susan E; Nanda, Aman; Wetle, Terrie

    2015-01-01

    Teaching professionalism is an important goal in American medical education. With the aging of the U.S. population, it is critical to understand how medical students develop professional behaviors when caring for older adults. Exposure to geriatrics and older patients can enhance students' professional development with patients of all ages and across different specialties. Medical students learn explicit and implicit messages during their education. In addition to helping to evaluate curricula, reflective journaling encourages individual development and helps in revealing how medical students become professionals. In this study, medical student volunteers described their responses to new geriatrics content in their curriculum, encounters with older patients in clinical settings, and their evolving physician identities. Multidisciplinary team analysis elicited 10 themes regarding: evaluation of geriatrics within the curriculum, recognition of geriatrics principles, and attitudes regarding aging and professional development over time. This article focuses on the impact of geriatrics exposure on students' professional development, revealing ways that students think about professionalism and older patients. Medical educators should consider journaling to help foster and gauge students' professional development.

  16. Do levels of perceived stress increase with increasing age after age 65? A population-based study.

    Science.gov (United States)

    Osmanovic-Thunström, Almira; Mossello, Enrico; Åkerstedt, Torbjörn; Fratiglioni, Laura; Wang, Hui-Xin

    2015-09-01

    psychological and health-related stressors often occur in advanced ages, but little is known about perceived stress in adults aged 65 and over. This study aimed to test the hypothesis that levels of perceived stress increase with increasing age and to detect factors that may account for the association. a dementia-free cohort of 1,656 adults aged 66-97 years living at home or in institutions, participating in the Swedish National Aging and Care study, Kungsholmen (SNAC-K) was assessed for levels of perceived stress using the 10-item perceived stress scale (PSS). prevalence of high stress according to the top tertile of the population (PSS score 20+) was 7.8% in adults aged 81+ years, 7.5% in adults aged 72-78 and 6.2% in adults aged 66 years (P = 0.020). More women than men reported high stress, 8.3 versus 5.4% (P = 0.001). Levels of stress increased with increasing age (P = 0.001) in the linear regression model. This association remained after adjustment for demographic and psychosocial factors, but no longer was present after adjusting for health-related factors. health-related stress is highly prevalent in older adults and seems to play an important role in the association between levels of perceived stress and age in older adults. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Exercise Promotion in Geriatric Oncology.

    Science.gov (United States)

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.

  18. The process of enchancing a geriatric module in undergraduate physiotherapy education in South Africa - perceived attituteds towards ageing among community-dwelling elderly persons in Cape Town

    Directory of Open Access Journals (Sweden)

    S.L. Amosun

    2014-04-01

    Full Text Available The framwork of Bloom's taxonomy was utilised in reviewing the educational outcomes of the geriatric module in undergraduate physiotherapy edication at the University of Cape Town.

  19. Trends in the utilization of nuclear medicine and radiopharmaceuticals in an aging population.

    Science.gov (United States)

    Hung, Mao-Chin; Hwang, Jeng-Jong

    2016-08-05

    To investigate the trends in the utilization of nuclear medicine procedures and radiopharmaceuticals in an aging population and to establish the prediction models. Based on Taiwan's National Health Insurance Research Database, a longitudinal study was conducted from 2000 to 2012. Descriptive statistics were adopted to analyze the frequencies and distributions of nuclear medicine procedures. Multiple linear regression analysis was applied to establish the prediction model for the utilization of nuclear medicine. The utilization of myocardial perfusion imaging increased most significantly, i.e. 250 per million population (pmp) increment annually, followed by the whole-body bone scan (176 pmp) and whole-body PET scan (100 pmp) in Taiwan during the period of 2000-2012. The use rate of nuclear medicine procedure which the first quartile (Q1) of age at examination above 35 years fits the regression model: Use rate expected year = 0.03 Q1 of age at examination × use rate baseline year + 14797 life expectancy expected year / life expectancy baseline year - 15030. Adversely, the use rate of procedure which Q1 of age at examination below 35 years fits the model: Use rate expected year = 0.01 Q1 of age at examination × use rate baseline year - 4565 life expectancy expected year / life expectancy baseline year + 4749. In addition, the similar models were found in the applications of radiopharmaceuticals. This study demonstrates the age at examination and life expectancy can be used to predict the utilities of nuclear medicine procedures and radiopharmaceuticals in an aging population. Nuclear medicine practice applied in the geriatrics would increase significantly with the aging of population.

  20. 11 CFR 110.18 - Voting age population.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting age...

  1. [The mobile geriatrics team, global patient management].

    Science.gov (United States)

    Bach, Fréderiue; Bloch, Frédéric

    2013-01-01

    The mobile geriatric team of Cochin hospital in Paris is responsible for the management and orientation of fragile elderly patients over the age of 75 admitted to emergency departments. It carries out a multi-disciplinary assessment, contributes to the creation of the care project and life project of geriatric patients and is involved in organising the patient's return home. This article focuses on the role of the social assistant through two clinical cases.

  2. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    OpenAIRE

    Cokorda Istri Devi Larayanthi

    2013-01-01

    Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, gene...

  3. [Geriatric day hospital: what evidence? A systematic review].

    Science.gov (United States)

    Petermans, Jean; Velghe, Anja; Gillain, Daniel; Boman, Xavier; Van Den Noortgate, Nele

    2011-09-01

    A systematic review of the international literature concerning the organisation of the Geriatric Day Hospital (GDH) was performed. From 1987 till now, few papers were found describing the activity and the effectiveness of the GDH. All the studies comparing specific geriatric approaches to regular medicine demonstrate the efficiency of geriatric care, particularly the geriatric assessment. So, with a degree of evidence 1a, a better outcome is found for patients undergoing a geriatric assessment and intervention, compared to patients having no geriatric assessment at all. However, there is no evidence of benefit for the geriatric day hospital compared to patients treated in a geriatric ward or other location of geriatric care. Moreover, there is no clear consensus on the settings and activities of a geriatric day hospital. Terms as day unit, day hospital, day care, are used interchangeably and are not always covering the same activity. The same remark can be made on the exact composition of the geriatric multidisciplinary team and its role. However nurses and paramedical workers are always mentioned as all performing geriatric assessment. The diagnostic activities on the GDH are seldom described and studied. More information is available on rehabilitation activity, often developed in specific patient populations such as stroke patients, dementia patients, cardiac patients or patients with other chronic diseases. In this selected patient populations positive effects on outcome are shown in the GDH (level of evidence 1a). Another problem is the heterogeneity of the population. For scientific reason the GDH should focus on organising care for specific medical problems. Diseases as dementia, stroke, cardiac insufficiency, could be good models to investigate the efficiency of geriatric assessment and interventions within the setting of a GDH.

  4. What to Expect From the Evolving Field of Geriatric Cardiology.

    Science.gov (United States)

    Bell, Susan P; Orr, Nicole M; Dodson, John A; Rich, Michael W; Wenger, Nanette K; Blum, Kay; Harold, John Gordon; Tinetti, Mary E; Maurer, Mathew S; Forman, Daniel E

    2015-09-15

    The population of older adults is expanding rapidly, and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with the complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. Although some assume that a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care. We present a rationale and vision for geriatric cardiology as a melding of primary cardiovascular and geriatrics skills, thereby infusing cardiology practice with expanded proficiencies in diagnosis, risks, care coordination, communications, end-of-life, and other competences required to best manage older cardiovascular patients. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Management and geriatric assessment of cancer in the elderly.

    Science.gov (United States)

    Terret, Catherine

    2004-06-01

    Due to the demographic evolution, the management of elderly patients with cancer currently represents a major challenge for the medical community. Aging may be associated with an increased rate of health problems possibly resulting in a loss of independence. These problems can interfere with cancer treatment strategies. Therefore, treatment decision making requires a multidisciplinary and multidimensional assessment of both the characteristics of the malignant disease and the host's general health status. Several oncological groups have developed specific programs for elderly cancer patients. Based on a multidimensional geriatric assessment tool, they aim to establish the best pattern of care for the population of elderly patients with cancer. Clinical research in geriatric oncology is also a very exciting field, particularly regarding the conception of clinical trials specifically designed for elderly patients. The particular aspects of the management of elderly patients with cancer and some critical challenges of clinical research will be presented and discussed in this review.

  6. Geriatric and Student Perceptions following Student-led Educational Sessions

    Directory of Open Access Journals (Sweden)

    Kristin Janzen

    2018-01-01

    Full Text Available Objective: The objective of this study was to measure the effect of student-led educational events on geriatric patient and student participant perceptions in a community setting. Methods: Students led three events at a senior community center, focusing on learning and memory, sleep hygiene, and arthritis pain. The participants were geriatric patients who themselves were providers of support to homebound peers (“clients” through an independently organized program. Geriatric participants completed pre- and post-event surveys to measure changes in familiarity with the topics. Student participants also completed pre- and post-event surveys that tracked changes in their comfort in working with the geriatric population. Results: Each event demonstrated at least one positive finding for geriatric patients and/or their clients. Students reported increased comfort in working with and teaching the geriatric population following the first and third events, but not the second. Conclusion: Student-led educational sessions can improve perceived health-related knowledge of geriatric participants while simultaneously exposing students to the geriatric patient population. Overall, both students and geriatric participants benefited from these events. Practice Implications: Incorporation of single, student-led educational events could be mutually beneficial to students and the elderly population in the community and easily incorporated into any healthcare curriculum. Funding:This work was supported by a Butler University Innovation Fund Grant. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

  7. Why Does Population Aging Matter So Much for Asia? Population Aging, Economic Security and Economic Growth in Asia

    OpenAIRE

    Sang-Hyop LEE; Andrew MASON; Donghyun PARK

    2011-01-01

    Asia as a whole is experiencing a rapid demographic transition toward older population structures. Within this broader region-wide trend, there is considerable heterogeneity, with different countries at different stages of the demographic transition. In this paper, we document Asia’s population aging, describe the region’s old-age support systems, and draw out the regional socioeconomic implications of population aging and old-age support systems. Population aging gives rise to two fundamenta...

  8. The educational challenge of dental geriatrics.

    Science.gov (United States)

    MacEntee, Michael I

    2010-01-01

    Education in dentistry as in medicine is guided principally by the ontology and theory of science, which provides definitions of health and disease, legitimizes research methods, and influences the role of the clinician. The challenge of managing chronic oral disease and disability prompts interest in social theory as much as science. Therefore, dental geriatrics requires a solid foundation in the humanities from the belief that the determinants of health and the cause of chronic diseases lie within an intermingling of biology, economics, sociocultural structure, and human behavior. The dental curriculum in many places is reorganizing from the horizontal foundation of basic sciences to an integration of foundational and clinical knowledge focused on clinical competencies and integrated care. The impact of this integration on dental geriatrics necessitates a more humanistic and naturalistic perspective in dental education to balance and challenge the current evidence for best clinical practice, which at present is based almost exclusively on science. Consequently, dental students should be exposed to a consilience of the science and the humanities if dentists are to address effectively the needs of an aging population.

  9. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Cokorda Istri Devi Larayanthi

    2013-04-01

    Full Text Available Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, general medical conditions, medications, certain substances, and others. Management of insomnia in geriatric patients were divided into 3 method: 1 manage underlying cause, 2 nonpharmacological therapies such as cognitive behavior therapy (CBT, and 3 pharmacological therapies such as benzodiazepine and non-benzodiazepine that eszopiclone and Ramelteon. Pharmacological treatment in geriatrics should follow the rule "start low, go slow", starting dose of ½ of the adult dose, and its use in the short term.

  10. Evaluation of geriatric changes in dogs

    Directory of Open Access Journals (Sweden)

    Soumyaranjan Pati

    2015-03-01

    Full Text Available Aim: The present study has been envisaged to ascertain the old age for critical management of geriatric dogs considering the parameters of externally visible changes, haemato-biochemical alterations and urine analysis in geriatric dogs approaching senility. Materials and Methods: The study was undertaken in the Department of Veterinary Pathology in collaboration with Teaching Veterinary Clinic complex spanning a period of 1 year. For screening of geriatric dogs, standard geriatric age chart of different breeds was followed. The external characteristics such as hair coat texture, dental wear and tear, skin texture and glaucoma were taken as a marker of old age. Haematology, serum biochemistry and urine analysis were also included in the study. Results: External visible changes like greying of hair, dull appearance of hair coat, glaucoma, osteoarthritis, dental wear and tear were commonly encountered in the aged dogs. The haemoglobin, total erythrocyte count and packed cell volume showed a decreasing trend in the geriatric groups. Biochemical values like total protein, albumin, calcium level showed a decreasing trend while urea level with an increasing trend in geriatric dogs without any much alteration in serum glutamicoxaloacetic transaminse, serum glutamic-pyruvate transaminase, cholesterol and creatinine. Physical examination of urine revealed yellow, amber, red, deep red color with turbidity and higher specific gravity. Chemical examination revealed presence of protein, glucose, ketone bodies, blood and bilirubin on some cases. The culture and sensitivity test of the urine samples revealed presence of bacteria with sensitive and resistance to some antibiotics. Conclusion: External visible changes are still the golden standard of determining the old age in dogs. Haemato-biochemical evaluation can be useful for correlating with the pathophysiological status of the animal. Biochemical analysis of urine can be employed rightly as kidney

  11. Decomposition of regional convergence in population aging across Europe

    OpenAIRE

    Kashnitsky, I.; de Beer, J.A.A.; van Wissen, L.J.G.

    2017-01-01

    In the face of rapidly aging population, decreasing regional inequalities in population composition is one of the regional cohesion goals of the European Union. To our knowledge, no explicit quantification of the changes in regional population aging differentiation exist. We investigate how regional differences in population aging developed over the last decade and how they are likely to evolve in the coming three decades, and we examine how demographic components of population growth contrib...

  12. Successful Aging: Multiple Trajectories and Population Heterogeneity

    OpenAIRE

    Fengyan Tang

    2014-01-01

    Following Rowe and Kahn¡¯s successful aging model, this study identified successful aging as a distinctive aging trajectory and examined gender differences in the aging process. Using the Health and Retirement Study data (2000-2008), this study applied group-based trajectory analysis to identify multiple aging trajectories in a sample of older Americans aged 65 and over (N=9,226). Six dimensions were analyzed in the multi-trajectory model: chronic disease, physical functional limitation, disa...

  13. Emerging trends in gerontology and geriatrics: implications for the self-care of the elderly

    DEFF Research Database (Denmark)

    Hickey, T; Dean, K; Holstein, B E

    1986-01-01

    people to describe a wide range of personal health behaviors encompassing lay care, self-help, enlightened consumerism, and various preventive measures as antidotes to the impairments of old age. This paper reports some of the outcomes of an international project which reviewed geriatric self-care...... has been viewed traditionally by health professionals as their domain, self-care and lay initiatives have recently been recognized by professionals as important to the health care of different population groups including older people. The concept of self-care has been used in various ways by different...... in different countries and health care systems. Various influences on the evolution of interest in geriatric self-care were identified including: similarities and differences in health care systems: demographic changes; cohort differences; the emergence of professionals with specialized training in geriatric...

  14. Auckland City Hospital's Ortho-Geriatric Service: an audit of patients aged over 65 with fractured neck of femur.

    Science.gov (United States)

    Wimalasena, Bodhi; Harris, Roger

    2016-07-01

    The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013. Ninety-one patients were audited; mean age was 83 years, 68% were female. Both inpatient and 30-day mortality was 5%. 120-day mortality was 15%. Seventy-six percent of patients were admitted from ED within the national health target prescribed period of 6 hours. Only one patient was treated non-surgically. Eighty-six percent had surgery within 48 hours of admission. Eighty-two percent of patients had rehabilitation and treatment by Older People's Health. Of those living at home pre-fracture, 76% returned home on discharge. Thirty-seven percent of patients were able to walk unaided prior to hip fracture, but only 1% on discharge. Average overall length of stay was 22 days. Bisphosphonates were prescribed for 56% of patients. Compared to 2007, Auckland City Hospital has demonstrated a significant improvement in the rate of provision of timely surgery for hip fracture patients. Most patients are receiving the guideline recommended fracture-specific surgical interventions. The assessment and treatment of osteoporosis needs further attention.

  15. Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition

    Directory of Open Access Journals (Sweden)

    Ana Conceição Norbim Prado Cunha

    2016-04-01

    Full Text Available Summary Objective: This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. Methods: 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC were found, as seen on the MEC website (www.emec.mec.gov.br in February 2013. Based on the list of institutions, the authors created a database. Results: Brazil's Southeast region is the one presenting most of the courses, both offered as core or elective subjects, in the area of Geriatrics. The Midwest region had the least offer of Geriatrics and Elderly Health and Care courses. The Southeast region presents the greater absolute number of institutions with elective subjects, followed by the South and Northeast regions, each with a single institution. The Southeast region was at the same time the one that presented the biggest absolute number of institutions offering core subjects in the area of Geriatrics, being followed by the Northeast, South, North, and Midwest regions. Conclusion: By analyzing the availability of courses that emphasize aging and Geriatrics in brazilian medical schools, the present study reveals that specialized training should be encouraged with respect to the specificities of health care given to the elderly population, which has a higher frequency of chronic and degenerative diseases.

  16. Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition.

    Science.gov (United States)

    Cunha, Ana Conceição Norbim Prado; Cunha, Natália Norbim Prado; Barbosa, Maira Tonidandel

    2016-04-01

    This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC) were found, as seen on the MEC website (www.emec.mec.gov.br) in February 2013. Based on the list of institutions, the authors created a database. Brazil's Southeast region is the one presenting most of the courses, both offered as core or elective subjects, in the area of Geriatrics. The Midwest region had the least offer of Geriatrics and Elderly Health and Care courses. The Southeast region presents the greater absolute number of institutions with elective subjects, followed by the South and Northeast regions, each with a single institution. The Southeast region was at the same time the one that presented the biggest absolute number of institutions offering core subjects in the area of Geriatrics, being followed by the Northeast, South, North, and Midwest regions. By analyzing the availability of courses that emphasize aging and Geriatrics in brazilian medical schools, the present study reveals that specialized training should be encouraged with respect to the specificities of health care given to the elderly population, which has a higher frequency of chronic and degenerative diseases.

  17. Malnutrition upon Hospital Admission in Geriatric Patients: Why Assess It?

    Directory of Open Access Journals (Sweden)

    Paolo Orlandoni

    2017-10-01

    Full Text Available ObjectiveTo assess the prevalence of malnutrition according to the new ESPEN definition in a population of geriatric hospital patients and to determine how malnutrition affects the length of hospital stay (LOS and hospital mortality.DesignA retrospective analysis of data gathered during nutritional screening surveys carried out three consecutive years, from 2012 to 2014, in an Italian geriatric research hospital (INRCA, Ancona was performed. On the day of the study, demographic data, data on clinical conditions and the nutritional status of newly admitted patients were collected. Patients were screened for malnutrition risk using the Malnutrition Universal Screening Tool (MUST. Subsequently, malnutrition was diagnosed, for subjects at high risk, following the criteria suggested by the European Association for Clinical Nutrition and Metabolism [body mass index (BMI < 18.5 kg/m2 or different combinations of unintentional weight loss over time and BMI values]. Sensitivity, specificity, positive and negative predictive value of MUST compared to ESPEN criteria were assessed. The characteristics of patients with a diagnosis of malnutrition were compared to those of non-malnourished patients. The impact of malnutrition on LOS and hospital mortality was investigated through logistic and linear regression models.SettingThe study was performed in an Italian geriatric research hospital (INRCA, Ancona.SubjectsTwo hundred eighty-four newly hospitalized geriatric patients from acute care wards (mean age 82.8 ± 8.7 years, who gave their written consent to participate in the study, were enrolled.ResultsAccording to the MUST, high risk of malnutrition at hospitalization was found in 28.2% of patients. Malnutrition was diagnosed in 24.6% of subjects. The malnutrition was an independent predictor of both the LOS and hospital mortality. The multivariate analyses—linear and logistic regression—were performed considering different potential

  18. Geriatric medical education in Louisiana: current status and future needs.

    Science.gov (United States)

    Cefalu, Charles A

    2002-01-01

    Despite the impending explosion in the size of American's elderly population, physicians remain undertrained in geriatric medicine. In Louisiana, this training is especially important for the family physician and internist, many of whom practice primarily in rural areas and carry the bulk of nursing home patient care on their shoulders. Louisiana's medical schools offer little in the way of training in geriatric medicine, despite the author's finding that there is a strong interest for such training among practitioners and residents. Meanwhile, at the national level, leaders in geriatric medicine are working to develop new ways to encourage participation in geriatric educational opportunities.

  19. Multimorbidity Patterns in Hospitalized Older Patients: Associations among Chronic Diseases and Geriatric Syndromes.

    Science.gov (United States)

    Clerencia-Sierra, Mercedes; Calderón-Larrañaga, Amaia; Martínez-Velilla, Nicolás; Vergara-Mitxeltorena, Itziar; Aldaz-Herce, Pablo; Poblador-Plou, Beatriz; Machón-Sobrado, Mónica; Egüés-Olazabal, Nerea; Abellán-van Kan, Gabor; Prados-Torres, Alexandra

    2015-01-01

    The clinical status of older individuals with multimorbidity can be further complicated by concomitant geriatric syndromes. This study explores multimorbidity patterns, encompassing both chronic diseases and geriatric syndromes, in geriatric patients attended in an acute hospital setting. Retrospective observational study. Unit of Social and Clinical Assessment (UVSS), Miguel Servet University Hospital (HUMS), Zaragoza (Spain). Year, 2011. A total of 924 hospitalized patients aged 65 years or older. Data on patients' clinical, functional, cognitive and social statuses were gathered through comprehensive geriatric assessments. To identify diseases and/or geriatric syndromes that cluster into patterns, an exploratory factor analysis was applied, stratifying by sex. The factors can be interpreted as multimorbidity patterns, i.e., diseases non-randomly associated with each other within the study population. The resulting patterns were clinically assessed by several physicians. The mean age of the study population was 82.1 years (SD 7.2). Multimorbidity burden was lower in men under 80 years, but increased in those over 80. Immobility, urinary incontinence, hypertension, falls, dementia, cognitive decline, diabetes and arrhythmia were among the 10 most frequent health problems in both sexes, with prevalence rates above 20%. Four multimorbidity patterns were identified that were present in both sexes: Cardiovascular, Induced Dependency, Falls and Osteoarticular. The number of conditions comprising these patterns was similar in men and women. The existence of specific multimorbidity patterns in geriatric patients, such as the Induced Dependency and Falls patterns, may facilitate the early detection of vulnerability to stressors, thus helping to avoid negative health outcomes such as functional disability.

  20. Multimorbidity Patterns in Hospitalized Older Patients: Associations among Chronic Diseases and Geriatric Syndromes.

    Directory of Open Access Journals (Sweden)

    Mercedes Clerencia-Sierra

    Full Text Available The clinical status of older individuals with multimorbidity can be further complicated by concomitant geriatric syndromes. This study explores multimorbidity patterns, encompassing both chronic diseases and geriatric syndromes, in geriatric patients attended in an acute hospital setting.Retrospective observational study.Unit of Social and Clinical Assessment (UVSS, Miguel Servet University Hospital (HUMS, Zaragoza (Spain. Year, 2011.A total of 924 hospitalized patients aged 65 years or older.Data on patients' clinical, functional, cognitive and social statuses were gathered through comprehensive geriatric assessments. To identify diseases and/or geriatric syndromes that cluster into patterns, an exploratory factor analysis was applied, stratifying by sex. The factors can be interpreted as multimorbidity patterns, i.e., diseases non-randomly associated with each other within the study population. The resulting patterns were clinically assessed by several physicians.The mean age of the study population was 82.1 years (SD 7.2. Multimorbidity burden was lower in men under 80 years, but increased in those over 80. Immobility, urinary incontinence, hypertension, falls, dementia, cognitive decline, diabetes and arrhythmia were among the 10 most frequent health problems in both sexes, with prevalence rates above 20%. Four multimorbidity patterns were identified that were present in both sexes: Cardiovascular, Induced Dependency, Falls and Osteoarticular. The number of conditions comprising these patterns was similar in men and women.The existence of specific multimorbidity patterns in geriatric patients, such as the Induced Dependency and Falls patterns, may facilitate the early detection of vulnerability to stressors, thus helping to avoid negative health outcomes such as functional disability.

  1. Multidimensional Geriatric Prognostic Index, Based on a Geriatric Assessment, for Long-Term Survival in Older Adults in Korea.

    Directory of Open Access Journals (Sweden)

    Hee-Won Jung

    Full Text Available The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH. The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1% and 340 SNUBH patients (30.7% died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital.

  2. Aging and decreased glomerular filtration rate: An elderly population-based study.

    Directory of Open Access Journals (Sweden)

    Regina C R M Abdulkader

    Full Text Available Although a reduced glomerular filtration rate (GFR in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases.This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging], a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when 0.20 g/g.The prevalence of GFR <60 mL/min/1.73m2 was 19.3%. Individuals with GFR <60 mL/min/1.73m2 were older (75±1 versus 69±1 years, p<0.001, had lower schooling (18 versus 30% with complete 8-year basic cycle, p = 0.010, and higher prevalence of hypertension (82 versus 63%, p<0.001, diabetes (34 versus 26%, p = 0.021, cardiovascular disease (43 versus 24%, p<0.001 and kidney damage (35% versus 15%, p<0.001. Only 0.7% of the entire studied population had GFR <60 mL/min/1.73m2 without simultaneous diseases or kidney damage. Among the individuals with GFR <60 mL/min/1.73m2, 3.5% had neither renal damage nor associated comorbidities, whereas among those with GFR ≥60 mL/min/1.73m2, 11.0% had none of these conditions. Logistic regression showed that older age, cardiovascular disease and hypertension were associated with GFR<60 mL/min/1.73m2.Decreased GFR was highly prevalent among the geriatric population in a megalopolis of a developing country. It was rarely present without simultaneous chronic comorbidities or kidney damage.

  3. Mobility and quality of life after discharge from a clinical geriatric setting focused on gender and age.

    Science.gov (United States)

    Strupeit, Steve; Wolf-Ostermann, Karin; Buss, Arne; Dassen, Theo

    2014-01-01

    The purpose of this study was to assess the long-term functional status and quality of life of older individuals with functional mobility impairment. A prospective longitudinal study was conducted. The study sample consisted of elderly patients who had been admitted to a rehabilitation facility in Hamburg, Germany. Data were collected from February 2008 to August 2009 in the rehabilitation center and the living environment of the participants after discharge. Quality of life was assessed using the WHO Quality of Life-BREF; activities of daily living were measured using the Barthel-Index (BI). Functional status and overall quality of life increased from admission (BI = 73.33) to 6 months postadmission (BI = 89.29) but decreased at 12 months postadmission (BI = 85.71). Quality of life significantly increased in the psychological domain from admission (57.85) to 6 months follow-up (67.85) (p = .010). Men showed a better functional status over time (p = .010) than women. Higher quality of life scores were associated with higher MMSE (p = .031) and self-efficacy scores (p = .019) at admission. The findings of this study suggest a need for interventions to improve functional status and quality of life in this population, especially following 6 months after discharge. Special interventions should address physical quality of life and physical functioning. Gender differences should be considered in planning and implementing programs. © 2013 Association of Rehabilitation Nurses.

  4. Skin Cancer Epidemics in the Elderly as An Emerging Issue in Geriatric Oncology.

    Science.gov (United States)

    Garcovich, Simone; Colloca, Giuseppe; Sollena, Pietro; Andrea, Bellieni; Balducci, Lodovico; Cho, William C; Bernabei, Roberto; Peris, Ketty

    2017-10-01

    Skin cancer is a worldwide, emerging clinical need in the elderly white population, with a steady increase in incidence rates, morbidity and related medical costs. Skin cancer is a heterogeneous group of cancers comprising cutaneous melanoma and non-melanoma skin cancers (NMSC), which predominantly affect elderly patients, aged older than 65 years. Melanoma has distinct clinical presentations in the elderly patient and represents a challenging question in terms of clinical management. NMSC includes the basal cell carcinoma and cutaneous squamous cell carcinoma and presents a wide disease spectrum in the elderly population, ranging from low-risk to high-risk tumours, advanced and inoperable disease. Treatment decisions for NMSC are preferentially based on tumour characteristics, patient's chronological age and physician's preferences and operational settings. Several treatment options are available for NMSC, from surgery to non-invasive/medical therapies, but patient-based factors, such as geriatric comorbidities and patient's life expectancy, do not frequently modulate treatment goals. In melanoma, age-related variations in clinical management are significant and may frequently lead to under-treatment, limiting access to advanced surgical and medical treatments. Clinical decision-making in the care of elderly skin cancer patient should ideally implement a geriatric assessment, prioritizing patient-based factors and efficiently differentiating fit from frail cancer patients. Current clinical practice guidelines for NMSC and melanoma only partially address geriatric aspects of cancer care, such as frailty, limited life-expectancy, geriatric comorbidities and treatment compliance. We review the recent evidence on the scope and problem of skin cancer in the elderly population as well as age-related variations in its clinical management, highlighting the potential role of a geriatric approach in optimizing dermato-oncological care.

  5. Aging-From molecules to populations

    DEFF Research Database (Denmark)

    Sander, Miriam; Avlund, Kirsten; Lauritzen, Martin

    2008-01-01

    life environmental factors influence aging-associated physical and cognitive decline? To what extent and by what mechanism does the social environment influence life course outcomes? What physiological factors underlie the timing and extent of aging-associated physical and cognitive decline? How do...... cultural stereotypes and perceptions of aging influence the process and experience of aging? One of the primary outcomes of the workshop was a recognition that cross-disciplinary studies and "out-of-the-box" approaches, especially those that adopt an integrated life course perspective on human health......-related cognitive decline to pathological cognitive decline associated with neurological disease? Are human progeriod diseases, characterized by premature aging, good models for "normal" human aging? Is delayed or "elite" aging informative about "normal" human aging? To what extent and by what mechanisms do early...

  6. Visualising the demographic factors which shape population age structure

    Directory of Open Access Journals (Sweden)

    Tom Wilson

    2016-09-01

    Full Text Available Background: The population pyramid is one of the most popular tools for visualising population age structure. However, it is difficult to discern from the diagram the relative effects of different demographic components on the size of age-specific populations, making it hard to understand exactly how a population's age structure is formed. Objective: The aim of this paper is to introduce a type of population pyramid which shows how births, deaths, and migration have shaped a population's age structure. Methods: Births, deaths, and population data were obtained from the Human Mortality Database and the Australian Bureau of Statistics. A variation on the conventional population pyramid, termed here a components-of-change pyramid, was created. Based on cohort population accounts, it illustrates how births, deaths, and net migration have created the population of each age group. A simple measure which summarises the impact of net migration on age structure is also suggested. Results: Example components-of-change pyramids for several countries and subnational regions are presented, which illustrate how births, deaths, and net migration have fashioned current population age structures. The influence of migration is shown to vary greatly between populations. Conclusions: The new type of pyramid aids interpretation of a population's age structure and helps to understand its demographic history over the last century.

  7. Predicting Successful Aging in a Population-Based Sample of Georgia Centenarians

    Directory of Open Access Journals (Sweden)

    Jonathan Arnold

    2010-01-01

    Full Text Available Used a population-based sample (Georgia Centenarian Study, GCS, to determine proportions of centenarians reaching 100 years as (1 survivors (43% of chronic diseases first experienced between 0–80 years of age, (2 delayers (36% with chronic diseases first experienced between 80–98 years of age, or (3 escapers (17% with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%, while those at risk for cardiovascular disease tended to be survivors (24%, delayers (39%, or escapers (32%. Approximately half (43% of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life.

  8. Predicting Successful Aging in a Population-Based Sample of Georgia Centenarians

    Science.gov (United States)

    Arnold, Jonathan; Dai, Jianliang; Nahapetyan, Lusine; Arte, Ankit; Johnson, Mary Ann; Hausman, Dorothy; Rodgers, Willard L.; Hensley, Robert; Martin, Peter; MacDonald, Maurice; Davey, Adam; Siegler, Ilene C.; Jazwinski, S. Michal; Poon, Leonard W.

    2010-01-01

    Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0–80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80–98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life. PMID:20885919

  9. Population Ageing, Retirement Age Extension and Economic Growth in China A Dynamic General Equilibrium Analysis

    OpenAIRE

    Xiujian Peng; Yinhua Mai

    2013-01-01

    China is experiencing rapid population ageing with the proportion of the population aged 65 and above projected to increase almost threefold between 2010 and 2050. The growth of the working age population is expected to stop approximately in 2015 and to turn strongly negative. China's low retirement age compounds the ageing problem. One means to mitigate the negative effects of shrinking labour force on economic growth is to stimulate labour force participation among the current working age p...

  10. Factores de riesgo de accidentes en la edad geriátrica Risk factors for accidents in geriatric age

    Directory of Open Access Journals (Sweden)

    Manolo Gómez Juanola

    2004-12-01

    Full Text Available Se realizó un estudio prospectivo, longitudinal y descriptivo con elementos analíticos, para evaluar los factores de riesgo de accidentes en los ancianos, durante el período de julio 2000 a junio 2001. La muestra quedó conformada por un universo de 101 gerontes, de los consultorios médicos 13 y 32, del municipio Mantua. Se aplicó el cálculo porcentual y X2 con nivel de ajuste ed a = 0,01 y a = 0,05. Dentro de los factores ambientales, en el área urbana predominaron: piso del baño deslizante (pA prospective, longitudinal and descriptive study was conducted with analytical elements to evaluate the risk factors for accidents in the elderly from July 2000 to June 2001.The sample was composed of 101 aged individuals from the family physicians' offices 13 and 32, in Mantua municipality. The percentage calculation and X2 with a level of adjustment of a = 0.01 and a = 0.05 were applied. The following environmental factors predominated in the urban area: slipping bathroom floor (p 0.01, cooker of an inadequate height (p 0.05, polished floors, changing furniture, propping, filtrations and inadequate shoes (p 0.01. Lamp or switch away from the bed, bathroom away from the bedroom and absence of shower curtains, unlevel/irregular floor, furniture in bad state, deficient lighting, poorly protected electrical sources and circulation of pets (p 0.01 prevailed in the rural area. The most common physiological risks were: pluripathology/polypharmacy and degenerative arthropathy as a cause of balance alterations and walking, respectively. They prevailed in females (p 0.05. Congestive heart failure, ischemic heart disease and cervical osteoarthritits predominated among the most frequent diseases in the females (p 0.05. 43.5 % of the males took only one drug. Sedatives (50-59 % were the most used drugs. 59.40 % of the elderly were evaluated as low risk for accidentality.

  11. Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.

    Science.gov (United States)

    Southerland, Lauren T; Gure, Tanya R; Ruter, Daniel I; Li, Michael M; Evans, David C

    2017-08-01

    The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n = 94) to those who did not (n = 103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, P quality indicators is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The Filipino Nursing Students' Dilemmas in Geriatric Care

    Science.gov (United States)

    de Guzman, Allan B.; Cruz, Andrei Angelo R.; Cruz, Angela Laurice G.; Cruz, Robert Edward D.; Cuarto, Jose Mari Nino L.

    2009-01-01

    The continually rising percentage of the elderly population and the demand for geriatric nursing care are dramatically related. While it is true that most undergraduate programs prepare nurses for the care of geriatric patients, most receive limited academic preparation in the nursing curriculum (Williams & Mezey, 2000). This is particularly…

  13. Examination of the Philadelphia Geriatric Morale Scale as a Subjective Quality-of-Life Measure in Elderly Hong Kong Chinese

    Science.gov (United States)

    Wong, Eric; Woo, Jean; Hui, Elsie; Ho, Suzanne C.

    2004-01-01

    Purpose: We examine the psychometric properties of the Philadelphia Geriatric Morale Scale (PGMS) in an elderly Chinese population in Hong Kong. Design and Methods: The study consisted of two cohorts: (a) 759 participants aged 70 years and older living in the community who were recruited as part of a territory-wide health survey and interviewed in…

  14. The growth of gerontology and geriatrics in Mexico: Past, present, and future.

    Science.gov (United States)

    Rivera-Hernandez, Maricruz; Flores Cerqueda, Sergio; García Ramírez, José Carlos

    2017-01-01

    Life expectancy is increasing in Mexico, creating new opportunities and challenges in different areas, including gerontology and geriatric education and research. Although in the European Union there are more than 3,000 institutions that focus on aging research, in Latin America there are only 250 programs where theoretical and practical knowledge is taught. In Mexico, the number of institutions that offer gerontology and geriatric education is relatively small. One of the major concerns is that Mexico is not adequately prepared to optimally deal with the aging of its population. Thus, the main challenge that Mexico faces is to train practitioners, researchers, and policy makers to be able to respond to the aging priorities of this country. The goal of this review is to investigate the literature regarding 60 years in the fields of gerontology and geriatrics in Mexico. Even when programs have evolved within the past decades, there are some challenges to gerontological and geriatric education and aging research in Mexico. The implications for Mexico are discussed, as well as opportunities for moving these fields forward.

  15. Forging a Frailty-Ready Healthcare System to Meet Population Ageing

    Directory of Open Access Journals (Sweden)

    Wee Shiong Lim

    2017-11-01

    Full Text Available The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization’s World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG and the Alexandra Health System (AHS to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy (“living well”, the well unhealthy (“living with illness”, the unwell unhealthy (“living with frailty”, and the end-of-life (EoL (“dying well”. For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as “wellness kampungs” and “share-a-pot”. A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members

  16. Decomposition of regional convergence in population aging across Europe

    NARCIS (Netherlands)

    Kashnitsky, I.; de Beer, J.A.A.; van Wissen, L.J.G.

    2017-01-01

    In the face of rapidly aging population, decreasing regional inequalities in population composition is one of the regional cohesion goals of the European Union. To our knowledge, no explicit quantification of the changes in regional population aging differentiation exist. We investigate how regional

  17. [Geriatrics or geriatricization of medicine : Quo vadis geriatrics?

    Science.gov (United States)

    Kolb, G F

    2017-12-01

    This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence. This certainly includes the increasing acquisition of decentralized joint treatment concepts and geriatric counselling services in the future, in addition to the classical assessment instruments. Keywords in association with this are: traumatology and othopedics of the elderly, geriatric neurology and geriatric oncology. Interdisciplinary geriatric expertise is increasingly being requested. Outpatient structures have so far not been prioritized in geriatrics. An independent research is under construction and it is gratifying that academic interest in geriatrics seems to be increasing and new professorial chairs have been established. It is not possible to imagine our hospital without geriatrics; however, there is still a certain imbalance between the clearly increased number of geriatric hospital beds, the representation of geriatrics in large hospitals (e.g. specialized and maximum care hospitals and university clinics), the secure establishment in further education regulations and the lack of a uniform nationwide concept of geriatrics.

  18. Psychometric Properties of the Malay Version of the Loewenstein Occupational Therapy Cognitive Assessment for Geriatrics (M-LOTCA-G) among the Malaysian Elderly Population

    Science.gov (United States)

    Mohd Natar, Ahmad Kamal; Nagappan, Rajendran; Ainuddin, Husna Ahmad; Masuri, Ghazali; Thanapalan, Chandra Kannan K.

    2015-01-01

    Current cognitive screening tests are difficult to use due to their deficit in cultural and conceptual significance and translation into other languages. The purpose of this study was to translate the Loewenstein Occupational Therapy Cognitive Assessment for Geriatrics (LOTCA-G) into Malay language and test its reliability and validity for…

  19. A STUDY ESTABLISHING THE IMPORTANCE OF BODY COMPOSITION ANALYSIS, REGULAR PHYSIOTHERAPY AND DIETARY MODIFICATIONS FOR INDEPENDENT AND HEALTHY LIVING AMONG GERIATRIC POPULATION: A DETAILED SYSTEMATIC REVIEW ARTICLE

    OpenAIRE

    Rohit Subhedar; R. K. Sinha; Saumi Sinha

    2015-01-01

    Background: This systematic review article aims towards comprehensive and elaborative collection of research articles related to the importance of body composition analysis, Physiotherapy and nutrition for independent geriatric lifestyle. The review article includes articles which suggest the importance of Body composition analysis, Physiotherapy interventions, specific exercises and a combination of fat free, fiber, fruit and fluid diet. Methods: A comprehensive electronic search was cond...

  20. [Renal cell carcinoma in older and geriatric patients].

    Science.gov (United States)

    Wagener, N

    2017-08-01

    Renal cell carcinoma (RCC) is a disease of older humans. Due to increased detection of tumours by ultrasound and computed tomography, the number of incidentally diagnosed RCCs has increased. These tumours are usually smaller and of lower stage. Furthermore, there is an increase of older people in the population. Characteristics of tumour biology, prognosis, diagnostics and therapy of localized, advanced and metastatic RCC in old and geriatric patients are provided. Systematic literature review, analysis and discussion of original research articles and expert opinions. The surgical treatment of RCC in old and geriatric patients requires attention to increased morbidity and mortality. Active surveillance or ablations are alternatives to surgical treatment in localized RCC. Systemic therapy in metastatic tumours exhibit analogous efficacy with slightly worse toxicity. RCC in old and geriatric patients requires an adaptation of classic therapeutic strategies. Management should be adjusted individually to age and comorbidities. Efficacy, risk and toxicity of all therapeutic options should be considered. A multidisciplinary approach is important for diagnosis, assessment and therapy. Recommendations should be discussed with patients and their relatives according to the individual needs, and treatment decisions should be based on patient preferences wherever possible.

  1. Disease prevalence in geriatric horses in the United Kingdom: veterinary clinical assessment of 200 cases.

    Science.gov (United States)

    Ireland, J L; Clegg, P D; McGowan, C M; McKane, S A; Chandler, K J; Pinchbeck, G L

    2012-01-01

    Geriatric horses (aged ≥ 15 years) represent a substantial proportion of the equine population, yet few studies have investigated the prevalence of diseases within this population in the UK. To describe the findings of veterinary clinical examination of 200 geriatric horses and ponies in north west England and north Wales, and to assess the effect of animal age and type (horse or pony) on the presence or absence of clinical signs and veterinary diagnosed health problems. From responses to a cross-sectional postal questionnaire survey of owners of geriatric horses (n = 918/1144), 200 horses were randomly selected to receive a veterinary clinical examination covering the major body systems. Twenty-six percent of animals were overweight (body condition score, BCS, >3/5) and 4.5% were underweight (BCS assessed at walk, 18.6% were lame on at least one limb, while 50.5% were lame in trot. The majority of animals (83.5%) had a reduction in range of motion in at least one joint. Eighty percent of animals had hoof abnormalities. Dental abnormalities were identified in 95.4% of animals, with cheek teeth diastemata, excessive wear/cupped out teeth and focal overgrowths the most frequently identified conditions. This study has identified many prevalent clinical signs of disease in geriatric horses. Description of the most prevalent health problems and further identification of risk factors for these conditions will aid in targeted improvements in veterinary care, owner education and welfare. © 2011 EVJ Ltd.

  2. Comprehensive geriatric assessment and its clinical impact in oncology.

    Science.gov (United States)

    Maas, Huub A A M; Janssen-Heijnen, Maryska L G; Olde Rikkert, Marcel G M; Machteld Wymenga, A N

    2007-10-01

    Comprehensive geriatric assessment (CGA) is a process that consists of a multidimensional data-search and a process of analyzing and linking patient characteristics creating an individualized intervention-plan, carried out by a multidisciplinary team. In general, the positive health care effects of CGA are established, but in oncology both CGA and the presence of geriatric syndromes still have to be implemented to tailor oncological therapies to the needs of elderly cancer patients. In this paper the conceptualization of geriatric syndromes, their relationship to CGA and results of clinical studies using CGA in oncology are summarized. Geriatric syndromes are associated with increased vulnerability and refer to highly prevalent, mostly single symptom states (falls, incontinence, cognitive impairment, dizziness, immobility or syncope). Multifactorial analysis is common in geriatric syndromes and forms part of the theoretical foundation for using CGA. In oncology patients, we reviewed the value of CGA on the following endpoints: recognition of health problems, tolerance to chemotherapy and survival. Most studies performed CGA to identify prognostic factors and did not include an intervention. The ability of CGA to detect relevant health problems in an elderly population is reported consistently but no randomized studies are available. CGA should explore the pre-treatment presence of (in)dependence in Instrumental Activities of Daily Living (IADL), poor or moderately poor quality of life, depressive symptoms and cognitive decline, and thereby may help to predict survival. However, if scored by the Charlson comorbidity-index, comorbidities are not convincingly related to survival. The few studies that included a CGA-linked intervention show inconsistent results with regard to survival but compared to usual care quality of life is improved in the surviving period. Functional performance scores and dependency at home appeared to be independent predictive factors for

  3. Ageing and longevity in Volga region population

    Directory of Open Access Journals (Sweden)

    Denisova T.P.

    2012-06-01

    Full Text Available The results of complete clinical and demographic investigation of Volga Region population of long-livers have been presented. Anthropologic, social, clinical, laboratory and instrumental markers of longevity have been determined.

  4. Population Aging: An Emerging Research Agenda for Sustainable Development

    Directory of Open Access Journals (Sweden)

    Shogo Kudo

    2015-10-01

    Full Text Available In recent years, population aging has been recognized as an emerging challenge in many parts of the world. Earlier studies discussed its impacts on the sustainability of social security systems and national economic growth; however, they tended to focus on the issues at the national level and were limited to developed countries. With the knowledge that population aging will be a predominant trend in both developed and developing countries, this paper aims to: (i describe the global population aging trend and its regional demography; (ii provide a structural review of population aging challenges at the national, communal and individual levels; and (iii elaborate future research topics on population aging with a particular emphasis on developing countries. Several indicators suggest rapid population aging in the coming decades, especially in Asia, Latin America and Africa. The structural review presents the diverse challenges that affect both young and older population groups. Finally, the need for linking population aging with the sustainable development concept and the possible rural decline caused by rapid urbanization are suggested as future research topics. Further studies to establish a body of knowledge on population aging in developing countries are required to place population aging on the agenda of future sustainable development discussions.

  5. [Assessment of nursing needs and risk management in geriatric oncology].

    Science.gov (United States)

    Taleb, Cherifa; Landre, Thierry; Bertrand, Eric; Schlatter, Joël; Ratiney, Robert; des Guetz, Gaëtan

    2013-01-01

    In France, the incidence and rate of mortality of cancer increase with age. For elderly patients suffering from cancer, the standard geriatric assessment, together with an oncological assessment aims to optimise the treatment. This geriatric oncology assessment enables the priorities to be identified and the cancer treatment to be adapted by anticipating the risks and organising the support care.

  6. Structured nursing intervention to geriatric patients discharged from Emergency Department

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie

    2010-01-01

    the nurse made relevant referrals to geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Results: 150 geriatric patients participated, mean age 81.7 (70-99). At discharge they had in mean 2 (0-9) unresolved problems, after 1 month 0.8 (0-5), and after 6...

  7. Population Matters Policy Brief: Preparing foran Aging World

    National Research Council Canada - National Science Library

    2001-01-01

    The world's population is aging at an accelerated rate. Declining fertility rates combined with steady improvements in life expectancy over the latter half of the 20th century have produced dramatic growth in the world's elderly population...

  8. Population Matters Policy Brief. Preparing for an Aging World

    National Research Council Canada - National Science Library

    2001-01-01

    The world's population is aging at an accelerated rate. Declining fertility rates combined with steady improvements in life expectancy over the latter half of the 20th century have produced dramatic growth in the world's elderly population...

  9. The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer

    Science.gov (United States)

    Buurman, Bianca M.; van Munster, Barbara C.; Kuper, Ingeborg M.J.A.; Smorenburg, Carolien H.; de Rooij, Sophia E.

    2011-01-01

    Introduction. A comprehensive geriatric assessment systematically collects information on geriatric conditions and is propagated in oncology as a useful tool when assessing older cancer patients. Objectives. The objectives were: (a) to study the prevalence of geriatric conditions in cancer patients aged ≥65 years, acutely admitted to a general medicine ward; (b) to determine functional decline and mortality within 12 months after admission; and (c) to assess which geriatric conditions and cancer-related variables are associated with 12-month mortality. Methods. This was an observational cohort study of 292 cancer patients aged ≥65 years, acutely admitted to the general medicine and oncology wards of two university hospitals and one secondary teaching hospital. Baseline assessments included patient characteristics, reason for admission, comorbidity, and geriatric conditions. Follow-up at 3 and 12 months was aimed at functional decline (loss of one or more activities of daily living [ADL]) and mortality. Results. The median patient age was 74.9 years, and 95% lived independently; 126 patients (43%) had metastatic disease. A high prevalence of geriatric conditions was found for instrumental ADL impairment (78%), depressive symptoms (65%), pain (65%), impaired mobility (48%), malnutrition (46%), and ADL impairment (38%). Functional decline was observed in 8% and 33% of patients at 3 and 12 months, respectively. Mortality rates were 38% at 3 months and 64% at 12 months. Mortality was associated with cancer-related factors only. Conclusion. In these acutely hospitalized older cancer patients, mortality was only associated with cancer-related factors. The prevalence of geriatric conditions in this population was high. Future research is needed to elucidate if addressing these conditions can improve quality of life. PMID:21914699

  10. China: awakening giant developing solutions to population aging.

    Science.gov (United States)

    Zhang, Ning Jackie; Guo, Man; Zheng, Xiaoying

    2012-10-01

    As the world's most populous country with the largest aging population and a rapidly growing economy, China is receiving increased attention from both the Chinese government and the governments of other countries that face low fertility and aging problems. This unprecedented shift of demographic structure has repercussions for many aspects of development including economic growth, social welfare, elder care, and other public welfare issues in China. Balancing population aging and economic growth requires innovative strategies and represents both challenges and opportunities for China.

  11. Incidence Rate of Concomitant Systemic Diseases in the Aging Population with Postmenopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    Selçuk Sayılır

    2016-08-01

    Full Text Available Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

  12. Population genomics of Bronze Age Eurasia

    Czech Academy of Sciences Publication Activity Database

    Allentoft, M. E.; Sikora, M.; Sjogren, K.-G.; Rasmussen, S.; Rasmussen, M.; Stenderup, J.; Damgaard, P. B.; Schroeder, H.; Ahlström, T.; Vinner, L.; Malaspinas, A.-S.; Margaryan, A.; Higham, T.; Chivall, D.; Lynnerup, N.; Harvig, L.; Baron, J.; Della Casa, P.; Dabrowski, P.; Duffy, P. R.; Ebel, A. V.; Epimakhov, A.; Frei, K.; Furmanek, M.; Gralak, T.; Gromov, A.; Gronkiewicz, S.; Grupe, G.; Hajdu, T.; Jarysz, R.; Khartanovich, V.; Khokhlov, A.; Kiss, V.; Kolář, Jan; Kriiska, A.; Lasak, I.; Lonhgi, C.; McGlynn, G.; Merkevicius, A.; Merkyte, I.; Metspalu, M.; Mkrtchyan, R.; Moiseyev, V.; Paja, L.; Pilli, G.; Pokutta, D.; Pospieszny, L.; Price, D.; Saag, L.; Sablin, M.; Shishlina, N.; Smrčka, V.; Soenov, V. I.; Szeverenyi, V.; Tóth, G.; Trifanova, S. V.; Varul, L.; Vicze, M.; Yepiskoposyan, L.; Zhitenev, L.; Orlando, L.; Sicheritz-Ponten, T.; Brunak, S.; Nielsen, R.; Kristiansen, K.; Willerslev, E.

    2015-01-01

    Roč. 522, č. 7555 (2015), s. 167-172 ISSN 0028-0836 Institutional support: RVO:67985939 Keywords : genetics * migration * Bronze Age Subject RIV: AC - Archeology, Anthropology, Ethnology Impact factor: 38.138, year: 2015

  13. [Health care expenditures and the aging population].

    Science.gov (United States)

    Felder, S

    2012-05-01

    The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.

  14. Green sea turtle age, growth, population characteristics

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Morphology, sex ratio, body condition, disease status, age structure, and growth patterns were characterized for 448 green sea turtles cold stunned in St. Joseph...

  15. Association of Geriatric Syndromes with Malnutrition Among Elderly

    Directory of Open Access Journals (Sweden)

    Arun Srinivaasan Soundararajan

    2017-05-01

    Full Text Available Background: Malnutrition is a serious and frequent condition among older adults. However, older adults are poorly assessed for malnutrition although it is not an uncommon problem in this population. Age related decline in food intake, is associated with various psychological, physiological, and social problems. Aims: The study was aimed to conduct more comprehensive nutritional assessment tests among malnourished and among normal elders to assess other geriatric syndromes and to investigate the association of geriatric syndromes with malnutrition. Methods and Material: An earlier community survey was conducted at the urban field practice area of PSG Institute of Medical Sciences and Research, Coimbatore on 154 households and 190 elders aged 60 years and above were interviewed. Malnutrition was assessed using mini nutritional assessment test (MNA in which 37 were found to be malnourished, 47 were found to be at risk of malnutrition and 106 were found to be normal. The present cross sectional study included 30 malnourished elders and 30 normal elders randomly selected from this population. The geriatric syndromes were assessed and compared between malnourished and normal. Results: It was observed that, the presence of visual disturbances (86.71% vs. 53.3% x2 =7.937, P<0.01, dizziness, (60.0% vs. 16.7% x2 =7.937, P<0.01, hearing loss (40.0% vs. 10.0% x2 =7.200, P<0.01, dementia, (30.01% vs. 3.3% x2 =7.680, P<0.01 and depression (60.0% vs.13.8% x2 =13.464, P<0.01 were significantly higher in malnourished compared to normal elderly. The functional dependence mean + standard deviation (for GUGT (2.16+0.83 vs. 1.36+0.49 t=4.530 P<0.001 and Barthel index (83.50+12.18 vs. 90.66+6.91 t=2.801 P<0.01 were also significantly different between malnourished and normal elderly. Conclusion: The presence of various geriatric syndromes was significantly higher in malnourished elderly compared to normal. Thus, the interventional programs for malnutrition among

  16. Frailty profile for geriatric patients in outpatient clinic of RSUP H. Adam Malik Medan

    Science.gov (United States)

    Permatasari, T. D.; Sihombing, B.; Arianto, P.

    2018-03-01

    Frailty is a circumstance of increased vulnerability to bad resolution of homeostasis after a stressor occasion, which increases the risk of adverse outcomes. Early detection of frailty in elderly patients is a must but is rarely in the Geriatric Outpatient settings. We conducted a study to see the frailty profile for geriatric patients in the outpatient clinic of RSUP H. Adam Malik Medan. A cross-sectional research with a descriptive method was in the Geriatric Outpatient Clinic of Adam Malik Hospital from July-September 2016. The population of this study was patients from the Geriatric Outpatient Clinic, and sampling was by using consecutive methods. Samples were by questionnaires assessing (FRAIL Scale).This study was140 patients. Based on age, the age group of 81-90 years was dominantly frail (53.8%). Most of the subjects worked as government employees (109 subjects), and most of them were robust (42.2%). Based on income, both groups were dominated by robust (38.3% and 41.3%, respectively). Based on BMI, most were robust with underweight 33.5%, normoweight 37.8%, and obese 44.7%. Among the 140 patients, frailty was in the 27.1% of the subjects and the contributing factors were Age, Gender, and Obesity.

  17. The Flynn Effect and Population Aging

    Science.gov (United States)

    Skirbekk, Vegard; Stonawski, Marcin; Bonsang, Eric; Staudinger, Ursula M.

    2013-01-01

    Although lifespan changes in cognitive performance and Flynn effects have both been well documented, there has been little scientific focus to date on the net effect of these forces on cognition at the population level. Two major questions moving beyond this finding guided this study: (1) Does the Flynn effect indeed continue in the 2000s for…

  18. Why Does Population Aging Matter So Much for Asia? Population Aging, Economic Growth, and Economic Security in Asia

    OpenAIRE

    Lee, Sang-Hyop; Mason, Andrew; Park, Donghyun

    2011-01-01

    Asia as a whole is experiencing a rapid demographic transition toward older populations, though different countries are at different stages of this region- wide trend. We document Asia's aging population, describe the region's old-age support systems, and highlight the regional socioeconomic implications of the transition for those support systems. Aging populations present two fundamental challenges to Asian policymakers: (1) developing socioeconomic systems that can provide economic securit...

  19. Geriatric oncology: a clinical approach to the older patient with cancer.

    Science.gov (United States)

    Repetto, L; Venturino, A; Fratino, L; Serraino, D; Troisi, G; Gianni, W; Pietropaolo, M

    2003-05-01

    Due to the ageing of the population and the sharp increase in life expectancy, cancer in the older person has become an increasingly common problem in the Western world. Although several authors have stressed that elderly cancer patients deserve special attention as a target group for research efforts, older aged patients are still less likely to be offered participation in clinical trials. The cellular and molecular mechanisms regulating the physiological process of ageing and senescence are far from understood, although inflammation is likely to play an important role, at least in some cancers. In addition, the relationship between ageing and cancer risk is also far from understood. One of the most intriguing aspects of ageing is how different the ageing process is from person to person; the basis for this variation is largely unknown. Population-based studies and longitudinal surveys have shown that comorbidity and physical and mental functioning are important risk factors; thus, a meaningful assessment of comorbidity and disability should be implemented in clinical practice. Modern geriatrics is targeted towards patients with multiple problems. Such patients are not simply old, but are geriatric patients because of interacting psychosocial and physical problems. As a consequence, the health status of old persons cannot be evaluated by merely describing the single disease, and/or by measuring the response, or survival after treatment. Conversely, it is necessary to conduct a more comprehensive investigation of the 'functional status' of the aged person. A geriatric consultation provides a variety of relevant information and enables the healthcare team to manage the complexity of health care in the elderly; this process is referred to as the Comprehensive Geriatric Assessment (CGA). The use of CGA is now being introduced into oncological practice. The definition of frailty is still controversial and represents a major issue of debate in clinical geriatrics. As

  20. China: Awakening Giant Developing Solutions to Population Aging

    Science.gov (United States)

    Zhang, Ning Jackie; Guo, Man; Zheng, Xiaoying

    2012-01-01

    As the world's most populous country with the largest aging population and a rapidly growing economy, China is receiving increased attention from both the Chinese government and the governments of other countries that face low fertility and aging problems. This unprecedented shift of demographic structure has repercussions for many aspects of…

  1. Emotional geriatric care: a health worker development framework for advancing health care for the elderly

    Directory of Open Access Journals (Sweden)

    Nestor Asiamah

    2017-07-01

    Full Text Available The trend of population ageing is a critical global condition and is expected to impose dire socio-economic ramifications on populations in the near future. Its contribution to the global burden of disease is increasing, and the implications of this situation for the future are awe-inspiring. This paper draws from the researchers’ experience and relevant literature to recommend a framework that would guide the development and institutionalization of a specialized system of geriatric care, hereby called emotional geriatric care. The application of this framework by governments and health care organizations is expected to constantly improve care for the elderly as a way of gearing health care administration in response to ageing.

  2. American Association for Geriatric Psychiatry

    Science.gov (United States)

    ... Position Statements Publications Bookstore American Journal of Geriatric Psychiatry Legislative & Regulatory Agenda AAGP eNews (Members Only) Tools ... Funding Training Resources and Curricula For Clinicians >> Geriatric Psychiatry Identifier Webinar: Billing and Coding Consumer Material Clinical ...

  3. THE ROMANIAN POPULATION BY GENDER AND AGE GROUPS IN 2011

    Directory of Open Access Journals (Sweden)

    GR. P. POP

    2015-06-01

    Full Text Available The Romanian Population by Gender and Age Groups in 2011. Following the previous studies on the demographic characteristics of the Romanian population, ethnicity and religion, this study covers the geodemographic issues of gender and age groups. As compared to the previous studies, our analysis covers these major population features in strong connection with the numerical evolution of the population, strongly determined by the socioeconomic background before 1990 and afterwards. We used the official data of the census in 2011 provided by the National Institute of Statistics. In order to create a representative picture of the Romanian population by gender and age groups, we employed the data illustrating the state of these two indicators in tables and maps. As compared to the values registered in 1992, the Romanian population in 2011 registered a decrease of 11.79%, relatively balanced in terms of gender structure, the male population holding a share of 48.65% and the female population, a share of 51.35%. The age structure also reveals a relative balance between active adult population (56.32% and the young and old population, together holding a share of 43.68%. Spatially, the structure of the Romanian population by gender and age structure, show differences at county level and also at a larger scale.

  4. [Age estimation and age structure of Cycas fairylakea population in Shenzhen City].

    Science.gov (United States)

    Wang, Dian-Pei; Ji, Shu-Yi; Chen, Fei-Peng; Peng, Shao-Lin

    2007-03-01

    Based on the structural characteristics of Cycas trunk, including vegetative leaf base scars, sporophyll concave rings, and average occurrence probabilities of vegetative leaf and sporophyll, a method for the age estimation of Cycas fairylakea population was developed, and the age of each individual was calculated. Three approaches, i.e., age structure diagram, age distribution curve and curve estimation were used to study the age structure of C. fairylakea population at genet and clone population levels. The age structure diagram showed that the clone population of C. fairylakea was stable, but the genet population was in declining. However, both of the clone and genet populations were in declining when using the other two approaches. It was considered that the C. fairylakea population was in declining, and needed an urgent protection.

  5. Ageing acute surgical population: the Auckland experience.

    Science.gov (United States)

    Linkhorn, Hannah; Hsee, Li

    2017-03-01

    This study provides data supporting the supposition that more elderly patients are requiring surgical care and illustrates the risks associated with acute surgical illness in elderly patients. The clinical records database was accessed to identify all patients discharged from general surgery and acute surgical unit (ASU) during 2013 and 2014. These groups were stratified by age (over 80 years). Data were collected on number of patients discharged per year, length of stay, number of intensive care unit admissions and number of procedures and mortality rates. There is an increasing number of patients aged over 80 years who were discharged from ASU; 7.02% (n = 296) in 2013 and 8.20% (n = 344) in 2014. Patients aged over 80 years were spending 1.88 days (P-value < 0.001) longer in hospital than those under 80 years in 2014. Mortality rates in 2013 were 3.716 deaths per 100 admissions and 5.814 per 100 admissions in 2014. In 2013, the risk ratio of death in hospital for patients over 80 years was 36.4 (P-value < 0.001) times higher than patients under 80 years. The mean length of stay and mortality rates are higher for patients over 80 years. Mortality rates are higher in acute admissions compared with elective admissions. This identifies a need for increased care for elderly patients admitted for acute surgical care. We suggest a trial of attaching a specialist geriatrician to the ASU who will provide a service for at risk patients. © 2016 Royal Australasian College of Surgeons.

  6. On random age and remaining lifetime for populations of items

    DEFF Research Database (Denmark)

    Finkelstein, M.; Vaupel, J.

    2015-01-01

    develop the population studies approach to the problem and generalize the setting in terms of stationary and stable populations of items. We obtain new stochastic comparisons for the corresponding population ages and remaining lifetimes that can be useful in applications. Copyright (c) 2014 John Wiley...

  7. The oncologic and the geriatric patient

    International Nuclear Information System (INIS)

    Philotheou, Geraldine M

    2002-01-01

    The oncologic and the geriatric patient have special needs in the nuclear medicine department. The nuclear medicine technologists must be knowledgeable and compassionate when dealing with these patients. The diagnosis of cancer will have a sociological and psychological impact on the patient, to which the technologist must relate in an empathetic way. Furthermore, the technologist should take cognisance of the patient's physical condition and be able to modify the examination accordingly. Dealing with the geriatric patient should be correctly placed on the continuum between a gerontological and geriatric approach taking into consideration normal changes due to aging. The patient experience when undergoing the high technology nuclear medicine diagnostic procedure is unique and all effort must be made to ensure the success of the examination and the satisfaction of the patient (Au)

  8. Decline of influenza-specific CD8+ T cell repertoire in healthy geriatric donors

    Directory of Open Access Journals (Sweden)

    Ramachandra Lakshmi

    2011-08-01

    Full Text Available Abstract Background While influenza vaccination results in protective antibodies against primary infections, clearance of infection is primarily mediated through CD8+ T cells. Studying the CD8+ T cell response to influenza epitopes is crucial in understanding the disease associated morbidity and mortality especially in at risk populations such as the elderly. We compared the CD8+ T cell response to immunodominant and subdominant influenza epitopes in HLA-A2+ control, adult donors, aged 21-42, and in geriatric donors, aged 65 and older. Results We used a novel artificial Antigen Presenting Cell (aAPC based stimulation assay to reveal responses that could not be detected by enzyme-linked immunosorbent spot (ELISpot. 14 younger control donors and 12 geriatric donors were enrolled in this study. The mean number of influenza-specific subdominant epitopes per control donor detected by ELISpot was only 1.4 while the mean detected by aAPC assay was 3.3 (p = 0.0096. Using the aAPC assay, 92% of the control donors responded to at least one subdominant epitopes, while 71% of control donors responded to more than one subdominant influenza-specific response. 66% of geriatric donors lacked a subdominant influenza-specific response and 33% of geriatric donors responded to only 1 subdominant epitope. The difference in subdominant response between age groups is statistically significant (p = 0.0003. Conclusion Geriatric donors lacked the broad, multi-specific response to subdominant epitopes seen in the control donors. Thus, we conclude that aging leads to a decrease in the subdominant influenza-specific CTL responses which may contribute to the increased morbidity and mortality in older individuals.

  9. Econometric model for age- and population-dependent radiation exposures

    International Nuclear Information System (INIS)

    Sandquist, G.M.; Slaughter, D.M.; Rogers, V.C.

    1991-01-01

    The economic impact associated with ionizing radiation exposures in a given human population depends on numerous factors including the individual's mean economic status as a function age, the age distribution of the population, the future life expectancy at each age, and the latency period for the occurrence of radiation-induced health effects. A simple mathematical model has been developed that provides an analytical methodology for estimating the societal econometrics associated with radiation effects are to be assessed and compared for economic evaluation

  10. Geriatric fall-related injuries.

    African Journals Online (AJOL)

    Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

  11. [Legal aspects of geriatric rehabilitation].

    Science.gov (United States)

    Klie, T

    1992-01-01

    Nowadays geriatric rehabilitation is recognized as a matter of social law performance. Nevertheless there are very small chances to realize corresponding legal claims in view of the infra-structural deficits. This subscription works out the claims of social law for geriatric rehabilitation, names questions of delineation between illness, prevention and care indigence and discusses problems of geriatric rehabilitant institutions and services.

  12. The development of old age human resource under the background of population ageing in china

    OpenAIRE

    Cheng, Xin; Xu, Jian-pei

    2007-01-01

    China is the country that has the most population in quantity of the world. Rapidly growing population has brought about enormous pressure on the social and economic development. Thus population control is always one of the population policies focuses in our country. However, China has not succeed in escaping out from the pressure of population control, another challenge-population ageing is coming. This challenge also can bring the great impact on the whole social and economic development. M...

  13. Geriatric problems correlated with cognitive decline using a screening test named "Dr. SUPERMAN" for comprehensive geriatric assessment in elderly inpatients.

    Science.gov (United States)

    Namioka, Nayuta; Sakurai, Hirofumi; Terayama, Hideyuki; Iwamoto, Toshihiko; Fujihira, Teruaki; Tsugehara, Hiromi; Tsuchida, Akihiko; Hanyu, Haruo

    2017-09-01

    We have recently developed and validated a screening test for comprehensive geriatric assessment (CGA). We investigated the prevalence of geriatric problems in elderly inpatients using CGA, and determined the relationship between geriatric problems and cognitive decline. We enrolled consecutive elderly inpatients aged >65 years who were admitted to all of the hospital departments at Tokyo Medical University Hospital, Tokyo, Japan, between July and December 2013. We investigated the prevalence of specific geriatric problems or situations in elderly inpatients using a screening test for CGA named "Dr. SUPERMAN." We examined 3969 elderly inpatients (2211 men and 1758 women; mean age 75.5 ± 6.7 years) using CGA. Inpatients were divided into three groups by age, namely, 65-74 years, 75-84 years and ≥85 years. Inpatients were divided into the two groups of "internal medicine" and "other departments." Geriatric problems were more frequently found in patients who were aged ≥85 years and admitted to "internal medicine" departments. Furthermore, multiple regression analysis found cognitive decline significantly correlated with ADL decline, age, poor medication adherence, upper and lower extremity function disorder, visual/auditory disorder, and urinary disorder. In particular, cognitive decline strongly correlated with a decline in activities of daily living. CGA should be considered for the treatment of elderly inpatients, particularly those with cognitive decline and admitted to "internal medicine" departments. Geriatr Gerontol Int 2017; 17: 1252-1256. © 2016 Japan Geriatrics Society.

  14. Older and incarcerated: policy implications of aging prison populations.

    Science.gov (United States)

    Psick, Zachary; Simon, Jonathan; Brown, Rebecca; Ahalt, Cyrus

    2017-03-13

    Purpose The purpose of this paper is to explore the policy Implications of aging prison populations. Design/methodology/approach An examination of the worldwide aging trend in prison and its implications for correctional policy, including an examination of population aging in California prisons as a case example of needed reform. Findings Prison populations worldwide are aging at an unprecedented rate, and age-related medical costs have had serious consequences for jurisdictions struggling to respond to the changes. These trends are accompanied by a growing body of evidence that old age is strongly correlated with desistance from criminal behavior, suggesting an opportunity to at least partially address the challenges of an aging prison population through early release from prison for appropriate persons. Originality/value Some policies do exist that aim to reduce the number of older, chronically ill or disabled and dying people in prison, but they have not achieved that goal on a sufficient scale. An examination of the situation in California shows that recognizing how the healthcare needs of incarcerated people change as they age - and how aging and aging-related health changes often decrease an older person's likelihood of repeat offense - is critical to achieving effective and efficient policies and practices aimed at adequately caring for this population and reducing their numbers in prisons when appropriate.

  15. Devastating epidemics in recent ages Greek populations.

    Science.gov (United States)

    Kotsiou, Antonia; Michalaki, Vasiliki; Anagnostopoulou, Helen N

    2017-12-01

    In the recent Greek ages the most devastating epidemics were plague, smallpox, leprosy and cholera. In 1816 plague struck the Ionian and Aegean Islands, mainland Greece, Constantinople and Smyrna. The Venetians ruling the Ionian Islands effectively combated plague in contrast to the Ottomans ruling all other regions. In 1922, plague appeared in Patras refugees who were expelled by the Turks from Smyrna and Asia Minor. Inoculation against smallpox was first performed in Thessaly by the Greek women, and the Greek doctors Emmanouel Timonis (1713, Oxford) and Jakovos Pylarinos (1715, Venice) made relevant scientific publications. The first leper colony opened in Chios Island. In Crete, Spinalonga was transformed into a leper island, which following the Independence War against Turkish occupation and the unification of Crete with Greece in 1913, was classified as an International Leper Hospital. Cholera struck Greece in 1853-1854 brought by the French troops during the Crimean War, and again during the Balkan Wars (1912-13) when the Bulgarian troops brought cholera to northern Greece. Due to successive wars, medical assistance was not always available, so desperate people turned many times to religion through processions in honor of local saints, for their salvation in epidemics.

  16. Oral Health and Salivary Profiles of Geriatric Outpatients in Cipto Mangunkusumo General Hosp ital

    Directory of Open Access Journals (Sweden)

    Aji Kurniawan

    2012-12-01

    Full Text Available Introduction: Population of geriatric patients would increase in line with that of elderly population. Health problems related to this group of people would have impact on general and oral health maintenance aiming for good quality of life. Objectives: This study aimed to determine the profile of oral health, saliva, and oral mucosa on geriatric patients at Geriatric Policlinic in Cipto Mangunkusumo Hospital. Materials and Methods: This research was a descriptive crosssectional study, which data was taken using questionnaire containing basic demographical information and oral clinical examination using standard form used by Faculty of Dentistry Universitas Indonesia. Results: The study included 75 geriatric patients, ranging from 60 to 86 of age. The mean of DMF-T score of 69 geriatric patients was 4.68 ±2.893, OHI-S 2.790 ±1.102, PBI 0.779±0.585. The mean of unstimulated salivary pH score was 6.618 ± 0.54 and stimulated buffer capacity of saliva was 7.46±2.827. Mean of salivary flow rate is 0.24mL/min and 39 people had hiposalivation. 93 normal variations and 117 pathological oral lesion was found. Conclusion: This study showed that poor oral health status and pathological oral lesion found in this study elderly population could be caused from poor salivary flow, pH saliva, and buffer capacity of saliva. Systematic oral examination of the elderly is of considerable importance and ought be carried out regularly by a dentist in collaboration with the physician; making holistic management of the elderly properly performed.DOI: 10.14693/jdi.v17i2.46

  17. WATER AND SALT METABOLISM IN THE GERIATRIC SYNDROMES

    Directory of Open Access Journals (Sweden)

    Carlos G. Musso

    2010-01-01

    Full Text Available Geriatrics has already described four syndromes of its own: confusional syndrome, incontinence (fecal and/or urinary, and gait disorders and immobility syndrome, naming them geriatric giants. This name reflects their prevalence and great importance in the elderly. Ageing process induces many changes in renal physiology such as a reduction in glomerular filtration rate (senile hyponatremia, and water and sodium reabsorbtion capability. Besides, there are particular water and salt metabolism alteration characteristics of the geriatric syndromes, such as dehydration and hypernatremia in psychiatric disturbances as well as hyponatremia in patients suffering from immobility syndrome. The geriatric giants and nephrogeriatric physiology changes, are a good example of feed-back between geriatric syndromes, clinical entities characteristics in the elderly that predispose and potentiate each other, leading to catastrophic clinical events.

  18. Estimating density dependence from time series of population age structure.

    Science.gov (United States)

    Lande, Russell; Engen, Steinar; Saether, Bernt-Erik; Coulson, Tim

    2006-07-01

    Population fluctuations are caused by demographic and environmental stochasticity, time lags due to life history, and density dependence. We model a general life history allowing density dependence within and among age or stage classes in a population undergoing small or moderate fluctuations around a stable equilibrium. We develop a method for estimating the overall strength of density dependence measured by the rate of return toward equilibrium, and we also consider a simplified population description and forecasting using the density-dependent reproductive value. This generality comes at the cost of requiring a time series of the population age or stage structure instead of a univariate time series of adult or total population size. The method is illustrated by analyzing the dynamics of a fully censused population of red deer (Cervus elaphus) based on annual fluctuations of age structure through 21 years.

  19. AGEING POPULATION: COMPARATIVE ANALYSIS AMONG EUROPEAN UNION STATES

    Directory of Open Access Journals (Sweden)

    Laura DIACONU (MAXIM

    2015-03-01

    Full Text Available The aging population is a global phenomenon, which has affected almost all the EU states. The consequences are very important since it affects the socio-economic environment usually on the long run. Some of them could consist in increasing the public expenditure on pensions, social security and health services, which will raise the overall burden on the working population. Sometimes, a significant reduction of the labour force will even diminish the growth rate of an economy. Considering these aspects, the present paper intends to analyse the demographic situation from the EU states, the factors that have generated it and to identify the possible future trends. To determine the evolution of the ageing population phenomenon, we have analysed some demographic indicators included in various statistical reports and databases, such as the fertility rate, the median age, the percentage of population over a certain age and the age dependency ratio.

  20. The challenge of cancer in middle-income countries with an ageing population: Mexico as a case study.

    Science.gov (United States)

    Aggarwal, Ajay; Unger-Saldaña, Karla; Lewison, Grant; Sullivan, Richard

    2015-01-01

    Mexico is undergoing rapid population ageing as a result of its epidemiological transition. This study explores the interface between this rapid population ageing and the burden of cancer. The number of new cancer cases is expected to increase by nearly 75% by 2030 (107,000 additional cases per annum), with 60% of cases in the elderly (aged ≥ 65). A review of the literature was supplemented by a bibliometric analysis of Mexico's cancer research output. Cancer incidence projections for selected sites were estimated with Globocan software. Data were obtained from recent national census, surveys, and cancer death registrations. The elderly, especially women and those living in rural areas, face high levels of poverty, have low rates of educational attainment, and many are not covered by health insurance schemes. Out of pocket payments and private health care usage remain high, despite the implementation of Seguro Popular that was designed to achieve financial protection for the lowest income groups. A number of cancers that predominate in elderly persons are not covered by the scheme and individuals face catastrophic expenditure in seeking treatment. There is limited research output in those cancer sites that have a high burden in the elderly Mexican population, especially research that focuses on outcomes. The elderly population in Mexico is vulnerable to the effects of the rising cancer burden and faces challenges in accessing high quality cancer care. Based on our evidence, we recommend that geriatric oncology should be an urgent public policy priority for Mexico.

  1. The relationship between geriatric depression and health-promoting behaviors among community-dwelling seniors.

    Science.gov (United States)

    Chang, Chyong-Fang; Lin, Mei-Hsiang; Wang, Jeng; Fan, Jun-Yu; Chou, Li-Na; Chen, Mei-Yen

    2013-06-01

    People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

  2. Social Problems Of Aged In A Rural Population

    Directory of Open Access Journals (Sweden)

    Singh Charan

    1995-01-01

    Full Text Available Research Question: What are the social problems of aged persons in a rural population? Objectives: i To study social problems of aged. ii To identify measures to eliminate them. Study design: Cross- sectional. Setting: Rural areas of Machhra Rural Health & Training Centre attached with Deptt. of SPM, Medical College, Meerut. Participants: Population above 60 years of age. Sample Size: 1000 households from 5 villages, which had 464 participants. Study Variables: Chi- square test. Results: In all, 259 (55.8% aged persons were engaged in productive work while 205 (44.2% were not doing any productive work. Of 376 aged persons living in joint families, 207 (55% were being respected, 71(18.9% were indifferently treated and 98 (26.1% were being neglected by family members. Recommendations: It is a strong case for proper planning to improve the lot of old age population especially for their social problems at the earliest.

  3. Number of X-ray examinations performed on paediatric and geriatric patients compared with adult patients

    International Nuclear Information System (INIS)

    Aroua, A.; Bochud, F. O.; Valley, J. F.; Vader, J. P.; Verdun, F. R.

    2007-01-01

    The age of the patient is of prime importance when assessing the radiological risk to patients due to medical X-ray exposures and the total detriment to the population due to radiodiagnostics. In order to take into account the age-specific radiosensitivity, three age groups are considered: children, adults and the elderly. In this work, the relative number of examinations carried out on paediatric and geriatric patients is established, compared with adult patients, for radiodiagnostics as a whole, for dental and medical radiology, for 8 radiological modalities as well as for 40 types of X-ray examinations. The relative numbers of X-ray examinations are determined based on the corresponding age distributions of patients and that of the general population. Two broad groups of X-ray examinations may be defined. Group A comprises conventional radiography, fluoroscopy and computed tomography; for this group a paediatric patient undergoes half the number of examinations as that of an adult, and a geriatric patient undergoes 2.5 times more. Group B comprises angiography and interventional procedures; for this group a paediatric patient undergoes a one-fourth of the number of examinations carried out on an adult, and a geriatric patient undergoes five times more. (authors)

  4. Effect of aging on renal function plus monitoring and support.

    Science.gov (United States)

    Baldea, Anthony J

    2015-02-01

    Several anatomic changes and physiologic alterations occur in the aging kidney, awareness of which is essential for the early recognition of acute kidney injury (AKI) to improve outcomes in hospitalized geriatric patients. There are no unique diagnostic methods or treatment modalities in the care of the geriatric patient with AKI. Therapy is mainly supportive, and the full spectrum of treatment options, including renal replacement therapy (RRT), should not be withheld from a patient based on age. More studies need to be performed to determine the optimal timing, intensity, and modality of RRT in the geriatric population. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The geriatric patient: use of acute geriatrics units in the emergency care of elderly patients in France.

    Science.gov (United States)

    Somme, D; Lazarovici, C; Dramé, M; Blanc, P; Lang, P O; Gauvain, J B; Voisin, T; Gonthier, R; De Wazières, B; Jeandel, C; Couturier, P; Blanchard, F; Saint-Jean, O

    2011-01-01

    We studied the factors influencing the choice of admission to Geriatrics units, instead of other acute hospital units after an emergency visit. We report the results from a cohort of 1283 randomly selected patients aged >75 years hospitalized in emergency and representative of the French University hospital system. All patients underwent geriatric assessment. Baseline characteristics of patients admitted to Geriatrics and other units were compared. A center effect influencing the use of Geriatrics units during emergencies was also investigated. Admission to a Geriatrics unit during the acute care episode occurred in 499 cases (40.3%). By multivariate analysis, 4 factors were related to admission to a Geriatrics unit: cognitive disorder: odds ratio (OR)=1.79 (1.38-2.32) (95% confidence interval=95% CI); "failure to thrive" syndrome OR=1.54 (1.01-2.35), depression: OR=1.42 (1.12-1.83) or loss of Activities of Daily Living (ADL): OR=1.35 (1.04-1.75). The emergency volume of the hospital was inversely related to the use of Geriatrics units, with high variation that could be explained by other unstudied factors. In the French University Emergency Healthcare system, the "geriatrics patient" is defined by the existence of cognitive disorder, psychological symptoms or installed loss of autonomy. Nevertheless, considerable nation-wide variation was observed underlining the need to clarify and reinforce this discipline in the emergency healthcare system. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Age structure changes and extraordinary lifespan in wild medfly populations.

    Science.gov (United States)

    Carey, James R; Papadopoulos, Nikos T; Müller, Hans-Georg; Katsoyannos, Byron I; Kouloussis, Nikos A; Wang, Jane-Ling; Wachter, Kenneth; Yu, Wei; Liedo, Pablo

    2008-06-01

    The main purpose of this study was to test the hypotheses that major changes in age structure occur in wild populations of the Mediterranean fruit fly (medfly) and that a substantial fraction of individuals survive to middle age and beyond (> 3-4 weeks). We thus brought reference life tables and deconvolution models to bear on medfly mortality data gathered from a 3-year study of field-captured individuals that were monitored in the laboratory. The average time-to-death of captured females differed between sampling dates by 23.9, 22.7, and 37.0 days in the 2003, 2004, and 2005 field seasons, respectively. These shifts in average times-to-death provided evidence of changes in population age structure. Estimates indicated that middle-aged medflies (> 30 days) were common in the population. A surprise in the study was the extraordinary longevity observed in field-captured medflies. For example, 19 captured females but no reference females survived in the laboratory for 140 days or more, and 6 captured but no reference males survived in the laboratory for 170 days or more. This paper advances the study of aging in the wild by introducing a new method for estimating age structure in insect populations, demonstrating that major changes in age structure occur in field populations of insects, showing that middle-aged individuals are common in the wild, and revealing the extraordinary lifespans of wild-caught individuals due to their early life experience in the field.

  7. Geriatrics and radiation oncology. Pt. 1. How to identify high-risk patients and basic treatment principles

    International Nuclear Information System (INIS)

    Fels, Franziska; Kraft, Johannes W.; Grabenbauer, Gerhard G.

    2010-01-01

    Background: Until the mid of this century, 33% of the Western population will be ≥ 65 years old. The percentage of patients being ≥ 80 years old with today 5% will triple until 2050. Therefore, radiation oncologists must be familiar with special geriatric issues to meet the increasing demand for multidisciplinary cooperation and to offer useful and individual treatment concepts. Patients and Methods: This review article will provide basic data on the definition, identification and treatment of geriatric cancer patients. Results: The geriatric patient is defined by typical multimorbidity (15 items) and by age-related increased vulnerability. Best initial identification of geriatric patients will be provided by assessment including the Barthel Index evaluating self-care and activity in daily life, by the Mini-Mental Status Test that will address cognitive pattern, and by the Timed 'Up and Go' Test for evaluation of mobility. As for chemotherapy, standard treatment was associated with increased toxicity, consequently, dose modifications and supportive treatment are of special importance. Conclusion: Geriatric cancer patients need to be identified by special assessment instruments. Due to increased toxicity following chemotherapy, supportive measures seem important. Radiation treatment as a noninvasive and outpatient-based treatment remains an important and preferable option. (orig.)

  8. School Age Populations Research Needs - NCS Dietary Assessment Literature Review

    Science.gov (United States)

    Drawing conclusions about the validity of available dietary assessment instruments in school age children is hampered by the differences in instruments, research design, reference methods, and populations in the validation literature.

  9. Modeling the brain morphology distribution in the general aging population

    Science.gov (United States)

    Huizinga, W.; Poot, D. H. J.; Roshchupkin, G.; Bron, E. E.; Ikram, M. A.; Vernooij, M. W.; Rueckert, D.; Niessen, W. J.; Klein, S.

    2016-03-01

    Both normal aging and neurodegenerative diseases such as Alzheimer's disease cause morphological changes of the brain. To better distinguish between normal and abnormal cases, it is necessary to model changes in brain morphology owing to normal aging. To this end, we developed a method for analyzing and visualizing these changes for the entire brain morphology distribution in the general aging population. The method is applied to 1000 subjects from a large population imaging study in the elderly, from which 900 were used to train the model and 100 were used for testing. The results of the 100 test subjects show that the model generalizes to subjects outside the model population. Smooth percentile curves showing the brain morphology changes as a function of age and spatiotemporal atlases derived from the model population are publicly available via an interactive web application at agingbrain.bigr.nl.

  10. Population Matters Policy Brief. Preparing for an Aging World

    National Research Council Canada - National Science Library

    2001-01-01

    .... One popular view envisions global aging as a looming catastrophe, as populations top-heavy with frail, retired elderly drain pension and social security funds, overwhelm health care systems, and rely...

  11. Population Matters Policy Brief: Preparing foran Aging World

    National Research Council Canada - National Science Library

    2001-01-01

    .... One popular view envisions global aging as a looming catastrophe, as populations top-heavy with frail, retired elderly drain pension and social security funds, overwhelm health care systems, and rely...

  12. Enhanced mobility for aging populations using automated vehicles.

    Science.gov (United States)

    2015-12-01

    Automated vehicles (AV) offer a unique opportunity to improve the safety and efficiency of the transportation : system and enhance the mobility of aging and transportation disadvantaged populations simultaneously. : However, before this potential can...

  13. Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition

    OpenAIRE

    Cunha, Ana Conceição Norbim Prado; Cunha, Natália Norbim Prado; Barbosa, Maira Tonidandel

    2016-01-01

    Summary Objective: This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. Methods: 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC) were found, as seen on the MEC website (...

  14. Measuring the speed of aging across population subgroups.

    Science.gov (United States)

    Sanderson, Warren C; Scherbov, Sergei

    2014-01-01

    People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article "The characteristics approach to the measurement of population aging" published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations.

  15. Translation and validation of Hindi version of Geriatric Oral Health Assessment Index (GOHAI)

    DEFF Research Database (Denmark)

    Mathur, Vijay Prakash; Jain, Veena; Pillai, Rajath

    2013-01-01

    OBJECTIVE: The aim of the study was to translate and validate the oral health-related quality of life assessment tool named Geriatric Oral Health Assessment Index (GOHAI) into Hindi language for use in the Indian population. METHODOLOGY: The 12-item GOHAI questionnaire was translated into Hindi......, back-translated and compared with the original English version. After pilot testing and appropriate changes, the Hindi version was administered to a group of 500 patients visiting the geriatric medicine clinic in All India Institute of Medical Sciences, New Delhi. The questionnaire was re...... edentulous participants. Age group was also found to be a significant factor for GOHAI scores. CONCLUSION: The Hindi version of GOHAI exhibits acceptable validity and reliability and can be used in the elderly Indian population as a measure of oral health-related quality of life....

  16. Factors impacting on the nutritional status of population aged 45 ...

    African Journals Online (AJOL)

    Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, and 12.7% underweight, with more females (48.0%) than males (25.9%) being overweight. Conclusion: Under nutrition and obesity are problems facing this population group aged 45 years and above in Nairobi. There is need for ...

  17. Evaluation of a blended learning model in geriatric medicine: a successful learning experience for medical students.

    Science.gov (United States)

    Duque, Gustavo; Demontiero, Oddom; Whereat, Sarah; Gunawardene, Piumali; Leung, Oliver; Webster, Peter; Sardinha, Luis; Boersma, Derek; Sharma, Anita

    2013-06-01

    Despite the increasingly ageing population, teaching geriatric medicine at medical schools is a challenge due to the particularities of this subspecialty and the lack of student interest in this subject. We assessed a blended system that combines e-learning and person-to-person interaction. Our program offered the students a hands-on learning experience based on self-reflection, access to technology, interactive learning, frequent interaction with the multidisciplinary team, more exposure to patients, and regular feedback. Our results indicate that the students appreciate this system as a rich and effective learning experience demonstrated by their positive feedback and by their significant improvement in knowledge assessed at the end of their rotation. Implementing an interactive blended system is a beneficial approach to teaching geriatric medicine in medical schools and to motivating medical students' interest in this important medical subspecialty. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

  18. An analysis of age at first marriage of China's population.

    Science.gov (United States)

    Li, R

    1985-10-01

    This study examines age at first marriage in China, using data from the 1982 10% sample of the population census. Among the married population of July 1, 1982, most men married for the first time at 23; by 24.08 years, half the men were married; the average age at first marriage was 25.49 years. Most women had their first marriage at 20; half were married before the age of 21.9; their average age at first marriage was 22.8 years. Among geographic groupings, the age at marriage is highest for Shanghai populations for both men (27.82 years) and women (25.76 years). The lowest age at marriage is 23.74 years for Heilongjiang Province and 21.44 for women in Qinghai Province. Female age at marriage tends to be higher in the East and South than in the West and North, and higher in coastal than inland areas. The geographic distribution of male age at marriage differs from that of women. Men commonly marry the earliest in the 3 Northeast provinces. Men marry later in Sichuan, Guangdong, Guangxi, Anhui, and shandong than in Beijing and Tianjin. In general, men tend to marry later than women, but the disparity is usually small. Since the revolution, female age at marriage has steadily risen. China's age at marriage is several years lower than that of Japan. Economic development and education levels have a strong impact on female age at marriage. However, female age at marriage has declined in very recent years, suggesting a more complex interaction between age at marriage and socioeconomic factors. Promoting late marriage is essential to controlling population growth.

  19. Geriatric Oncology Program Development and Gero-Oncology Nursing.

    Science.gov (United States)

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

    2016-02-01

    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. New challenges of geriatric cardiology: from clinical to preclinical research

    Science.gov (United States)

    Malavolta, Marco; Caraceni, Daniele; Olivieri, Fabiola; Antonicelli, Roberto

    2017-01-01

    The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases (CVD). The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research. PMID:28663759

  1. Spirometry reference equations for central European populations from school age to old age.

    Science.gov (United States)

    Rochat, Mascha K; Laubender, Ruediger P; Kuster, Daniela; Braendli, Otto; Moeller, Alexander; Mansmann, Ulrich; von Mutius, Erika; Wildhaber, Johannes

    2013-01-01

    Spirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations. To develop spirometry reference equations for central European populations between 8 and 90 years of age. We used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS). The spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51%) females and 58'267 (49%) males. Altogether, there were 18'211 (15.3%) children under the age of 18 years. We developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

  2. Cancer and aging in Ibero-America.

    Science.gov (United States)

    Soto-Perez-de-Celis, E; Cordoba, R; Gironés, R; Karnakis, T; Paredero, I; Chavarri-Guerra, Y; Navarrete-Reyes, A P; Avila-Funes, J A

    2018-02-12

    Population aging represents a worldwide challenge. In Ibero-America (Spain, Portugal, and the American countries in which the Spanish or Portuguese language are spoken), the number of older adults is growing, leading to an increase in aging-related diseases such as cancer. Older adults already account for half of all cancer cases in Ibero-America, and this proportion will continue to increase. Furthermore, Ibero-American healthcare systems are not adequately prepared to provide care for older adults with cancer, mainly due to a lack of resources and generalized paucity of geriatric training for healthcare providers. Across the region, several clinical initiatives, educational activities and research collaborations have been established to set the foundations of Ibero-American geriatric oncology and to increase the geriatric knowledge among healthcare providers. This article provides an overview of the current landscape of geriatric oncology in Ibero-America, highlighting its critical challenges, opportunities for improvement and collaboration, and future directions.

  3. Study of cutaneous manifestations in geriatrics

    OpenAIRE

    Shashikant B. Dhumale; Rajesh Khyalappa

    2016-01-01

    Background: Cutaneous signs and symptoms increases as the age advances. These are physiological as well as pathological changes. They can be due to systemic diseases present in old age. Methods: All the 200 geriatric patients have cutaneous manifestations. Results: Pruritus, eczema, stasis eczema, fungal infections were common. Diabetes was found in large incidence i.e. 27.5%, which show certain skin manifestations like pruritus, skin tag etc. Conclusions: Poor hygiene and systemic ...

  4. Population ageing and intergenerational conflict: a post-Keynesian view.

    Science.gov (United States)

    Jackson, W A

    1992-01-01

    The author reexamines the relationships among demographic aging, the dependency burden, and intergenerational conflict from a post-Keynesian perspective, in which unemployment and excess capacity are normal to the functioning of capitalist economies, and resources are not generally fully utilized. He "argues that the Keynesian process of national income determination precludes any immediate relationship between population ageing and the 'burden' imposed on income recipients. Below full employment, a rising dependency ratio is not guaranteed to reduce the expenditure share of income recipients or raise their tax rates. An exclusive emphasis on intergenerational conflict can give a misleading impression of the consequences of population ageing." The focus is on developed countries. excerpt

  5. Testing evolutionary theories of aging in wild populations.

    Science.gov (United States)

    Bronikowski, Anne M; Promislow, Daniel E L

    2005-06-01

    Classic theories for the evolution of senescence predict that rates of aging should be highest in populations in which extrinsic mortality is high. This predication is called into question in new work by David Reznick and co-workers, who found that guppies Poecilia reticulata derived from natural populations with high levels of predation live the longest in the laboratory. This study illustrates that the effect of mortality on aging might depend on how we define aging, and on the particular cause of increased mortality.

  6. Aging in Mexico: Population Trends and Emerging Issues.

    Science.gov (United States)

    Angel, Jacqueline L; Vega, William; López-Ortega, Mariana

    2016-12-07

    Although all nations in the America's face a common demographic reality of longevity, declining fertility rates and changes in family roles a growing body of research points to a dramatic demographic transformation in Mexico. Although Mexico's population is relatively young, with a median age of 27.9 in 2015, it will age rapidly in coming years, increasing to 42 years by 2050. The rapid median age in the nation also reflects the growing proportion of people 65 or older, and is expected to triple to 20.2% by 2050. This article examines how the age and gender structure of Mexico offers important insights about current and future political and social stability, as well as economic development. Mexico is the world's eleventh largest country in terms of population size and the "demographic dividend" of a large youthful population is giving way to a growing older population that will inevitably place demands on health care and social security. The shift in age structure will result in increased dependency of retirees on the working-age population in the next 20 years. Mexico does not provide universal coverage of social security benefits and less than half of the labor force is covered by any pension or retirement plan. As a result, elderly Mexicans often continue working into old age. The high total poverty rate in the country, especially among the older population magnifies the problem of the potential dependency burden. The article ends with a discussion of key public policy issues related to aging in Mexico. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Clinical features of chronic urticaria in aging population.

    Science.gov (United States)

    Chuamanochan, Mati; Kulthanan, Kanokvalai; Tuchinda, Papapit; Chularojanamontri, Leena; Nuchkull, Piyavadee

    2016-09-01

    Different clinical features of skin diseases have been addressed between aging patients and non-aging patients. However, data focusing on the clinical features of chronic urticaria (CU) in aging patients especially in the Asian population are still limited. This study aimed to investigate the clinical characteristics of CU in aging and non-aging patients in the Asian population. Case records of 1622 CU patients attending the Urticaria Clinic, Department of Dermatology, Siriraj Hospital, Mahidol University, Thailand between 2000 and 2013 were retrospectively reviewed. All CU patients older than 60 years were recruited. Twice the number of CU patients who were non-aging were enrolled using a systematic sampling method. Of the 1622 CU patients, 67 (4.1%) were aging patients. From these, 134 non-aging patients with CU were recruited. The majority of patients for both groups were female, with 67.2% and 77.6% of the aging and non-aging groups, respectively. In both groups, the most common cause of CU was chronic spontaneous urticaria. In the aging group, positive autologous serum skin test, anti-thyroid antibodies and antinuclear antibodies were found more commonly than in the non-aging group, without a statistically significant difference. The mean duration of the disease tended to be shorter in the aging group. Our study showed that CU in aging patients was uncommon (4.1%). Aging patients with CU seemed to have shorter disease duration and higher percentages of autoantibodies than non-aging patients with CU without a statistically significant difference.

  8. Caring for an Ageing Population: Are Physiotherapy Graduates Adequately Prepared?

    Science.gov (United States)

    Ramklass, Serela S.; Butau, Anne; Ntinga, Nomusa; Cele, Nozipho

    2010-01-01

    In view of South African policy developments related to the care of older persons, it was necessary to examine the nature of the geriatrics content within physiotherapy curricula. A survey was conducted amongst final-year student physiotherapists at South African universities, together with content analysis of physiotherapy curricula. Very little…

  9. Population Ageing in Rural Settlements in the Republic of Croatia

    Directory of Open Access Journals (Sweden)

    Ivo Nejašmić

    2016-08-01

    Full Text Available One of the basic demographic characteristics of Croatia is the inherited dispersed population density with a large number of small settlements and the undeveloped system of regional and micro-regional centres. Such settlement structure was entirely inappropriate in the conditions of accelerated and urban-based industrialization after the Second World War. This period was characterised by a mass transition of agricultural population into non-agricultural activities, along with the abandonment of rural settlements. In addition to the strong emigration from rural areas in which younger age groups participated for the most part, there was a continuous reduction in fertility, too. All this has led to the narrowing of young age groups and consequently to the increase in the proportion of the elderly. An important factor of demographic ageing is the reduction in mortality of persons over 30 years of age and longer life respectively. Life expectancy of the Croatian population was 64.8 years in 1960 and 77.2 years in 1972. The average age constantly increased: it was 32.5 years in 1961, 35.4 in 1981 and it reached the high 41.7 years in 2011. The aggression and war against Croatia happened in the 1990s. Dramatic events affected the general social conditions and processes, strongly accelerating negative demographic trends. All this had further affected the socio-demographically eroded rural areas. There was a particularly difficult situation in the regions directly affected by the war; part of these areas had had the features of extreme demographic regression before the war sufferings and the war only further strengthened it. The overall population of Croatia is characterised by decreasing fertility, natural depopulation (negative natural change, total depopulation (since 1990 and intense population ageing. The duration and intensity of these processes clearly testifies to the demographic development of Croatia being very unfavourable. All this also

  10. [Geriatric assessment prior to oncological therapy].

    Science.gov (United States)

    Wedding, U

    2013-06-01

    Ageing is the single most important risk factor for cancer. This is also true for most cancer diseases of the genitourinary tract. In combination with the demographic changes in Germany and most other countries, the consequence is a substantial increase in the number of elderly patients with cancer. Most therapies in oncology have a high risk for toxic side effects. Ageing is a very heterogeneous process. The chronological age of a patient insufficiently reflects the individual resources, deficits and risk factors but this can be assessed by a structured geriatric assessment. Integration of geriatric assessment into oncological treatment decisions is still low and is one of the major tasks in cancer care in the future.

  11. Using Facebook Within a Geriatric Pharmacotherapy Course

    Science.gov (United States)

    2010-01-01

    Objective To evaluate using an Internet-based social networking site within an elective geriatric pharmacotherapy course. Design Thirty pharmacy students enrolled in a geriatric pharmacotherapy elective course were invited to join a closed Facebook (Facebook Inc, Palo Alto, CA) group to enhance communication among students and faculty members within the course. Creating a discussion board was the primary activity in the course. Each week, 3 students were assigned to post a healthy aging topic, and other students in the class were expected to post their comments and reactions. The healthy aging topics also were discussed during class. Assessment Students wrote reflections about their experiences using Facebook for the activities within this course. A survey instrument also measured students' opinions about using Facebook for educational purposes. Conclusion Using Facebook allowed students to discuss topics more openly and encouraged classroom discussions of healthy aging topics. PMID:21179256

  12. Using facebook within a geriatric pharmacotherapy course.

    Science.gov (United States)

    Estus, Erica L

    2010-10-11

    To evaluate using an Internet-based social networking site within an elective geriatric pharmacotherapy course. Thirty pharmacy students enrolled in a geriatric pharmacotherapy elective course were invited to join a closed Facebook (Facebook Inc, Palo Alto, CA) group to enhance communication among students and faculty members within the course. Creating a discussion board was the primary activity in the course. Each week, 3 students were assigned to post a healthy aging topic, and other students in the class were expected to post their comments and reactions. The healthy aging topics also were discussed during class. Students wrote reflections about their experiences using Facebook for the activities within this course. A survey instrument also measured students' opinions about using Facebook for educational purposes. Using Facebook allowed students to discuss topics more openly and encouraged classroom discussions of healthy aging topics.

  13. Comanagement of Geriatric Patients With Hip Fractures

    Science.gov (United States)

    Rocca, Gregory J. Della; Moylan, Kyle C.; Crist, Brett D.; Volgas, David A.; Stannard, James P.; Mehr, David R.

    2013-01-01

    The objective of this 3-year retrospective, controlled, cohort study is to characterize an interdisciplinary method of managing geriatric patients with hip fracture. All patients aged 65 years or older admitted to a single academic level I trauma center during a 3-year period with an isolated hip fracture were included as participants for this study. Thirty-one geriatric patients with hip fracture were treated with historical methods of care (cohort 1). The comparison group of 115 similar patients was treated under a newly developed, institutional comanagement hip fracture protocol (cohort 2). There were no differences in age, sex distribution, or comorbidity distribution between the 2 cohorts. Patients requiring intensive care unit (ICU) admission decreased significantly from 48% in cohort 1 to 23% in cohort 2 (P = .0091). Length of ICU stay for patients requiring ICU admission also decreased significantly, from a mean of 8.1 days in cohort 1 to 1.8 days in cohort 2 (P = .024). Total hospital stay decreased significantly, from a mean of 9.9 days in cohort 1 to 7.1 days in cohort 2 (P = .021). Although no decrease in in-hospital mortality rates was noted from cohort 1 to cohort 2, a trend toward decreased 1-year mortality rates was seen after implementation of the hip fracture protocol. Hospital charges decreased significantly, from US$52 323 per patient in cohort 1 to US$38 586 in cohort 2 (P = .0183). Implementation of a comanagement protocol for care of geriatric patients with hip fracture, consisting of admission to a geriatric primary care service, standardized perioperative assessment regimens, expeditious surgical treatment, and continued primary geriatric care postoperatively, resulted in reductions in lengths of stay, ICU admissions, and hospital costs per patient. On an annualized basis, this represented a savings of over US$700 000 for our institution. PMID:23936734

  14. Impaired nutritional status in geriatric trauma patients.

    Science.gov (United States)

    Müller, F S; Meyer, O W; Chocano-Bedoya, P; Schietzel, S; Gagesch, M; Freystaetter, G; Neuhaus, V; Simmen, H-P; Langhans, W; Bischoff-Ferrari, H A

    2017-05-01

    Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender. A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; Pnutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07-4.05). In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.

  15. Falls and other geriatric syndromes in Blantyre, Malawi: a community survey of older adults.

    Science.gov (United States)

    Allain, T J; Mwambelo, M; Mdolo, T; Mfune, P

    2014-12-01

    The prevalence of geriatric syndromes (falls, immobility, intellectual or memory impairment, and incontinence) is unknown in many resource-poor countries. With an aging population such knowledge is essential to develop national policies on the health and social needs of older people. The aim of this study was to provide a preliminary survey to explore the prevalence of falls and other geriatric syndromes and their association with known risk factors in people aged > 60 years in urban Blantyre, Malawi. This was a cross-sectional, community survey of adults aged > 60 years. Subjects were recruited at home or in the waiting areas of chronic care clinics. They were interviewed to complete a questionnaire on age-associated syndromes and comorbid problems. The Abbreviated Mental Test (AMT) and Timed Up and Go (TUG) tests were carried out. Ninety-eight subjects were studied; 41% reported falling in the past 12 months, 33% of whom (13% of all subjects) were recurrent fallers. Twenty-five percent reported urine incontinence, 66% self-reported memory difficulties, and 11% had an AMT score Blantyre, Malawi. Falling is associated with cognitive impairment and urinary incontinence. There is an urgent need for more understanding of geriatric problems in this setting to develop national policies on health and social needs of older people. It is likely that many of the contributory factors to falls would be amenable to multifactorial interventions similar to those found to be effective in developed countries.

  16. The impact of population ageing on future Danish drug expenditure

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach

    Background Population ageing is likely to place an increasing burden on future health care budgets. Several studies have demonstrated that the impact of ageing on future hospital expenditures will be overestimated when not accounting for proximity to death. This is because greater health care...... expenditure among the elderly partly is due the high "costs of dying". Aims The aim of this study was to estimate the impact of the ageing Danish population on future total expenditures on out-of-hospital prescription drugs and to describe the association between age and drug expenditure among survivors...... compared to that of decedents. Methods Taking expenditure during the last year of life and the changes in mortality rates into account, future drug expenditure was projected by multiplying estimated mean annual drug expenditure according to age, gender and survival status by the predicted future number...

  17. [Analysis on age structure and dynamics of Kindonia uniflora populations].

    Science.gov (United States)

    Zhang, Wenhui; Li, Jingxia; Li, Hong; Liu, Xiangjun

    2004-04-01

    Kindonia uniflora is a perennial clone herbaceous plant, and also, a native endangered plant in China. This paper studied its age structure, life table and survivorship curve in different habitats in Taibai mountain area. The results indicated that the age structure and dynamics of K. uniflora populations in the Betula utilis forest at altitude 2500-2700 m, in the Abies fargesii forest at altitude 2700-2900 m, and in the Larix chinensis forest at altitude 2900-3100 m had the similar pattern and developing tendency. The number of younger ramets at 1-2 years old or older than 5 years was less, and the number of ramets at 3-5 years old was the highest in the age structures. The negative values of dx (dead number), qx (mortality rate) and Kx (Killing rate) in the life table showed the increasing rate of the population sizes during the age stage. The survivorship curve of K. uniflora populations in different habitats belonged to Deevey C after 3-5 years old. The mortality rate of populations during 5-10 years stage was higher, and was stable after 10 years old. As for the characters of asexual propagation and clone growth, the rhizomes of the populations were in humus of soil, and developed and expanded as guerilla line style. During growth season, only one leaf grew above ground at every inter-node, and the population growth and development were rarely influenced by external factors. The forest communities, such as Betula utilis, Abies fargesii and Larix chinensis forest, in which K. uniflora populations lived, were at middle or higher mountain, where there were rarely disturbance from human being. Therefore, the habitats for K. uniflora populations to live were relatively stable. As the altitude increased, the disturbances from human being became less, the density of K. uniflora populations increased, the life cycle expanded, the peak of population death delayed, and the population living strategy changed to adapt to the habitats. K. uniflora populations preferred to

  18. Clinical manifestations of geriatric depression in a memory clinic: toward a proposed subtyping of geriatric depression.

    Science.gov (United States)

    Dillon, Carol; Machnicki, Gerardo; Serrano, Cecilia M; Rojas, Galeno; Vazquez, Gustavo; Allegri, Ricardo F

    2011-11-01

    As the older population increases so does the number of older psychiatric patients. Elderly psychiatric patients manifest certain specific and unique characteristics. Different subtypes of depressive syndromes exist in late-life depression, and many of these are associated with cognitive impairment. A total of 109 depressive patients and 30 normal subjects matched by age and educational level were evaluated using a neuropsychiatric interview and an extensive neuropsychological battery. Depressive patients were classified into four different groups by SCAN 2.1 (schedules for clinical assessment in Neuropsychiatry): major depression disorder (n: 34), dysthymia disorder (n: 29), subsyndromal depression (n: 28), and depression due to mild dementia of Alzheimer's type (n: 18). We found significant associations (pdepressive status and demographic or clinical factors that include marital status (OR: 3.4, CI: 1.2-9.6), level of daily activity (OR: 5.3, CI: 2-14), heart disease (OR: 12.5, CI: 1.6-96.3), and high blood cholesterol levels (p:.032). Neuropsychological differences were observed among the four depressive groups and also between depressive patients and controls. Significant differences were observed in daily life activities and caregivers' burden between depressive patients and normal subjects. Geriatric depression is associated with heart disease, high cholesterol blood levels, marital status, and daily inactivity. Different subtypes of geriatric depression have particular clinical features, such as cognitive profiles, daily life activities, and caregivers' burden, that can help to differentiate among them. The cohort referred to a memory clinic with memory complaints is a biased sample, and the results cannot be generalized to other non-memory symptomatic cohorts. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Geriatric Dermatoses In Southern Orissa

    Directory of Open Access Journals (Sweden)

    Sahoo A

    2000-01-01

    Full Text Available Two hundred geriatric patients, aged 55 years and above, studied at Medical College, Berhampur accounted for 3% of Skin & VD OPD attendance with a male preponderance (M: F: 4:1. Majority (97% of these patients were literate, 55% belonged to low socio-economic group. Among them 32.5% of males were farmers and all females were housewives. Forty-nine dermatologic diseases were encountered, twenty-nine patients presented with multiple complaints and the rest had single complaint. Pruritus was the commonest symptom (54%, 41.5% of which was associated with different dermatoses and the rest 12.5% with senile xerosis. Fungal infection was the commonest dermatosis. Senile xerosis (12.5%, seborrhoeic keratosis (10%, psoriasis (9%, idiopathic guttate hypomelanosis (6.5%, malignant and premalignant conditions (5%, vitiligo (3.5% and lichen planus (3% were some of the other dermatoses seen. Diabetes was the commonest systemic disease (10.5%.

  20. Canadian Provincial Population Growth: Fertility, Migration, and Age Structure Effects

    Directory of Open Access Journals (Sweden)

    Edmonston, Barry

    2009-01-01

    Full Text Available AbstractThe effect of changes in rates of mortality, fertility, and migration depend not only on the age specific patterns and levels of these rates, but on the age structure of the population. In orderto remove the influences of the age structure and concentrate on the impact of the demographic rates themselves, a common practice is to analyze the influences of the rates for a standard age structure. This paper adapts the general approach of using a standard age structure to a stationary population equivalent (SPE model, and analyzes current population change, using the SPE model, for provinces of Canada. Below-replacement fertility levels are only partially offset by net immigration. The SPE model evidences the decrease in the eventual provincial populations brought about by the below replacement fertility. Out-migration for some provincesto other areas of Canada accentuates their eventual population decreases.RésuméLes effets des changements des taux de mortalité, fécondité, et de migration dépendent non seulement des modèles par âge et des niveaux de ces taux, mais aussi de la structure par âge de la population. Pour éliminer les influences de la structure par âge et se concentrer sur les effets des taux démographiques mêmes, une pratique courante est d’analyser les influences des taux par une structure par âge de norme. Cet article adapte l’approche générale de la structure parâge à un modèle de population stationnaire équivalente (PSE. Cet article analyse les changements de population, en utilisant le modèle de PSE, dans les provinces canadiennes. Le taux de fécondité inférieur au seuil de reproduction de la population n’est que légèrement compensé par l’immigration nette. Le modèle de PSE démontre le déclin des populations provinciales éventuelles causé par le taux de fécondité inférieur au seuil de reproduction de la population. Le taux d’émigration entre certaines provinces et reste du

  1. Redefining the Economics of Geriatric Orthopedics.

    Science.gov (United States)

    Truntzer, Jeremy; Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-12-01

    The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios.

  2. Redefining the Economics of Geriatric Orthopedics

    Science.gov (United States)

    Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-01-01

    Introduction: The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. Materials and Methods: A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. Results: In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. Conclusion: The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios. PMID:26246943

  3. Aging and environmental factors: an estimation of the health state of the elderly population residing in industrialized vs. rural areas.

    Science.gov (United States)

    Santangelo, Antonino; Albani, Salvatore; Beretta, Massimiliano; Cappello, Antonella; Mamazza, Grazia; Pavano, Salvatore; Testaì, Manuela; Tomarchio, Marcello; Zuccaro, Carmela; Maugeri, Domenico

    2011-01-01

    The possibilities have already been discussed that the environment of the living beings may influence the aging process, by causing alterations of the homeostatic capacities to such an extent that definitive pathologies will come into being. Therefore, the aim of the present study was at estimating the effective impact of the environmental pollution on the health state of the subjects residing in highly industrialized areas. For this purpose, we compared 2 populations over the age of 56 years, one from the industrialized areas and the other of agricultural character. The health indicator we utilized was the rate of hospitalization calculated for the main geriatric pathologies. It has been observed that among the residents of highly polluted areas, the hospitalizations were more frequent for the screened pathologies. This finding could be an indicator of an interference of the environmental pollution with the physiological process of aging. One can also suspect that for the cardiovascular pathologies also the factor of physical fatigue being more prevalent in the rural population might play an important role in the high occurrence of this type of diseases. On the basis of these findings we intend to emphasize that the sanitary programs of a given territory should consider in the development and application of a sanitary service the intrinsic characteristics of the given area, when designing the possibly most adequate health care service. Published by Elsevier Ireland Ltd.

  4. Cardiopulmonary disease in the geriatric dog and cat

    International Nuclear Information System (INIS)

    Miller, M.S.; Tilley, L.P.; Smith, F.W.K. Jr.

    1989-01-01

    The incidence of cardiopulmonary disease increases with age. Degenerative valvular disease, chronic obstructive pulmonary disease, and arrhythmias are common in the geriatric dog. Chronic bronchial disease, pulmonary neoplasia, and arrhythmias occur in the geriatric cat. Systemic diseases in both species often show cardiopulmonary manifestations. Medical management to treat the underlying disease and to control clinical signs is complicated by altered absorption, metabolism, and elimination of drugs

  5. Wound care in the geriatric client

    Directory of Open Access Journals (Sweden)

    Steve Gist

    2009-06-01

    Full Text Available Steve Gist, Iris Tio-Matos, Sharon Falzgraf, Shirley Cameron, Michael BeebeGeriatrics and Extended Care, Programs, VA Puget Sound Health Care Systems, American Lake Division, Tacoma, WA, USAAbstract: With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension, and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydro-fibers, composite and alginate dressings.Keywords: wound care, pressure ulcers, vascular ulcers, diabetic ulcers, debridement, elderly

  6. Computer Simulation of Sexual Selection on Age-Structured Populations

    Science.gov (United States)

    Martins, S. G. F.; Penna, T. J. P.

    Using computer simulations of a bit-string model for age-structured populations, we found that sexual selection of older males is advantageous, from an evolutionary point of view. These results are in opposition to a recent proposal of females choosing younger males. Our simulations are based on findings from recent studies of polygynous bird species. Since secondary sex characters are found mostly in males, we could make use of asexual populations that can be implemented in a fast and efficient way.

  7. [Age structure and growth characteristic of Castanopsis fargesii population].

    Science.gov (United States)

    Song, Kun; Da, Liang-jun; Yang, Tong-hui; Yang, Xu-feng

    2007-02-01

    In this paper, the age structure and growth characteristics of Castanopsis fargesii population in a shade-tolerant broadleaved evergreen forest were studied, aimed to understand more about the regeneration patterns and dynamics of this population. The results showed that the age structure of C. fargesii population was of sporadic type, with two death peaks of a 30-year gap. This population had a good plasticity in growth to light condition. Because there were no significant differences in light condition under the canopy in vertical, the saplings came into their first suppression period when they were 5-8 years old, with a height growth rate less than 0. 1 m x a(-1) lasting for 10 years. The beginning time of the first growth suppression period was by the end of the first death peak of the population, and the ending time of the first growth suppression period was at the beginning of the second death peak of the population, demonstrating that growth characteristic was the key factor affecting the age structure of C. fargesii.

  8. Geriatric syndromes: medical misnomer or progress in geriatrics?

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Rigaud, A.S.; Hoeyweghen, R.J. van; Graaf, J. de

    2003-01-01

    Both in geriatric and internal medicine journals, and in medical textbooks certain (aggregates of) symptoms are labelled as 'geriatric syndromes'. In frail elderly patients a large number of diseases present with well-known and highly prevalent atypical symptoms (e.g. immobility, instability,

  9. Geriatric evaluation of oncological elderly patients.

    Science.gov (United States)

    Malaguarnera, Michele; Frazzetto, Paola Mariangela; Erdogan, Ozyalcn; Cappellani, Alessandro; Cataudella, Emanuela; Berretta, Massimiliano

    2013-11-01

    Cancer has a high prevalence in older age. The management of cancer in the older aged person is an increasingly common problem. Age may be construed as a progressive loss of stress tolerance, due to decline in functional reserve of multiple organ systems, high prevalence of comorbid conditions, limited socioeconomic support, reduced cognition, and higher prevalence of depression. In the elderly, the comorbidities and physiological changes in the pharmacokinetics reduce the prospective for therapy and suggest the importance of a multidimensional assessment of cancer patients as well as the formulation of predictive models of risk, in order to estimate the life expectancy and tolerance to treatment. The pharmacological changes of age include decreased renal excretion of drugs and increased susceptibility to myelosuppression, mucositis, cardio toxicity and neurotoxicity. The chemotherapy in patients older than 75 years is very limited. The geriatric assessment is considered a valid tool in geriatric medical. It is important for two main reasons: first of all, for the need to distinguish the features linked to the geriatric syndromes from those ones which are strictly connected to the cancer pathology; secondly, for its potential prognostic value.

  10. The aging population poses a global challenge for blood services.

    Science.gov (United States)

    Ali, Akif; Auvinen, Marja-Kaisa; Rautonen, Jukka

    2010-03-01

    The Finnish transfusion registry data suggest some alarming signals and future challenges that are likely to be faced by transfusion services as populations continue to age. Computerized data collection was performed on all potentially transfused patients in Finland, thus covering approximately 70% of all blood usage. We simulated the red blood cell (RBC) usage according to the Finnish practice on different age groups but the population demographics from other countries. The Finnish data demonstrate a marked increase in RBC consumption with increasing age among recipients, beginning at around 50 years of age. The 70- to 80-year-olds have an eightfold higher RBC consumption than 20- to 40-year-olds. A large part of the variation in RBC use per capita can be explained by the age distribution of the different populations and not by the different national and regional treatment policies and protocols used. If current efforts are not enough to serve the changing population demographic and if increasing demands for blood products cannot be met, there is need to consider unprecedented measures such as reversing certain donor deferrals or even exporting blood from country to country.

  11. Surgical oncology outcomes in the aging US population.

    Science.gov (United States)

    Yeo, Heather L; O'Mahoney, Paul R A; Lachs, Mark; Michelassi, Fabrizio; Mao, Jialin; Finlayson, Emily; Abelson, Jonathan S; Sedrakyan, Art

    2016-09-01

    As the population ages, an increasing number of older patients are undergoing major surgery. We examined the impact of advanced age on outcomes following major gastrointestinal cancer surgery in an era of improved surgical outcomes. This was a population-based, retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database. We evaluated patients undergoing major abdominal gastrointestinal cancer surgery from 2005-2012. Multivariable logistic regression was performed to determine the independent effect of advanced age on outcomes. Our primary outcome was 30-d mortality, and our secondary outcomes were 30-d major postoperative adverse events, discharge disposition, length of stay, reoperation, and readmission. Elderly (≥65 y) patients were twice as likely to have multiple comorbidities as those age groups. Mortality increased with age across all procedures (P age on mortality was highest in hepatectomy (odds ratio = 5.17, 95% confidence interval = 2.19-12.20) and that for major postoperative adverse events was highest in proctectomy (odds ratio = 2.32, 95% confidence interval = 1.53-3.52). Patients were more likely to be discharged to an institutional care facility as age increased across all procedures (P age on postoperative outcomes was present across all operations but had its highest association with liver and rectal cancer resections. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Risk Factors for Graft Failure and Death following Geriatric Renal Transplantation.

    Directory of Open Access Journals (Sweden)

    Hyungjin Cho

    Full Text Available Population aging is a major health concern in Asian countries and it has affected the age distribution of patients with end-stage renal disease (ESRD. As a consequence, the need for kidney transplantation in the geriatric population has increased, but the shortage of donors is an obstacle for geriatric renal transplantation. The aim of this study was to evaluate risk factors for graft failure and death in geriatric renal transplantation.Kidney transplantations performed in a tertiary hospital in South Korea from May 1995 to December 2014 were retrospectively reviewed. Recipients younger than 60 years of age or who underwent other organ transplantations were excluded. The Kaplan-Meier method was used to assess patient and graft survival. A Cox regression analysis was used to evaluate risk factors for graft failure and patient death.A total of 229 kidney transplantation patients were included. Graft survival at 1, 5, and 10 years were 93.2%, 82.9%, and 61.2% respectively. Patient survival at 1, 5, and 10 years were 94.6%, 86.9%, and 68.8%, respectively. According to the Cox multivariate analysis, ABO incompatibility (hazard ratio [HR] 3.91, p < 0.002, DGF (HR 3.544, p < 0.004, CMV infection (HR 2.244, p < 0.011, and HBV infection (HR 6.349, p < 0.015 were independent risk factors for graft survival. Recipient age (HR 1.128, p < 0.024, ABO incompatibility (HR 3.014, p < 0.025, CMV infection (HR 2.532, p < 0.010, and the number of HLA mismatches (HR 1.425, p < 0.007 were independent risk factors for patient death.Kidney transplantation in the geriatric population showed good clinical outcomes. ABO incompatibility, DGF, CMV infection, and HBV infection were risk factors for graft failure and the recipient age, ABO incompatibility, CMV infection, and the number of HLA mismatches were risk factors for patient death in geriatric renal transplantation.

  13. Enhancing geriatric nursing scholarship: specialization versus generalization.

    Science.gov (United States)

    Mezey, M; Fulmer, T; Fairchild, S

    2000-07-01

    This article explores the relative merits of encouraging preparation of more nurses with specialization in geriatrics as compared to encouraging geriatric preparation among nurses whose major field of study is outside geriatrics. The article explores two approaches to examining capacity for geriatric nursing scholarship among nurse scholars not involved in geriatrics, and in schools of nursing with strength in research but with little geriatric research. The findings show an ongoing need to strengthen geriatric nursing as an area of specialization. Faculty prepared in geriatric nursing are underrepresented in schools of nursing, and only a small number of doctoral students specialize in geriatric nursing. Academic nursing programs with strength in geriatric nursing need ongoing support to maintain and expand current geriatric programs. Data support that encouraging individual non-geriatric nurse faculty and doctoral candidates to focus their work on areas of concern to geriatric nursing, and strengthening geriatrics in research-intensive schools of nursing that have not heavily invested in geriatric scholarship are viable options for strengthening academic geriatric nursing. Establishing mechanisms to attract nurse scholars working outside the scope of geriatric nursing to address clinical issues of concern to older adults offers promise in rapidly attracting new scholars to geriatric nursing.

  14. Prejudices and elderly patients' personality -- the problem of quality of care and quality of life in geriatric medicine.

    Science.gov (United States)

    Błachnio, Aleksandra; Buliński, Leszek

    2013-08-16

    The article discusses the position of elderly patients in medical intervention context. The phenomenon of greying population has changed the attitude towards the old but common observations prove that quality of geriatric care is still unsatisfactory. In order to improve specialists' understanding of ageing, the comparative study on personality among people at different age was designed. The results are discussed in relation to the elderly patient-centred paradigm and in order to counterbalance still present ageist practices. The research involved 164 persons in the early and late adulthood stage ages. Among the old there were the young old (aged 65-74) and the older old (aged 75+). All participants were asked to fill the NEO-FFI. The results prove age-related differences in personality. In late adulthood in comparison to early adulthood there is the decline in openness to experiences. Two traits: agreeableness and conscientiousness increase significantly. Age did not differentiate significantly the level of neuroticism and of extraversion. The results of cluster analyses show the further differences in taxonomies of personality traits at different period of life. The results challenge the stereotypes that present older people as neurotic, and aggressive. The age did not differentiate significantly the level of neuroticism and of extraversion. In general, the obtained results prove that the ageist assumption that the geriatric patients are troublesome is not arguable. This article builds support for effective change in geriatric professional practices and improvement in the elderly patients' quality of life.

  15. Electroconvulsive Therapy in the Elderly: New Findings in Geriatric Depression.

    Science.gov (United States)

    Geduldig, Emma T; Kellner, Charles H

    2016-04-01

    This paper reviews recent research on the use of electroconvulsive therapy (ECT) in elderly depressed patients. The PubMed database was searched for literature published within the past 4 years, using the search terms: "electroconvulsive elderly," "electroconvulsive geriatric," "ECT and elderly," and "ECT elderly cognition." The studies in this review indicate excellent efficacy for ECT in geriatric patients. Adverse cognitive effects of ECT in this population are usually transient and not typically severe. In addition, continuation/maintenance ECT (C/M-ECT) may be a favorable strategy for relapse prevention in the elderly after a successful acute course of ECT. ECT is an important treatment option for depressed geriatric patients with severe and/or treatment-resistant illness. New data add to the evidence demonstrating that ECT is a highly effective, safe, and well-tolerated antidepressant treatment option for geriatric patients.

  16. Experience with dedicated geriatric surgical consult services: Meeting the need for surgery in the frail elderly

    Directory of Open Access Journals (Sweden)

    Rosemarie E Hardin

    2009-01-01

    Full Text Available Rosemarie E Hardin1, Thierry Le Jemtel2, Michael E Zenilman11Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA; 2Department of Medicine, Tulane Medical Center, New Orleans, LA, USABackground: Surgeons are increasingly faced with consultation for intervention in residents of geriatric centers or in patients who suffer from end stage medical disease. We review our experience with consult services dedicated to the needs of these frail patients.Study design: Patients were prospectively followed after being evaluated by three different geriatric surgical consult services: Group 1 was based at a geriatric center associated with a tertiary medical center, Group 2 was based at a community geriatric center, and Group 3 was based with an hospital-based service for ambulatory patients with end stage congestive heart failure.Results: A total of 256 frail elderly patients underwent of 311 general surgical procedures ranging from major abdominal and vascular procedures to minor procedures such as debridement of decubitus ulcers, long-term intravenous access, enterostomy and enteral tube placement. Almost half of the surgical volume in Group 1 and 3 were ‘maintenance’ (decubitus debridement, long term intravenous or stomal or tube care; all of Group 2 were for treatment of decubiti. There was minimal morbidity and mortality from surgery itself, and overall one year survival for Groups 1, 2, and 3 was 46%, 60%, and 79%, respectively. Multivariate analysis showed that each group had its own unique indicators of decreased survival: Group 1 dementia and coronary artery disease, in Group 2 gender and coronary artery disease, and Group 3, gender alone. Age, number of comorbid illnesses, and type of surgery (major vs minor were not significant indicators.Conclusions: This is the first review of the role of dedicated surgical consult services which focused on residents of geriatric centers and frail elderly. Conditions routinely encountered

  17. Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Laura J. Anzaldi

    2017-10-01

    Full Text Available Abstract Background Geriatric syndromes, including frailty, are common in older adults and associated with adverse outcomes. We compared patients described in clinical notes as “frail” to other older adults with respect to geriatric syndrome burden and healthcare utilization. Methods We conducted a retrospective cohort study on 18,341 Medicare Advantage enrollees aged 65+ (members of a large nonprofit medical group in Massachusetts, analyzing up to three years of administrative claims and structured and unstructured electronic health record (EHR data. We determined the presence of ten geriatric syndromes (falls, malnutrition, dementia, severe urinary control issues, absence of fecal control, visual impairment, walking difficulty, pressure ulcers, lack of social support, and weight loss from claims and EHR data, and the presence of frailty descriptions in clinical notes with a pattern-matching natural language processing (NLP algorithm. Results Of the 18,341 patients, we found that 2202 (12% were described as “frail” in clinical notes. “Frail” patients were older (82.3 ± 6.8 vs 75.9 ± 5.9, p < .001 and had higher rates of healthcare utilization, including number of inpatient hospitalizations and emergency department visits, than the rest of the population (p < .001. “Frail” patients had on average 4.85 ± 1.72 of the ten geriatric syndromes studied, while non-frail patients had 2.35 ± 1.71 (p = .013. Falls, walking difficulty, malnutrition, weight loss, lack of social support and dementia were more highly correlated with frailty descriptions. The most common geriatric syndrome pattern among “frail” patients was a combination of walking difficulty, lack of social support, falls, and weight loss. Conclusions Patients identified as “frail” by providers in clinical notes have higher rates of healthcare utilization and more geriatric syndromes than other patients. Certain geriatric syndromes were more highly

  18. Outcomes of Geriatric Burns Treated as Outpatients.

    Science.gov (United States)

    Tanizaki, Shinsuke

    2017-10-01

    Most literature about geriatric burns has focused on inpatient management; therefore, our study investigated the effects of burn characteristics and preexisting medical comorbidities on treatment outcomes for geriatric burn patients treated as outpatients. A retrospective review was conducted for 391 patients over 65 years of age seen in the emergency department of Fukui Prefectural Hospital over a 10-year period. Charts were reviewed for age, sex, burn characteristics, burn mechanisms, preexisting medical comorbidities, and treatment outcomes. Multivariate regression analysis was used to examine the relationship between outcomes of outpatients and comorbidities, which were calculated by the Charlson comorbidity index. Seventy-three patients aged 65 years and older were treated as outpatients at Fukui Prefectural Hospital. The majority (80%) of these patients had burns on less than 5% of their total body surface area. Scald burns accounted for 63% of burn mechanisms, with burns to the lower extremities being the most frequent. The mean percentage of total burn surface area was 4% in the outpatient group and 28% for the inpatient group. The mean time to healing was 24.3 days in outpatients. Of the 73 outpatients, 17 (23%) showed delayed healing. Of these 17 patients, 3 patients experienced wound infection and 2 patients had documented hypertrophic scarring. Four patients ultimately underwent excision and grafting. The common preexisting medical comorbidities in the outpatient group were congestive heart failure and diabetic mellitus. There were no significant differences for medical comorbidities between outpatients and inpatients. The Charlson comorbidity index for outpatients with delayed healing was higher than that for those without delayed healing. The Charlson comorbidity index was associated with delayed healing of outpatients, but age or total burn surface area were not. The characteristics of geriatric burn outpatients were distinct from those of inpatients

  19. [Geriatric intensive care patients : Perspectives and limits of geriatric intensive care medicine].

    Science.gov (United States)

    Müller-Werdan, U; Heppner, H-J; Michels, G

    2018-04-18

    Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age. The main reasons for changes in therapeutic targets are the will of the patient and risk-benefit considerations. The guidelines of the ethics section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) provide assistance and suggestions for a structured decision-making process.

  20. Population Aging in Iran and Rising Health Care Costs

    Directory of Open Access Journals (Sweden)

    Mohammad Mirzaie

    2017-09-01

    Conclusion Based on the results of this research, it can be said that people throughout their life cycle always allocate a percentage of their total spending to health care costs, but the percentage of this allocation is different at different ages. In a way the demand for healthcare costs increases with aging, it rises significantly in the old age. At the macro level, due to an increase in the percentage of elderly in the population over the next decade, there will also be an increase in the share of health care costs.

  1. Geriatric Syncope and Cardiovascular Risk in the Emergency Department.

    Science.gov (United States)

    Ali, Nissa J; Grossman, Shamai A

    2017-04-01

    Syncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow. This article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk. Although syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern. History, physical examination, and electrocardiography (ECG) have the greatest utility in evaluating syncope. Additional testing should be guided by history and physical examination. There are multiple scoring tools developed to aid in management and these are reviewed in the article. Common predictors that would indicate a need for further work-up include a history of cardiac or valvular disease (i.e., ventricular dysrhythmia, congestive heart failure), abnormal ECG, anemia or severe volume depletion (i.e., from a gastrointestinal bleed), syncope while supine or with effort, report of palpitations or chest pain, persistent abnormal vital signs, or family history of sudden death. With advancing age, cardiovascular morbidity plays a more frequent and important role in the etiology of syncope. The syncope work-up should be tailored to the patient's presentation. Disposition should be based on the results of the initial evaluation and risk factors for adverse outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Geriatric Cardiology: An Emerging Discipline.

    Science.gov (United States)

    Dodson, John A; Matlock, Daniel D; Forman, Daniel E

    2016-09-01

    Given changing demographics, patients with cardiovascular (CV) disease in developed countries are now older and more complex than even a decade ago. This trend is expected to continue into the foreseeable future; accordingly, cardiologists are encountering patients with a greater number of comorbid illnesses as well as "geriatric conditions," such as cognitive impairment and frailty, which complicate management and influence outcomes. Simultaneously, technological advances have widened the therapeutic options available for patients, including those with the most advanced CV disease. In the setting of these changes, geriatric cardiology has recently emerged as a discipline that aims to adapt principles from geriatric medicine to everyday cardiology practice. Accordingly, the tasks of a "geriatric cardiologist" may include both traditional evidence-based CV management plus comprehensive geriatric assessment, medication reduction, team-based coordination of care, and explicit incorporation of patient goals into management. Given that the field is still in its relative infancy, the training pathways and structure of clinical programs in geriatric cardiology are still being delineated. In this review, we highlight the rationale behind geriatric cardiology as a discipline, several current approaches by geriatric cardiology programs, and future directions for the field. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Aging populations may improve the standard of living | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-21

    Jun 21, 2016 ... Recent research has shown that worldwide population changes could increase economic growth and promote equity across generations. Researchers have developed a system to quantify economic flows across different age groups. These “National Transfer Accounts” measure how different generations ...

  4. Population Aging and the Generational Economy: A Global ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-10-31

    Oct 31, 2011 ... Lee and Mason have done scholars and practitioners a magnificent service by undertaking this comprehensive, compelling, and supremely innovative examination of the economic consequences of changes in population age structure. The book is a bona fide crystal ball. It will be a must read for the next ...

  5. Population Aging and the Generational Economy: A Global ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    31 oct. 2011 ... This path-breaking book provides a comprehensive analysis of the macroeconomic effects of changes in population age structure across the globe. ... La mission du Canada auprès des Nations Unies projettera des extraits du film Little Gandhi, un documentaire sur la Syrie subventionné par le CDRI.

  6. Peritoneal dialysis in an ageing population: a 10-year experience.

    LENUS (Irish Health Repository)

    Smyth, Andrew

    2012-02-01

    Chronic kidney disease (CKD) is becoming increasingly prevalent and there are increasing numbers of older patients with advanced CKD. Peritoneal dialysis (PD) is a potential treatment. This study aims to compare PD outcomes in age-defined populations in the largest PD centre in the Republic of Ireland over 10 years.

  7. Population Ageing and the Theory of Demographic Transition: The ...

    African Journals Online (AJOL)

    Purpose – From high fertility and mortality rates in the 1960's, Mauritius has seen a demographic transition such that today population growth is among the lowest in the developing world. This has inevitably brought about the problem of ageing. The main objectives of the study are firstly to throw light on the demographic ...

  8. Is Geriatric Medicine Possible in a Middle-Income Country? The Case of Costa Rica.

    Science.gov (United States)

    Morales-Martínez, Fernando

    2017-08-01

    This article outlines the current and future-projected demographic data, organization, networks for the care of older people, and perspectives in Costa Rica in relation to the challenges resulting from exponential growth of the older adult population, most notably those aged 80 and older. It includes consideration of the Norms of Integrated Care of the Older Adult of Costa Rica's national social security system and contributions from other public and private institutions. It also makes note of commentaries on the need for ever-increasing efforts to manage the care of Costa Rica's burgeoning older adult population. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  9. Aging population and public pensions: Theory and macroeconometric evidence

    Directory of Open Access Journals (Sweden)

    Verbič Miroslav

    2014-01-01

    Full Text Available Rapidly aging population in high-income countries has exerted additional pressure on the sustainability of public pension expenditure. We present a theoretical model of public pension expenditure under endogenous human capital, where the latter facilitates a substantial decrease in equilibrium fertility rate alongside the improvement in life expectancy. We demonstrate how higher life expectancy and human capital endowment facilitate a rise of net replacement rate. We then provide and examine an empirical model of old-age expenditure in a panel of 33 countries for the period 1998-2008. Our results indicate that increases in effective retirement age and total fertility rate would reduce age-related expenditure substantially. While higher net replacement rate would alleviate the risk of old-age poverty, further increases would add considerable pressure on the fiscal sustainability of public pensions.

  10. Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

    DEFF Research Database (Denmark)

    Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn

    2016-01-01

    -rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus...... Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms...

  11. Undergraduate teaching in geriatric medicine: mapping the British Geriatrics Society undergraduate curriculum to Tomorrow's Doctors 2009.

    Science.gov (United States)

    Forrester-Paton, Calum; Forrester-Paton, Jayne; Gordon, Adam Lee; Mitchell, Hannah K; Bracewell, Nicola; Mjojo, Jocelyn; Masud, Tahir; Gladman, John R F; Blundell, Adrian

    2014-05-01

    in 2008, the British Geriatrics Society (BGS) developed the Recommended Undergraduate Curriculum in Geriatric Medicine. This was subsequently mapped to the second edition of Tomorrows' Doctors (TD2, 2003). Following the publication of the third edition of Tomorrow's Doctors in 2009 (TD3), the mapping exercise was repeated to verify the extent to which the updated General Medical Council recommendations supported teaching in ageing and geriatric medicine. we analysed TD3 and identified 48 aspects of its general guidance that were relevant to the teaching of medicine for older people. We then mapped these to the 2009 BGS curriculum. the BGS curriculum was supported in full by TD3. However, learning outcomes relating to the interpretation and conduct of research in TD3 had no corresponding outcomes in the BGS curriculum. the BGS curriculum for medical undergraduates continues to provide a specific and complete list of learning objectives, all of which could help to operationalise the general statements made in TD3 with relation to ageing and geriatric medicine. Learning outcomes in research in frail older patients have been added following this mapping exercise.

  12. Association of anemia and hypoalbuminemia in German geriatric inpatients: Relationship to nutritional status and comprehensive geriatric assessment.

    Science.gov (United States)

    Röhrig, G; Becker, I; Polidori, M C; Schulz, R-J; Noreik, M

    2015-10-01

    Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people. This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2% female and 31.8% male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients. Patients with anemia suffered significantly more often from HA (pGeriatric inpatients with anemia should be evaluated in terms of the presence of malnutrition risk and HA.

  13. On the age difference between the oldest population I and the extreme population II stars

    International Nuclear Information System (INIS)

    Saio, H.; Shibata, Y.

    1977-01-01

    The age difference between the oldest Population I stars and the extreme Population II stars is investigated by comparison of observational H-R diagrams with theoretical results using the common input physics and computer prgram for both populations. Chemical compositions adopted for Population I and II stars are, X=0.7 and Z=0.02, and X=0.7, and Z=2 x 10 -4 , respectively. Evidence collected indicates that the open cluster NGC 188 and the globular cluster M92 are the representative samples of the oldest Population I and extreme Population II stars, respectively. Comparison between the observed H-R diagrams and theoretical isochrones in terms of the luminosity of the subgiant region and the turnoff point for NGC 188 and M92, respectively, then suggests that there is a significant age difference between Population I and II objects. The uncertainty of the oxygen abundance in the extreme Population II stars and its effect on their age determination is briefly discussed. (Auth.)

  14. Changes in Statin Prescription Patterns in Patients Admitted to an Australian Geriatric Subacute Unit.

    Science.gov (United States)

    Noaman, Samer; Al-Mukhtar, Omar; Abramovic, Sheri; Mohammed, Hanin; Goh, Cheng Yee; Long, Claire; Neil, Christopher; Janus, Edward; Cox, Nicholas; Chan, William

    2018-01-31

    Assessment of demographic and clinical factors influencing the decision of statin discontinuation in the elderly population admitted to subacute geriatric unit. The aim of this study is to assess the clinical factors impacting the decision-making process of statin discontinuation in the elderly. We retrospectively assessed changes in statin discontinuation and prescription among patients (≥60 years old) discharged from a geriatric evaluation and management unit by reviewing hospital digital medical records at Western Health - The Williamstown Hospital over a 12-month period from 4 February 2012 until 4 February 2013 inclusive. The main outcome of the study was to determine the independent predictors of statin discontinuation using logistic regression analysis. Of the studied population, 46% were already prescribed statins prior to their admission. Statins were discontinued in 17.5% of patients at discharge. Predictors of statin de-prescription included octogenarian status, primary prevention indication, poor functional recovery, residential care facility discharge destination and lower cognitive function. The presence of previous cardiovascular disease history and the burden of comorbidities were not predictors of statin discontinuation. We observed that factors that conveyed poor prognosis such as advanced age, poor functional recovery, worse cognitive function, being discharged to a residential care facility as well as primary prevention indication for statin prescription are predictors of statin discontinuation in the geriatric unit. Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  15. Epidemiological aspects related to population aging in a health area

    Directory of Open Access Journals (Sweden)

    Raidel González Rodríguez

    2015-10-01

    Full Text Available Background: the increase of the number of the elderly in our country augments necessities, social and health system demands during the last years.Objective: to describe the epidemiological aspects related to the population aging of the health area corresponding to a family doctor’s office in Pinar del Río province.Methods: a cross-sectional, descriptive and observational research was carried out in the family doctor’s office no. 15 belonging to "Raúl Sánchez" Teaching Polyclinic during the last three-month period of 2014. The universe was made up of 113 elderly belonging to that health area and the sample comprised 73 of them, according to intentional sampling. The variables analyzed were: age groups, most frequent diseases and medication intake.Results: elderly aged between 80 and 89 years old represented 56,1 %. The medication groups most frequently taken were the vitamins, in 82,1 %, the sedative-hypnotic ones, in 56,1 % and the antihypertensive drugs in 43,8 %. The most frequent diseases were hypertension, with 64,3 % cerebrovascular diseases, with 35,6 % and psychiatric diseases, with 24,6 %.Conclusions: issues related to the population aging were described in the study sample. A conception and integral medical care to ensure the quality of life and health of that population is required.

  16. The epidemiology of dysphonia in the aging population.

    Science.gov (United States)

    Marino, Jeffrey P; Johns, Michael M

    2014-12-01

    The expanding elderly population continues to exert profound effects on the United States healthcare delivery system. This review summarizes the epidemiology of dysphonia in the aging population as well as its impact on quality of life and the emerging challenges of managing elderly patients with voice disorders. Although often underreported, dysphonia is present in as many as one in three elderly patients. The differential diagnosis for dysphonia in an aging patient is broad, and multifactorial causes are common. In the elderly, dysphonia exerts significant adverse effects on quality of life and often occurs against a background of multiple chronic medical conditions, polypharmacy, hearing loss, dysphagia, and neurologic disease. Recent data have demonstrated that elderly patients respond well to both surgical and nonsurgical treatments for voice disorders. Elderly patients and medical providers, as well as families and caregivers, must be educated about the prevalence of dysphonia in the aging population, its psychosocial impact, and available treatment options. Optimizing the care of voice disorders is essential to maximizing quality of life in aging patients.

  17. [Judging method of individual age and age structure of Stellera chamaejasme population in degraded steppe].

    Science.gov (United States)

    Xing, Fu; Gou, Jixun; Wei, Chunyan

    2004-11-01

    Based on the minute observation of branches morphology of root-crown of Stellera chamaejasme in Cleistogenes squarosa community and its growth characteristics, this paper studied the age structure of S. chamaejasme population, and an individual age judging method "the times of quasi-dichotomous branching plus two" was put forward for the first time. Remnant stubbles, branch trace, and annular trace on the root crown were regarded as important morphological features, and used to confirm the times of quasi-dichotomous branching. The results showed that the oldest individuals at three grazing succession stages (i.e., heavy grazing, over grazing and extreme grazing) were 15, 16 and 19 years old, respectively. Among all age classes, the numbers of eight years old individuals were the largest, and the age ratio was 18.71%, 24.20% and 19.06%, respectively, at the different succession stages. There were no one- and two-year old individuals at heavy grazing stage, and no one-year old individuals at the other two grazing stages. The age structures of the populations were "early declining types", and the survival curves were similar to protuberant type or Deevey I type. The numbers of old age individuals (thirteen years old and more) at the three succession stages accounted for 4.83%, 2.84% and 14.02%, respectively. The age structure of the population tended to aging with the increase of grazing intensity.

  18. Spirometry reference equations for central European populations from school age to old age.

    Directory of Open Access Journals (Sweden)

    Mascha K Rochat

    Full Text Available BACKGROUND: Spirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations. OBJECTIVE: To develop spirometry reference equations for central European populations between 8 and 90 years of age. MATERIALS: We used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS. RESULTS: The spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51% females and 58'267 (49% males. Altogether, there were 18'211 (15.3% children under the age of 18 years. CONCLUSION: We developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

  19. Validez y confiabilidad del cuestionario del ENASEM para la depresión en adultos mayores Validity and reliability of the screening questionnaire for geriatric depression used in the Mexican Health and Age Study

    Directory of Open Access Journals (Sweden)

    Sara Gloria Aguilar-Navarro

    2007-08-01

    Full Text Available OBJETIVO: Estimar la validez y confiabilidad de un instrumento para detectar depresión en adultos mayores. MATERIAL Y MÉTODOS: El estudio se realizó en la consulta externa del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ, entre mayo de 2005 y marzo de 2006. Se utilizaron el diagnóstico clínico de depresión a través de el Manual Diagnóstico y Estadístico de Trastornos Mentales, en su cuarta versión revisada (DSM-IV-TR, y la Escala de depresión geriátrica (EDG de Yesavage, para establecer las propiedades clinimétricas de un cuestionario dicotómico de nueve reactivos, desprendido del Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM. RESULTADOS: En el proceso de validación participaron 199 individuos de edad media de 79.5 años. El resultado del cuestionario de la ENASEM estuvo significativamente correlacionado con el diagnóstico clínico de depresión (pOBJECTIVE: To assess the validity and reliability of a geriatric depression questionnaire used in the Mexican Health and Age Study (MHAS. METHODS: The study was conducted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ clinic from May 2005 to March 2006. This depression screening nine-item questionnaire was validated using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR (fourth revised version and Yesavage's 15-item Geriatric Depression Scale (GDS-15 criteria. The instrument belongs to the MHAS, a prospective panel study of health and aging in Mexico. RESULTS: A total of 199 subjects 65 years of age and older participated in the validation process (median age= 79.5 years. MHAS questionnaire result was significantly correlated to the clinical depression diagnosis (p<0.001 and to the GDS-15 score (p<0.001. Internal consistency was adequate (alpha coefficient: 0.74. The cutoff point e" 5/9 points yielded an 80.7% and 68.7% sensitivity and specificity respectively. The fidelity

  20. AN AGING POPULATION: A COMPETITIVE ADVANTAGE FOR COMPANIES

    Directory of Open Access Journals (Sweden)

    Petra Barešová

    2018-03-01

    Full Text Available This article focuses on one of the most currently discussed topics, the ageing population. Population aging can be discussed from different perspectives, exploring various challenges associated with it. The authors examined marketing communications from the point of view of a target group, over age 55. The main objective of this study was to find out which marketing communication tools those over age 55 prefer, including selected aspects of printed advertising. At the same time, it was examined whether there is a different gender perspective on this issue. To find out answers to the main question of this study, we conducted quantitative research by using a questionnaire survey among the population over age 55 living in the Czech Republic (Zlín Region. The results of this study were compared with the results of a previous study conducted in 2014, focusing on the marketing communication tools targeted at the 55+ group from the point of view of companies. The research results have shown that the target groups’ most effective (preferred marketing communication tools are printed materials (leaflets and catalogues, sales promotions, competitions, club memberships, gifts, fairs, markets and fairs, and last but not least, newspapers and magazines. Based on the results, it can be said that these tools, in comparison with others, contain sufficient information that the customer can read and think about, save, and eventually return to them. At the same time, they are tools that bring a certain benefit or advantage to the customer, which can then be verified in person. If the results are compared from a gender perspective, different preferences were revealed in the selection of marketing communication tools. There were also different views on some selected aspects of printed materials. These findings can be implemented by companies and organizations in their marketing campaigns, allowing them to better reach the target group of people over age 55

  1. Social participation and the onset of hypertension among the middle-aged and older population: Evidence from the China Health and Retirement Longitudinal Study.

    Science.gov (United States)

    Tu, Raoping; Inoue, Yosuke; Yazawa, Aki; Hao, Xiaoning; Cai, Guoxi; Li, Yueping; Lin, Xiuquan; He, Fei; Yamamoto, Taro

    2018-03-30

    While previous studies have examined the association between health-related behaviors and hypertension, comparatively little attention has been paid to the role of social participation (i.e. participating in community organizations). The aim of the present study was to investigate the longitudinal association between social participation and hypertension among the middle-aged and older population (aged ≥45 years) in China where the prevalence of hypertension has been increasing rapidly in the past few decades. Data came from the China Health and Retirement Longitudinal Study waves 2011 and 2013. Information was obtained from 5483 participants on blood pressure, social participation and covariates. A sex-stratified Poisson regression model with a robust variance estimator was used to examine the associations. During the period between 2011 and 2013, 20.6% of men and 17.2% of women developed hypertension. A Poisson regression model showed that participating in community organizations once a week or more frequently was inversely associated with the onset of hypertension in women (incidence rate ratio 0.80, 95% confidence interval 0.67-0.95, P = 0.012). Among men, no such association was found. The present study suggests that promoting social participation might help mitigate the disease burden associated with hypertension in China, particularly among women. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  2. Risk of Cardiovascular Disease in an Aging HIV Population

    DEFF Research Database (Denmark)

    Martin-Iguacel, R; Llibre, J M; Friis-Moller, N

    2015-01-01

    With more effective and widespread antiretroviral treatment, the overall incidence of AIDS- or HIV-related death has decreased dramatically. Consequently, as patients are aging, cardiovascular disease (CVD) has emerged as an important cause of morbidity and mortality in the HIV population....... The incidence of CVD overall in HIV is relatively low, but it is approximately 1.5-2-fold higher than that seen in age-matched HIV-uninfected individuals. Multiple factors are believed to explain this excess in risk such as overrepresentation of traditional cardiovascular risk factors (particularly smoking...

  3. Evaluation of a simulation training programme for geriatric medicine.

    Science.gov (United States)

    Braude, Philip; Reedy, Gabriel; Dasgupta, Deblina; Dimmock, Valerie; Jaye, Peter; Birns, Jonathan

    2015-07-01

    geriatrics encompasses diverse medical, social and ethical challenges requiring a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of older people. It is therefore vital that trainees in geriatrics are afforded opportunities to develop skills in managing this complex population. Simulation has been adopted as a teaching tool in medicine; however, evidence for its use in geriatrics has been limited to small, single-site studies primarily involving role-play or discrete clinical skills training. a standardised, two centre, multimodal, interprofessional, geriatrics simulation training programme was developed using curriculum-mapped scenarios in which the patient perspective was central. Simulation techniques used included high-fidelity patient manikins, actors with integrated clinical skills using part-task trainers and role-play exercises. A mixed-methods evaluation was used to analyse data from participants before and after training. eighty-nine candidates attended 12 similar courses over 2 years. Thematic analysis of candidate feedback was supportive of simulation as a useful tool, with benefits for both technical and non-technical skills. Candidates commented that simulation was a valuable training modality addressing curriculum areas rarely taught formally including continence assessment, end-of-life decisions and multidisciplinary situations. Quantitative analysis of pre- and post-course questionnaires revealed a significant improvement of self-reported confidence in managing geriatric scenarios (mean improvement 11.5%; P geriatrics. Simulation training affords situational learning without compromising patient safety and is an exciting and novel method of delivering teaching for geriatrics that could be integrated into national training curricula. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. A community-based approach for integrating geriatrics and gerontology into undergraduate medical education.

    Science.gov (United States)

    Martinez, Iveris L; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences. This approach is intended to expose students to older adults from diverse communities and adequately prepare students to address the complex and individual needs of these patients. Initial results indicate proficiency in the minimum geriatric competencies covered. The growth and diversity of the older adult population makes it important to integrate and evaluate geriatrics education in undergraduate medical education.

  5. Does Population Aging Drive Up Pro-Elderly Social Spending?

    DEFF Research Database (Denmark)

    Vanhuysse, Pieter

    This essay reviews recent evidence on the pro-elderly social spending bias of OECD welfare states. It shows that the cross-national variance in this variable is remarkably large, with Southern Europe and countries such as Germany, Austria, Japan, the USA, and Switzerland being most heavily pro......-elderly biased. It then points out that population ageing actually cannot explain very much of this pro-elderly bias variance. For instance, countries such as Denmark, Finland and Sweden are demographically old societies, yet they boast among the lowest pro-elderly spending biases in the OECD world, due...... to their greater commitment to family-friendly policies, active labour market policies and similar pro-young policies. The essay reviews a series of similarly counter-intuitive findings about generational politics and policies as published in Ageing Populations in Post-Industrial Democracies (Vanhuysse and Goerres...

  6. Impact of Population Aging on Asia's Future Growth

    OpenAIRE

    Park, Donghyun; Shin, Kwanho

    2011-01-01

    First, the expert contributors argue, Asia must find ways to sustain rapid economic growth in the face of less favorable demographics, which implies slower growth of the workforce. Second, they contend, Asia must find ways to deliver affordable, adequate, and sustainable old-age economic security for its growing elderly population. Underpinned by rigorous analysis, a wide range of concrete policy options for sustaining economic growth while delivering economic security for the elderly are the...

  7. Perceived health in the Portuguese population aged ? 35

    OpenAIRE

    Figueiredo, João Paulo de; Cardoso, Salvador Massano

    2014-01-01

    OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which coll...

  8. [The geriatric assessment].

    Science.gov (United States)

    Friedrich, Christoph; Schultheis, Beate S; Pientka, Ludger

    2009-01-01

    Due to demographic changes there is an increasing number of elderly and old patients with cancer. This group of patients shows a significant heterogeneity and differs from the average young patient. Identification of relevant functional deficits and comorbidities remains crucial for an efficient treatment strategy of this patient group. For this reason, the geriatric assessment has been developed and integrated in daily oncological practice. Within this diagnostic approach oncologists can for example identify elderly fit patients suitable for aggressive treatments or identify at-risk patients for complications. Recent studies have shown that this approach is feasible in daily practice and capable of improving outcome. There is still the need for more specific instruments for different cancers. Copyright 2009 S. Karger AG, Basel.

  9. Continuing education in geriatrics for rural health care providers in ...

    African Journals Online (AJOL)

    Population trends in developing countries show an increasing population of older adults (OAs), especially in rural areas. The purpose of this study was to explore the geriatrics continuing education needs of health care providers (HCPs) working in rural Uganda. The study employed a descriptive design to collect data from ...

  10. Prevalence of oral soft tissue lesions and medical assessment of geriatric outpatients in North India

    Directory of Open Access Journals (Sweden)

    Sameer Rastogi

    2015-01-01

    Full Text Available Introduction: Oral health reflects overall well-being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in old age. Oral health evaluation should be an integral part of the physical examination, and dentistry is essential to qualify geriatric patient care. Aim: To determine the prevalence of oral soft tissue lesions and systemic diseases in institutionalized geriatric population in North India. Materials and Methods: Geriatric patients were clinically evaluated using a standard questionnaire and assessed for known medical illnesses and prevalence of oral soft tissue lesions. Four hundred patients (71% males and 29% females with age ranging from 60 to 100 years were considered in the study group. Twenty-two (33.8% patients were edentulous and seven patients (10.8% were denture wearers. Forty-four (67.69% patients reported with tobacco habits. Results: Most prevalent medical illness reported was diminished vision (15.5%, followed by hypertension (10% and diabetes mellitus (6.25%. Several oral soft tissue lesions were reported among the study population. The most prevalent lesions were leukoplakia (12%, smoker′s melanosis (10%, smoker′s palate (9%, pigmentation on tongue (6%, frictional keratosis (5%, lichen planus (3%, denture stomatitis (2.5%, aphthous ulcers (2%, angular chelitis (1.5%, oral submucous fibrosis (1.5%, melanotic macule (1.5%, candidiasis (1.5%, irritation fibroma (1%, geographic tongue (1%, median rhomboid glossitis (1%, and traumatic ulcer (1%. Conclusion: The findings observed in this population are important and can have a determinant effect on the overall quality of life in this population. This information is a crucial prerequisite for health awareness programs involving the community health workers, oral physicians, and medical professionals.

  11. The embodied and relational nature of the mind: implications for clinical interventions in aging individuals and populations

    Directory of Open Access Journals (Sweden)

    Rejeski WJ

    2013-06-01

    Full Text Available W Jack Rejeski,1 Lise Gauvin2 1Department of Health and Exercise Science and Department of Geriatric Medicine, Wake Forest University, Winston-Salem, NC, USA; 2Research Center of the University of Montréal Hospital Center, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada Abstract: Considerable research over the past decade has garnered support for the notion that the mind is both embodied and relational. Jointly, these terms imply that the brain, physical attributes of the self, and features of our interpersonal relationships and of the environments in which we live jointly regulate energy and information flow; they codetermine how we think, feel, and behave both individually and collectively. In addition to direct experience, evidence supports the view that stimuli embedded within past memories trigger multimodal simulations throughout the body and brain to literally recreate lived experience. In this paper, we review empirical support for the concept of an embodied and relational mind and then reflect on the implications of this perspective for clinical interventions in aging individuals and populations. Data suggest that environmental influences literally “get under the skin” with aging; that musculoskeletal and visceral sensations become more prominent in activities of the mind due to aging biological systems and chronic disease. We argue that conceiving the mind as embodied and relational will grow scientific inquiry in aging, transform how we think about the self-system and well-being, and lead us to rethink health promotion interventions aimed at aging individuals and populations. Keywords: behavior change, gerontology, disablement, well-being, embodiment

  12. Promoting ICT innovations for the ageing population in Japan.

    Science.gov (United States)

    Obi, Toshio; Ishmatova, Diana; Iwasaki, Naoko

    2013-04-01

    The paper aims to explore effective measures and strategies for the promotion of ICT-enabled innovations for the elderly and people with special needs. The paper begins by reviewing current government initiatives in the field of e-health and accessibility that are addressing challenges faced by Japan's rapidly ageing society. It then evaluates the results of Japanese government efforts in the promotion of ICT solutions for its older population against the availability of special infrastructure, device interfaces, and services and applications that meet five essential needs of the elderly with regard to quality of life in highly developed countries. The results of the study suggest that more efforts are needed to exploit ICT to transform all domains of society in order to meet the challenges produced by a rapidly ageing population. For that purpose the paper proposes 12 main areas in which to facilitate ICT innovations for an ageing population. It then outlines a number of strategic directions for the formulation of specific measures that will place Japan in the forefront of societal transformation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Geriatrics Education Team Model Results in Sustained Geriatrics Training in 15 Residency and Fellowship Programs and Scholarship.

    Science.gov (United States)

    Denson, Steven; Simpson, Deborah; Denson, Kathryn; Brown, Diane; Manzi, Gabriel; Rehm, Judith; Wessel, Bambi; Duthie, Edmund H

    2016-04-01

    Caring for the growing elderly population will require specialty and subspecialty physicians who have not completed geriatric medicine fellowship training to participate actively in patient care. To meet this workforce demand, a sustainable approach to integrating geriatrics into specialty and subspecialty graduate medical education training is needed. This article describes the use of a geriatrics education team (GET) model to develop, implement, and sustain specialty-specific geriatrics curricula using a systematic process of team formation and needs assessment through evaluation, with a unique focus on developing curricular interventions that are meaningful to each specialty and satisfy training, scholarship, and regulatory requirements. The GET model and associated results from 15 specialty residency and fellowship training programs over a 4-year period include 93% curriculum sustainability after initial implementation, more than half of the programs introducing additional geriatrics education, and more than 80% of specialty GETs fulfilling their scholarship requirements through their curriculum dissemination. Win-wins and barriers encountered in using the GET model, along with the model's efficacy in curriculum development, sustainability, and dissemination, are summarized. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  14. Geriatric Fever Score: a new decision rule for geriatric care.

    Directory of Open Access Journals (Sweden)

    Min-Hsien Chung

    Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

  15. Aging with HIV vs. HIV seroconversion at older age: a diverse population with distinct comorbidity profiles.

    Science.gov (United States)

    Guaraldi, Giovanni; Zona, Stefano; Brothers, Thomas D; Carli, Federica; Stentarelli, Chiara; Dolci, Giovanni; Santoro, Antonella; Beghetto, Barbara; Menozzi, Marianna; Mussini, Cristina; Falutz, Julian

    2015-01-01

    People aging with HIV might have different health conditions compared with people who seroconverted at older ages. The study objective was to assess the prevalence of, and risk factors for, individual co-morbidities and multimorbidity (MM) between HIV-positive patients with a longer duration of HIV infection, and patients who seroconverted at an older age. We compared estimates across both groups to a matched community-based cohort sampled from the general population. We performed a case-control study including antiretroviral therapy (ART)-experienced patients who were HIV seropositive for ≥ 20.6 years ("HIV-Aging"), or who were seropositive for Aged") having access in 2013 at the Modena HIV Metabolic Clinic. Patients were matched in a 1:3 ratio with controls from the CINECA ARNO database. MM was defined as the concurrent presence of >2 NICM. Logistic regression models were constructed to evaluate associated predictors of NICM and MM. We analysed 404 HIV-Aging and 404 HIV-Aged participants in comparison to 2424 controls. The mean age was 46.7 ± 6.2 years, 28.9% were women. Prevalence of HIV co-morbidities and MM were significantly higher in the HIV-positive groups compared to the general population (paging vs aged group. This difference turned to be significant in patients above the age of 45 years old (paging with HIV display heterogeneous health conditions. Host factors and duration of HIV infection are associated with increased risk of MM compared to the general population.

  16. Population aging and the extended family in Taiwan

    Directory of Open Access Journals (Sweden)

    2004-05-01

    Full Text Available Population aging produces changes in the availability of kin with uncertain implications for extended living arrangements. We propose a highly stylized model that can be used to analyze and project age-specific proportions of adults living in extended and nuclear households. The model is applied to Taiwan using annual data from 1978-1998. We estimate cohort and age effects showing that more recently born cohorts of seniors are less likely to live in extended households, but that as seniors age the proportion living in extended households increases. The effect of individual aging has diminished over time, however. The proportion of non-senior adults living in extended households has increased steadily because changes in the age structure have increased the availability of older kin. The model is used to project living arrangements and we conclude that the proportion living in extended households will begin to decline gradually for both seniors and non-seniors. The extended family is becoming less important in Taiwan, but it is not on the way out.

  17. The Impact of an Aging Population in the Workplace.

    Science.gov (United States)

    White, Mercedia Stevenson; Burns, Candace; Conlon, Helen Acree

    2018-03-01

    According to the Centers for Disease Control and Prevention, the number of people 65 years of age or older living in the United States is projected to double by 2030 to 72 million adults, representing 20% of the total U.S. Evidence suggests that older Americans are working longer and spending more time on the job than their peers did in previous years. The increased number of older adults working longer is observed not only in the Unites States but also worldwide. There are numerous ramifications associated with the changing demographics and the expanding prevalence of an aging population in the workforce. Dynamics that arise include stereotyping and discrimination, longevity and on-site expert knowledge, variances in workplace behavior, a multigenerational employee pool, chronic disease management, occupational safety, and the application of adaptive strategies to reduce injury occurrences. Occupational health nurses play a pivotal role in implementing best practices for an aging-friendly workplace.

  18. Economic impacts of demographics ageing of Czech population

    Directory of Open Access Journals (Sweden)

    Bohumil Minařík

    2006-01-01

    Full Text Available Through the last fifteen years, the Czech Republic rank among the advanced European countries. It has brought both positives and negatives. The most problematic are questions of a population ageing as a result of the natural increase of inhabitants. In this article, there are presented sources of information and basic methodical instruments and related demographic indicators. This article is dealing with an actual demographic situation in the Czech Republic and its anticipated development until 2050 year in reference to a natality, mortality and foreign migration. In the last fifteen years, the mortality decreased significantly (from 12.5 in 1990 to 10.5 in 2004 and expectation of life (men: from 67.5 in 1990 to 72.6 in 2004, women: from 76.0 to 79.4 on one hand, but on the other hand, the total fertility decreased dramatically (from 1.89 in 1990 to 1.20 in 2004. Until 2050 year is supposed to increase the average age of population at about ten years and a rate of age category over 65 years should grow to double of actual situation. On the other hand, medial variety of prediction is supposed (beyond a certain temporary decrease to increase of total fertility to a value of 1.62 at average birth mother age over 29 years. The outcome of this work will be another expressive downgrade of demographic situation and extreme pressure to the retirement system. The other part of work is dealing with causes and consequences of population ageing, for example in reference to a labour market and unemployment, but also in reference to educational system, health and retirement system. This article also recapitulates relevant continuity of the unfavourable demographic situation solution, especially in the point of main political subject view in the Czech Republic. There are mainly different options of population policy, a pressure to a decrease of a population education and especially a retirement reform. The particular proposals are influenced by a different

  19. Cold hardiness increases with age in juvenile Rhododendron populations

    Directory of Open Access Journals (Sweden)

    Rajeev eArora

    2014-10-01

    Full Text Available Winter survival in woody plants is controlled by environmental and genetic factors that affect the plant's ability to cold acclimate. Because woody perennials are long-lived and often have a prolonged juvenile (pre-flowering phase, it is conceivable that both chronological and physiological age factors influence adaptive traits such as stress tolerance. This study investigated annual cold hardiness (CH changes in several hybrid Rhododendron populations based on Tmax, an estimate of the maximum rate of freezing injury (ion leakage in cold-acclimated leaves from juvenile progeny. Data from F2 and backcross populations derived from R. catawbiense and R. fortunei parents indicated significant annual increases in Tmax ranging from 3.7 to to 6.4 C as the seedlings aged from 3 to 5 years old. A similar yearly increase (6.7° C was observed in comparisons of 1- and 2-year-old F1 progenies from a R. catawbiense x R. dichroanthum cross. In contrast, CH of the mature parent plants (> 10 years old did not change significantly over the same evaluation period. In leaf samples from a natural population of R. maximum, CH evaluations over two years resulted in an average Tmax value for juvenile 2- to 3- year- old plants that was 9.2 C lower than the average for mature (~30 years old plants. . A reduction in CH was also observed in three hybrid rhododendron cultivars clonally propagated by rooted cuttings (ramets - Tmax of 4-year-old ramets was significantly lower than the Tmax estimates for the 30- to 40-year-old source plants (ortets. In both the wild R. maximum population and the hybrid cultivar group, higher accumulation of a cold-acclimation responsive 25kDa leaf dehydrin was associated with older plants and higher CH. The feasibility of identifying hardy phenotypes at juvenile period and research implications of age-dependent changes in CH are discussed.

  20. A comparison of end-stage renal disease and Alzheimer's disease in the elderly through a comprehensive geriatric assessment.

    Science.gov (United States)

    Soysal, Pinar; Isik, Ahmet Turan; Buyukaydin, Banu; Kazancioglu, Rumeyza

    2014-08-01

    The percentage of patients receiving haemodialysis (HD) treatment and of patients with Alzheimer's disease (AD) within the elderly population is increasing day by day. Functional dependence, malnutrition, cognitive impairment or depression impairs the quality of life and increases mortality in both diseases. This study aims to assess HD and AD patients through comprehensive geriatric assessment (CGA) and compare their results. A total of 579 patients (121 HD, 188 AD patients and 270 control subjects) over the age of 65, who were followed at geriatric and nephrology departments between January 2011 and July 2012, were included in this prospective cross-sectional study. Mini-Mental State Examination, Mini-Nutritional Assessment, Geriatric Depression Scale and basic and Instrumental Activities of Daily Living indexes were applied to all patients. The results obtained were compared among the patient groups. The mean age of the participants was 72.6 ± 8.2. Based on the CGA findings, the results for both groups were considerably different from control group. While depression scores were observed higher in HD patients than in AD patients, cognition, nutrition and functional capacity were mostly affected in AD patients. The management of geriatric HD patients is substantially complex. Depression, cognitive impairment and decrease in functional capacity can often be overlooked, so findings may be ascribed to underlying kidney impairment. Therefore, comprehensive geriatric assessment should be regularly performed in HD patients in order to detect problems at an early stage, to take necessary preventative measures, to initiate treatment as soon as possible and to enhance quality of life.

  1. Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

    Directory of Open Access Journals (Sweden)

    Genaro G. Ortiz

    2012-01-01

    Full Text Available Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA, Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE and the Geriatric Depression Scale (GDS, respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men; no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men; no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60. Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

  2. Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

    Science.gov (United States)

    Ortiz, Genaro G.; Arias-Merino, Elva D.; Flores-Saiffe, María E.; Velázquez-Brizuela, Irma E.; Macías-Islas, Miguel A.; Pacheco-Moisés, Fermín P.

    2012-01-01

    Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60. PMID:23243421

  3. Refractive errors in a Brazilian population: age and sex distribution.

    Science.gov (United States)

    Ferraz, Fabio H; Corrente, José E; Opromolla, Paula; Padovani, Carlos Roberto; Schellini, Silvana A

    2015-01-01

    To determine the prevalence of refractive errors and their distribution according to age and sex in a Brazilian population. This population-based cross-sectional study involved 7654 Brazilian inhabitants of nine municipalities of Sao Paulo State, Brazil, between March 2004 and July 2005. Participants aged >1 year were selected using a random, stratified, household cluster sampling technique, excluding individuals with previous refractive or cataract surgery. Myopia was defined as spherical equivalent (SE) ≤-0.5D, high myopia as SE ≤-3.0D, hyperopia as SE ≥+0.5D, high hyperopia as SE ≥+3D, astigmatism as ≤-0.5DC and anisometropia as ≥1.0D difference between eyes. Age, sex, complaints and a comprehensive eye examination including cycloplegic refraction test were collected and analysed using descriptive analysis, univariate and multivariate methods. The prevalence of astigmatism was 59.7%, hyperopia 33.8% and myopia was 25.3%. Astigmatism had a progressive increase with age. With-the-rule (WTR) axes of astigmatism were more frequently observed in the young participants and the against-the-rule (ATR) axes were more frequent in the older subjects. The onset of myopia occurred more frequently between the 2nd and 3rd decades of life. Anisometropia showed a prevalence of 13.2% (95% CI 12.4-13.9; p refractive error and hyperopia was also associated with sex. Hyperopia was associated with WTR axes (odds ratio 0.73; 95% CI: 0.6-0.8; p prevalent refractive error in a Brazilian population. There was a strong relationship between age and all refractive errors and between hyperopia and sex. WTR astigmatism was more frequently associated with hyperopia and ATR astigmatism with myopia. The vast majority of participants had low-grade refractive error, which favours planning aimed at correction of refractive error in the population. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

  4. Association of Microalbuminuria with Metabolic Syndrome among Aged Population

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Li

    2016-01-01

    Full Text Available Background. The impact of the various components of metabolic syndrome (MetS on chronic kidney disease has been conflicting. We aim to investigate the association between MetS and microalbuminuria and identify the major contributing components of MetS that result in microalbuminuria in the Chinese aged population. Methods. A total of 674 adults aged 55–98 years (males: 266; mean age: 66.5±7.5 years were studied. MetS was defined by the 2004 Chinese Diabetes Society criteria and microalbuminuria by urine albumin-creatinine ratio (UACR ≥3 mg/mmoL. Results. The prevalence of microalbuminuria was gradually increased with increasing number of MetS components (P<0.05. In multivariate regression, after adjusting for age and sex, MetS was the strongest correlate of microalbuminuria (OR = 1.781, 95% CI = 1.226–2.587; P<0.05 followed by the fasting plasma glucose (FPG (OR = 1.217, 95% CI = 1.044–1.092; P<0.05, systolic blood pressure (SBP (OR = 1.011, 95% CI = 1.107–1.338; P<0.05, and high-density lipoprotein cholesterol (HDL-C (OR = 0.576, 95% CI = 0.348–0.953; P<0.05. Conclusions. MetS is independently associated with microalbuminuria in the Chinese aged population. Elevated FPG is the most predominant component of metabolic syndrome associated with microalbuminuria followed by elevated SBP and reduced HDL-C.

  5. Locations that Support Social Activity Participation of the Aging Population

    Directory of Open Access Journals (Sweden)

    Pauline van den Berg

    2015-08-01

    Full Text Available Social activities are an important aspect of health and quality of life of the aging population. They are key elements in the prevention of loneliness. In order to create living environments that stimulate older adults to engage in social activities, more insight is needed in the social activity patterns of the aging population. This study therefore analyzes the heterogeneity in older adults’ preferences for different social activity location types and the relationship between these preferences and personal and mobility characteristics. This is done using a latent class multinomial logit model based on two-day diary data collected in 2014 in Noord-Limburg in the Netherlands among 213 respondents aged 65 or over. The results show that three latent classes can be identified among the respondents who recorded social activities in the diary: a group that mainly socializes at home, a group that mainly socializes at a community center and a group that is more likely to socialize at public ‘third’ places. The respondents who did not record any interactions during the two days, are considered as a separate segment. Relationships between segment membership and personal and mobility characteristics were tested using cross-tabulations with chi-square tests and analyses of variance. The results suggest that both personal and mobility characteristics play an important role in social activity patterns of older adults.

  6. Poor oral health, a potential new geriatric syndrome

    NARCIS (Netherlands)

    Putten, G.J. van der; Baat, C. de; Visschere, L. De; Schols, J.

    2014-01-01

    This article presents a brief introduction to the medical aspects of ageing and age-related diseases, and to some geriatric syndromes, followed by a discussion on their impact on general and oral healthcare provision to community-dwelling older people. Recent investigations suggest that inflammation

  7. [Modern principles of the geriatric analysis in medicine].

    Science.gov (United States)

    Volobuev, A N; Zaharova, N O; Romanchuk, N P; Romanov, D V; Romanchuk, P I; Adyshirin-Zade, K A

    2016-01-01

    The offered methodological principles of the geriatric analysis in medicine enables to plan economic parameters of social protection of the population, necessary amount of medical help financing, to define a structure of the qualified medical personnel training. It is shown that personal health and cognitive longevity of the person depend on the adequate system geriatric analysis and use of biological parameters monitoring in time. That allows estimate efficiency of the combined individual treatment. The geriatric analysis and in particular its genetic-mathematical component aimed at reliability and objectivity of an estimation of the person life expectancy in the country and in region due to the account of influence of mutagen factors as on a gene of the person during his live, and on a population as a whole.

  8. Geriatric Case Managers' Perspectives on Suicide Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Slovak, Karen; Pope, Natalie D; Brewer, Thomas W

    2016-01-01

    It has been suggested that clinical screening for suicide, along with firearm assessment and safety counseling, are important in service provision to older adults. It is unclear, however, how geriatric case managers respond to these issues. This study surveyed geriatric case managers (n=161) from Area Agencies on Aging in Ohio on their knowledge, attitudes, and behaviors related to suicide, firearm assessment, and safety counseling. Results indicated that the majority of respondents (70%) agree their clients are at risk for suicide. However, few (30%) in this study reported that they assess for firearms and less than half (48%) discuss firearms with their clients/family members when specifically assessing for suicide. Analyses identified barriers that contribute to the decreased likelihood that routine firearm assessment and safety counseling would occur, such as lack of training and time. Implications include the need for training with geriatric case managers that addresses barriers to suicide, firearm assessment and safety counseling as a means to decrease these population risks.

  9. Use of geriatric assessment and screening tools of frailty in elderly patients with prostate cancer. Review.

    Science.gov (United States)

    Molina-Garrido, Maria-José; Guillén-Ponce, Carmen

    2017-06-01

    The management of prostate cancer in the elderly is a major public health concern in most countries. Currently, most prostate cancers are diagnosed in elderly males. The elderly population is very heterogeneous. Thus, the current challenge is to identify better those individuals for whom specific screening tools and a Comprehensive Geriatric Assessment (CGA) would be beneficial. On the basis of the recommendations of the Prostate Cancer Working Group in the International Society of Geriatric Oncology, older patients with prostate cancer should be managed according to their individual health status and not by their age. CGA is the best tool for determining the health status of an older patient. In this article, we sought to assemble all available evidence on the models of CGA and the prevalence of geriatric conditions in older patients with prostate cancer. We also discuss the feasibility of the most used screening tools in elderly patients, that is, the Vulnerable Elders Survey-13 (VES-13) and G-8 as screening tools in this group of patients.

  10. Influence of facial skin ageing characteristics on the perceived age in a Russian female population.

    Science.gov (United States)

    Merinville, E; Grennan, G Z; Gillbro, J M; Mathieu, J; Mavon, A

    2015-10-01

    The desire for a youthful look remains a powerful motivator in the purchase of cosmetics by women globally. To develop an anti-ageing solution that targets the need of end consumers, it is critical to understand which signs of ageing really matter to them and which influence their age perception. To date, such research has not been performed in a Russian population. The aim of this work was to identify the signs of ageing that contribute the most to an 'older' or 'younger' look for Russian women aged 40 years old and above. The age of 203 Russian female volunteers was estimated from their standard photographs by a total of 629 female naïve assessors aged 20-65 years old. Perceived age data were related to 23 facial skin features previously measured using linear correlation coefficients. Differences in average severity of the correlating skin ageing features were evaluated between women perceived older and women perceived younger than their chronological age. Volunteers' responses to a ranking question on their key ageing skin concerns previously collected were analysed to provide an additional view on facial ageing from the consumer perspective. Nine facial skin ageing features were found to correlate the most with perceived age out of the 23 measured. Such results showed the importance of wrinkles in the upper part of the face (crow's feet, glabellar, under eye and forehead wrinkles), but also wrinkles in the lower half of the face associated with facial sagging (upper lip, nasolabial fold). Sagging was confirmed of key importance to female volunteers aged 41-65 years old who were mostly concerned by the sagging of their jawline, ahead of under eye and crow's feet wrinkle. The severity of hyperpigmented spots, red and brown, was also found to contribute to perceived age although to a weaker extent. By providing a clear view on the signs of ageing really matter to Russian women who are aged 40 years old and above, this research offers key information for the

  11. Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic

    NARCIS (Netherlands)

    Kikkert, Lisette H. J.; de Groot, Maartje H; van Campen, Jos P.; Beijnen, Jos H.; Hortobagyi, Tibor; Vuillerme, Nicolas; Lamoth, Claudine C. J.

    2017-01-01

    Fall prediction in geriatric patients remains challenging because the increased fall risk involves multiple, interrelated factors caused by natural aging and/or pathology. Therefore, we used a multi-factorial statistical approach to model categories of modifiable fall risk factors among geriatric

  12. Nursing Assessment and Intervention to Geriatric Patients Discharged from Emergency Departments

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Poulsen, Ingrid; Hendriksen, Carsten

    2011-01-01

    relevant referrals to geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: 150 geriatric patients participated, mean age 81.7 (70-99). At discharge they had in mean 2 164 (0-9) unresolved problems, after 1 month 0.8 (0-5), and after 6 months 0...

  13. Insulin-dependent diabetic patients with macrovascular complications suffer from many geriatric conditions

    NARCIS (Netherlands)

    Rijnen, Lieke; Buurman, Bianca M.; Jong, Simone J.; Holleman, F.; de Rooij, Sophia E.

    2013-01-01

    Current diabetic care guidelines focus mainly on managing metabolic control and macro- and microvascular comorbidities. This focus may be too narrow given the number of geriatric conditions present in these often aged patients. We studied the prevalence of multimorbidity, (undiagnosed) geriatric

  14. Addiction, Mental Health and Dual Pathology in Geriatrics

    OpenAIRE

    Bruno De Lema Larre

    2015-01-01

    The mental pathology is not "trending topic" in any forum, prejudices, clichés and destitution by society, forge this a very murky issue, as scientific evidence about it. If addiction is added and the pose in geriatric patients had a total "TABU" Substance abuse at age 50, will be extended to geriatric ages, a tsunami is approaching. Only in the United States and Canada it is estimated that 2.8 million over 50 years with addiction and that by 2020 will be about 5.7 ...

  15. Elder Self-neglect and Suicidal Ideation in an U.S. Chinese Aging Population: Findings From the PINE Study.

    Science.gov (United States)

    Dong, XinQi; Xu, Ying; Ding, Ding

    2017-07-01

    Self-neglect and suicidal ideations are important public health issues among the aging population. This study aims to examine the association between self-neglect, its phenotypes, and suicidal ideation among U.S. Chinese older adults. Guided by a community-based participatory research approach, the Population Study of Chinese Elderly in Chicago (PINE) study is a population-based epidemiological study conducted from 2011 to 2013 among 3,159 Chinese older adults aged 60 years and older in the Greater Chicago area. Self-neglect was assessed by a 27-item instrument, describing five phenotypes with hoarding, poor personal hygiene, unsanitary condition, lack of utilities, and need of home repair. Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Logistic regression is utilized to analyze the association. Higher level of self-neglect was found significantly associated with increased risk of self-reported suicidal ideation within 2 weeks (odds ratio 2.97 [1.54-5.72]); 12 months (odds ratio 2.82 [1.77-4.51]); and lifetime (odds ratio 2.74 [1.89-3.95]). For phenotypes, the study found that poorer personal hygiene and severer level of unsanitary conditions were associated with increased risk of suicidal ideation at all three time periods. This study suggests that self-neglect and its phenotypes are significantly associated with suicidal ideation among Chinese older adults. Longitudinal studies are needed to explore the mechanisms through which self-neglect links with suicidal ideation. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. The effects of temperature and diet on age grading and population age structure determination in Drosophila.

    Science.gov (United States)

    Aw, Wen C; Ballard, J William O

    2013-10-01

    The age structure of natural population is of interest in physiological, life history and ecological studies but it is often difficult to determine. One methodological problem is that samples may need to be invasively sampled preventing subsequent taxonomic curation. A second problem is that it can be very expensive to accurately determine the age structure of given population because large sample sizes are often necessary. In this study, we test the effects of temperature (17 °C, 23 °C and 26 °C) and diet (standard cornmeal and low calorie diet) on the accuracy of the non-invasive, inexpensive and high throughput near-infrared spectroscopy (NIRS) technique to determine the age of Drosophila flies. Composite and simplified calibration models were developed for each sex. Independent sets for each temperature and diet treatments with flies not involved in calibration model were then used to validate the accuracy of the calibration models. The composite NIRS calibration model was generated by including flies reared under all temperatures and diets. This approach permits rapid age measurement and age structure determination in large population of flies as less than or equal to 9 days, or more than 9 days old with 85-97% and 64-99% accuracy, respectively. The simplified calibration models were generated by including flies reared at 23 °C on standard diet. Low accuracy rates were observed when simplified calibration models were used to identify (a) Drosophila reared at 17 °C and 26 °C and (b) 23 °C with low calorie diet. These results strongly suggest that appropriate calibration models need to be developed in the laboratory before this technique can be reliably used in field. These calibration models should include the major environmental variables that change across space and time in the particular natural population to be studied. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Geriatric assessment with focus on instrument selectivity for outcomes.

    Science.gov (United States)

    Extermann, Martine

    2005-01-01

    More than one half of all cancers in developed countries occur in patients aged 70 years and older. Therefore, in recent years, there has been a growing interest in integrating a comprehensive geriatric assessment into the management of these patients with cancer. This review article emphasizes the data gathered so far on the correlation between such an assessment and outcome in patients with cancer. The most developed data relate to functional status and comorbidity. Geriatric instruments appear more sensitive than classic oncological instruments in measuring functional status. There is also good evidence that as a patient's age advances, comorbidity affects in an increasing fashion their survival and cancer management. Some evidence is beginning to appear as to the impact a comprehensive geriatric assessment could have on the oncologic management of older patients with cancer.

  18. Growing older in the context of needing geriatric assessment

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel; Hvitved, Ida; Andersen, Hanne Elkjær

    2016-01-01

    experience growing older. METHODOLOGY: A qualitative study was performed. The empirical data consisted of qualitative in-depth interviews with eight older persons referred to geriatric assessment (median age 76, range 65-86). The interviews were analysed based on Giorgi's descriptive phenomenological......AIM: The number of older adults will increase worldwide in the next 30 years, with many expected to develop chronic diseases and consequently require additional medical assessments and adequate care. The aim of this study was to describe how a group of older adults who need geriatric assessment...... of their advancing age. CONCLUSION: Growing older while in need of comprehensive geriatric assessment led to participants feeling they were no longer able to do the same things, they used to do. Consequently, compensation became an essential part of adaption to the altered situation. Aides that helped to overcome...

  19. Growing number of pensioners and population aging in Serbia

    Directory of Open Access Journals (Sweden)

    Stojilković Jelena

    2011-01-01

    Full Text Available The aim of this paper is to shed more light on population aging by using indicators such as years of service and average years in retirement, since the most benefits from the Fund for Pension and Disability Insurance are paid for elderly. As a method for better understanding the structure of pensioners, we used the data on years one spends as employee before gaining pension benefits, so we could get better information about previous activity of retirees, but also to emphasize legal issues that have increased the number of early retirement recipients. Many countries do not allow early retirement, so the limitation of minimum years required for the early retirement is necessary for reduction of pension spending. Another important characteristic of the financial sustainability of the Fund for Pension and Disability Insurance are the average years in retirement. Given the fact that the life expectancy of the elderly is slightly increasing, it is realistic to expect longer use of pension of old-age and disability pensioners, who are on average younger. Apart from showing the level of financial sustainability of the fund, this indicator shows the characteristics of mortality in the country. Pension Fund data show certain development tendencies that will continue in the future because all processes related to population are long-term, including those related to pensioners that are beside socio-economic, influenced by demographic factors.

  20. Risk and Aging Vascular in a city population

    Directory of Open Access Journals (Sweden)

    Enrique Ruiz Mori

    2016-04-01

    Full Text Available Objetive: Cardiovascular diseases that every year have more prevalence in the country, are the product of risky factors, many of them modifiable and preventable. The objective of the present study has been to know and analyze the factors of cardiovascular risk and determine the vascular age in the population of Lima. Material and methods: A descriptive cross sectional study, carried out in March 2016, in the southern, northern and eastern cones of Metropolitan Lima, in people older than 30 and younger than 75 years old. The survey structured for the study collected the following variables: gender, age, arterial hypertension, smoking, diabetes, physical activity and type of diet. Blood presure, weight and tall were recorded. Results: In total, 485 participants were included, 197 men and 288 women. The age was 49,5± 9,9 years old. The more frequent risky factor was the unhealthy diet (47,6%, followed by sedentary lifestyle (42,5%. Arterial hypertension was observed in 20,8%, being more frequent in men. 85.2% did not smoke and overweight was found in 47.2%, being its frequency higher in women. The low risk was determined in 60,4% and it was predominant in women, while higher risk was 18.6% in men. The average cardiovascular age was higher in 1,4 years compared to the chronological age beign more marked in men, in whom the difference was 5,8 years between 50 and 59 years old. Conclusions: The more frecuente cardiovascular risk has been unhealthy diet followed by sedentary lifestyle. The high risk was 18,6% predominating in

  1. Curriculum content in geriatric dentistry in USA dental schools.

    Science.gov (United States)

    Ettinger, Ronald L; Goettsche, Zachary S; Qian, Fang

    2018-03-01

    The aim of this study was to re-examine the teaching of geriatric dentistry in the USA dental schools, to identify curriculum content and compare the findings to previous reports. All dental schools in the United States were contacted via email with a questionnaire to assess the teaching of geriatric dentistry. Non-responding schools were sent a minimum of three reminder emails to complete the survey. A statistical analysis was performed. Descriptive statistics were conducted to profile the variables of interest. Bivariate analysis was performed to explore if any of the variables were related using Fisher's exact test, non-parametric Wilcoxon rank-sum test and the Kruskal-Wallis test. Fifty-six of the 67 dental schools completed the questionnaire. Geriatric dentistry was taught in all dental schools; for 92.8%, the course was compulsory. We found that 62.5% were teaching it as an independent course, 25% as an organised series of lectures and 8.9% as occasional lectures in parts of other courses. Clinically, 84.2% have some form of compulsory education in geriatric dentistry. Public schools were marginally associated with an increased interest in expanding the geriatric dentistry curriculum (P = .078). No differences were found between these variables and school location. Geriatric dentistry is now required in 92.8% of dental schools. The teaching of traditional topics has not changed much; however, the number of gerontological topics has increased. Clinical teaching needs to be expanded, as in only 57.1% of schools was it a requirement. The ageing imperative will require research to determine the impact of teaching on services to the geriatric community. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  2. We're not just playing games: Into aging--an aging simulation game.

    Science.gov (United States)

    Dillon, Deborah; Ailor, Diane; Amato, Shelly

    2009-01-01

    The elderly represent the largest-growing segment of the population. Specialized training in geriatrics is essential for healthcare professionals to provide optimal health care. As part of an ongoing education program on geriatrics, the game Into Aging: Understanding Issues Affecting the Later Stages of Life, 2nd ed. (1991) was provided to staff members of a facility to help healthcare providers develop personal insight into the aging process through role play. This game has provided the staff members with a better understanding of the issues patients experience as they deal with declines in health.

  3. Geriatric Nursing and Long Term Care Content in Baccalaureate Nursing Programs in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Lun Hsieh

    2018-03-01

    Full Text Available Summary: Background: The population aged 65 years old and above is expected to dramatically increase annually in Taiwan. Health care professionals need to be prepared to better serve the aged and disabled population. The purpose of this study is to survey Taiwan's current Geriatric Nursing (GN or Long Term Care (LTC courses offered in baccalaureate nursing programs. Methods: A descriptive research design was used and detailed checklist review was applied. Data were obtained from the official websites for the content review of Taiwan's current baccalaureate programs in GN and/or LTC course offered in baccalaureate nursing programs. Results: The results showed that the content of the GN course included aging process, communication, ethical, elderly activity, health promotion, nutrition and dementia care. LTC courses focus on the current system of LTC, policy, management of LTC institutions, ethical issues in LTC, and various types of LTC services such as day care, home care and LTC facilities. Conclusion: The survey findings indicated that GN and LTC education must be recognized by providing required stand-alone courses and interdisciplinary education in nursing curricula. These courses should be included in curricular design and innovations to ensure nursing students to acquire strong competence for the future through education. Keywords: gerontology, geriatric nursing, long term care, baccalaureate curriculum

  4. A comparative study of depression and associated risk factors among elderly inmates of old age homes and community of Rajkot: A Gujarati version of the geriatric depression scale-short form (GDS-G

    Directory of Open Access Journals (Sweden)

    Dipeshkumar D Zalavadiya

    2017-01-01

    Full Text Available Background: The prevalence of depression among elderly people varies across different setups such as old age homes (OAHs, community, and medical clinics. Aims: The aim of this study was to compare the epidemiological factors pertaining to depression among elderly residents of OAHs and community, using a new Gujarati version of the Geriatric Depression Scale-Short Form (GDS-G. Settings and Design: A cross-sectional, epidemiological study conducted in an urban setup of Western India. Materials and Methods: All the eligible 88 elderly residents of all the six OAHs and 180 elderly residents from the same city were administered a pretested semistructured questionnaire having the GDS-G form. Statistical Analysis: Descriptive statistics, odds ratio, Spearman's rank correlation test. Results: The elderly of OAHs were more depressed compared to those of community (odds ratio = 1.84; 95% confidence interval = 1.09–3.06. Older age, females, weaker family ties, economic maladies, poorer self-perception of health status, presence of chronic ailments, absence of recreational activity, lack of prayers, impaired sleep, history of addiction emerged as the predictors of depression in both the setups. More health complaints and a later self-perception of visit to a doctor were found among the depressed than the nondepressed in both the setups. Conclusions: Depressive symptoms were quite high among the elderly in both the setups. Special attention should be given toward health checkups of depressed persons in the OAH and improvement of family ties among depressed persons of the community.

  5. Validation of an instrument to evaluate quality of life in the aging population: WHOQOL-AGE.

    Science.gov (United States)

    Caballero, Francisco Félix; Miret, Marta; Power, Mick; Chatterji, Somnath; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Leonardi, Matilde; Olaya, Beatriz; Haro, Josep Maria; Ayuso-Mateos, José Luis

    2013-10-23

    There is a need for short, specific instruments that assess quality of life (QOL) adequately in the older adult population. The aims of the present study were to obtain evidence on the validity of the inferences that could be drawn from an instrument to measure QOL in the aging population (people 50+ years old), and to test its psychometric properties. The instrument, WHOQOL-AGE, comprised 13 positive items, assessed on a five-point rating scale, and was administered to nationally representative samples (n = 9987) from Finland, Poland, and Spain. Cronbach's alpha was employed to assess internal consistency reliability, whereas the validity of the questionnaire was assessed by means of factor analysis, graded response model, Pearson's correlation coefficient and unpaired t-test. Normative values were calculated across countries and for different age groups. The satisfactory goodness-of-fit indices confirmed that the factorial structure of WHOQOL-AGE comprises two first-order factors. Cronbach's alpha was 0.88 for factor 1, and 0.84 for factor 2. Evidence supporting a global score was found with a second-order factor model, according to the goodness-of-fit indices: CFI = 0.93, TLI = 0.91, RMSEA = 0.073. Convergent validity was estimated at r = 0.75 and adequate discriminant validity was also found. Significant differences were found between healthy individuals (74.19 ± 13.21) and individuals with at least one chronic condition (64.29 ± 16.29), supporting adequate known-groups validity. WHOQOL-AGE has shown good psychometric properties in Finland, Poland, and Spain. Therefore, considerable support is provided to using the WHOQOL-AGE to measure QOL in older adults in these countries, and to compare the QOL of older and younger adults.

  6. A practical review of energy saving technology for ageing populations.

    Science.gov (United States)

    Walker, Guy; Taylor, Andrea; Whittet, Craig; Lynn, Craig; Docherty, Catherine; Stephen, Bruce; Owens, Edward; Galloway, Stuart

    2017-07-01

    Fuel poverty is a critical issue for a globally ageing population. Longer heating/cooling requirements combine with declining incomes to create a problem in need of urgent attention. One solution is to deploy technology to help elderly users feel informed about their energy use, and empowered to take steps to make it more cost effective and efficient. This study subjects a broad cross section of energy monitoring and home automation products to a formal ergonomic analysis. A high level task analysis was used to guide a product walk through, and a toolkit approach was used thereafter to drive out further insights. The findings reveal a number of serious usability issues which prevent these products from successfully accessing an important target demographic and associated energy saving and fuel poverty outcomes. Design principles and examples are distilled from the research to enable practitioners to translate the underlying research into high quality design-engineering solutions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Altered Synchronizations among Neural Networks in Geriatric Depression.

    Science.gov (United States)

    Wang, Lihong; Chou, Ying-Hui; Potter, Guy G; Steffens, David C

    2015-01-01

    Although major depression has been considered as a manifestation of discoordinated activity between affective and cognitive neural networks, only a few studies have examined the relationships among neural networks directly. Because of the known disconnection theory, geriatric depression could be a useful model in studying the interactions among different networks. In the present study, using independent component analysis to identify intrinsically connected neural networks, we investigated the alterations in synchronizations among neural networks in geriatric depression to better understand the underlying neural mechanisms. Resting-state fMRI data was collected from thirty-two patients with geriatric depression and thirty-two age-matched never-depressed controls. We compared the resting-state activities between the two groups in the default-mode, central executive, attention, salience, and affective networks as well as correlations among these networks. The depression group showed stronger activity than the controls in an affective network, specifically within the orbitofrontal region. However, unlike the never-depressed controls, geriatric depression group lacked synchronized/antisynchronized activity between the affective network and the other networks. Those depressed patients with lower executive function has greater synchronization between the salience network with the executive and affective networks. Our results demonstrate the effectiveness of the between-network analyses in examining neural models for geriatric depression.

  8. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits].

    Science.gov (United States)

    Pareja, Teresa; Hornillos, Mercedes; Rodríguez, Miriam; Martínez, Javier; Madrigal, María; Mauleón, Coro; Alvarez, Bárbara

    2009-01-01

    To evaluate the impact of comprehensive geriatric assessment and management of high-risk elders in a medical short stay unit located in the emergency department of a general hospital. We performed a descriptive, prospective study of patients admitted to the medical short stay unit for geriatric patients of the emergency department in 2006. A total of 749 patients were evaluated, with a mean (standard deviation) stay in the unit of 37 (16) h. The mean age was 86 (7) years; 57% were women, and 50% had moderate-severe physical impairment and dementia. Thirty-five percent lived in a nursing home. The most frequent reason for admission was exacerbation of chronic cardiopulmonary disease. Multiple geriatric syndromes were identified. The most frequent were immobility, pressure sores and behavioral disorders related to dementia. Seventy percent of the patients were discharged to home after being stabilized and were followed-up by the geriatric clinic and day hospital (39%), the home care medical team (11%), or the nursing home or primary care physician (20%). During the month after discharge, 17% were readmitted and 7.7% died, especially patients with more advanced age or functional impairment. After the unit was opened, admissions to the acute geriatric unit fell by 18.2%. Medical short stay units for geriatric patients in emergency departments may be useful for geriatric assessment and treatment of exacerbations of chronic diseases. These units can help to reduce the number of admissions and optimize the care provided in other ambulatory and domiciliary geriatric settings.

  9. Do we need community geriatrics?

    LENUS (Irish Health Repository)

    O'Hanlon, S

    2012-01-30

    Community geriatrics has evolved as a specific aspect of geriatric medicine in the UK. In Ireland there is uncertainty as to how it should be planned. This is the first national survey of consultants, specialist registrars and general practitioners to seek their opinions. Most consultants and GPs reported already having a community aspect to their current practice, e.g. nursing home visits or community hospital visits, whereas most SpRs did not. Forty three of 62 respondents (69%) agreed that there is a need for community geriatricians and that there should be integration with hospital medicine. Fifty seven of 62 respondents (92%) felt that there would be a beneficial effect on GP services, though some expressed concern about work overlap. Thirteen of the 25 SpRs (52%) in training hoped to begin practice in community geriatrics in the future.

  10. Mitochondrial DNA variation in the Viking age population of Norway.

    Science.gov (United States)

    Krzewińska, Maja; Bjørnstad, Gro; Skoglund, Pontus; Olason, Pall Isolfur; Bill, Jan; Götherström, Anders; Hagelberg, Erika

    2015-01-19

    The medieval Norsemen or Vikings had an important biological and cultural impact on many parts of Europe through raids, colonization and trade, from about AD 793 to 1066. To help understand the genetic affinities of the ancient Norsemen, and their genetic contribution to the gene pool of other Europeans, we analysed DNA markers in Late Iron Age skeletal remains from Norway. DNA was extracted from 80 individuals, and mitochondrial DNA polymorphisms were detected by next-generation sequencing. The sequences of 45 ancient Norwegians were verified as genuine through the identification of damage patterns characteristic of ancient DNA. The ancient Norwegians were genetically similar to previously analysed ancient Icelanders, and to present-day Shetland and Orkney Islanders, Norwegians, Swedes, Scots, English, German and French. The Viking Age population had higher frequencies of K*, U*, V* and I* haplogroups than their modern counterparts, but a lower proportion of T* and H* haplogroups. Three individuals carried haplotypes that are rare in Norway today (U5b1b1, Hg A* and an uncommon variant of H*). Our combined analyses indicate that Norse women were important agents in the overseas expansion and settlement of the Vikings, and that women from the Orkneys and Western Isles contributed to the colonization of Iceland. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  11. Geriatric veterinary dentistry: medical and client relations and challenges.

    Science.gov (United States)

    Holmstrom, Steven E

    2005-05-01

    Quality of life is an important issue for geriatric patients. Allowing periodontal disease, fractured teeth, and neoplasia to remain untreated decreases this quality of life. Age itself should be recognized; however, it should not be a deterrent to successful veterinary dental care.

  12. Geriatric fall-related injuries | Hefny | African Health Sciences

    African Journals Online (AJOL)

    There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is ...

  13. Elderly and preventive care of the geriatric pathologies in African environment.

    Science.gov (United States)

    Kâ, Ousseynou; Gaye, Awa; Mbacké Leye, Mamadou Makhtar; Ngom, Ndeye Fatou; Dia, Anta Tal; Diop, Saïd Nourou; Sow, Ahmédou Moustapha

    2016-12-01

    Senegal will not be spared by the process of the aging of its population. In fact, according to surveys, the demographic increase in the population of the old people, which is 3.5% higher than the national average (2.5%). But for the time being, gerontology problems are not arising in terms of demographic weight, but rather in terms of the breaking up of solidarity networks, uncontrolled urbanization and poverty. As far as health is concerned, the old people generally are faced with the same problems as their Northern counterparts; they are exposed to chronic diseases that demand their taking in charge in a long period of time. Besides, these diseases are a great handicap and they are also disabling diseases. So taking them in charge puts a financial on their meager family budgets or their pensions. In addition, there are no specialists in geriatrics, and those working in the field did not receive any training for that. Moreover, most of our health facilities are lacking in diagnostic means. Therefore, gerontology-geriatrics solutions that are adapted to our socio-economic context should be assigned straight away. The problem is not about stopping the process of aging, which, as a physiological process, is inevitable and irreversible, but rather delaying its effects. The matter at issue will be about how to set up a decentralized and integrated program that is designed to fight against geriatric diseases and disorders and that mainly focuses on screening and primary and secondary prevention, for our low financial resources and the low medical equipment of our health facilities cannot help us to adequately take charge of complications related to these diseases.

  14. [Management of malnutrition in geriatric hospital units in Germany].

    Science.gov (United States)

    Smoliner, C; Volkert, D; Wirth, R

    2013-01-01

    Elderly hospitalized patients have a high risk for developing malnutrition. The causes for an impaired nutritional status in old age are various and the impact is far-reaching. Malnutrition is a comorbidity that is well treatable and various studies show the favorable effect of nutrition therapy on nutritional status and prognosis. In the past few years, several guidelines have been developed to improve nutritional management and to ensure standardized procedures to identify patients at nutritional risk who will benefit from nutrition therapy. However, it is still not clear to what extent nutrition management has been implemented in geriatric wards in Germany. This survey is intended to give an overview on the situation of the current diagnosis and therapy of malnutrition and nutritional management in geriatric hospital units for acute and rehabilitative care. In 2011, the task force of the German Geriatric Society ("Deutsche Gesellschaft für Geriatrie", DGG) developed a questionnaire which was sent out to 272 directors of geriatric hospital and rehabilitational units. Included were questions regarding the size and staffing of the hospital and wards, food provision, diagnosis and therapy of malnutrition, as well as communication of malnutrition and nutrition therapy in the doctor's letter. A total of 38% of the questioned units answered. The following information was compiled: 31% of the geriatric facilities employed a doctor with training in clinical nutrition, 42% employ dieticians or nutritional scientists, and 90% speech and language pathologists. In 36% of the wards, a so-called geriatric menu is offered (small portions, rich in energy and/or protein, easy to chew). In 89% of the wards, snacks are available between meals. Diagnosis of malnutrition is mainly done by evaluation of weight and BMI. Validated and established screening tools are only used in 40% of the geriatric wards. Food records are carried out in 64% of the units when needed. Diagnosed

  15. [Nutritional study in geriatric patients (older than 65 years of age) with ambulatory enteral nutrition: correlation between underlying disease, nutritional support, and drug treatment].

    Science.gov (United States)

    Martínez Vázquez, M J; Piñeiro Corrales, G; Martínez Olmos, M

    2002-01-01

    To identify the current status of out-patient enteral nutrition among elderly patients in Galicia: indications, access routes, forms of administration, types of diet, complications, disability status. Assessment of nutritional status and concomitant pharmacological treatment. Prospective, observational, multi-centric study lasting for one month. Data capture by means of a questionnaire regarding: age, sex, diagnosed pathology leading to nutritional analysis, disability status, current nutritional status, type of diet, months under treatment with NEA (out-patient enteral nutrition in its Spanish acronym), form of administration, complications, concomitant medication. The statistical methodology included a descriptive analysis and a study of the correlations between the different variables. For the comparison of both groups, Student's t test or Mann-Whitney's U test was used for quantitative variables and chi-squared, Yate's correction or Fisher's exact test was used for qualitative variables. 469 patients were studied, corresponding to 13 publicly-funded centres. Age: 81.15 years (95% CI 80.8-82.3), women (70.6%). neurological disorders (46.1%), cerebrovascular accidents (27.5%), neoplasia (12.4%) and others (14.1%). 45.2% presented a bedbound disability status and 53.5% presented communication difficulties. Standard diet was the most common (39.4%). DURATION OF THE NUTRITION: > 1 year in 36.7% of cases, between 6 months and 1 year for 21.3%, between 3 and 6 months for 10.9% and Nasogastric tube was the route for administration in 55.2%. Patients with nutrition treatment lasting over 1 year presented a significantly lower rate of malnutrition (p nasogastric tube. The most frequent interaction was digoxin-fibre (29.6%) and incorrect administration was observed with omeprazol and medication to combat Parkinson's disease.

  16. Geriatric Depression Scale (GDS: A Tool for Assessment of Depression in Elderly

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    Vandana A. Kakrani

    2015-01-01

    Full Text Available Background: India is in the process of rapid demographic progression of increased life expectancy and aging with geriatric population of 7.2 percent which is estimated to rise to 20 percent in 2050. With increasing geriatric population elderly with dementia and associated depressive illness are expected to rise in number to almost an epidemic. Among the morbidity encountered in elderly, depressive disorders are common. Aim & Objectives: The present study was conducted with the objective to assess the extent and degree of depression in elderly, and study some correlates associated with depression in them. Material & Methods: The study was carried out at geriatric clinic of Dr. D. Y. Patil Medical College, Pune under the guidance of department of community medicine. Methodology:The randomly selected elderly above the age of 60 years attending the clinic and willing to participate in study were administered the questionnaire of Geriatric Depression Scale (GDS, scores were given, based on which the subjects were categorized as mild, moderate and severe. Those with score >5 were considered as suggestive of depression and some factors studied were analysed to find out their association with depression. Results: It was revealed that the proportion of elderly having depression was 52.4% with 84.6% of depressed in age group of 76-80 years. Moderate to severe type was more commonly seen in illiterate; however some degree of depression was present in all elderly irrespective of literacy status. Moderate to severe type was seen more commonly in elderly living in nuclear families (23.8%, and living alone (33.3%. Thus more than half of elderly studied were having depression, and it was observed that as the age advanced the degree of depression significantly increased. Some of the factors studied like low education status, poor economic status, nuclear family status, single status, loneliness, were associated with depression. The GDS Scale can be considered as

  17. Personalized nutrigenomics: tailoring the diet to the aging diabesity population

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    Douglas M Ruden

    2011-02-01

    Full Text Available Douglas M Ruden1, Xiangyi Lu21Wayne State University, Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Institute of Environmental Health Sciences, Detroit, MI, USA; 2Institute of Environmental Health Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USAAbstract: According to the International Diabetes Federation (IDF, 190 million people worldwide suffer from diabetes, and this number is estimated to double by the year 2025. Diabetes is especially prominent in the elderly population because the IDF indicates age above 45 years as a major risk factor for diabetes. The most common trials for controlling diabetes focus on tighter glucose control as a means to reduce the long-term complications. However, whether tight blood sugar control or other dietary or pharmaceutical interventions in the elderly are more appropriate is not known. Major changes have taken place in our diet over the past 10,000 years since the beginning of the Agricultural Revolution, but our genes have not changed. Furthermore, the large numbers of diabetic elderly in the population are a recent phenomenon, because those with diabetes have historically died young. Genetically speaking, humans today live in a nutritional environment that differs from that for which our genetic constitution was selected. For example a high omega-6/omega-3 ratio, found in today’s Western diets, promotes the pathogenesis of many chronic diseases, including cardiovascular disease and diabetes. Knowing who is at risk would be useful if it meant that one could avoid the environmental triggers that convert susceptibility to disease. The prospect of targeting specific dietary treatments at the elderly, who are predicted to gain the most therapeutic benefits, clearly has important clinical and economic consequences. In this review, we will discuss modern molecular genetic and epidemiological techniques which are now, or soon will

  18. Facilitators and barriers influencing the readiness to receive dental implants in a geriatric institutionalised population-A randomized non-invasive interventional study.

    Science.gov (United States)

    Merz, Miriam A; Terheyden, Hendrik; Huber, Christian G; Seixas, Azizi A; Schoetzau, Andreas; Schneeberger, Andres R

    2017-09-01

    Although elderly people have many serious dental issues and are in need of prosthesis, few opt for dental implants. The aim of this study was to investigate barriers that prevent elderly people from receiving dental implants. Specifically, we examined (i) whether the message was delivered before or after the interview had an impact, and (ii) whether it did matter who delivered the message. Sixty-six residents from seven residential homes in the Canton of Grisons, Switzerland were included. The sample was randomized to a treatment group that received comprehensive education about dental implants before the interview and a control group that received education after completing the questionnaire. The sample consisted of 54 women (81.8%) and 12 males (18.2%) with an average age of 86.2 years. Education before the interview did not show any impact on the attitude towards dental implants. Main reasons for a negative attitude towards implants were old age and high costs. Participants who received information about implants from their relatives and their own dentist and not from the study dentist were significantly more willing to receive implants. Providing an adequate education about benefits and risks of receiving dental implants does not change the attitude towards dental implants. The source of information/messenger does influence attitudes towards implants. If the person delivering the education and information is a relative or a known medical person, the person's attitude is more likely to change as compared to people receiving the information from an unrelated person. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  19. Virtual patients in geriatric education.

    Science.gov (United States)

    Tan, Zaldy S; Mulhausen, Paul L; Smith, Stephen R; Ruiz, Jorge G

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction.

  20. Virtual Patients in Geriatric Education

    Science.gov (United States)

    Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…

  1. The effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer.

    Science.gov (United States)

    Verweij, N M; Souwer, E T D; Schiphorst, A H W; Maas, H A; Portielje, J E A; Pronk, A; van den Bos, F; Hamaker, M E

    2017-11-01

    Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer. Colorectal cancer patients who were referred for a geriatric consultation between 2013 and 2015 in three Dutch teaching hospitals were included in a prospective database. The outcome of geriatric assessment, non-oncological interventions and geriatricians' treatment recommendations were evaluated. The total number of included referrals was 168. The median age was 81 years (range 60-94). Most patients (71%) had colon cancer and 49% had tumour stage III disease. The reason for geriatric consultation was uncertainty regarding the optimal oncologic treatment in 139 patients (83%). Overall 93% of patients suffered from geriatric impairments; non-oncological interventions that followed after geriatric consultation was mostly aimed at malnutrition. The geriatrician recommended the 'more intensive treatment' option in 69% and the 'less intensive treatment' option in 31% of which 63% 'supportive care only'. Geriatric consultation can be useful in treatment decision making in elderly patients with colorectal cancer. It may lead to changes in the treatment plan for individual cases and may result in an additional optimisation of patient's health status prior to treatment.

  2. Brain computed tomography findings in geriatric depression and primary degenerative dementia.

    Science.gov (United States)

    Alexopoulos, G S; Young, R C; Shindledecker, R D

    1992-03-15

    Brain computed tomography (CT) scans were performed in hospitalized geriatric patients with major depression (n = 45) or primary degenerative dementia (n = 21). Depressed patients with onset of illness at age 60 years or older (n = 32) had greater ventricular size than geriatric depressives with earlier age of illness onset (n = 13). CT parameters of late-onset depressives were comparable to those of patients with primary degenerative dementia. However, early-onset geriatric depressives had significantly smaller ventricles and less sulcal widening than demented patients. The findings suggest that late-onset depression may have a stronger association with neurological dementing disorders than early-onset depression.

  3. 78 FR 6289 - Estimates of the Voting Age Population for 2012

    Science.gov (United States)

    2013-01-30

    ..., United States Code, Section 441a(e), I hereby give notice that the estimates of the voting age population... Population Area Population 18 and Area 18 and over over United States 240,185,952 Alabama 3,697,617 Alaska... voting age population estimates as of July 1, 2012, for each state and the District of Columbia. We are...

  4. Novel ethical dilemmas arising in geriatric clinical practice.

    Science.gov (United States)

    Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M

    2015-05-01

    The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population.

  5. Preschool Age Populations Research Needs - NCS Dietary Assessment Literature Review

    Science.gov (United States)

    Drawing conclusions from the validation studies on preschool populations discussed in this chapter is difficult because of the varied study designs, the relatively small study populations, and limited number of studies on each dietary assessment method.

  6. Morbidity pattern and health-seeking behavior of aged population residing in Shimla hills of north India: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Deepak Sharma

    2013-01-01

    Full Text Available Background: Population aging is a global phenomenon. In India, the size of the elderly population is growing fast. Many older adults have multiple medical conditions. Understanding elderly health problems and health-seeking behavior is prerequisite for proving comprehensive geriatric care to them. Objectives: To assess the morbidity pattern and study the health-seeking behavior of the elderly people of Shimla district in Himachal Pradesh. Materials and Methods: A total of 400 elderly people aged 60 years and above were selected from urban and rural areas of Shimla hills in North India by simple random sampling. Statistical software Epi info software version 3.2 was used for analyzing data. Descriptive statistics were used to describe sociodemographic and morbidity variables. Results: The most common morbidity identified among them were musculoskeletal problems (55.0% followed by hypertension (40.5%. Two third were seeking treatment for their health problems. Among older persons not seeking treatment for their medical condition, most considered these morbidities as an age-related phenomenon. Many perceived that the health services were too far. Conclusion: The high morbidity load among elderly in the present study stresses for efforts to provide better health care to them and thus ensure that they remain active members of our society. Residence emerged out to be most significant determinant of healthcare-seeking behavior. Policy makers must focus on rural elderly and their beliefs which prevent them from seeking healthcare.

  7. Geriatric management in medieval Persian medicine.

    Science.gov (United States)

    Emami, Morteza; Sadeghpour, Omid; Zarshenas, Mohammad M

    2013-10-01

    In Iran, a large group of patients are elderly people and they intend to have natural remedies as treatment. These remedies are rooted in historical of Persian and humoral medicine with a backbone of more than 1000 years. The current study was conducted to draw together medieval pharmacological information related to geriatric medicine from some of the most often manuscripts of traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plants through a search of the PubMed, Scopus and Google Scholar databases. In the medieval Persian documents, digestible and a small amount of food such as chicken broth, honey, fig and plum at frequent intervals as well as body massage and morning unctioning are highly recommended. In the field of pharmacotherapy, 35 herbs related to 25 families were identified. Plants were classified as tonic, anti-aging, appetizer, memory and mood enhancer, topical analgesic and laxative as well as health improvement agents. Other than historical elucidation, this paper presents medical and pharmacological approaches that medieval Persian practitioners applied to deal with geriatric complications.

  8. Geriatric dentistry education and context in a selection of countries in 5 continents.

    Science.gov (United States)

    Marchini, Leonardo; Ettinger, Ronald; Chen, Xi; Kossioni, Anastassia; Tan, Haiping; Tada, Sayaka; Ikebe, Kazunori; Dosumu, Elizabeth Bosede; Oginni, Fadekemi O; Akeredolu, Patricia Adetokunbo; Butali, Azeez; Donnelly, Leeann; Brondani, Mario; Fritzsch, Bernd; Adeola, Henry A

    2018-03-30

    To summarize and discuss how geriatric dentistry has been addressed in dental schools of different countries regarding to (1) teaching students at the predoctoral level; (2) advanced training, and (3) research. A convenience sample of faculty members from a selection of high, upper-middle and lower-middle income countries were recruited to complete the survey. The survey had 5 open-ended main topics, and asked about (1) the size of their elderly population, (2) general information about dental education; (3) the number of dental schools teaching geriatric dentistry, and their teaching methods; (4) advanced training in geriatric dentistry; (5) scholarship/research in geriatric dentistry. (1) There is great variation in the size of elderly population; (2) duration of training and content of dental education curriculum varies; (3) geriatric dentistry has not been established as a standalone course in dental schools in the majority of the countries, (4) most countries, with the exception of Japan, lack adequate number of dentists trained in geriatric dentistry as well as training programs, and (5) geriatric dentistry-related research has increased in recent years in scope and content, although the majority of these papers are not in English. © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.

  9. Geriatric Pulsar Still Kicking

    Science.gov (United States)

    2009-02-01

    's clearly fading as it ages, it is still more than holding its own with the younger generations." It's likely that two forms of X-ray emission are produced in J0108: emission from particles spiraling around magnetic fields, and emission from heated areas around the neutron star's magnetic poles. Measuring the temperature and size of these heated regions can provide valuable insight into the extraordinary properties of the neutron star surface and the process by which charged particles are accelerated by the pulsar. The younger, bright pulsars commonly detected by radio and X-ray telescopes are not representative of the full population of objects, so observing objects like J0108 helps astronomers see a more complete range of behavior. At its advanced age, J0108 is close to the so-called "pulsar death line," where its pulsed radiation is expected to switch off and it will become much harder, if not impossible, to observe. "We can now explore the properties of this pulsar in a regime where no other pulsar has been detected outside the radio range," said co-author Oleg Kargaltsev of the University of Florida. "To understand the properties of 'dying pulsars,' it is important to study their radiation in X-rays. Our finding that a very old pulsar can be such an efficient X-ray emitter gives us hope to discover new nearby pulsars of this class via their X-ray emission." The Chandra observations were reported by Pavlov and colleagues in the January 20, 2009, issue of The Astrophysical Journal. However, the extreme nature of J0108 was not fully apparent until a new distance to it was reported on February 6 in the PhD thesis of Adam Deller from Swinburne University in Australia. The new distance is both larger and more accurate than the distance used in the Chandra paper, showing that J0108 was brighter in X-rays than previously thought. "Suddenly this pulsar became the record holder for its ability to make X-rays," said Pavlov, "and our result became even more interesting without us

  10. Phenotype of normal spirometry in an aging population.

    Science.gov (United States)

    Vaz Fragoso, Carlos A; McAvay, Gail; Van Ness, Peter H; Casaburi, Richard; Jensen, Robert L; MacIntyre, Neil; Gill, Thomas M; Yaggi, H Klar; Concato, John

    2015-10-01

    In aging populations, the commonly used Global Initiative for Chronic Obstructive Lung Disease (GOLD) may misclassify normal spirometry as respiratory impairment (airflow obstruction and restrictive pattern), including the presumption of respiratory disease (chronic obstructive pulmonary disease [COPD]). To evaluate the phenotype of normal spirometry as defined by a new approach from the Global Lung Initiative (GLI), overall and across GOLD spirometric categories. Using data from COPDGene (n = 10,131; ages 45-81; smoking history, ≥10 pack-years), we evaluated spirometry and multiple phenotypes, including dyspnea severity (Modified Medical Research Council grade 0-4), health-related quality of life (St. George's Respiratory Questionnaire total score), 6-minute-walk distance, bronchodilator reversibility (FEV1 % change), computed tomography-measured percentage of lung with emphysema (% emphysema) and gas trapping (% gas trapping), and small airway dimensions (square root of the wall area for a standardized airway with an internal perimeter of 10 mm). Among 5,100 participants with GLI-defined normal spirometry, GOLD identified respiratory impairment in 1,146 (22.5%), including a restrictive pattern in 464 (9.1%), mild COPD in 380 (7.5%), moderate COPD in 302 (5.9%), and severe COPD in none. Overall, the phenotype of GLI-defined normal spirometry included normal adjusted mean values for dyspnea grade (0.8), St. George's Respiratory Questionnaire (15.9), 6-minute-walk distance (1,424 ft [434 m]), bronchodilator reversibility (2.7%), % emphysema (0.9%), % gas trapping (10.7%), and square root of the wall area for a standardized airway with an internal perimeter of 10 mm (3.65 mm); corresponding 95% confidence intervals were similarly normal. These phenotypes remained normal for GLI-defined normal spirometry across GOLD spirometric categories. GLI-defined normal spirometry, even when classified as respiratory impairment by GOLD, included adjusted mean values in the

  11. The descriptive epidemiology of delirium symptoms in a large population-based cohort study: results from the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS).

    Science.gov (United States)

    Davis, Daniel H J; Barnes, Linda E; Stephan, Blossom C M; MacLullich, Alasdair M J; Meagher, David; Copeland, John; Matthews, Fiona E; Brayne, Carol

    2014-07-28

    In the general population, the epidemiological relationships between delirium and adverse outcomes are not well defined. The aims of this study were to: (1) construct an algorithm for the diagnosis of delirium using the Geriatric Mental State (GMS) examination; (2) test the criterion validity of this algorithm against mortality and dementia risk; (3) report the age-specific prevalence of delirium as determined by this algorithm. Participant and informant data in a randomly weighted subsample of the Cognitive Function and Ageing Study were taken from a standardized assessment battery. The algorithmic definition of delirium was based on the DSM-IV classification. Outcomes were: proportional hazard ratios for death; odds ratios of dementia at 2-year follow-up. Data from 2197 persons (representative of 13,004) were used, median age 77 years, 64% women. Study-defined delirium was associated with a new dementia diagnosis at two years (OR 8.82, 95% CI 2.76 to 28.2) and death (HR 1.28, 95% CI 1.03 to 1.60), even after adjustment for acute illness severity. Similar associations were seen for study-defined subsyndromal delirium. Age-specific prevalence as determined by the algorithm increased with age from 1.8% in the 65-69 year age group to 10.1% in the ≥85 age group (p delirium, age-specific period prevalence ranged from 8.2% (65-69 years) to 36.1% (≥85 years). These results demonstrate the possibility of constructing an algorithmic diagnosis for study-defined delirium using data from the GMS schedule, with predictive criterion validity for mortality and dementia risk. These are the first population-based analyses able to account prospectively for both illness severity and an earlier study diagnosis of dementia.

  12. Activity in GEriatric acute CARe (AGECAR: rationale, design and methods

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    Fleck Steven J

    2012-06-01

    Full Text Available Abstract Background The Activity in GEriatric acute CARe (AGECAR is a randomised control trial to assess the effectiveness of an intrahospital strength and walk program during short hospital stays for improving functional capacity of patients aged 75 years or older. Methods/Design Patients aged 75 years or older admitted for a short hospital stay (≤14 days will be randomly assigned to either a usual care (control group or an intervention (training group. Participants allocated in the usual care group will receive normal hospital care and participants allocated in the intervention group will perform multiple sessions per day of lower limb strength training (standing from a seated position and walking (10 min bouts while hospitalized. The primary outcome to be assessed pre and post of the hospital stay will be functional capacity, using the Short Physical Performance Battery (SPPB, and time to walk 10 meters. Besides length of hospitalization, the secondary outcomes that will also be assessed at hospital admission and discharge will be pulmonary ventilation (forced expiratory volume in one second, FEV1 and peripheral oxygen saturation. The secondary outcomes that will be assessed by telephone interview three months after discharge will be mortality, number of falls since discharge, and ability to cope with activities of daily living (ADLs, using the Katz ADL score and Barthel ADL index. Discussion Results will help to better understand the potential of regular physical activity during a short hospital stay for improving functional capacity in old patients. The increase in life expectancy has resulted in a large segment of the population being over 75 years of age and an increase in hospitalization of this same age group. This calls attention to health care systems and public health policymakers to focus on promoting methods to improve the functional capacity of this population. Trial registration ClinicalTrials.gov ID: NCT01374893.

  13. History of geriatric medicine: from Hippocrates to Marjory Warren.

    Science.gov (United States)

    Ritch, A

    2012-01-01

    It is widely assumed that geriatric medicine was an invention of the twentieth century. However, from the time of Hippocrates, there has been interest in the prolongation of the lifespan, the maintenance of health in old age and agerelated disease patterns. The debate about whether old age was a natural phenomenon or a disease state was not resolved until the nineteenth century. Calls for medicine relating to old age to be recognised as a discrete entity at the time when medical specialisation was developing were disregarded until the second half of the twentieth century. This review discusses the history of the theories of ageing and of disease and the practice of medicine for older people from the classical period up to Marjory Warren's initiative in London in 1935 and the development of geriatrics as a medical specialty.

  14. GERIATRICS-FUTURE SOCIAL MEDICINE

    Directory of Open Access Journals (Sweden)

    JS Mathur

    2013-12-01

    Full Text Available The problem of aging has draw the attention of World Health Organization in 1982 and again in 2000 and expressed concern on the increasing population of aged over 60 years of age and poses the growing policy challenging in both developed and developing countries.  ILO in 2002 has warned in its report that the number of old people aged 60 years and over are increasing throughout World in a “demographic resolution”.  According U N Population data  and their analysis, the persons over 60 years and their rate will be accelerated over the next 50 years.  In developing countries population 60 years are expected to increase 33.3 percent in 2050 from 11.7 percent in 1950 and aged over 60 years to increase 19.3 percent from 6.4 percent for the same period in the developing countries. Similarly the persons over 80 years in the total population in the developing countries in expected to rise from 0.7% percent in 2000 to 3.3 % percent in 2050.  But this is rise in expected to be 400 percent in developing countries.

  15. Geriatric patients may not experience increased risk of oligoanalgesia in the emergency department.

    Science.gov (United States)

    Cinar, Orhan; Ernst, Ryan; Fosnocht, David; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin; Madsen, Troy

    2012-08-01

    The aim of this study is to compare the pain management practices in geriatric patients in the emergency department (ED) with that in other adult ED patients to determine whether these patients face increased risk of oligoanalgesia. This study was a prospective analysis of a convenience sample of patients presenting to an urban academic tertiary care hospital ED from 2000 through 2010. We compared patients aged 65 years and older (geriatric) with adults younger than 65 years and evaluated analgesic administration rates, opioid administration and dosing, and pain and satisfaction scores (0 to 10 scale). A total of 15,387 patients presented to the ED during the 10-year study period and agreed to participate in the study; 1,169 patients were geriatric (7.6%). Geriatric patients had a mean age of 75.0 years (SD 7.2 years), whereas mean age of the 14,218 nongeriatric patients was 35.5 years (SD 12.2 years). Geriatric patients reported less pain at presentation (6.2 versus 6.9). After adjusting for presentation pain scores, geriatric patients were not less likely to receive an analgesic during the ED visit (odds ratio 0.90; 95% confidence interval 0.78 to 1.05) or less likely to receive an opioid (odds ratio 1.01; 95% confidence interval 0.87 to 1.18). Geriatric patients, on average, received lower doses of morphine (3.3 versus 4.2 mg) and had longer waiting times for their initial dose of an analgesic medication (65 versus 75 minutes). Despite longer wait times for analgesia, geriatric and nongeriatric patients were similar in rates of analgesia and opioid administration for pain-related complaints. These findings contrast with previous studies reporting lower rates of analgesia administration among geriatric patients. Copyright © 2012. Published by Mosby, Inc.

  16. Aging in France: Population Trends, Policy Issues, and Research Institutions

    Science.gov (United States)

    Beland, Daniel; Durandal, Jean-Philippe Viriot

    2013-01-01

    Like in other advanced industrial countries, in France, demographic aging has become a widely debated research and policy topic. This article offers a brief overview of major aging-related trends in France. The article describes France's demographics of aging, explores key policy matters, maps the institutional field of French social gerontology…

  17. Stable stroke occurrence despite incidence reduction in an aging population

    DEFF Research Database (Denmark)

    Thorvaldsen, P; Davidsen, M; Brønnum-Hansen, Henrik

    1999-01-01

    A stroke register was established at the Glostrup Population Studies in 1982 with the objective to monitor stroke occurrence in the population continuously during a 10-year period and contribute data to the WHO Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Project. The pur......A stroke register was established at the Glostrup Population Studies in 1982 with the objective to monitor stroke occurrence in the population continuously during a 10-year period and contribute data to the WHO Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Project...

  18. Comprehensive geriatric assessment

    African Journals Online (AJOL)

    2007-09-14

    Sep 14, 2007 ... for the toll of illness. Illnesses accumulate with age and increase in severity and number. Frailty (a complex interplay of health and illness, attitudes, resources and .... In some cases tamoxifen, routinely prescribed to treat breast cancer, may help cancer proliferate, according to David Shapiro and colleagues ...

  19. Comprehensive geriatric assessment in elderly patients with dementia.

    Science.gov (United States)

    Namioka, Nayuta; Hanyu, Haruo; Hatanaka, Hirokuni; Fukasawa, Raita; Sakurai, Hirofumi; Iwamoto, Toshihiko

    2015-01-01

    We have recently developed and validated a screening test for comprehensive geriatric assessment (CGA) named "Dr. SUPERMAN". We compared the results obtained by the CGA of patients with Alzheimer's disease (AD), vascular dementia (VaD) and dementia with Lewy bodies (DLB), and determined the relationship between functional deficits and clinical characteristics in each type of dementia. We used Dr. SUPERMAN to examine patients with AD (24 men and 53 women, mean age 83.0 ± 5.1 years), VaD (10 men and 12 women, mean age 80.4 ± 5.0 years) and DLB (28 men and 20 women, mean age 81.2 ± 5.5 years). Patients with DLB or VaD had functional deficits more frequently than those with AD in many fields. Significant correlations between functional impairments and clinical characteristics, such as age, sex and Mini-Mental State Examination scores, in the non-AD group (including DLB and VaD) were found in more extensive fields than those in the AD group. Patients with dementia, particularly DLB, have several geriatric problems. Correlations between functional deficits and clinical characteristics differ between the AD group and the non-AD group. Non-AD patients of older age who are male and have advanced dementia are more likely have several functional deficits. In addition to age and severity of dementia, the type of dementia should be considered in the treatments and interventions of elderly patients with dementia. © 2014 Japan Geriatrics Society.

  20. Co-Prescription of QT-Interval Prolonging Drugs: An Analysis in a Large Cohort of Geriatric Patients.

    Directory of Open Access Journals (Sweden)

    Simone Schächtele

    Full Text Available Drug-induced QT-interval prolongation is associated with occurrence of potentially fatal Torsades de Pointes arrhythmias (TdP. So far, data regarding the overall burden of QT-interval prolonging drugs (QT-drugs in geriatric patients are limited.This study was performed to assess the individual burden of QT-interval prolonging drugs (QT-drugs in geriatric polymedicated patients and to identify the most frequent and risky combinations of QT-drugs.In the discharge medication of geriatric patients between July 2009 and June 2013 from the Geriatrics in Bavaria-Database (GiB-DAT (co-prescriptions of QT-drugs were investigated. QT-drugs were classified according to a publicly available reference site (CredibleMeds® as ALL-QT-drugs (associated with any QT-risk or High-risk-QT-drugs (corresponding to QT-drugs with known risk of Torsades de Pointes according to CredibleMeds® and in addition as SmPC-high-risk-QT-drugs (according to the German prescribing information (SmPC contraindicated co-prescription with other QT-drugs.Of a cohort of 130,434 geriatric patients (mean age 81 years, 67% women, prescribed a median of 8 drugs, 76,594 patients (58.7% received at least one ALL-QT-drug. Co-prescriptions of two or more ALL-QT-drugs were observed in 28,768 (22.1% patients. Particularly risky co-prescriptions of High-risk-QT-drugs or SmPC-high-risk-QT-drugs with at least on further QT-drug occurred in 55.9% (N = 12,633 and 54.2% (N = 12,429 of these patients, respectively. Consideration of SmPCs (SmPC-high-risk-QT-drugs allowed the identification of an additional 15% (N = 3,999 patients taking a risky combination that was not covered by the commonly used CredibleMeds® classification. Only 20 drug-drug combinations accounted for more than 90% of these potentially most dangerous co-prescriptions.In a geriatric study population co-prescriptions of two and more QT-drugs were common. A considerable proportion of QT-drugs with higher risk only could be detected by

  1. Characteristics of geriatric patients seeking medication treatment for pathologic gambling disorder.

    Science.gov (United States)

    Grant, J E; Kim, S W; Brown, E

    2001-01-01

    This study was constructed to compare geriatric patients seeking medication treatment for pathologic gambling disorder (PGD) with younger pathologic gamblers. This comparison study assessed three groups with PGD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition: 16 subjects over the age of 60 years, 11 subjects between the ages of 20 and 30 years, and 46 subjects between the ages of 40 and 50 years. All subjects were evaluated in terms of demographic characteristics, clinical features of PGD, and treatment history. Geriatric gamblers had a later age of onset of gambling and developed pathologic gambling over a longer period of time. Geriatric subjects were more likely to play slot machines and demonstrate less variety in their choice of gambling activity. Geriatric gamblers were also more likely to gamble secondary to boredom. Geriatric subjects were as likely as the other age groups to report slight or no response to nonpharmacologic treatment. There appear to be some differences in the clinical features of PGD among geriatric subjects, and these differences may have treatment implications.

  2. Stable stroke occurrence despite incidence reduction in an aging population

    DEFF Research Database (Denmark)

    Thorvaldsen, P; Davidsen, M; Brønnum-Hansen, Henrik

    1999-01-01

    A stroke register was established at the Glostrup Population Studies in 1982 with the objective to monitor stroke occurrence in the population continuously during a 10-year period and contribute data to the WHO Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Project....... The purpose of the current analysis was to estimate temporal trends in stroke occurrence....

  3. Recommendations for Care of Geriatric Maxillofacial Trauma Patients Following a Retrospective 10-Year Multicenter Review.

    Science.gov (United States)

    Shumate, Robert; Portnof, Jason; Amundson, Melissa; Dierks, Eric; Batdorf, Robert; Hardigan, Patrick

    2017-10-26

    The purpose of this study was to analyze maxillofacial trauma sustained by patients at least 75 years old. With the injury patterns identified, treatment recommendations for the contemporary oral and maxillofacial surgeon are made. This study was a retrospective case series using data from 2 level 1 trauma centers. The variables of interest included age at traumatic event, gender, mechanism of trauma, concomitant injuries, radiographic studies performed, management of maxillofacial injuries, and disposition. Numerical analysis was completed with statistical software. One hundred seventy-six patients at least 75 years old who sustained facial trauma were identified. Ground-level falls caused most cases of maxillofacial trauma in the geriatric population. The median age at the time of trauma was 83 and 85 years for men and women, respectively. The most common injuries were midface fractures. Intracranial hemorrhage was the most common concomitant injury, and all but 1 patient underwent computed tomography of at least the head after their traumatic event. Most maxillofacial injuries were treated without operative repair. The information gained from this study suggests that oral and maxillofacial surgeons should counsel geriatric patients on the risk of falls and encourage the prevention of potential hazards for falls in their homes. Copyright © 2017. Published by Elsevier Inc.

  4. 75 FR 4343 - Estimates of the Voting Age Population for 2009

    Science.gov (United States)

    2010-01-27

    ... DEPARTMENT OF COMMERCE Office of the Secretary Estimates of the Voting Age Population for 2009 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2009, for each state and...

  5. 76 FR 37314 - Estimates of the Voting Age Population for 2010

    Science.gov (United States)

    2011-06-27

    ... DEPARTMENT OF COMMERCE Office of the Secretary Estimates of the Voting Age Population for 2010 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2010, for each state and...

  6. 77 FR 4000 - Estimates of the Voting Age Population for 2011

    Science.gov (United States)

    2012-01-26

    ... DEPARTMENT OF COMMERCE Office of the Secretary Estimates of the Voting Age Population for 2011 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2011, for each state and...

  7. Trans-generational effects on ageing in a wild bird population

    NARCIS (Netherlands)

    Bouwhuis, S.; Charmantier, A.; Verhulst, S.; Sheldon, B. C.

    Ageing, long thought to be too infrequent to study effectively in natural populations, has recently been shown to be ubiquitous, even in the wild. A major challenge now is to explain variation in the rates of ageing within populations. Here, using 49 years of data from a population of great tits

  8. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help......, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have......, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...

  9. [Comparative assessment of aging rates in population from different cities].

    Science.gov (United States)

    Negasheva, M A; Lapshina, N E; Sineva, I M; Gritchina, O I; Kharlova, A G; Okushko, R V

    437 people (214 men and 223 women) at the age of 50-90 years old, residents of different cities of Russia and Pridnestrovie (Moscow, Barnaul, Tiraspol) have been examined. Using a complex of morphofunctional characteristics, parameters of the biological age have been analyzed, and groups with delayed, moderate and accelerated aging rates have been outlined. Regional peculiarities in distribution of incidence of different variants of aging rates have been revealed. In Moscow men and women, the delayed variant of development of age involution changes is the most widespread. In Tiraspol women, compared to the Moscow group, incidence of people with accelerated aging rates is 2 times higher, which can be stipulated by influence of a complex of biosocial factors.

  10. Expert consensus panel guidelines on geriatric assessment in oncology.

    Science.gov (United States)

    O'Donovan, A; Mohile, S G; Leech, M

    2015-07-01

    Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. A four-round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations to gain consensus on a given topic. Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cut-off for assessment, represented a higher degree of disagreement. The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. © 2015 John Wiley & Sons Ltd.

  11. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    Directory of Open Access Journals (Sweden)

    João Paulo de Almeida Tavares

    2013-01-01

    Full Text Available The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES among 1,068 Portuguese registered nurses (RNs. Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α=.919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  12. Validation of geriatric care environment scale in portuguese nurses.

    Science.gov (United States)

    Paulo de Almeida Tavares, João; Leite da Silva, Alcione; Sá-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α = .919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  13. Age and Time Population Differences: Young Adults, Gen Xers, and Millennials

    Science.gov (United States)

    Menard, Lauren A.

    2013-01-01

    Age and Time disparities in young adult research populations are common because young adults are defined by varying age spans; members of Generation X and Millennial generations may both be considered young adults; study years vary, affecting populations; and qualitative methods with limited age/year samples are frequently utilized. The current…

  14. Why do nursing students not want to work in geriatric care? A national questionnaire survey.

    Science.gov (United States)

    Haron, Yafa; Levy, Sara; Albagli, Mazal; Rotstein, Ruth; Riba, Shoshana

    2013-11-01

    Given the severe shortage of nurses in geriatric care in Israel and the planned expansion of their role in the care of older people, the Israel Ministry of Health's Nursing Division decided to investigate the readiness of current students to work in geriatrics. To gather last-year student nurses' views on geriatric nursing as a career choice and identify the factors behind those views. A cross-sectional questionnaire study was designed. 486 students (70% of the total last-year student nurse population) across the whole range of study settings completed the questionnaire in 2011. On the basis of extensive data collection from focus groups of student nurses and working geriatric nurses a structured, self-administered questionnaire was compiled. The researchers distributed and collected the questionnaire in the students' classrooms. 61% of the 486 respondents had no intention of working in geriatrics while 12% considered the prospect favourably. 27% of the respondents were prepared to consider geriatric nursing as a career choice only after advanced specialist training in that field. 69% said that the planned expansion of the powers of geriatric nurses would incline them more favourably to work in geriatrics. A relatively high proportion of those interested in working in geriatrics were men. The students' appraisal of the content of their training programme and of the current state of geriatrics in Israel appeared not to influence career choice. Multiple regression analysis found that the factors most predictive of geriatric care as a career choice were a generally favourable attitude to older people, the expansion of nurse powers in the sector and previous experience in older people care. Studying on an academic programme as opposed to a diploma programme was a negative predictor. The non-influence of training programme content/design is the key finding. The chief recruitment effort should be invested in making the domain of geriatric nursing more attractive to

  15. Distortion product otoacoustic emissions in young adult and geriatric cats.

    Science.gov (United States)

    Strain, George M; McGee, Kain A

    2017-03-01

    Recordings of distortion product otoacoustic emissions (DPOAEs) were taken from 15 geriatric cats (mean age ± standard deviation, SD, 13.6 ± 2.7 years; range 10.2-19.4 years) and 12 young adult control cats (mean ± SD 4.6 ± 0.5 years; range 3.4-5 years) to identify frequency-specific age-related changes in cochlear responses. Recordings were performed for primary frequencies from 2 to 12 kHz in 2 kHz increments. Cats were considered to be geriatric > 11.9 ± 1.9 years of age. Brainstem auditory evoked response (BAER) recordings were also made for subjective comparison with DPOAE responses. No differences in DPOAE response amplitudes were observed at any tested frequency in geriatric cats compared to control cats, reflecting an apparent absence of loss of cochlear outer hair cells along the length of the cochlea. No linear regression relationships were found for DPOAE response amplitude versus age in geriatric cats, despite the progressive nature of age-related hearing loss in other species. The absence of reductions in response at any of the tested frequencies in cats within the age span where cats are considered to be geriatric indicates that age-related hearing loss, if it does develop in cats, begins later in the life span of cats than in dogs or human beings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Maternal age and fetal loss: population based register linkage study

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Wohlfahrt, J; Christens, P

    2000-01-01

    To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history.......To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history....

  17. Technology in geriatrics.

    Science.gov (United States)

    Pilotto, Alberto; Boi, Raffaella; Petermans, Jean

    2018-03-13

    Recently, the interest of industry, government agencies and healthcare professionals in technology for aging people has increased. The challenge is whether technology may play a role in enhancing independence and quality of life and in reducing individual and societal costs of caring. Information and communication technologies, i.e. tools aimed at communicating and informing, assistive technologies designed to maintain older peoples' independence and increasing safety, and human-computer interaction technologies for supporting older people with motility and cognitive impairments as humanoid robots, exoskeletons, rehabilitation robots, service robots and companion-type are interdisciplinary topics both in research and in clinical practice. The most promising clinical applications of technologies are housing and safety to guarantee older people remaining in their own homes and communities, mobility and rehabilitation to improve mobility and gait and communication and quality of life by reducing isolation, improve management of medications and transportation. Many factors impair a broad use of technology in older age, including psychosocial and ethical issues, costs and fear of losing human interaction. A substantial lack of appropriate clinical trials to establish the clinical role of technologies to improve physical or cognitive performances and/or quality of life of subjects and their caregivers may suggest that the classical biomedical research model may not be the optimal choice to evaluate technologies in older people. In conclusion, successful technology development requires a great effort in interdisciplinary collaboration to integrate technologies into the existing health and social service systems with the aim to fit into the older adults' everyday life.

  18. 28 CFR 2.78 - Geriatric parole.

    Science.gov (United States)

    2010-07-01

    ... for violence; (6) Criminal history; and (7) Alternatives to maintaining geriatric long-term prisoners in traditional prison settings. (f) A prisoner, the prisoner's representative, or the institution...

  19. International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

    NARCIS (Netherlands)

    Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L. G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

    2014-01-01

    Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the

  20. Replacement Migration: Is It a Solution to Declining and Ageing Populations?

    Science.gov (United States)

    United Nations, New York, NY. Dept. of Economic and Social Affairs.

    The United Nations (UN) Population Division monitors fertility, mortality, and migration trends for all countries as a basis for producing the official UN population estimates and projections. Among recent demographic trends, two are prominent: (1) population decline and (2) population aging. Focusing on these two critical trends, a study…

  1. Extending healthy ageing: nutrient sensitive pathway and centenarian population

    Directory of Open Access Journals (Sweden)

    Davinelli Sergio

    2012-04-01

    Full Text Available Abstract Ageing is a challenge for any living organism and human longevity is a complex phenotype. With increasing life expectancy, maintaining long-term health, functionality and well-being during ageing has become an essential goal. To increase our understanding of how ageing works, it may be advantageous to analyze the phenotype of centenarians, perhaps one of the best examples of successful ageing. Healthy ageing involves the interaction between genes, the environment, and lifestyle factors, particularly diet. Besides evaluating specific gene-environment interactions in relation to exceptional longevity, it is important to focus attention on modifiable lifestyle factors such as diet and nutrition to achieve extension of health span. Furthermore, a better understanding of human longevity may assist in the design of strategies to extend the duration of optimal human health. In this article we briefly discuss relevant topics on ageing and longevity with particular focus on dietary patterns of centenarians and nutrient-sensing pathways that have a pivotal role in the regulation of life span. Finally, we also discuss the potential role of Nrf2 system in the pro-ageing signaling emphasizing its phytohormetic activation.

  2. Chronic pain, depression symptoms and daily living independency level among geriatrics in nursing home.

    Science.gov (United States)

    Tarakcı, Ela; Zenginler, Yonca; Kaya Mutlu, Ebru

    2015-01-01

    The aim of this study was to investigate pain, depression and independence in activities of daily living in geriatric residents of nursing homes, as well as to evaluate the relationship between these parameters. 186 nursing home residents, aged 65 to 90 years, were enrolled in the study. Their socio-demographic features, depression levels, pain levels and independence in activities of daily living were evaluated using a socio-demographic assessment form, the Geriatric Depression Scale (GDS), the Visual Analogue Scale (VAS) and the Nottingham Extended Activities of Daily Living Index (NEADL), respectively. For statistical analyses, participants were divided into groups with and without chronic pain. The main finding of this study was that 55.9% of the participants reported chronic pain, and these participants had significantly higher GDS (p=0.001) and lower NEADL scores (p=0.01) than those who reported no chronic pain. We found a significant correlation between VAS and GDS (r=0.47, p=0.001), VAS and NEADL (r=-0.30, p=0.001), and GDS and NEADL scores (r=-0.50, p=0.001). Female gender (p=0.001), number of children (p=0.005), number of chronic diseases (p=0.009), and GDS score (p=0.001) were found to affect chronic pain in multivariate model. Investigation of pain, presence of depression, and independence in activities of daily living is important in determining the necessary measures to be adopted for promoting the health and well-being of the geriatric population.

  3. Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge.

    Science.gov (United States)

    Johari, Nuruljannah; Manaf, Zahara Abdul; Ibrahim, Norhayati; Shahar, Suzana; Mustafa, Norlaila

    2016-01-01

    Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia. A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life. Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life ( R 2 =0.633, F (3, 67)=38.462; P <0.001), whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain ( R 2 =0.558, F (2, 68)=42.953; P <0.001). Social support and cognitive status were the determinants of social relationship ( R 2 =0.539, F (2, 68)=39.763; P <0.001) and also for the environmental domain of the quality of life ( R 2 =0.496, F (2, 68)=33.403; P <0.001). The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients' quality of life.

  4. The Impact of Hyposalivation on Quality of Life (QoL and Oral Health in the Aging Population of Al Madinah Al Munawarrah

    Directory of Open Access Journals (Sweden)

    Mohammad S. Ahmad

    2017-04-01

    Full Text Available Hyposalivation (HS affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL, and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14, and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association (p = 0.02 between the caries status and mean saliva flow rate. There was also a significant (p < 0.001 positive correlation between caries and the OHIP-14 scores (Spearman’s ρ = 0.293. The prevalence of hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL.

  5. Effect of Visual Impairment on Physical and Cognitive Function in Old Age: Findings of a Population-Based Prospective Cohort Study in Germany.

    Science.gov (United States)

    Hajek, André; Brettschneider, Christian; Lühmann, Dagmar; Eisele, Marion; Mamone, Silke; Wiese, Birgitt; Weyerer, Siegfried; Werle, Jochen; Pentzek, Michael; Fuchs, Angela; Riedel-Heller, Steffi G; Luck, Tobias; Bickel, Horst; Weeg, Dagmar; Koppara, Alexander; Wagner, Michael; Scherer, Martin; Maier, Wolfgang; König, Hans-Helmut

    2016-11-01

    To examine how visual impairment affects physical and cognitive function in old age. A longitudinal population-based prospective cohort study. General practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves. Individuals aged 77-101 at follow-up Wave 2 (N = 2,394). Physical and cognitive function were assessed using an adapted scale that had been previously developed, and visual impairment was rated on a Likert scale (none, mild, severe or profound). Adjusting for sociodemographic factors and comorbidity, linear fixed-effects regression showed that the onset of severe visual impairment was associated with a decline in physical function score in the total sample (β = -0.15, P = .01) and in women (β = -.15, P = .03). Moreover, the onset of severe visual impairment was associated with decline in cognitive function score in the total sample (β = -0.38, P Visual impairment affects physical and cognitive function in old age. Interventional strategies to postpone visual impairment may contribute to maintaining physical and cognitive function. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  6. Habitual physical activity and vascular aging in a young to middle-age population at low cardiovascular risk

    DEFF Research Database (Denmark)

    Kozakova, Michaela; Palombo, Carlo; Mhamdi, Leila

    2007-01-01

    and stiffness in a population of young to middle-age subjects at low cardiovascular risk. METHODS: The study population consisted of 432 healthy subjects (166 men; mean+/-SD age, 43+/-8 years; range, 30 to 60 years) free of carotid atherosclerosis and with low coronary heart disease risk, as determined...... physical activity was negatively related to indices of carotid stiffness (r from -0.20 to -0.25, Pobesity, blood pressure, plasma lipids, and smoking habits, age...... and physical activity were independently related to carotid stiffness. CONCLUSIONS: This study provides cross-sectional evidence that habitual physical activity is inversely related to the age-dependent increase in carotid wall stiffness in a young to middle-age population at low risk...

  7. Renal microvascular disease in an aging population: a reversible process?

    Science.gov (United States)

    Futrakul, Narisa; Futrakul, Prasit

    2008-01-01

    Renal microvascular disease and tubulointerstitial fibrosis are usually demonstrated in aging in humans and animals. It has recently been proposed that renal microvascular disease is the crucial determinant of tubulointerstitial disease or fibrosis. Enhanced circulating endothelial cell loss is a biomarker that reflects glomerular endothelial injury or renal microvascular disease, and fractional excretion of magnesium (FE Mg) is a sensitive biomarker that reflects an early stage of tubulointerstitial fibrosis. In aging in humans, both of these biomarkers are abnormally elevated. In addition, a glomerular endothelial dysfunction determined by altered hemodynamics associated with peritubular capillary flow reduction is substantiated. A correction of such hemodynamic alteration with vasodilators can effectively improve renal perfusion and restore renal function. Thus, anti-aging therapy can reverse the renal microvascular disease and dysfunction associated with the aging process.

  8. Enhanced mobility for aging populations using automated vehicles : [summary].

    Science.gov (United States)

    2016-01-01

    Studies show that aging adults have travel needs that can be inadequately addressed by todays : transportation system. Automated vehicles (AVs), ranging from assistive technologies to full : automation, may offer a safe and efficient transportatio...

  9. Bilingualism provides a neural reserve for aging populations.

    Science.gov (United States)

    Abutalebi, Jubin; Guidi, Lucia; Borsa, Virginia; Canini, Matteo; Della Rosa, Pasquale A; Parris, Ben A; Weekes, Brendan S

    2015-03-01

    It has been postulated that bilingualism may act as a cognitive reserve and recent behavioral evidence shows that bilinguals are diagnosed with dementia about 4-5 years later compared to monolinguals. In the present study, we investigated the neural basis of these putative protective effects in a group of aging bilinguals as compared to a matched monolingual control group. For this purpose, participants completed the Erikson Flanker task and their performance was correlated to gray matter (GM) volume in order to investigate if cognitive performance predicts GM volume specifically in areas affected by aging. We performed an ex-Gaussian analysis on the resulting RTs and report that aging bilinguals performed better than aging monolinguals on the Flanker task. Bilingualism was overall associated with increased GM in the ACC. Likewise, aging induced effects upon performance correlated only for monolinguals to decreased gray matter in the DLPFC. Taken together, these neural regions might underlie the benefits of bilingualism and act as a neural reserve that protects against the cognitive decline that occurs during aging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Population ageing and survival challenges in rural Ghana | Mba ...

    African Journals Online (AJOL)

    The significant achievements of global declines in infant and maternal mortality, reductions in fertility, decreases in infectious and parasitic diseases and improvements in nutrition and education have resulted in the numerical growth of elderly populations around the world. The demographic profile of Ghana reveals that ...

  11. Is Our Aging Population a Threat to Education?

    Science.gov (United States)

    Francese, Peter

    2014-01-01

    A great many New England institutions of higher education are about to find out if demography will determine their fate because unprecedented and substantial population change is sweeping across the region. With fewer than 15 million year-round residents, it is the nation's smallest and one of the slowest-growing of the nine census divisions. This…

  12. Disaster resilience and population ageing: the 1995 Kobe and 2004 Chuetsu earthquakes in Japan.

    Science.gov (United States)

    Chen, Haili; Maki, Norio; Hayashi, Haruo

    2014-04-01

    This paper provides a framework for evaluating the effects of population ageing on disaster resilience. In so doing, it focuses on the 1995 Kobe and 2004 Chuetsu earthquakes, two major disasters that affected Japan before the 2011 Great East Japan earthquake. It analyses regional population recovery on the basis of pre-disaster and post-recovery demographic characteristics using defined transition patterns of population ageing. The evaluation framework demonstrates that various recovery measures make different contributions to disaster resilience for each transition pattern of population ageing. With reference to regional population ageing, the framework allows for a prediction of disaster resilience, facilitating place vulnerability assessments and potentially informing policy-making strategies for Japan and other countries with ageing populations. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  13. Urinary tract infections in the geriatric patients.

    Science.gov (United States)

    Alpay, Yesim; Aykin, Nevil; Korkmaz, Pinar; Gulduren, Hakki Mustafa; Caglan, Figen Cevik

    2018-01-01

    Urinary tract infections (UTI) are the second most common infection in geriatric population. This study investigated clinical findings, diagnostic approaches, complicating factors, prognosis, causative microorganisms and antimicrobial susceptibility in geriatric patients diagnosed with UTI. A total of 140 hospitalised patients with UTIs were evaluated within three years between January 2011-January 2015 at the Eskisehir Yunus Emre State Hospital. UTI diagnosed when there were systemic and urinary signs and symptoms and a positive dipstick test and urine culture result, leukocyte and CRP like serum parameters. Among the studied patients, 41.4% had urological diseases, 20.7% had diabetes mellitus and 19.2% had neurological diseases. The most common symptoms and signs were fever, dysuria nausea/vomiting, general condition impairment, pyuria, haematuria. The laboratory values for CRP, ESR and leukocyte count were 84 mg/dL, 56 mm/s and 11.9 (10^3μL), with mean values being determined. Among patients having a urinary catheter (17.1%), 27.9% had a history of UTI, while 29.3% had been hospitalised. Escherichia coli and Klebsiella pneumoniae were the most commonly identified microorganisms. The mean duration for hospitalisation was 7.6 days, while a 5% mortality rate was observed over the course of the disease. Because of the potential for serious complications and mortality, elderly patients with urinary tract infection, should receive immediate empirical treatment based on anamnesis, clinical evaluation and urinalysis and should be re-examined using results from cultures and antibiograms upon follow-up.

  14. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    OpenAIRE

    Paulo de Almeida Tavares, Jo?o; Leite da Silva, Alcione; S?-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal...

  15. [Aspects for data mining implementation in gerontology and geriatrics].

    Science.gov (United States)

    Mikhal'skiĭ, A I

    2014-01-01

    Current challenges facing theory and practice in ageing sciences need new methods of experimental data investigation. This is a result as of experimental basis developments in biological research, so of information technology progress. These achievements make it possible to use well proven in different fields of science and engineering data mining methods for tasks in gerontology and geriatrics. Some examples of data mining methods implementation in gerontology are presented.

  16. [Nutritional management in geriatric traumatology].

    Science.gov (United States)

    Singler, K; Goisser, S; Volkert, D

    2016-08-01

    The prevalence of malnutrition or the risk of malnourishment is high among orthogeriatric patients and a poor nutritional status is associated with a negative outcome. A comprehensive management of preoperative and postoperative nutritional and fluid intake in these patients can help to improve the situation. The management includes identification of patients affected, a thorough assessment of the nutritional status, work-up of possible underlying causes, documentation of nutritional and fluid intake and, most importantly, procedures to improve the preoperative and postoperative nutritional situation. This article gives an overview of the recently updated recommendations on nutritional management in orthogeriatric patients as published by the orthogeriatric working group of the German Geriatric Society.

  17. Fertility, Mortality and Age Composition Effects of Population Transition in China and India: 1950-2015

    OpenAIRE

    Chaurasia, Aalok Ranjan

    2017-01-01

    "This paper compares the population transition in China and India during 1950-2015 by decomposing population growth into the growth attributed to the changes in fertility and mortality (intrinsic growth), and the growth attributed to the change in population age composition (momentum growth). The analysis reveals similarities and differences in the population transition path followed by the two countries and suggests that India lags behind China by about 30 years in terms of population transi...

  18. Population ageing and healthcare demand: The case of Slovenia.

    Science.gov (United States)

    Vrhovec, Jure; Tajnikar, Maks

    2016-11-01

    The aim of this paper is to explore the consequences of demographic ageing on healthcare demand in Slovenia for primary care, secondary care, hospital day-care treatments, and hospitalisations. In the paper, we develop a model for making projections of the total number of treatments using the age-group projection method with the scenario approach. The model allows the number of treatments to be observed with respect to medical services, age groups and main disease groups. The results are presented for the cross-section years 2015, 2025 and 2035. The smallest increase in the number of treatments occurs in primary care, a larger one for secondary care, and the largest for hospital day-care services and hospitalisations (up to 29.9%). The structure of demand will also change. Demand for healthcare services for children and infants will decrease while demand for diseases associated with older age groups will increase, particularly for diseases of the circulatory system, eye and adnexa, and diseases of the blood and blood-forming organs. The results presented in this paper can help improve understanding of similar processes in other countries for total healthcare demand and for changes in the structure of demand. The results show that the healthcare system in Slovenia will face a major additional burden in the next 20 years. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Survival Outlook for Middle-Aged Populations in South Mrica

    African Journals Online (AJOL)

    1974-10-12

    Oct 12, 1974 ... A recent report from Chile revealed that at 3 months of age, the mortality rate of infants was 3 times higher among artificially fed infants than among ..... and diabetes, all of which are aetiologically important in coronary heart disease, and weight reduction should be the first (and is often the most successful) ...

  20. Exceptional Brain Aging in a Rural Population-Based Cohort

    Science.gov (United States)

    Kaye, Jeffrey; Michael, Yvonne; Calvert, James; Leahy, Marjorie; Crawford, Debbie; Kramer, Patricia

    2009-01-01

    Context: The 2000 US Census identified 50,454 Americans over the age of 100. Increased longevity is only of benefit if accompanied by maintenance of independence and quality of life. Little is known about the prevalence of dementia and other disabling conditions among rural centenarians although this information is important to clinicians caring…

  1. Population Aging and the Generational Economy : A Global ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    31 oct. 2011 ... Le livre est une véritable boule de cristal. Une lecture incontournable pour la prochaine décennie. David Bloom, titulaire de la chaire Clarence James Gamble d'économie et démographie et directeur du Département de santé mondiale et de la population, École de santé publique de Harvard University, ...

  2. Therapeutic evaluation of grain based functional food formulation in a geriatric animal model.

    Science.gov (United States)

    Teradal, Deepa; Joshi, Neena; Aladakatti, Ravindranath H

    2017-08-01

    This study investigates the effect of wholesome grain based functional food formulation, on clinical and biochemical parameters in 24-30 months old Wistar albino geriatric rats, corresponding to human age 60-75 years. Animals were randomly divided into five, groups. Experimental diets were compared to the basal rat diet (Group I). Four food, formulation were-wheat based (Group II), finger millet based (Group III), wheat based, diet + fenugreek seed powder (Group IV), finger millet based diet + fenugreek powder, (Group V). These five types of diets were fed to the experimental rats for 6 weeks. Hematological and biochemical parameters were evaluated. The results showed that, feed intake was influenced by the type of feed. Diets supplemented with, fenugreek (Group IV) caused a significant increase in serum hemoglobin. The total serum protein values were significantly highest in Group III. Total serum albumin was found to be lower in Group I and highest in Group II. The concentration of BUN was highest in Group I and the lowest in control diet. Serum cholesterol and glucose were significantly reduced in Group IV. Several hematological and serum mineral values were influenced by the type of diet. The type of diet did not influence the organs weight. A moderate hypoglycemic and hypercholesterolemic effect was observed in composite mix fed rats. This study clearly justifies the recommendation to use wholesome grain based functional foods for geriatric population.

  3. Addressing Geriatric Oral Health Concerns through National Oral Health Policy in India

    Directory of Open Access Journals (Sweden)

    Abhinav Singh

    2015-01-01

    Full Text Available There is an escalating demand for geriatric oral healthcare in all developed and developing countries including India. Two-thirds of the world’s elderly live in developing countries. This is a huge population that must receive attention from policy-makers who will be challenged by the changing demands for social and health services including oral health services. Resources are limited thus rather than being aspirational in wanting to provide all treatment needed for everybody, this critique presents a road map of how we might answer the present and future geriatric oral health concerns in a most efficient manner in a developing country. Viewing the recent Indian demographic profile and the trends in oral health, pertinent policy subjects have been discussed concerning the oral health needs of the elderly and also the associated challenges which include strategies to improve quality of life, strategies to train and educate the dental workforce and above all the role of healthcare systems towards realization of better aged society in India and other developing countries

  4. Emergency general surgery in the geriatric patient.

    Science.gov (United States)

    Desserud, K F; Veen, T; Søreide, K

    2016-01-01

    Emergency general surgery in the elderly is a particular challenge to the surgeon in charge of their care. The aim was to review contemporary aspects of managing elderly patients needing emergency general surgery and possible alterations to their pathways of care. This was a narrative review based on a PubMed/MEDLINE literature search up until 15 September 2015 for publications relevant to emergency general surgery in the geriatric patient. The number of patients presenting as an emergency with a general surgical condition increases with age. Up to one-quarter of all emergency admissions to hospital may be for general surgical conditions. Elderly patients are a particular challenge owing to added co-morbidity, use of drugs and risk of poor outcome. Frailty is an important potential risk factor, but difficult to monitor or manage in the emergency setting. Risk scores are not available universally. Outcomes are usually severalfold worse than after elective surgery, in terms of both higher morbidity and increased mortality. A care bundle including early diagnosis, resuscitation and organ system monitoring may benefit the elderly in particular. Communication with the patient and relatives throughout the care pathway is essential, as indications for surgery, level of care and likely outcomes may evolve. Ethical issues should also be addressed at every step on the pathway of care. Emergency general surgery in the geriatric patient needs a tailored approach to improve outcomes and avoid futile care. Although some high-quality studies exist in related fields, the overall evidence base informing perioperative acute care for the elderly remains limited. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  5. Depression in Geriatric and Adult Medical Inpatients.

    Science.gov (United States)

    Magni, Guido; And Others

    1985-01-01

    Administered two scales for the evaluation of depression to two groups of medical inpatients: adults (N=201) and geriatric subjects (N=178). Results confirmed a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects. Factors most predictive of depressive symptoms are identified. (JAC)

  6. gerIatrIc ImperatIve

    African Journals Online (AJOL)

    gerIatrIc. •. •. ImperatIve. A major challenge to health professionals. D. GLAJCHEN. In recent years I have noted, with increasing envy, the inherent strength as well as the impressive clinical and ... ments of geriatrics in this country will form the basis of a separate .... effects of nutrition (quantity, under-nutrition without malnutri-.

  7. Venlafaxine-Induced Orthostatic Hypotension in a Geriatric Patient

    Directory of Open Access Journals (Sweden)

    Vidyashree Chikkaramanjegowda

    2013-01-01

    Full Text Available Venlafaxine is not usually associated with risk of orthostatic hypotension. A 65-year-old US Caucasian female taking 225 mg/day of venlafaxine extended-release developed symptomatic orthostatic hypotension. The systolic and diastolic blood pressure dropped by 25 and 18 mm Hg, respectively, from supine position to standing position within 3 minutes. The patient was otherwise healthy and the orthostatic hypotension resolved with venlafaxine discontinuation. This was a probable venlafaxine adverse drug reaction according to the Naranjo scale. This case contributes to the scarce literature that indicates that clinicians need to be aware that occasionally venlafaxine can induce clinically significant orthostatic hypotension, particularly in geriatric patients. Our patient did not have orthostatic hypotension when she was taking venlafaxine at 60 years of age in higher venlafaxine doses (300 mg/day but developed this adverse drug reaction when venlafaxine was restarted at the geriatric age. This case indicates that a history of prior tolerance to venlafaxine does not guarantee tolerance after 65 years of age. If a clinician decides to use venlafaxine in geriatric patients, the clinician should warn the patient about the risk of orthostatic hypotension and consider very slow titration and low doses.

  8. Age-dependent dose coefficients for tritium in Asian populations

    International Nuclear Information System (INIS)

    Trivedi, A.

    1999-10-01

    The International Commission on Radiological Protection (ICRP) Publications 56 (1989) and 67 (1993) have prescribed the biokinetic models and age-dependent dose coefficients for tritiated water and organically bound tritium. The dose coefficients are computed from values selected to specify the anatomical, morphological and physiological characteristics of a three-month-old, one-year-old, five-year-old, 10-year-old, 15-year-old and adult (Reference Man) Caucasian living in North America and Western Europe. However, values for Reference Man and other age groups are not directly applicable to Asians, because of differences in race, custom, dietary habits and climatic conditions. An Asian Man model, including five age groups, has been proposed by Tanaka and Kawamura (1996, 1998) for use in internal dosimetry. The basic concept of the ICRP Reference Man and the system describing body composition in ICRP Publication 23 (1975) were used. Reference values for Asians were given for the body weight and height, the mass of soft tissue, the mass of body water and the daily fluid balance, and are used to compute the dose coefficients for tritium. The age-dependent dose coefficients for Asians for tritiated water intakes are smaller by 20 to 30% of the currently prescribed values (Trivedi, 1998). The reduction in the dose coefficient values is caused by the increased daily fluid balance among Asians. The dose coefficient for tritiated water is 1.4 x 10 -11 Sv Bq -1 for Asian Man compared to 2.0 x 10 -11 Sv Bq -1 for Reference Man. The dose coefficients for organically bound tritium are only marginally different from those of the ICRP values. The dose coefficient for organically bound tritium for Asian Man is 4.0 x 10 -11 Sv Bq -11 compared to 4.6 x 10 -11 Sv Bq -1 for Reference Man. (author)

  9. Age-dependent dose coefficients for tritium in Asian populations

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, A

    1999-10-01

    The International Commission on Radiological Protection (ICRP) Publications 56 (1989) and 67 (1993) have prescribed the biokinetic models and age-dependent dose coefficients for tritiated water and organically bound tritium. The dose coefficients are computed from values selected to specify the anatomical, morphological and physiological characteristics of a three-month-old, one-year-old, five-year-old, 10-year-old, 15-year-old and adult (Reference Man) Caucasian living in North America and Western Europe. However, values for Reference Man and other age groups are not directly applicable to Asians, because of differences in race, custom, dietary habits and climatic conditions. An Asian Man model, including five age groups, has been proposed by Tanaka and Kawamura (1996, 1998) for use in internal dosimetry. The basic concept of the ICRP Reference Man and the system describing body composition in ICRP Publication 23 (1975) were used. Reference values for Asians were given for the body weight and height, the mass of soft tissue, the mass of body water and the daily fluid balance, and are used to compute the dose coefficients for tritium. The age-dependent dose coefficients for Asians for tritiated water intakes are smaller by 20 to 30% of the currently prescribed values (Trivedi, 1998). The reduction in the dose coefficient values is caused by the increased daily fluid balance among Asians. The dose coefficient for tritiated water is 1.4 x 10{sup -11} Sv Bq{sup -1} for Asian Man compared to 2.0 x 10{sup -11} Sv Bq{sup -1} for Reference Man. The dose coefficients for organically bound tritium are only marginally different from those of the ICRP values. The dose coefficient for organically bound tritium for Asian Man is 4.0 x 10{sup -11} Sv Bq{sup -11} compared to 4.6 x 10{sup -11} Sv Bq{sup -1} for Reference Man. (author)

  10. Population ageing and pension reform in a small open economy with non-traded goods

    NARCIS (Netherlands)

    Bettendorf, Leon J. H.; Heijdra, Ben J.

    2006-01-01

    In this paper we study the implications of population ageing in an economy with a sizeable non-traded goods sector. To this effect a highly stylized micro-founded macro model is constructed in which the age structure of the population plays a non-trivial role. The model distinguishes separate birth

  11. Population Ageing and Pension Reform in a Small Open Economy with Non-Traded Goods

    NARCIS (Netherlands)

    L.J.H. Bettendorf (Leon); B.J. Heijdra (Ben)

    2004-01-01

    textabstractIn this paper we study the implications of population ageing in an economy with a sizeable non-traded goods sector. To this effect a highly stylized micro-founded macro model is constructed in which the age structure of the population plays a non-trivial role. The model distinguishes

  12. Population aging and the affluent society: the case of the Netherlands

    NARCIS (Netherlands)

    Kuné, J.B.

    2009-01-01

    Developed countries are currently in an unprecedented transition to a new era with ageing populations. Ageing will result in a smaller proportion of the population being employed in the decades after 2010/2020. Changing demography, fewer workers and more retirees give rise to much concern about the

  13. The effect of population aging on health expenditure growth : A critical review

    NARCIS (Netherlands)

    de Meijer, C.; Wouterse, B.; Polder, J.J.; Koopmanschap, M.

    2013-01-01

    Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in

  14. [Factors related to nutritional status in geriatric patients receiving institutional and home care].

    Science.gov (United States)

    Unanue-Urquijo, Sara; Badia-Capdevila, Helena; Rodríguez-Requejo, Sara; Sánchez-Pérez, Inma; Coderch-Lassaletta, Jordi

    2009-01-01

    Malnourishment in the geriatric population is a common and serious situation that is often undiagnosed. This study aimed to compare nutritional status, measured by the Mini Nutritional Assessment (MNA), in the geriatric population institutionalized in residential centres and those included in the In-Home Assistance Program (IHAP) overseen by two urban-rural primary care teams, as well as to identify the factors related to the risk of malnourishment. We performed a cross-sectional estimation study of the prevalence of malnourishment or risk of malnourishment according to different explanatory variables by means of a logistics model. A total of 102 institutionalized patients and 170 patients included in the IHAP aged more than 65 years old were analyzed. No significant differences were found between institutionalized patients and those included in the IHAP by age, sex or pharmaceutical consumption, but differences were found in typology and the Barthel test. Chronic disease predominated in patients assisted at home (62.4%) and dementia in those who were institutionalized (39.2%). According to the MNA, malnourishment or risk of malnourishment was found in 67.6% of patients in the IHAP and in 93.1% of institutionalized patients. When adjustments were made for age and typology, correct nutritional status was 4.35 times more frequent in IHAP patients than in institutionalized patients. The profile of patients at greater risk of compromised nutritional status or with established malnourishment includes those that are institutionalized, older than 74 years and/or with dementia. These patients should receive corrective or preventative measures for malnourishment.

  15. Associations between cognitive abilities and life satisfaction in the oldest-old. Results from the longitudinal population study Good Aging in Skåne

    Directory of Open Access Journals (Sweden)

    Enkvist Å

    2013-07-01

    Full Text Available Åsa Enkvist, Henrik Ekström, Sölve Elmståhl Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö, Sweden Introduction: Studies on the associations between cognitive abilities and life satisfaction (LS in the oldest-old are few. The aim of this study was to explore whether abilities in six different cognitive domains could predict LS in the oldest-old 3 years later. Methods: The study population consisted of 681 individuals aged 78–98 years, drawn from the longitudinal population study “Good Aging in Skåne,” which is part of a national survey (The Swedish National Study on Aging and Care. Scores on 13 cognitive tests were related to scores on Neugartens’ LS index A (LSI-A 3 years later. The cognitive tests were added into six different cognitive domains. A multiple regression analysis was constructed for each cognitive domain separately, with scores on the LSI-A as the dependent variable. The model was adjusted stepwise for sex, age, education, functional capacity, and depressive mood. Results: Significant correlations were found between digit cancellation, word recall, verbal fluency (VF A, VF animals, VF occupations, and mental rotations at baseline, as well as LSI-A at follow-up. The domains of spatial abilities (B = 0.453, P = 0.014 and processing speed (B = 0.118, P = 0.020 remained significantly associated with LSI-A 3 years later after adjustment. Conclusion: The cognitive domains of spatial abilities and processing speed predicted LS 3 years later in the oldest-old. Clinical implications are discussed. Keywords: oldest-old, life satisfaction, longitudinal, crystallized and fluid intelligence, cognition

  16. Loss of olfactory function and nutritional status in vital older adults and geriatric patients.

    Science.gov (United States)

    Toussaint, Nicole; de Roon, Margot; van Campen, Jos P C M; Kremer, Stefanie; Boesveldt, Sanne

    2015-03-01

    The aim of this cross-sectional study was to assess the association of olfactory function and nutritional status in vital older adults and geriatric patients. Three hundred forty-five vital (mean age 67.1 years) and 138 geriatric older adults (mean age 80.9 years) were included. Nutritional status was assessed using the mini nutritional assessment-short form. The Sniffin' Sticks was used to measure olfactory function. Eleven percentage of the vital older adults were at risk of malnutrition, whereas 60% of the geriatric participants were malnourished or at risk. Only 2% of the vital older adults were anosmic, compared with 46% of the geriatric participants. Linear regression demonstrated a significant association (P = 0.015) between olfactory function and nutritional status in the geriatric subjects. However, this association became insignificant after adjustment for confounders. Both crude and adjusted analysis in the vital older adults did not show a significant association. The results indicate that, in both groups of elderly, there is no direct relation between olfactory function and nutritional status. We suggest that a decline in olfactory function may still be considered as one of the risk-factors for malnutrition in geriatric patients-once co-occurring with other mental and/or physical problems that are more likely to occur in those patients experience. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Integrating geriatrics into medical school: student journaling as an innovative strategy for evaluating curriculum.

    Science.gov (United States)

    Shield, Renée R; Farrell, Timothy W; Nanda, Aman; Campbell, Susan E; Wetle, Terrie

    2012-02-01

    The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer preclerkship and clerkship students between 2007 and 2010. The journals were used to assess the quality of curricular integration of geriatrics didactic and clinical content, to gather information for shaping the evolving curriculum, and to elicit students' responses about their professional development and caring for older adults. Student "journalers" wrote narrative reactions to and evaluations of aging-related content and exposure to older patients in response to written semistructured questions. An interdisciplinary team (including a health services researcher, gerontologist, medical anthropologist, and 2 geriatricians) used qualitative analysis to code the 405 journal entries. The team identified 10 themes within the following domains: (a) evaluation of efforts to integrate geriatrics within the medical school curriculum, (b) recognition and application of geriatrics principles, (c) student attitudes and cultural experiences regarding aging and the care of older patients, and (d) personal and professional development over time. Themes emerging within these domains reflect the effectiveness of geriatrics integration within the new curriculum as well as students' professional development. Journaling provides a novel and effective method for capturing medical students' responses to curricular content in real time, allowing for midcourse corrections and identifying key components of their professional development.

  18. Generation time, net reproductive rate, and growth in stage-age-structured populations

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2014-01-01

    to age-structured populations. Here we generalize this result to populations structured by stage and age by providing a new, unique measure of reproductive timing (Tc) that, along with net reproductive rate (R0), has a direct mathematical relationship to and approximates growth rate (r). We use simple...... examples to show how reproductive timing Tc and level R0 are shaped by stage dynamics (individual trait changes), selection on the trait, and parent-offspring phenotypic correlation. We also show how population structure can affect dispersion in reproduction among ages and stages. These macroscopic...... features of the life history determine population growth rate r and reveal a complex interplay of trait dynamics, timing, and level of reproduction. Our results contribute to a new framework of population and evolutionary dynamics in stage-and-age-structured populations....

  19. How to Implement a Geriatric Assessment in Your Clinical Practice

    Science.gov (United States)

    Sattar, Schroder; Alibhai, Shabbir M.H.; Wildiers, Hans

    2014-01-01

    Cancer is a disease that mostly affects older adults. Other health conditions, changes in functional status, and use of multiple medications change the risks and benefits of cancer treatment for older adults. Several international organizations, such as the International Society of Geriatric Oncology, the European Organization for Research and Treatment of Cancer, recommend the conduct of a geriatric assessment (GA) for older adults with cancer to help select the most appropriate treatment and identify any underlying undetected medical, functional, and psychosocial issues that can interfere with treatment. The aim of this review is to describe what a GA is and how to implement it in daily clinical practice for older adults with cancer in the oncology setting. We provide an overview of commonly used tools. Key considerations in performing the GA include the resources available (staff, space, and time), patient population (who will be assessed), what GA tools to use, and clinical follow-up (who will be responsible for using the GA results for developing care plans and who will provide follow-up care). Important challenges in implementing GA in clinical practice include not having easy and timely access to geriatric expertise, patient burden of the additional hospital visits, and establishing collaboration between the GA team and oncologists regarding expectations of the population referred for GA and expected outcomes of the GA. Finally, we provide some possible interventions for problems identified during the GA. PMID:25187477

  20. Determinants of health and disability in ageing population: the COURAGE in Europe Project (collaborative research on ageing in Europe).

    Science.gov (United States)

    Leonardi, Matilde; Chatterji, Somnath; Koskinen, Seppo; Ayuso-Mateos, Jose Luis; Haro, Josep Maria; Frisoni, Giovanni; Frattura, Lucilla; Martinuzzi, Andrea; Tobiasz-Adamczyk, Beata; Gmurek, Michal; Serrano, Ramon; Finocchiaro, Carla

    2014-01-01

    COURAGE in Europe was a 3-year project involving 12 partners from four European countries and the World Health Organization. It was inspired by the pressing need to integrate international studies on disability and ageing in light of an innovative perspective based on a validated data-collection protocol. COURAGE in Europe Project collected data on the determinants of health and disability in an ageing population, with specific tools for the evaluation of the role of the built environment and social networks on health, disability, quality of life and well-being. The main survey was conducted by partners in Finland, Poland and Spain where the survey has been administered to a sample of 10,800 persons, which was completed in March 2012. The newly developed and validated COURAGE Protocol for Ageing Studies has proven to be a valid tool for collecting comparable data in ageing population, and the COURAGE in Europe Project has created valid and reliable scientific evidence, demonstrating cross-country comparability, for disability and ageing research and policy development. It is therefore recommended that future studies exploring determinants of health and disability in ageing use the COURAGE-derived methodology. COURAGE in Europe Project collected data on the determinants of health and disability in an ageing population, with specific tools for the evaluation of the role of built environment and social networks on health, disability quality of life and well-being. The COURAGE Protocol for Ageing Studies has proven to be a valid tool for collecting comparable data in the ageing population. The COURAGE in Europe Consortium recommends that future studies exploring determinants of health and disability in ageing use COURAGE-derived methodology. Copyright © 2013 John Wiley & Sons, Ltd.